Communicable diseases 2

8/7/2019 Communicable diseases 2

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Prepared by:

FELIPE GARCIA DIZON, III, RN, MANc


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EPI TARGET DISEASES


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Pseudo membrane


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Pseudo membrane


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Bulls Neck


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Diptheria Continued

DIAGNOSTICS

y Nose and throat swab (Gold standard)

y Schick test


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DIPTHERIA

NURSING MANAGEMENT

y Bed rest (_____)???

yAvoid exertion during defecation

y Soft dietm

y Frequency???

y Boost immune system ???

y Nose & throat ???


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Diptheria Continued

PREVENTION:

y Isolation (14 days) until 3 negative swab

cultures

y IMMUNIZATION


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PERTUSSIS (Whooping Cough)

CA: Bordatella Pertussis, Hemophilus

Pertussis, Bordet Gengou Bacillus

MOT: direct/droplet/soiled articles


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PERTUSSIS

S/SX:

y CATARRHAL STAGE (1-2 weeks)

Coryza

Sneezing

Lacrimation

Dry cough

Comes become irritating and severe


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PERTUSSIS PAROXYSMAL STAGE (7th-14th day)y Recurrent and explosive cough 5-10 rapid

coughs

y Inspiratory whoop

yVomiting

y Nosebleeding

y Conjunctival hemmorhage

y Periorbital edemay COUGHING accompanied by:

Profused sweating

Involuntary urination

Exhaustion


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PERTUSSIS

y COUGH- Provoked by crying, eating,

drinking or any physical exertion

CONVALESCENT STAGE:

y decreased incidence of coughing and

severity

yAttack subsides after six weeks of onset


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PERTUSSIS

DIAGNOSTIC Exam

y Nasopharyngeal swabs (gold standard)

y Sputum culture

y CBC


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PERTUSSIS

Nursing Management

y Isolation

y Do not leave alone

y Protect from draft (sunshine and air)

y Quiet room

y Minimal handling

y Suctioning equipment at bedy Keep away soiled linens

yVomiting???


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PERTUSSIS

PREVENTION

yVaccine ???

y Isolation 4-6 weeks from onset


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POLIOMYELITIS (infantileparalysis, Heine-Medine Disease)

CA: Legio Debilitans

MOT: direct-oropharyngealsecretions/feces, indirect-soiled

articles, vector-flies, contaminated

water, utensils, food


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POLIOMYELITIS

TYPES with S/SX:

yABORTIVE: (4-8 %)

Head ache

Sore throat

Moderate fever

Occasional vomiting

Low back pain

Recovers within 72 hours


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POLIOMYELITIS

Non-paralytic

yAll the above signs

y Pain in the neck, back, arms, legs and

abdomen

y Inability to place the hands in between the

knees

y (+) pandys test

y Transient paresis

y Lasts for1-2 weeks


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POLIOMYELITIS

y PARALYTIC

Above sign and symptoms

(+) Hoynes sign (limp head)

Paralysis occurs

Kernigs sign


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POLIOMYELITIS

Brudzinskis sign

Hypersensitivity to touch


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POLIOMYELITIS

y DIAGNOSTIC

Throat swab

Stool culture

CSF


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POLIOMYELITIS

NURSING MANAGEMENT

y Watch for signs of fecal impaction (d/t

dhn)

y Prevent pressure sores

y Handwashing

y Hot packs to affected limbs

yProper disposal

y oral & skin care


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POLIOMYELITIS

PREVENTION

y OPV

y Proper disposal of GIT secretions

y Proper food handling


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POLIOMYELITIS


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EPI (Expanded program o

VACCINE AGE AT 1 ST

DOSE

NUMBER

OF DOSES

INTERVAL Route

BCG Birth or any

time at birth

1 .05 ID

R

DPT 6 weeks 3 4 wks .5 IM

OPV 6 wks 3 4 weeks 2 drops

Oral

HEPAB At birth 3 6 wks from 1 st

dose, 8 weeks from2nd dose

.5 SC

MEASLES 9 months 1 .5 IM


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TETANUS TOXOID for

womenVACCINE INTERVAL % protected Duration of protection

TT1 As early as

possible during

pregnancy

TT2 4 weeks later 80% Infants born to

mother will be

protected from

neonatal tetanus

-3 years

protection for themother

TT3 6 MONTHS later 95% Infants protected

-5 years

protection for the

mother


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TETANUS TOXOID for

womenVACCINE INTERVAL % protected Duration of

protection

TT4 One year later 99% Infants protected-10 years

protection for the

mother

TT5 One year later 99% Gives lifetime

protection for the

mother-all infants born to

that mother will

be protected


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Non- EPI Communicable

Diseases DENGUE FEVER (H. Fever, break

bone fever, dandy fever, Hemorrhagic

Fever)

MOT: VECTOR (Aedes Aegypti)

CA: DENGUE VIRUS

(Flavivirus 1, 2, 3, 4)

