Professional Documents
Culture Documents
I - Definition of Terms Community- derived from a latin word “comunicas” which means a group of
people. · a group of people with common characteristics or interests living together within a territory or
geographical boundary · place where people under usual conditions are found
Health - is the OLOF (Optimum Level of Functioning)
Community Health - part of paramedical and medical intervention/approach which is concerned on the
health of the whole population
Aims: 1. health promotion 2. disease prevention 3. management of factors affecting health
Nursing - both profession & a vocation. Assisting sick individuals to become healthy and healthy
individuals achieve optimum wellness
MISSION OF CHN
· Health Promotion – activities related to enhancement of health
· Health Protection – activities designed to protect the people
· Health Balance – activities designed to maintain well being
· Disease prevention – activities relate to avoid complication
· Social Justice – activities related to practice equity among clients
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2. In CHN, the client is considered as an ACTIVE partner NOT PASSIVE recipient of care
3. CHN practice is affected by developments in health technology, in particular, changes in society, in
general
4. The goal of CHN is achieved through multi-sectoral efforts
5. CHN is a part of health care system and the larger human services system.
Role of CH Nurse:
· Clinician - who is a health care provider, taking care of the sick people at home or in the RHU
· Health Advocator – speaks on behalf of the client
· Advocator – act on behalf of the client
· Supervisor - who monitors and supervises the performance of midwives
· Facilitator - who establishes multi-sectoral linkages by referral system
· Collaborator – working with other health team member
1.a Family
1.a.1 Family Coping Index
· Physical Independence - ability of the family to move in & out of bed & performed activities of daily living
· Therapeutic Independence - ability of the family to comply with the therapeutic regimen (diet, medication
& usage of appliances)
· Knowledge of Health Condition- wisdom of the family to understand the disease process
· Application of General &Personal Hygiene- ability of the family to perform hygiene & maintain
environment conducive for living
· Emotional Competence – ability of the family to make decision maturely & appropriately (facing the
reality of life)
· Family Living Pattern- the relationship of the family towards each other with love, respect & trust
· Utilization of Community Resources – ability of the family to know the function & existence of resources
within the vicinity
· Health Care Attitude – relationship of the family with the health care provider
· Physical Environment – ability of the family to maintain environment conducive for living
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TASK: emphasize the importance of pregnancy & immunization & learn the concept of parenting
· Stage III –Family with Pre- school Children (3-6yrs old)
TASK: learn the concept of responsible parenthood
· Stage IV – Family with School age Children (6-12yrs old)
TASK: Reinforce the concept of responsible parenthood
· Stage V - Family with Teen Agers (13-25yrs old)
TASK: Parents to learn the concept of “let go system” and understands the “generation gap”
· Stage VI – Launching Center (1st child will get married up to the last child)
TASK: compliance with the PD 965 & acceptance of the new member of the family
· Stage VII -Family with Middle Adult parents (36-60yrs old)
TASK: provide a healthy environment, adjust with a new lifestyle and adjust with the financial aspect
· Stage VIII – Aging Family (61yrs old up to death)
TASK: learn the concept of death positively
1.b Community
COMMUNITY ASSESSMENT: · Status – information about morbidity, mortality & life expectancy ·
Structure – information about age, gender and socio economic · Process – information about how the
community function
1. COMMUNITY DIAGNOSIS
A process by which the nurse collects data about the community in order to identify factors which may
influence the deaths and illnesses of the population, to formulate a community health nursing diagnosis
and develop and implement community health nursing interventions and strategies.
2 Types:
Comprehensive Community Diagnosis Problem-Oriented Community Diagnosis
- aims to obtain general information about - type of assessment responds to a particular
the community need
STEPS: ·
Preparatory Phase
1. site selection
2. preparation of the community
3. statement of the objectives
4. determine the data to be collected
5. identify methods and instruments for data collection
6. finalize sampling design and methods
7. make a timetable
· Implementation Phase
1. data utilization
2. data collection
3. data organization/collation
4. data presentation
5. data analysis
· Evaluation Phase
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2. BIOSTATISTICS
2.1 DEMOGRAPHY - study of population size, composition and spatial distribution as affected by births,
deaths and migration.
Sources : Census – complete enumeration of the population
2 Ways of Assigning People:
1. De Jure - People were assigned to the place where assigned to the place they usually live regardless
of where they are at the time of census. 2.De Facto - People were assigned to the place where they are
physically present at are at the time of census regardless, of their usual place of residence.
Components:
1. Population size
2. Population composition * Age Distribution * Sex Ratio * Population Pyramid * Median age - age below
which 50% of the population fall and above which 50% of the population fall. The lower the median age,
the younger the population (high fertility, high death rates). * Age – Dependency Ratio - used as an index
of age-induced economic drain on human resources * Other characteristics: - occupational groups -
economic groups - educational attainment - ethnic group
3. Population Distribution * Urban-Rural - shows the proportion of people living in urban compared to the
rural areas * Crowding Index - indicates the ease by which a communicable disease can be transmitted
from 1 host to another susceptible host. * Population Density - determines congestion of the place
3. VITAL STATISTICS
• the application of statistical measures to vital events (births, deaths and common illnesses) that is
utilized to gauge the levels of health, illness and health services of a community.
