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Causative agent Mycobacter ium tuberculosi s, M. bovis
MOT Droplet infection, Cow’s Milk containing Mycobacte rium bovis
Pathogno monic sign Hemopt ysis
Diagnosis • AFB SMEAR • Chest Xray • Tuberculi n testing/ • Mantoux Test
DOC • DIRECTLY Observed Treatment Short Course (DOTS) •RIPES
Nursing intervention 1. Diet- if with anorexiaSFF; high protein 2. Drugstrict compliance 3. Rest Contraindicat e: Chest Clapping (stimulates hemoptysis )
Prevention • Immunizatio n • BCG at birth 1 dose @ Right deltoid • Proper disposal of nasopharyng eal secretion • Covering of nose and mouth when coughing or sneezing Preventive: Proper disposal of nasopharyngeal secretions Covering of nose and mouth when sneezing and coughing (cough manners)
droplet infection/i ndirect contact
Rusty or prune juice sputum
• sputum exam • chest x-ray
Coryneba cterium diptheriae or the Klebs-
Respirator y droplets
Formati on of pseudo membra ne
• Nose and throat swab /culture
• Fever, Dyspnea , Cyanosis • Productive cough Chest pain aggravated by coughing • Increase RR, shallow • Stabbing chest pain when coughing In children: • Nasal flaring • Chest retraction Nasal • Sero-sanguinos secretion with ‘foul mousy’odor
Procaine penicillin Less than 2 months = 200,000 IU 2-12 months = 400,000 IU 1-5 years = 800,000 IU
1. Mainte nance of proper airway 2. Relieve chest pain 3. Adequ ate nutrition 4. Preven t spread of infection by disposing secretions properly
1. antidiphtheria serum 2. AntibioticsPenicillin
1. Place the patient in CBR until 2 weeks after recovery
• Immunizatio n-DPT at 6 weeks after birth at one month
B. Nervous (to prevent myocarditis ) 2. Droplet Bordet – Gengou Agar plate INFLUENZ A Flu Myxovirus Influenza virus A.Loeffler Bacillus • Schick Test • Moloney’s test Nasopharyngeal • Marked degree of toxemia • Swollen lymph nodes • Dysphagia Laryngeal • Aphonia • BOD. contact with nasophary Catarrhal Erythromycin -Colds. fever. chest indrawing • Croup 3. Penicillin night.DPT • Proper disposal of nasopharyngeal secretions a. Adequate rest and good ventilation b. Small frequent feedings (soft) 4. Bordetella pertusis Nasophary ngeal secretions. Prevent Aspiration 3. Complete bed rest 2. cough at . Intestinal c. Use ice collar to relieve pain 1. TSB Annual vaccination for high risk people or for . Maintenanc e of proper airway 3.listlessne ss (balisa) Spasmodic/ Paroxysmal -5 to 10 forceful successive coughing w/c ends in a prolonged inspiratory phase or a whoop -Vomiting -Teary red eyes and protrusion of eyeballs Convulsion Convalescence .s/s subside and patient can recover a. Respiratory – most common b. C Droplet. Application of abdominal binder interval • Cover of nose and mouth when sneezing and coughing • Never kiss the patient • Immunizatio n . To prevent respiratory obstruction Tracheosto my Pertussis Whooping cough Hemophilu s pertusis.
Monitor vital signs d. body weakness or muscle pain. fluids). sore throat.mild respiratory symptoms After 2 days. AI Influenza A H5N1 virus Direct contact with droppings of infected bird Person-toperson through respiratory droplets and direct contact with body fluids of a person with SARS. Adequate nutrition individuals who wish to reduce chances of getting flu avoid migratory birds. sore eyes. TSB c.g. Adequate rest and good ventilation b. DOB Sudden onset of high grade fever Headaches/body aches Ist day. Adequate nutrition Fever. cough. oxygen. SARS CoV . >Empiric broad spectrum antibiotics also given against communityacquired pneumonia and atypical pneumonia a. Thorough cooking of poultry meat • Containmen t • Mask N95 • Strict quarantine and isolation measures Avian Influenza Bird flu.dry cough and respiratory difficulty Supportive treatment as needed (e.ngeal secretions c. Monitor vital signs d. Severe Acute Respirator y Syndrome (SARS) Corona virus.
