MODULE 7: COMMUNICABLE DISEASES

(Typhoid Fever)

Case Analysis #1
1. With what was presented, what would most likely be the predisposing factor for the
diagnosis of appendicitis?
 First is the age (24); appendicitis most often affects people between the ages of
15-30 years old. This is the only predisposing factor that was presented in the
situation, it is the biological factor that may influence the likelihood an individual
needs a health service.

2. As a nurse, what will be your priority assessment in gathering data from the client in
order to formulate a plan of care?
 Pain assessment and abdominal assessment or in general, physical exam should be
done to assess the problem area and the amount of pain the patient is currently
feeling. This helps the nurse plan to alleviate the pain and to give interventions
appropriate from the results of the assessment.

3. The initial diagnosis is made on the basis of?

 It is based on the chief complaint of the patient upon consultation, which is
abdominal pain and tenderness, and upper quadrant pain. These symptoms alone
are possible for the diagnosis of appendicitis.

a. How would you explain to the relatives the condition of the patient through health
teachings?
 The patient must take lots of rest. Moving a lot can make her feel more pain. It is
also important that she drinks plenty of fluids to avoid dehydration. The patient
must now avoid strenuous activity and lifting heavy objects until the doctor says
its safe to do so. Appendicitis I a condition in which the appendix becomes
infected, causing pain to the patient.

Case Analysis #2
What is possible result of the diagnostic test that warrant the dismissal of initial diagnosis.
a. What is the specific condition that the surgical team seen resulting to their conclusion
that the patient does not need to undergo surgical operation?
  The patient has typhoid fever. Typhoid fever is a bacterial infection that is spread
through contaminated water and food. Which is why the patient has abdominal
pain and tenderness. Typhoid fever is a communicable disease that cannot be
treated by performing a surgery. Surgery is usually indicated in cases of intestinal
perforation, but in this case, the abdominal pain is a symptom of the actual
condition and not appendicitis.

b. How would you prepare the relative to be calm who are showing anxiety over the
pronouncement of cancellation of possible surgical operation?
 Tell the relative to try to relax and not panic because there isn’t anything bad that
is happening. Carefully explain that the reason why the surgery is cancelled is
because there is no need to be removed from the patient’s abdomen; it is because
the patient has typhoid fever and not appendicitis.

c. Why do you think the patient was referred to medical dept? What manifestation
warranted the referral?
 The patient is transferred to med dept because her case is an acute illness. There is
no indication for the patient to have surgery. The rose spots are what made the
staff(s) initiate the transferring of the patient from surgical ward to medical ward.
Rose spots is the pathognomonic sign of typhoid fever.

d. Base on the develop manifestation of the patient, what possible laboratory test the
family med doctor will order to confirm his suspicious
 Blood analysis, stool analysis, and urine analysis. This is to examine the specimen
under a microscope for the Salmonella typhi bacteria, which is the causative agent
of typhoid fever.
e. Anticipating the patient’s current condition, construct a plan of care,
prioritizing 3 problems you might expect to occur to the patient (3 NCP).
 See attached file

f. Discuss the importance of their cooperation and construct health teaching and its
importance.
 Typhoid fever is a life-threatening infection, it is important for the patient and the
relative to cooperate with the health care team in charge of taking care of the
patient. It is crucial to practice proper hand hygiene, especially before eating or
preparing food and after using the toilet. Also, avoid drinking unclean/untreated
water. Contaminated drinking water is a particular problem in areas where
 typhoid fever is endemic. For the patient, it is important to eat foods that are easy
to digest, drink plenty of water, and practice proper food safety.

g. What is possible nursing diagnosis you can formulate on this case?

 Acute pain related to inflammation of the small intestine.
 Hyperthermia related to infection process: salmonella thypi.
 Imbalanced Nutrition: Less than body requirements related to inadequate intake.