TYPES:
A. Fertility Rate
B. Mortality Rate
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C. Morbidity Rate
A. PREVALENCE RATE
Total # of new & old cases in a given calendar year X 100
Total # of persons examined at same given time
B. INCIDENCE RATE
Total # of new cases in a given calendar year X 100
Estimated population as of July 1 of the same year
C. ATTACK RATE
Total # of person who are exposed to the disease X 100
# of persons exposed to the same disease in same given year
III - Epidemiology
· the study of distribution of disease or physiologic condition among human population s and the factors
affecting such distribution
· the study of the occurrence and distribution of health conditions such as disease, death, deformities or
disabilities on human populations
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Philippine Scenario:
· In the past 20 years some infectious degenerative diseases are on the rise.
· Many Filipinos are still living in remote and hard to reach areas where it is difficult to deliver the
health services they need
· The scarcity of doctors, nurses and midwives add to the poor health delivery system to the poor
• PROJECTED POPULATION :
MALE - 42,874,766
FEMALE - 42,362,147
BOTH SEXES - 85,236,913
• LIFE EXPECTANCY
FEMALE - 70 yrs. old
MALE - 64 yrs. Old
V. Health Care Delivery System · the totality of all policies, facilities, equipments, products, human
resources and services which address the health needs, problems and concerns of the people. It is large,
complex, multi-level and multi-disciplinary.
HEALTH SECTORS
· GOVERNMENT SECTORS
Department of Health Vision: Health for all by year 2000 ands Health in the Hands of the People by
2020
Mission: In partnership with the people, provide equity, quality and access to health care esp. the
marginalized
5 Major Functions:
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· National Health Plan is a long-term directional plan for health; the blueprint defining the country’s health
– PROBLEMS, POLICY THRUSTS STRATEGIES, THRUSTS
GOAL : · to enable the Filipino population to achieve a level of health which will allow Filipino to lead a
socially and economically-productive life, with longer life expectancy, low infant mortality, low maternal
mortality and less disability through measures that will guarantee access of everyone to essential health
care
OBJECTIVES: · promote equity in health status among all segments of society · address specific health
problems of the population · upgrade the status and transform the HCDS into a responsive, dynamic and
highly efficient, and effective one in the provision of solutions to changing the health needs of the
population · promote active and sustained people’s participation in health care
“ MAJOR HEALTH PLANS TOWARDS “HEALTH IN THE HANDS OF THE PEOPLE IN THE YEAR
2020”
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JANUARY
· National Cancer Consciousness Week - (16-22)
FEBRUARY
· Heart Month
· Dental Health Month
· Responsible Parenthood Campaign National Health Insurance Program
MARCH
· Women's Health Month
· Rabies Awareness Month
· Burn Injury Prevention Month
· Responsible Parenthood Campaign
· Colon and Rectal Cancer Awareness Month
· World TB Day - (24)
APRIL
· Cancer in Children Awareness Month
· World Health Day - (7)
· Bright Child Week Phase I -
· Garantisadong Pambata (11-17)
MAY
· Natural Family Planning Month
· Cervical Cancer Awareness Month
· AIDS Candlelight Memorial Day - (21)
· World No Tobacco Day - (31)
JUNE
· Dengue Awareness Month
· No Smoking Month
· National Kidney Month
· Prostate Cancer Awareness Month
JULY
· Nutrition Month
· National Blood Donation Month
· National Disaster Consciousness Month
AUGUST
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SEPTEMBER
· Generics Awareness Month
· Liver Cancer Awareness Month
OCTOBER
· National Children's Month
· Breast Cancer Awareness Month
· National Newborn Screening Week (3-9)
· Bright Child Week Phase II Garantisadong Pambata (10-16)
NOVEMBER
· Filariasis Awareness Month
· Cancer Pain Management Awareness Month
· Traditional and Alternative Health Care Month
· Campaign on Violence Against Women and Children
DECEMBER
· Firecracker Injury Prevention Campaign:
· “OPLAN IWAS PAPUTOK”
· IMCI is an integrated approach to child health that focuses on the well-being of the whole child.
· IMCI strategy is the main intervention proposed to achieve a significant reduction in the number
of deaths from communicable diseases in children under five
Goal:
· By 2010, to reduce the infant and under five mortality rate at least one third, in pursuit of the goal
of reducing it by two thirds by 2015.
AIM:
· to reduce death, illness and disability, and to promote improved growth and development among
children under 5 years of age.
· IMCI includes both preventive and curative elements that are implemented by families and
communities as well as by health facilities.
IMCI OBJECTIVES:
· To reduce significantly global mortality and morbidity associated with the major causes of
disease in children
· To contribute to the healthy growth & development of children
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Presenting complaint:
· Cough and/or fast breathing
· Lethargy/Unconsciousness
· Measles rash
· “Very sick” young infant
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- Respiratory infections can occur in any part of the respiratory tract such as the nose, throat, larynx,
trachea, air passages or lungs. Assess and classify PNEUMONIA
· cough or difficult breathing
· an infection of the lungs
· Both bacteria and viruses can cause pneumonia
· Children with bacterial pneumonia may die from hypoxia (too little oxygen) or sepsis
(generalized infection).
** A child with cough or difficult breathing is assessed for:
· How long the child has had cough or difficult breathing
· Fast breathing – increase in RR
· Chest indrawing – Visible mark of ICS upon inhalation
· Stridor in a calm child – adventitious sounds heard even without the aid of stethoscope.
REMEMBER:
** If the child is 0 months up to 2 months the child has fast breathing if you count 60 breaths per
minute or more
** If the child is 2 months up to 1 year old the child has fast breathing if you count 50 breaths per
minute or more.