cervix. Mucous patches – mouth. throat.(+/-) of purulent discharge • abscess formation in Bartholins/Ske ne’s glands • Tetracycline 500mg QID for 7 days • Ceftriaxone for pregnant women • Penicillin • Other treatment for patients with coexisting chlamidial infection SYPHILLIS Pox. Bad Blood Disease Treponema pallidum • Sexual contact • Blood transfusi on • Placenta l transmis sion(5th mo of gestatio n) • VDRLvenereal disease researsh lab • RPR. arthritic and bone pain Penicillin G Newborn = 100. moth eaten appearance. patchy alopecia. Morning Drop • Direct contact with exudate via sexual contact • transmissi on to the neonate during the passage through the birth canal Neisseria gonorrhea Positive gram stain smear of discharge or secretion Positive culture Male . Gleet. Gonoclap.chronic-scar in epididymis -obstruct flow of sperms.protatitis . Monogamous relationship . Jack.sterility Female – burning sensation upon urination if urinary meatus is involved . iritis.pyuria .4 million units IM single dose >Erythromyci n prophylaxis for ophthalmia neonatorum >Encourage follow up cultures in 4 to 7 days after treatment and again at 6 months >Teach importance of abstinence from sexual intercourse until cultures are negative >stress Importance to take full course of antibiotics >stress importance of treating partner too • Patient Education • Bed rest • Aspirin • Warn patient of Jarish Herxheimer reaction Safe sex.redness and edema of urinary meatus .000 units/kg single IM dose Adult = 2.purulent discharge .GONORRH EA Gonococcu s (GC).rapid plasma reagin test • Fluorescen t Treponem al Primary : chancre Secondary : condyloma lata. Lues.
Urge client to have sexual partner treated . Burning sensation in vagina • Nystatin vaginal suppositor y twice a day for 714 days • vaginal douche of 2 tsp ordinary baking powder dissolved in 1 quart of warm water • application of gentian violet to the vagina and perineum to prevent staining of undergarm ents Antibiotics: doxycyclin e and azithromyc in 1. Pruritus in vagina b. odorless discharge • Patches of curdlike. beefy red irritation. cheesy material that adhere to the vaginal mucosa CANDIDIA SIS Moniliasis Candida albicans CHLAMIDI AL INFECTIO N Chlamydia trachomati s Sexual contact isolation of the organism in a tissue culture or a. cheese-like. inflammation of the vaginal epithelium • White.Antibody Absorption Test (FTA-ABS) Latent stage Not infectious except to the fetus of the pregnant Tertiary syphilisGummas • Itching.
5% • Sharps or needle – 0. Mononucleo side Reverse Transcriptase Inhibitors (Azidothymidi ne .5% 1.serological complement fixation c. Emphasize the importance of long term drug therapy because of the pathogens unique life cycle. Pruritus of urethral infection in men e. ACQUIRED IMMUNOD EFICIENCY SYNDROM E (AIDS) HIV • blood 90% • Sexual contact 0.Lamivudine . dyspareunia • Usually asymptomatic in men • ELISA – screening test • Western blot – confirmato ry test • CD4 – T cell count (1000) • Persistent fever within 1 month • Chronic diarrhea • Stunted growth • 10 weight loss 6 minor • Persistent cough • Persistent genaralized lymphadenop Metronidazol e (Flagyl) 250mg TID for 1 week. Retrovir) 2.1 % to . NonMNRTI 2. Painful intercourse d. which make it difficult to eliminate • Do not give metronidaz ole during the first trimester of pregnancy • Sitz bath • Acid douches (1 tablespoon of vinegar in 1L of water) Symptomatic A abstinence and B be faithful supportive C condom D don’t use drug .1 to . Zidovudine . Burning sensation during urination TRICHOM ONIASIS Trichomona s vaginalis Sexual contact • Yellow green frothy vaginal discharge • Burning and pruritus of vagina • Dysuria.
