THYPUS ABDOMINAL

NURSING CARE
Arranged by:

FITRIANI NUR

Nim: A.20.12.062
DEFINITION

• Typhoid is a bacterial infection of the small intestine that causes

systematic symptoms in the bloodstream caused by salmonella typosa,
salmonella types A, B, C, besides this it can also cause gastroenteritis
(inflammation of the stomach).
• Typhus abdominalis is an acute infectious disease that is usually found in
the digestive tract with symptoms of fever for more than one week and
impaired consciousness. (Suryadi, Skp, 2001:281).
ETIOLOGY
1. Salmonella thyposa, a gram-negative bacillus that moves with vibrating
hairs, does not have spores that have at least three kinds of antigens namely:
O antigen, H antigen, V1 antigen and hyaline membrane protein.
2. Salmonella paratyphi A, B, and C are part of the salmonella virus which can
be determined by laboratory tests.
RISK FACTORS FOR TYPHOID
1. Work or travel to areas where typhoid fever is common.
2. Work a clinical microbiologist.
3. Having contact with people infected with typhoid fever.
4. Drink water that has been contaminated with feces containing Salmonella bacteria typhi.
PATHOPHYSIOLOGY
Typhoid disease is caused by the bacillus Salmonella typhosa. Transmission can
occur through the 5 F namely Food, Fingers (fingers/nails), Fomitus (vomiting), Fly
(flies), and through feces. The most prominent is through the human mouth when eat
contaminated food then germs penetrate into the small intestine and lymphoid tissue and
proliferate.
Furthermore, the germs enter the bloodstream and reach the reticuloendothelial cells
in the liver and spleen, so that these organs enlarge with pain on touch.
This process occurs at 10-14 days of budding and ends when the reticuloendothelial
cells release germ into the blood. Next germ into several organs of the body, especially the
lymphoid glands of the small intestine and cause ulcers that are oval-shaped in the mucosa
above Pejeri plaques. Ulcers can cause intestinal bleeding and perforation.
CLINICAL MANIFESTATION
1. In children the incubation period is 5-14 days
2. Fever rises until the end of the 1 st week
3. Fever decreases in the 4th week
4. The appearance of a rash
5. Headache and stomach pain
6. Bloating, nausea, vomiting, diarrhea, constipation
7. Dizziness, bradycardia, muscle pain
8. Cough
9. Epistaxis
10. Webbed tongue
11. Hepatomegaly, splenomegaly, meteroismus
12. Mental disorders
SUPPORTING EXAMINATION
1. Complete peripheral blood test
2. Examination of SGOT and SPGT increased
3. Widal test check
4. Culture
5. Anti salmonella typhy IgM
COMPLICATIONS
1. Small intestine complications: bleeding, perforation and peritonitis
2. Complications outside the small intestine, including:
a. Cardiovascular complications
b. Pulmonary complications
c. Hepatobiliary complications
d. Kidney complications
e. Bone complications
f. Complications of neuropsyciatric/typhoid toxic
MANAGEMENT

1. Giving antibiotics. Some antibiotics used to treat typhoid that is:

a. Azithromycin
b. Ciprofloxacin or cetriaxone

2. Adequate rest, rest during fever up to 2 weeks after the temperature returns to normal (total rest), then you
can sit down, if it’s not hot again you can stand up later walk in the room
3. Diet and supportive therapy. The diet must contain:
a. Foods with sufficient fluids, calories, vitamins and protein
b. Does not contain much fiber
c. Not stimulating and does not cause a lot of gas
d. Soft food are given during breaks
CASE
Mr.Y, 19 years old unmarried status, Selayar ethnicity and religion of Islam. Mr.Y is a student and lives in
Tile-Tile no.23 rt. 05 rw. 03. Mr. Y came to the hospital KH. HAYYUNG SELAYAR with complaints of fever
for 7 days and in the morning the fever goes down but in the afternoon and evening it goes up again, nausea,
vomiting, and pain in the lower abdomen. On examination, the tongue was dry and covered with a thick
membrane, the patient looked pale and weak. The patient said that his appetite was reduced. From the
examination of lower abdomen there is swelling. From the results of BP: 120/80 mmHg, HR: 90 x/minute, T:
39oC, R: 23 x/ minute.
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