** If the child is 12 months up to 5 years the child has fast breathing if you count 40 breaths per
minute or more.
PNEUMONIA – TREATMENT SCHEME
•Give first dose of an
appropriate antobiotic •Give
Vitamin A •Treat the child to
•Any general danger sign or
SEVERE PNEUMONIA OR prevent low blood sugar
•Chest indrawing or •Stridor in
VERY SEVERE DISEASE •Refer urgently to the hospital
calm child
•Give paracetamol for fever >
38.5oC
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COTRIMOXAZOLE AMOXYCILLIN
GIVE VITAMIN A
AGE VITAMIN A CAPSULES 200,000 IU
6 months – 12 months 1//2 ( 100,000 IU) red capsules
12 months – 5 years old 1 ( 200,000 IU) blue capsules
GIVE IRON
Iron/Folate Tablet FeSo4 200mg + Iron Syrup FeSo4 150 mg/5ml
AGE or WEIGHT
250mcg Folate (60mg elemental iron) ( 6mg elemental iron per ml )
2months-4months ( 4 - <6kg ) 2.5 ml
4months – 12months ( 6 - <10kg ) 4 ml
12months – 3 years ( 10 - <14kg ) 1/2 5 ml
3years – 5 years ( 14 – 19kg ) 1/2 7.5 ml
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GIVE MEBENDAZOLE · Give 500mg Mebendazole as a single dose in health center if : > hookworm /
whipworm are a problem in children in your area, and > the child is 2 years of age or older, and > the
child has not had a dose in the previous 6 months
OSTEOPOROSIS PROGRAM
• It is characterized by a decrease in bone mass and density that progresses without a symptom
or pain until a fracture occurs generally in the hip, spine or wrist.
• Objectives:
• To increase awareness on the prevention and control of osteoporosis as a chronic debilitating
condition;
• To increase awareness by physicians and other health professionals on the screening, treatment
and rehabilitation of osteoporosis;
• To empower people with knowledge and skills to adopt healthy lifestyle in preventing the
occurrence of osteoporosis.
REPRODUCTIVE HEALTH
1. Family Planning
2. MCH & Nutrition
3. Prevention / treatment of Reproductive Tract Infection & STD
4. Prevention of abortion & its complication
5. Education & counseling on sexuality & sexual health
6. Adolescent sexual reproductive health
7. Violence against women
8. Men’s reproductive health ( Male sexual disorder )
9. Breast CA & other gyne problem
10. Prevention / treatment of infertility
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PROTEIN ENERGY MALNUTRITION 1. Marasmus – looks like an old worried man - less subcutaneous
fats 2. Kwashiorkor - a moon face child - with flag sign (hair changes) VITAMIN A DEFICIENCY
Early symptoms: Xeropthalmia (Nigtblindess)
BLINDNESS
ALTERNATIVE MEDICINE
· RA 8423
· 23 IN 93
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A. FAMILY PLANNING
I. Spacing / Artificial Method
A. Hormonal
B. Mechanical & Barrier
C. Biologic
D. Natural
II. Permanent (surgical/irreversible)
A. Tubal Ligation
B. Vasectomy
III. Behavioral Method
B. BREASTFEEDING
II - CHILD CARE
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MENTAL HEALTH · a state of well-being where a person can realize his or her own abilities, to cope with
the normal stresses of life and work productively
Components of Mental Health Program · Stress Management and Crisis Intervention · Drugs and
Alcohol Abuse Rehabilitation · Treatment and Rehabilitation of Mentally-Ill Patients · Special Project for
Vulnerable Groups
Community Organizing
· a continuous and sustained process of
· EDUCATING THE PEOPLE,
· CRITICAL AWARENESS
· MOBILIZING
4 Phases:
· Pre entry
· Entry
· Organizational Building
· Sustenance and Strengthening
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I - TUBERCULOSIS · TB is a highly infectious chronic disease that usually affects the lungs.
Causative Agent: Mycobacterium Tuberculosis
S/S: · cough · afternoon fever · weight loss · night sweat · blood stain sputum
Prevalence/Incidence: · ranks sixth in the leading causes of morbidity (with 114,221 cases) in the
Philippines · sixth leading cause of mortality (with 28507 cases) in the Philippines.
Nursing and Medical Management · Ventilation systems · Ultraviolet lighting · Vaccines, such as the
bacillus Calmette Guerin (BCG) vaccine · drug therapy
Preventing Tuberculosis · BCG vaccination · Adequate rest · Balanced diet · Fresh air · Adequate
exercise · Good personal Hygiene
DOTS (Direct Observed Treatment Short Course)
Regimen Type of TB Patient
New pulmonary smear (+) cases · New
seriously ill pulmonary smear (-) cases w/
Regimen I 2RIPE / 4RI
extensive lung lesions · New severely ill extra-
pulmo TB
· New pulmonary smear (+) case · New
seriously ill pulmonary smear (-) cases w/
Regimen II 2RIPES/ 1RIPE / 5RIE
extensive lung lesions · New severely ill extra-
pulmo TB
· New smear(-) but with minimal pulmonary TB
Regimen III 2RIP / 4RI on radiography as confirmed by a medical
officer · New extra-pulmo TB (not serious)
Prevalence Rate · Metro Manila, the prevalence rate ranged from 0.40 – 3.01 per one thousand
population.