Health education Dapsone: may increase the number of lesion also iritis. -Ritonavir.Saquinavir. orchitis Lamprene: may cause skin discoloratio . A ctive and passive exercise to avoid contracture s 4. Multibacilla ry: >Rifampici n once a month >Dapsone OD(24-30 mos) >Lampren Leprosy Hansen’s disease Mycobacter ium leprae Prolonged intimate skin to skin contact Droplet Infection • Skin smear test • Skin lesion biopsy • Lepromin skin test 1.• • • • athy Sarcoma Pharyngeal candidiasis Recurrent herpes zoster Progressive disseminated herpes simplex Dideoxyinosi ne (Didanosine).Nel finavir Monotherap y: Dapsone Multi drug therapy (MDT) (Treatment approach: depends on microorganis ms in skin lesions) a. Indanavir. Psychologi cal aspect of care 2. Dideixycytidi ne ( Zalcitabine) 3. Paucibacill ary: >Rifampici n once a month >Dapsone OD (6-9 mos) b. Protease inhibitors . S kin care: -prevent injury 3.
Posteruptive: > fine branny desquamatio n 1.given at 15 months . Little red disease Paramyxovi rus droplet Koplik spots Clinical signs & symptoms 1. First disease. Third disease Togavirus droplet . coryza.5 ml SC deltoid Precaution: fever. Immunization – 0. Eruptive > rashes exanthem– maculopapul ar (smaller than measles) . Pre-eruptive – Forscheimer spots (fine red spots found on soft palate) 2. no desquamatio n nor pigmentation > enlargement of lymph Symptomatic n. Pre-eruptive: > 3 Cs: Cough. Proper disposal of nasal secretions German Measles Rubella. Eruptive: > Koplik spots – > Rashes Cephalocaudal maculopapular rash 3.e OD (2430 mos) (clofazimi ne) Measles Rubeola. dryness and flakiness > Complete bed rest > Adequate nutrition > Increase fluid intake > Increase vitamin C & A > Keep patient warm & dry > darken the room 1. mild rash MMR.check for allergy to eggs 2. conjunctivitis 2. 3 day measles.
post. muscle pain 2. post. itchy. gown. more abundant in covered parts of the body > unilocular appearance of lesions 3. proper disposal of nasopharynge al secretions . Pre-eruptive > fever. Cervical 1. headache. 1 month interval 1 dose in child Symptomatic > acyclovir (anti-viral) > KMnO4 – A: astringent effect B: bactericidal – > analgesics are necessary for weeks or even months after blisters > use of mask. body malaise.Chicken pox Varicella. Auricular. Eruptive phase described as vesiculopustular. Bulutong Varicella Zoster virus Airborne Clinical HerpesZoster (Shingles) Varicella zoster virus Occurs in a partially immune individual due to a previous varicella infection Clinical nodes: suboccipital. follows a nerve pathway (unilateral). Post-eruptive Superficial depigmented scars rashes are clustered. painful Symptomatic antiviral (acyclovir) > prevention of secondary infection of the skin lesions > cut fingernails short & wash hands to minimize bacterial infections > isolation of patient > Cool soda bath/ baking soda paste reduce itchiness > Immunization Varivax 2 doses in adult.
>Deep IM at buttocks area >Single dose >Animal Serum (ERIG) equine rabies immunoglobu lin Eg. HyperRAB 0. abrasion or lick on a damaged skin or mucous membrane • Brain Biopsy – negri bodies • Virus culture and isolation • Observat ion of dog for 10 days Invasive stagenumbness on site. flu – like symptoms. Lyssavac plain B.50 cc/vial (IM) Site: Deltoid or Vastus lateralis 2. difficulty in swallowing. hydrophobia. Active 1. px fears water due to laryngospas m. Passive immunization : > Given up to 7 days after being bitten. La Rage Rhabdoviru s Bite. apprehensive . with slight photosensitiv ity. Lyssavac N– 2. marked insomnia. verorab : 0. ARS (antirabies serum).have dried up RABIES Hydrophobi a.2cc/kg BW • Provid e a dim & quiet environme nt • Room should be away from sub-utility rooms (area for washing: avoid sound of water) • Restrai n patient even before aggressive behavior sets in • Wear protective barriers • Immuniz ation of animals • All animals should be caged or chained • Stay away from stray animals . irritable. Lyssa. Excitement stageaerophobia. Purified duck embryo IM deltoid or SubQ OD for 14 days 1. restless. photosensitiv ity Paralytic stageparalysis A.