Sources: Infected person, stagnant water


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DENGUE FEVER

S/SX

Phases: INITIAL FEBRILE (2-3 days)

y Fever (c headache)

y Convulsions

y Palms and soles are flushed

yAnorexia

yVomitingy Petechial rash

yAbdominal pain

y Hemorrhagic manefestations


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DENGUE FEVER

CIRCULATORY PHASE

y Fall in temp 3rd to fifth day

y Restless

y Cool clammy skin

y Cyanosis

y GIT hemorrhage

y BP Fallsy Pulse rapid and weak

y Shock untreated may lead to comma


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DENGUE FEVER

CLASSIFICATION ACCORDING TO

SEVERITY

y Grade I

Fever

Abdominal pain

Headache

Muscle and joint pains


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DENGUE FEVER

y GRADE II

Grade I (+) spontaneous bleeding

GRADE III Grade II plus circulatory failure

Cold clammy skin

Weak pulse

hypotension


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DENGUE FEVER

GRADE IV

Grade III plus shock=== death


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DENGUE FEVER

DIAGNOSTICS

y TOURNIQUET TEST

y Hematologic test- confirmatory

y Heamagglutination test


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DENGUE FEVER

NURSIING MANAGEMENT

y Mosquito

y Bed rest during bleeding

yVS monitoring

y Elevated trunk

y Ice packs

y Supportive


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HEPATITIS A

CA HEP A virus

MOT: fecal oral, contaminateddrinks, food


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HEPATITIS A

S/SX

y Flu like illness

y Diarrhea

y Fatigue

yAnorexia

yAbdominal pain

y Nauseay Fever

y Dark colored urine

yjaundice


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HEPATITIS A

DIAGNOSTICS

y HAV compliment fixation rate

y Liver function test


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HEPATITIS A

NURSING MANAGEMENT

y Observe for melena

y Bed rest

y Nutrition

y Skin and oral care

y Limit activity when fatigued

y Mild exercise during recovery


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RABIES

CA- rhabdovirus

MOT- from the saliva of infectedanimal to a bite/scratch or other break

in the skin


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RABIES

S/sx

yANIMAL: DUMB stage

y FURIOUS STAGE

y HUMAN: Mental depression Stage

y Excitement stage


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RABIES

S/SX 3 stages

PRODROMAL/INVASION

y Fever

yAnorexia

y Malaise

y Sore throat

y Copious salivationy Lacrimation

y Pespirations


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RABIES

y Irritability

y Hyperexcitability

yApprehension

y Restlessness

y Drowsiness

y Depressions

y

Insomniay Melancholia


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RABIES

EXCITEMENT (noise and touch)

yApprehension

y Terror

y Delirium

y Maniacal behavior

y Listlessness

y Depressiony Sensitive to light, noise, odors

y Cold clammy skin

y Eyes fixed


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RABIES

Painful spasms of the mouth, pharynx,

larynx when attempting to swallow

Hydrophobia

Aerophobia

Drooling

Fever 3-4 day

Death during spasms d/t heart/respi

failure

Pt. deteriorates rapidly within 1-3

days


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RABIES Quiet Unconscious

Loss of bowel and bladder control

Tachycardia Irregular respiration

Rise in temperature

Increasing paralysis Circulatory collapse

Coma

Death d/t ??


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RABIES

Diagnostics

y Hx of exposure

y Development of characteristic symptoms

y Microscopic (Negri bodies)

y in brain tissue or saliva


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RABIES

Nursing Care

y Supportive:

Treatment of Wound with soap and water

Restful environment ???

Cover IVF with paper bag

Provide comfort


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RABIES

Active immunization

y Dose 1: As appropriate

y Dose 2: 7 days after Dose 1

y Dose 3: 21 days or 28 days after Dose 1

Passive Immunization

yA person who is exposed and has never beenvaccinated against rabies should get 5 doses

of rabies


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RABIES

vaccine - one dose right away, and additional

doses on the 3rd, 7th, 14th, and 28thdays. They

should also get a shot ofRabies Immune

Globulin at the same time as the firstdose


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SCHISTOSOMIASIS

(BILHARIASIS/SNAIL FEVER)

CA: Shistosoma Japonicum

3 TYPES

Shistosoma japonica (Intestinal)

Schistosoma mansoni (Intestinal)

Schistosoma haematobium (Urinary tract)

Which is endemic in the Phils.?

MOT: ingestion of contaminated

water, through the skin pores,

intermediate host Oncomelania

Quadrasi


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SCHISTOSOMIASIS

Sources of Infection: Feces (infected

person) dogs, pigs, carabao, cows,

monkeys

S/SX:

DIARRHEA

BLODDY STOOLS (mucoid like; on & off)ABDOMINAL DISCOMFORT

ENLARGEMENT OF ABDOMEN

SPLEENOMEGALY


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SCHISTOSOMIASIS

MALAISE

ANEMIA

INFLAMED LIVER

LOW GRADE FEVER COUGH

JAUNDICE

HEADACHE

DIZZINESS CONVULSION


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SCHISTOSOMIASIS

PRURITIC RASH @ site of entry

swimmers itch


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SCHISTOSOMIASIS

DX:

y Fecalysis

y Liver and rectal biopsy

y ELISA


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SCHISTOSOMIASIS

PREVENTION AND CONTROL:

Basic principle: interrupt the life cycle of the

worm

y Reduce snail density clearing vegetation,constructing drainage, proper irrigation &

drainage,

y Proper waste disposal

y Control of stray animals

y Prevent bathing in infested streamsy Build foot bridges over infested streams

y Provide safe water- bathing, drinking, laundrying

y HEALTH EDUCATION- disease process, MOT

Communicable diseases 2

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