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I – LEPTOSPIROSIS · an infectious disease that affects humans and animals, is considered the most
common zoonosis in the world
Causative Agent: Leptospira interrogans
S/S: -high fever -severe headache -chills -muscle aches -vomiting -may include jaundice (yellow skin and
eyes) -red eyes -abdominal pain -diarrhea
TREATMENT: PET - > Penicillins , Erythromycin, Tetracycline
II - MALARIA · Malaria (from Medieval Italian: mala aria - "bad air"; formerly called ague or marsh fever)
is an infectious disease that is widespread in many tropical and subtropical regions.
Causative Agent: Anopheles female mosquito
Signs & Symptoms: Chills to convulsion Hepatomegaly Anemia Sweats profusely Elevated temperature
Treatment: Chemoprophylaxis – chloroquine taken at weekly interval, starting from 1-2 weeks before
entering the endemic area.
Preventive Measures: (CLEAN)
Chemically treated mosquito nets
Larvae eating fish
Environmental clean up
Anti mosquito soap/lotion
Neem trees/eucalyptus tree
III - FILIARIASIS · name for a group of tropical diseases caused by various thread-like parasitic round
worms (nematodes) and their larvae
· larvae transmit the disease to humans through a mosquito bite
· can progress to include gross enlargement of the limbs and genitalia in a condition called elephantiasis
S/S:
Asymptomatic Stage
· Characterized by the presence of microfilariae in the peripheral blood
· No clinical signs and symptoms of the disease
· Some remain asymptomatic for years and in some instances for life
Acute Stage
· Lymphadenitis (inflammation of lymph nodes)
· Lymphangitis (inflammation of lymph vessels)
· In some cases the male genitalia is affected leading to orchitis (redness, painful and tender scrotum)
Chronic Stage
· Hydrocoele (swelling of the scrotum)
· Lyphedema (temporary swelling of the upper and lower extremities
· Elephantiasis (enlargement and thickening of the skin of the lower and / or upper extremities, scrotum,
breast)
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Abdominal pain
Loose bowel movement
Low grade fever
Inflammation of liver & spleen
Pallor
Seizure
VII – DENGUE · DENGUE is a mosquito-borne infection which in recent years has become a major
international public health concern..
· It is found in tropical and sub-tropical regions around the world, predominantly in urban and semi-urban
areas.
S/S: (VLINOSPARD)
· Vomiting
· Low platelet
Increase Platelet count
· Nausea
· Onset of fever
· Severe headache
· Pain of the muscle and joint
· Abdominal pain
· Rashes
· Diarhhea
TREATMENT:
· The mainstay of treatment is supportive therapy.
- intravenous fluids
- A platelet transfusion
- No aspirin
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Communicable Disease
Module on Communicable Diseases
Community Health Nursing is faced with problems regarding communicable diseases. It is
important therefore that the nurse poses basic knowledge on how to deal with related problems
and more so prevent its occurrence, since this is like wise the focus of community health
nursing.
INTRODUCTION
This module focuses on the basic communicable diseases affecting the patterns of mortality and
morbidity in the Philippine community. It will give you the basic information regarding the
description, etiology, mode of transmission, incubation period, signs and symptoms, diagnostic
procedures and management of these diseases. As an added bonus each topic is carefully
selected to prepare you both in the practical application in the community setting and the board
exam most especially. Due to this you are advised to be familiarized with the following phrases:
ON THE BOARD refers to common question that comes out in the board exam.
CLINICAL FOCUS refers to the important reminders that are crucial in the actual practice.
GROUP ALERT refers to age group variation that also demand different approaches. A post test
is prepared for your satisfaction so that you will be able to measure your knowledge. It is
recommended that you supplement your studies with text books which focus on the said topic.
This is just a guide and although careful review has been made the author waive any
responsibility that may negatively occur due to application of the concepts learned here in.
OBJECTIVE GENERAL To study the different communicable diseases affecting man and the
family as a component of the community
SPECIFIC By the end of the module in 7 days you should be able to;
1. Understand the basic concepts of CD
2. Familiarize with the basic control and method of prevention to the said diseases.
3. be able to apply to practice the concepts learned by effectively giving health education all
these is expected to be attained by you none the less, by passing at least 65% of the final
assessment questions.
What is infection? Infection is the successful entry and multiplication of micro-organism in the
human body. Usually their entrance results in the appearance of the disease. But it doesn’t
always follow the same. Some organism may enter the body but no obvious illness is apparent.
What are the types of infection? There are two types of infection it could be nosocomial or
opportunistic. Nosocomial – refers to hospital acquired infection with sets in within the premises
of the hospital during confinement. Remember an infection is considered nosocomial if it sets in
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after 72 hours upon admission. Most of the time the responsible organism are hospital
pathogens such as pseudomonas, klebsiella etc. Opportunistic – refers to the type infection
acquired due to the failure of the immune defenses. Usually this is caused by the normal
microflora.
What are communicable diseases and contagious diseases? Communicable diseases are
any disease that are caused by microorganism and can be transferred from one body to another,
hence it is communicable. Contagious diseases are any communicable infection that are easily
transmissible. ON THE BOARD! Keep in mind that every contagious disease is communicable
and all communicable diseases are infection but never the other way around.
What is pathogenicity? It is the over all ability of the organism to cause pathogenic changes in
the body. Which is further described by the following terms:
Mode of action – manner by which organism damages the host. Example clostridium tetani
releases toxin while plasmodium falciparum kills the RBC.