Proper handling of food c. Rabuman. Type 2 . Handwashing TETANUS Lockjaw Clostridiu m tetani Acquired thru wound (any kind of wound) 1. by TRIPOD POSITION Hayne’s sign: Poker’s sign: Paralytic Stage FLACCID PARALYSIS Masseter muscle – trismus or lockjaw Facial musclePatient is treated symptomatic ally • Bedrest • Use hot compress for spasm • PROM when pain and spasms are gone • In case of respiratory paralysis.IM • Avoid mode of transmission – droplet a. Type 3. Droplets • Lumbar Puncture – protein content of CSF is increase: (+) Pandy’s test • EMG • Muscle • Stool exam. constipationpayers patches Pre.133 cc/Kg BW POLIOMYE LITIS Infantile paralysis. Immunization – OPV or Sabin(3doses @ 6wks with 1 month interval) Salk . anorexia. Imogam 0. Type 1 .D. quiet environment Minimal and gentle • Immunization (DPT. nausea. ATSantibodies -Prepare epinephrine and Dim light. – done 10 days after infection Invasive stage or abortive stage Abdominal pain. Proper disposal of secretions b. Tetanus toxoid) . vomiting.L.paralytic stage Involvement of the CNS but w/out paralysis Char. px is placed in mechanica l ventilator called iron lung machine.g.L.L.D. Fecal – oral route 2. Leon 1. diarrhea. Brunhilde 2.D. Lansing 3. Heinemedin disease Legio Debelitans 1.>Human serum (HRIG) human rabies immunoglobu lin E.
Penicillin. umbilical stump risus sardonicus or sardonic grin Muscle of spineopisthotonus or arching of the back Respiratory muscledyspnea and chest heaviness Abdominal muscleabdominal rigidity(1st) Extremity musclesstiffness of extremities corticosteroid in cases of delayed hypersensitiv ity reaction 2. Chloramphe nicol • Steroidsantiinflamm atory agent • Osmotic diuretics – mannitol to reduce CSF fluid • Anticonvuls ants Dilantin (symptomatic and supportive) • Promote rest and safety • Monitor VS and neurologic status • Fever – provide TSB • Convulsion s – protect from injury • Proper disposing of tissues used for nasopharen geal secretions ( in plastic bags) • Covering of nose and mouth when coughing and sneezing. malaise. flat on bed after • Increase WBC. chills.laceration. burn. muscle relaxant (DiazephamValium) handling of patient Protect patient from injury Provide px comfort Always have padded tongue depressor Watch for urinary retention Wound Care: Washing with antiseptic Thin dressing Debride necrotic tissues • Clean wound immediately MENINGITI Fungal S meningiti sCryptococ cal meningiti s Meningoc occal meningiti smeningoc oxemia or spotted feverNeisseria meningiti s Respirator y droplet • Lumbar tap or Lumbar puncture • Secure consent • Fetal position during. ABPenicillin 3. petechia. N/V.Fever. or blotchy purpuric lesion appear Waterhouse Friederichsen syndrome (+) shock and rashes • Antimicrobi al agent – Rifampicin. bite. decrease sugar Clinical Manifestation s: 1. increase protein. headache – Rashes. . Meningococc emia .