Virulence – it is the over all strength of the microorganism
Dose – the number of the organism required to cause infection for example as little as 4 tubercle
bacilli inhaled is sufficient to cause Tuberculosis among high risk patient. Invasiveness – the
ability of the organism to penetrate an intact barrier
Toxigenicity – the ability of the organism to produce toxins
Specificity – is the ability of the organism to attach on specific cellular surface receptors. Viability
– the ability to sustain life outside the body of the host
Antigenicity – the ability of the organism to stimulate and or resist antibody response
STAGES OF INFECTION
a) Exposure – the stage of contact with the infectious agent
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b) Incubation or latent – the organism successfully entered the body. No apparent illness is
present. The organism is still multiplying so as to manifest an actual illness.
c) Prodromal – the manifestation of vague signs and symptoms start to appear. Example fever,
cough, pain etc.
d) Acute disease – an acute disruption in the physiologic mechanism. Disease due to the
infecting organism is already present.
e) Convalescence – the stage of resolution. The body is able to maintain homeostasis. The
infectious organism is under control
f) Relapse – a stage of reactivation of a previous infection which may be due to re-exposure or
waning immunity.
CHAIN OF INFECTION The series of events that takes place in order for infection to occur.
The following subtopics describe each component of the chain.
ON THE BOARD! Remember infection will never occur unless the six chain are completed.
a) Causative agent – refers to the microorganism such as fungi, protozoa, parasite, viruses,
bacteria etc.
b) Reservoir – the medium or body which the microorganism thrive and survive.
c) Portal of Entry – opening in the body where in the microorganism could use as passageway to
reach the internal physiological structures. For example mouth, nose, wound etc.
d) Portal of exit – any opening to which the organism uses to exit from the body. Example are
anus, nose, vagina, penis, etc.
e) Mode of transmission – the method on how the organism travels from one infected host to
another.
i. Direct – requires physical contact from the point source of infection. Such as kissing and
unprotected sexual intercourse.
ii. Indirect – transmitted through fomites and other non living organism. Contaminated surgical
instruments.
iii. Vector borne – relies greatly on the presence of the secondary host to cause infection. e.g.
mosquitos, flies and rats
iv. Droplet – organism travels through droplet nuclei that comes out during coughing, sneezing
etc.
v. Airborne – the organism can uniquely suspend in the air and carried on air current and the like
method.
f) Susceptible host – any person whose immune defenses are weak or those who are healthy
but do not posses adequate specific immunity
ON THE BOARD! Remember that the mode of transmission is the chain that is easiest to break!
THE DEFENSE MECHANISM OF THE BODY The defensive mode is divided into three,
namely:
i. 1st line of defense
ii. 2nd line of defense
iii. 3rd line of defense
1st LINE OF DEFENSE Non specific defense mechanism this is the first to come in contact with
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harmful organism. E.g. skin, saliva,. Tears, stomach acids, urine etc. 2ND LINE OF DEFENSE
Non specific phagocytic response. E.g. phagocytosis by neutrophils.
3RD LINE OF DEFENSE Specific immune response dependent upon the presence of specific
anti bodies. E.g. immunity against chickenpox
IMMUNITY Ability of the body to effectively mount an immune response to prevent infection. it is
usually dependent on the presence of antibodies.
a. Natural active – contact with infectious organism and the immunity that follows after that.
b. Natural passive – immunity received from the mother through the placenta
c. Artificial active – immunity gained after the administration of vaccines
d. Artificial passive – immunity gained after receiving immune serum or immune globulin.
EPIDEMIOLOGY Refers to study of the pattern and distribution of diseases among the identified
population.
a. Endemic – the disease is always present in a community the rise and fall remains steadily
predictable.
b. Epidemic – there is a sharp increase in the number of disease as it affects the population over
a period of time and specific locality.
c. Pandemic – nations are affected by a disease. It is commonly referred to as international
epidemic.
d. Sporadic – patches in appearance. The disease does not manifest it self as a dominant entity.
Most often the disease affects only a small portion of the community.
e. Out break – the disease has affected the population but the number of the people afflicted is
above the endemic proportion but lower than epidemic levels. An outbreak is an indicator of
impending epidemic.
Disinfection – the use of chemicals like alcohol or other physical means to destroy disease
causing organism outside the body.
a. Terminal disinfection – disinfecting the surroundings of the patient
b. Concurrent disinfection – disinfection of substances and materials discharged from the body.
Isolation – the act of separating an infected patient to prevent cross infection. The following are
the types of isolation precaution.
i. First Tier – Standard precaution ; applied to all patient regardless of their clinical diagnosis. It is
desired that the application of this tie will protect the nurse and the patient from body fluids
including blood as well as wounds or any break in the skin and mucous membrane. Use of
gloves.
ii. Second Tier – Transmission based precaution refers to any patient who require more stringent
control that necessitates deeper method than those identified above. These includes contact,
airborne and droplet precaution.
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a. Contact precaution – to protect against direct and indirect transmission. Mask and gown are
added.
b. Airborne precaution – the use of air filters to prevent infection due to organism suspended in
the air.
c. Droplet precaution – maintaining a distance of 3 feet from the point source of infection to
avoid droplet nuclei. The use of high particulate mask and goggles are added.
Quarantine – the act of limiting the movement and freedom of travel of any patient who have
been exposed from an infectious organism. The length of time is dependent to the maximum
incubation period of the suspected disease. Surveillance - monitoring of patients, high risk
groups or families to predict, identify and control infection.
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MENINGITIS
Description: An acute inflammation of the meninges
Caused by Nesseria meningitides this is usually a normal inhabitant of
Etiology:
the nasopharynx.
Mode of
Droplet infection
transmission:
Incubation period: 2 – 10 days
The organism enters the bloodstream after invading the respiratory
tissues. Reaches the spinal cord and of course the meninges. It
stimulates chemotaxis that leads to leukocyte infiltration of the
Pathophysiology: meninges. As a result inflammation follows. This build up pressure, pus
and compresses sensitive nervous tissues, that may decrease the level
of consciousness and in more severe cases pus could impede blood
flow and brain infarct my ensue.
The most significant finding indicating meningeal irritation: brudzinski
Signs and symptoms and kernigs sign. Other sign observable are headache, opisthotonus,
fever and petechiae
Diagnostic
Lumbar puncture (CSF analysis)
procedure
Institute droplet precaution Rifampicin or Ciprofloxacin for prophylaxis
Ampicillin is the drug of choice Ceftriaxone for systemic and CNS
infection given in combination with Ampicillin to combat resistant
organism. Mass prophylaxis is not needed provided that all children in
Management day care centers who have been exposed are exempted hence they need
prophylaxis, this also includes all other children who are close to the
infected patient such as when they share eating utensils. Nurses and
Doctors are not at risk of having the disease except when close contact
occurred like in mouth to mouth resuscitation.
ENCEPHALITIS
Description: Inflammation of the tissues of the Brain
Mosquito borne – Japanese enceph, West Nile enceph etc Viral borne –
Etiology: Complication of chicken pox or measles Amebic – Acanthamoeba
hystolytica
Mosquito borne – bite of the infected mosquito Viral – may be droplet or
Mode of
airborne Amebic – accidental entry in the naso - pharynx due to
transmission:
swimming in infested waters.
Incubation period: Mosquito borne – varied Viral – 5 – 15 days Amebic – 3 – 7 days
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The infectious organism regardless of the type penetrate the brain and
causes inflammation of the brain tissues it self. the inflammatory
Pathophysiology:
response compresses the brain structure which explains the rapid
deterioration of the LOC. Encephalitis is more severe than meningitis.
Marked decrease in LOC. Brudzinski and kernigs may also be present if
Signs and symptoms meningeal irritation result. The most significant though is the
appearance of decorticate and decerebate rigidity.
Diagnostic
Lumbar Tap (CSF analysis) EEG
procedure
Primarily supportive. The body can neutralize the organism thru the
presence of antibody. Amebic encephalitis may benefit from
Management
metronidazole. Anti inflammatory may be given Mannitol could decrease
ICP
POLIOMYELITIS
Description: An acute paralytic infection that destroys the affected nerves.
Etiology: Caused by polio virus 1 (Brunhilde), 2 (Lansing), 3 (Leon)
Mode of Fecal – oral route. Particularly rampant among those in the squatters
transmission: area who have no access to sanitary toilet facilities
Incubation period: 7 – 14 days
The virus enters the oral cavity and reproduces in the intestines which
later penetrate the intestinal wall causing viremia and reaching the motor
Pathophysiology:
nerves and the spinal cord. The virus reproduces inside the nerve and as
they are released, the infected cell die, hence paralysis results.
Pokers sign, Haynes sign, tonsillitis, abdominal pain and flaccid
Signs and symptoms
paralysis
Diagnostic
Stool exam, pandys test, EMG
procedure
Prevention OPV No anti viral therapy. Toilet hygiene must be reinforced
Watch out for respiratory paralysis Assist in rehabilitation (physical
Management
therapy and comfort measures OPV is preferred over IPV because the
latter can only provide
RABIES
Description: Another acute viral infection which have a zoonotic origin
Primarily carried by mammals specially land and aerial mammals. In the
Etiology: Philippines Dogs and Cats are among the most important reservoir. The
causative organism is Rhabdo Virus
Mode of Bite of infected animal. Scratch wound from cats can also cause
transmission: infection since cats usually lick their paws.
Incubation period: 10 days for man 14 days for animals
Pathophysiology: The virus replicates at sight of infection which later proceeds to infect
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the nearby axons and then reaches the nerve it self. From that point
onwards the virus travels along the nerve pathway to reach the brain. In
the brain the virus insights inflammatory reaction that give rise to the
appearance of encephalitis like symptoms later the organism descends
from the brain and exit to affect other nerves in he body. The affectation
of trigeminal nerve causes throat spasms which gives rise to its classic
finding “hydrophobia”
Hydrophobia, aerophobia, laryngeal, Pharyngeal spasm excessive
Signs and symptoms
salivation.
Diagnostic Fluorescent antibody Staining, Negri bodies found in brain biopsy of the
procedure infected animal
Human Diploid Cell Vaccine, Rabies Immunoglobulin, Rabies Anti serum.
tetanus anti serum is also given if with negative or inadequate
immunization history Wash wound with soap and water, may apply
wound antiseptic Once sign and symptoms are present passive
Management immunization is already useless. Supportive therapy comes next. Protect
from glare and sunlight, protect from water and air current. Cover IV
bottle and tubing with carbon paper or any other else that can effectively
hide the iv fluids. Secure consent and restrain the patient. Observed
contact and droplet precaution.