increase ICP 3. Fastidial/Pyre xial Stage- Antibiotic: Chloramphen icol 100mg/kg in 4 doses for 14 days (side effect is bone marrow depression) (symptomatic and supportive) Promote rest and safety Monitor VS and neurologic status Fever – provide TSB Convulsions – protect from injury 1. chills and vomiting Convulsion Signs of neurologic damage patient is treated symptomatic ally Typhoid Fever Enteric fever Salmonell a typhosa Fecal-oral route ingestion of contamina ted food and water Source of Infection: 5 F’s Rose Spots Blood culturedone during prodromal stage Widal Test – antibody test Becomes 1.Proper regulation of IVF . abdominal pain.s/s Altered LOC lethargic Fever.25cc IM deltoid *6 months immunity . dull headache. Maintenanc e of fluid and electrolyte imbalance . altered LOC 4. nuchal rigidity 2. 2.Adequate fluids .• Blood Culture Symptoms of meningeal irritation 1. Prodromal Stage-Fever. convulsive seizures • Kernig’s sign • brudzinski’s sign • Opistothonus JAPANESE ENCEPHAL ITIS Brain fever Arbovirus Mosquito bite (Culex) • Lumbar puncture • EEG Clinical Manifestati ons. nausea and vomiting. diarrhea or constipation.5 cc IM deltoid -children: <10 years old 0.eradicate mosquito thru DOH program • CDT Immunizati on-adults: 0.
Finger. Fomites positive on the 2nd week Typhidot Stool culture – done on the 2nd week 3 Clinical Features of Typhoid Presence of Rose Spots (abdomen and chest)only symptom specific to typhoid Ladderlike fever Splenomegal y 3. Flies. Maintenanc e of nutrition . Isolation of patients • Vivotif. hematochezi a b. abdominal pain.Feces. persistence of fever.Sudden. Intestinal Hemorrhages -melena.Do not give milk which can lead to increase acidity and diarrhea 3.s/s will subside .High calorie.Defervescenc e Stage a.Lysis/Convale scence. rigid abdomen 4.3 doses: 1 hour before meal q other day .3 years immunity • Protect / Purify water supplies • Proper excreta disposal • Hand washing • Proper preparatio n and handling of food • Avoid eating fresh and uncooked vegetables and fruits in endemic areas • Do not put anything in your mouth . severe. Food. low residue diet .in capsule form . Intestinal Perforationperitonitis .Assess for the sign of dehydration 2.
disorientation) • Icteric (Weil’s syndrome) – jaundice. meningeal manifestation (convulsion. IcteroHemorrhagi a Leptospira interrogans spirochetes • Can be transmitt ed by the semen of infected animal • Skin penetrati on.Cholera 3. Bacil lary Dysenter yShigellosi s 2.Leptospir osis(orang e eye) Mud fever. hemorrhages.• Immune or Antibody toxic stageTest with or • Liver without function jaundice. joint ion Test pain. ciprofloxacin Cholera: Cotrimoxazole. >LAATrespiratory Leptospir distress a Antigen. >LATheadache. • Personal hygiene - . Monito r urine output • Eradicate rats • Avoid wading in contaminate d pool of water/ swamps Shigellosis: Cotrimoxazole. hepatomegaly .4-30 test. ingestion of infected or carcasse s of either wild or domestic animals Dysentery 1. Leptospir N/V. Amo Fecal oral route Cholera: RICE WATER STOOL • BLOOD • septic stage EXAMINAT – high fever ION 4-7 days. Sympt omatic and supportiv e 2. Viole nt Dysentery . Canicola fever. a abdominal Agglutinat pain. renal involvement (RF) • Stool Examinati onamoebiasi s • Rectal Swab – for cholera and shigellosis Antibiotics: penicillin. BUN days CREATINE o Anicteric – low grade fever. Swine herd’s Disease.o q12 x 7 days 1. Swamp fever.T etracycline (not given to < 8 yrs old and pregnant women) ***Do not give calciumrich foods (tetracycline binds with calcium) Prophylaxisdoxy 100 mg p. doxycycline. Tetracycline Amoebiasis: • Control of fever • Maintenanc e of fluid and electrolyte balance • Oral Rehydratio n Salt (ORS) • CDT Vaccine (Cholera/Dys entery/Typh oid) • 6 months immunity – given only on outbreaks. Weil’s Disease.