LEPROSY
A chronic infection that usually affects the peripheral nerves and leads
Description:
to paresthesias
A possible zoonotic infection which is rarely cultured in laboratory but
Etiology: seen to be growing freely among armadillo. Causative organism is
Mycobacterium leprae
Mode of Droplet infection is the most important transmission. Skin contact may
transmission: cause infection only if there is an open lesion with prolonged contact.
Incubation period: 6 months to 8 years
The organism enters the body via droplet infection. It is ingested by
macrophages but can’t be killed, as this circulating macrophage reaches
the skin the bacteria penetrate the nerves. Later due to immune
Pathophysiology: recognition WBC attacks the infected cell which results to the
destruction of the affected cell hence the appearance of paresthesias
and consumption of the involved extremity becomes apparent due to
immune response it self.
Painless wound, paresthesias, ulcer that does not heal, leonine
Signs and symptoms appearance, maderosis. Nerve involvement with acid fast bacilli is the
pathognomic sign of leprosy
Diagnostic
Scraped incision method.
procedure
Management Institute concurrent disinfection specially of nasal discharge. Prevention
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MALARIA
Another type of mosquito borne infection most common in the
Description:
tropics
The causative organisms are Plasmodium Vivax, Falciparum, Ovale,
Etiology:
and Malariae. The primary vectors are anopheles mosquitoes.
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Mode of
Bite of the infected mosquito
transmission:
Incubation For Falciparum 12 days, for Vivax and Ovale 14 days and for
period: Malariae 30 days
From the bite of the infected mosquito the organism enters the body
via bloodstream and immediately proceed to the liver in the form of
sporozoites. Inside the hepatocytes reproduction continues until the
Pathophysiology: host burst releasing the parasite in the form trophozoites that enters
the RBC, inside it the organism divides and form schizont. This will
later produce merozoites that enters RBC the process causes drop
in the number of circulating RBC leading to anemia and cachexia.
A cycle of hot stage (high fever) followed by diaphoretic stage
Signs and
(sweating) and then cold stage (chilling). The cycle repeats leading
symptoms
to malarial cachexia
Diagnostic
Malarial smear or peripheral blood smear
procedure
Chloroquine is the drug of choice. Primaquine must be given to
Management prevent relapse. Prevent by using mosquito repellant and mosquito
net Chloroquine is the drug of choice for prophylaxis.
FILIRIASIS
Description: A chronic lymphatic disorder that is related to elephantiasis
Etiology: Causative organism is Wuchereria bancrofti primary vector Culex spp.
Mode of
Bite of the infected mosquito
transmission:
Incubation period: 6 – 12 months
The organism enters the body after the vectors’ bite, it then matures and
migrate on the lymphatic vessels but it usually affects those in the lower
extremity. The protozoal parasite crowds and destroy the filtering ability
Pathophysiology:
of the lymph nodes which then leads to the accumulation of lymph or
body fluids causing edema and at worst cases gross deformity hence it
could lead to elephantiasis.
Recurrent low grade fever, lymphangitis, nocturnal asthma and in worst
Signs and symptoms
cases elephantiasis
Diagnostic
Microscopic examination of peripheral blood.
procedure
Use of mosquito repellant and nets Hetrazan is effective against Filiriasis
Management adverse reaction though are seen in a number of patients, if such may be
present may use Ivermectin
RESPIRATORY SYSTEM
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DIPHTHERIA
An acute infection of the upper respiratory system whose complication
Description:
may include the lower respiratory tract.
Etiology: The organism, Corynebacterium diphtheriae is ubiquitous.
Mode of
Droplet infection is the means of spread
transmission:
Incubation period: 1 – 7 days
The organism infects the oral cavity which later due to its ability of
releasing toxins causes the death of the involved tissues. This gives rise
to the appearance of psudomembarne which may be dislodge and block
Pathophysiology:
the airway. As toxins are secreted the heart, kidney and the nerves
absorb it, this toxins halt protein synthesis of the infected cell which
later on causes its death.
Pathognomonic Sign is pseudo membrane. Tonsillitis may also be
Signs and symptoms present. Fever and malaise. If complication arises paralysis, endocarditis
and kidney failure may be seen.
Diagnostic
Throat swab
procedure
Gather specimen for culture Prepare for epinephrine and possible
Management intubation Be ready for antitoxin therapy after checking for allergy
Administer penicillin or erythromycin
PERTUSIS
A widespread organism that threaten any one who have no immunity
Description:
against it.
Etiology: Causative organism is Bordetella pertussis
Mode of
Droplet infection
transmission:
Incubation period: 7 – 21 days
Pathophysiology: The organism enters the upper respiratory tract attaches to the
respiratory epithelium and causes an increased production of cyclic
amino phosphate that essentially leads to hyperactivity of the mucous
secreting cells. Thick tenacious secretions blocks the airway. The
organism also halts the mucociliary escalator leaving coughing reflex
the last effective protective mechanism of expelling sputum. Due to its
relative tenaciousness the body experiences difficulty in coughing out
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TUBERCULOSIS
Description: A chronic lung infection that leads to consumption of alveolar tissues
Etiology: Causative organism is acid fast bacillus mycobacterium tuberculosis.
Mode of
Droplet infection as well as airborne
transmission:
Incubation period: 2 – 4 weeks
The bacilli is inhaled and taken in the alveoli where macrophage will
ingest but fail to kill the organism. As these macrophages migrate to
nearby lymph nodes it will die and leave the capsulated bacteria
Pathophysiology: undigested. Once the body’s immune system dropped, the bacteria will
be activated and stimulate immune response which likewise damage the
alveolar tissues leading to casseation necrosis and could eventually
consume the entire lungs if the process is repeated frequently
Signs and symptoms Afternoon fever, night sweats, cough for 2 weeks, anorexia weight loss.