monkey s and wild rats • tiny snail called Oncome lania quadrasi Droplet or by direct contact with saliva of infected • Stool exam – look for egg of parasite.ebic Dysentery Amoebiasi s Metronidazol e o NaCl. hematobi um Parotitis Mumps Paramyxovi rus penetratio n of free swimming fork-tailed cercaria. Glucose Schistoso miasis Snail fever. myalgia and cough 3. Blood fluke Schistoso ma japonicum . protect food from flies • Snail Control (Oncomelani a quadrasi) – use of molluscides • Environment al Sanitation – proper disposal of excretion Clinical a. malaise b. carabao s. Sodium Bicarbonat e. Prodromal: Headache. lymphadenop athy • given early at the course of disease • Praziquant el (Biltricide) = 30 mg/kg BID • Fuadin IM OR IV handwashin g • Environment sanitation – boiling of water. fever. Emaciatio ns from chronic disease 5. S. S. Potassium Chloride. ingestion of contamina ted water Sources of infection • Feces of infected person • Dogs. kato katz technique o Blood exam – COPT (circumov al precipitin test) o ELISA 1. splenomegaly. Dysentery –like symptoms 4. Bilharziasis. “swimmer ’s itch” 2. pigs. Place patient on CBR until swelling subside • MMR vaccine – given on 1518 months (1dose) . Hepatom egaly. mansoni. Acute phase: 1. Low grade Fever.
Joint & bone pain . Antipyreti cs (don’t use aspirin) 3. Oral fluids and electrolyte 2. 2. Grade I . citronel) N – atural mosquito repellants (neem tree. Patient should be excluded from school/work for 9 days after onset Watch for bleeding: • Nosebleed – cold compress over forehead • Melena – cold compress over stomach area. . Platelet transfusio n 4. Break bone fever ArthropodBorne virus (arbovirus) belonging to the family Flaviviridae 4 serotypes (DENV1. Hot or cold application over parotid gland to relieve pain 5. Convulsio ns Dilantin 2.Petechial formation Herman’s sign – generalized flushing of Symtomatic and supportive 1. 4) Vectors: • Aedes aegypti • Aedes albopict us.person Swelling of the salivary glands leading to difficulty in swallowing and chewing.Nausea & vomiting . peri-orbital pain . avoid eating dark colored foods • Proper covering of mouth and nose when coughing and sneezing DOH CLEAN Program C – hemically treated mosquito nets L – arvae eating fish E– nvironmental sanitation (4pm habit) A– ntimosquito soaps (basil. + earache peaks at two days and stays up to 10 days DENGUE Dandy Fever.Headache. bland diet 4.Abdominal pain . Wear fitted supporter to prevent pulling gravity in testes 3. 3.tiger mosquit o • Culex fatigans 1. Soft.High grade fever (3-5 days) .
convulsion -Primaquine -Fansidar • Keep patient comfortabl e with dry. Quantitati ve Buffy Coat (QBC)rapid test for malaria the skin 2. Limit dusk to dawn exposure. Grade III – grade II + circulatory failure .NPO Observe for signs of shock eucalyptus.Epistaxis . headache.MALARIA Ague. clammy skin .Chilling manifestation s (10-15 mins) nursing responsibility : provide warmth to patient 2. Grade II signs & symptoms of grade I + bleeding . 3. Cold stage – . oregano) Anti-malarial agents -Chloroquine (drug of Choice) -Quinineneurologic toxicity. • Monitor V/S • Diet high calories. weak pulse. abdominal pain & • • • Gingival bleeding – offer ice chips. sleep under mosquito nets . replace fluid loss.Gum bleeding 3. Grade IV – grade III + hypovolemic shock 1. rapid. muscular twitching. delirium. Hot stage – Characterized by fever. Advise malaria chemoprophy laxis when travelling to malaria endemic areas 2.GI bleeding . warm clothes. “King of Tropical Diseases” Plasmodiu m 1. increased RR 4. wear protective clothing 4.Altered VS – decreased BP. Malarial Smear 2. use soft bristle toothbrus h Hematem esis . vitamins and minerals • Fluid and 1.Cold.
use topical s balance repellents .vomiting .Lasts for 4-6 hours Nursing responsibility : lower body temperature 3. Diaphoretic stage – Excessive sweating/ feeling of weakness due to the past stages px underwent electrolyte 5.
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