Diagnostic
Sputum microscopy, CXR, Mantoux test
procedure
Institute DOTS Give as ordered; Pyrazinamide, Izoniazid, Rifampicin,
Ethambutol and Streptomycin. Check for sensitivity to any of the drug
Management mentioned Provide B6 if receiving Izoniazid Watch out for visual problem
if receiving Ethambutol Ethambutol is contra indicated for children who
cant verbalize visual problems yet.
PNEUMONIA
Description: an acute usually bacterial in nature
the most common causative organism is strptococcus pneumoniae
ubiquitous, orgainsm and may be transferred among population that has
Etiology:
poor ventilation and impaired respiratory cilliary function. certain
disease like measles may promote the development of pneumonia
Mode of
Droplet infection
transmission:
Incubation period: 24 to 72 hrs usually 48 hrs
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the organism enters the respiratory tract and if the cilliary mechanism
fails to prevent its further entry the organism then infects the lower
respiratory centers where it stimulate an inflammatory reaction. this
response leads to migration of WBC in particular with neutrophil hence
Pathophysiology:
leukocyte infiltration is seen in chest x-rays as consolidation. the build
up puss increases the alveolar presure causing in atelectasis once
collapsed alveoli cant participate in gas exchange anymore leading to
impaired DOB.
Rusty colored sputum is the pathognomonic sign this is caused by WBC
Signs and symptoms infiltrates, RBC and sputum. DOB, increased RR, coughing and in late
cases lethargy, cyanosis and death.
Diagnostic
sputum exam
procedure
Co Trimoxazole and gentamycin are the drug of choice. although Co-tri
is used more widely than gentamycin because of its oral preparation
which are allowed to be administered by midwives for patient in far flung
Management areas. instruct the mothers to continue the administration of antibiotic
for 5 straight days TSB if in case fever may arise Promote proper room
ventilation avoid crowding as much as possible Use Pneumococcal
vaccine as indicated
COLDS (CORYZA)
Description: The causative agent comes from adenovirus and rhino virus.
Mode of
Droplet infection, direct contact.
transmission:
Incubation period: 1 – 3 days
As the virus enters the respiratory tract, it attaches itself to the mucous
membrane and causes local irritation and inflammation. In response, the
mucous membrane releases mucous to flush out the virus. Since there is
an increased in the production of the mucous it usually flows back and
Pathophysiology:
causes rhino rhea and because of the naso-lacrymal duct, increased
mucous production impedes the drainage of tears thus watery eyes is
present. Complications: Children – otitis media and bronchopneumonia
Adult – sinusitis
•General malaise
•Fever, chills
Signs and symptoms
•Sneezing, dry and scratchy throat
•Teary eyes, headache
•Continues water discharge from nares
a. Provide adequate rest and sleep b. Increase fluid intake c. Provide
Management
adequate and nutritious diet d. Encourage vitamins specially vitamin C
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1. drugs
o analgesics
o corticosteroids
o acetic acid compresses or white petrolatum
Management o anti-viral (acyclovir)
2. isolate client
3. apply drying lotion
4. administer medications as ordered
5. instruct client to preventive measures
SCABIES
An infection of the skin produced by burrowing action of a parasite mite
Description:
resulting in irritation and the formation of vesicles or postules.
Itchmite, sarcoptes scabei, occurs in individual living in area of poverty
Etiology:
where cleanliness is lacking.
Mode of Direct contact with infected persons, indirect contact through soiled bed
transmission: linens, clothing and others.
Incubation period: -
Both female and male parasites live on the skin. A female parasite
burrows into the superficial skin to deposit eggs. Pruritus occurs and
scratching of skin may produce secondary infection. Scattered follicular.
Pathophysiology:
Eruption contains immature mites. Inflammation may produce postules
and crust. Eggs is hatched in 4 days. Larvae undergo a series of matts
before becoming adult. Life cycle is complete in 1-2 weeks.
· intense itching especially at night · sites – between fingers or flexor
Signs and symptoms surfaces of wrists and palms, around nipples, umbilicus, in axillary folds,
near groin or gluteal folds, penis, scrotum.
Diagnostic
Presence on skin of female mite, ova and feces upon skin scrapping.
procedure
RINGWORM (TRICHOPHYTOSIS)
A group of diseases caused by a number of vegetable fungi and
Description:
affecting various portion of the body in different ways (skin, hair, nails)
Etiology: TINEA PEDIS (Athlete’s foot) – a superficial fungal infection due to
trichophyton Rubrum, mentagrophytes, or epidermophyton floccosum
which may manifest itself as an acute, inflammatory, vesicular process
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or as chronic rash involving the soles of the feet and the inter-digital web
spaces. particularly common in summer, contracted swimming area and
locker rooms. TINEA CORPORIS or TINEA CIRCINATA – ringworm of the
body. TINEA CRURIS (Jock itch) – superficial fungal infection of the
groin which may extend to the inner thigh and buttocks areas and
commonly associated with tinea pedis. TINEA CAPITIS (ringworm of the
scalp) – caused by microsporum canis, trichophyton tonsurans. · usually
spread through child to child contact, use of towels, combs, brushes and
hats · kitten and puppies may be the source of the infection · primarily
seen in children before puberty ·
TINEA PEDIS · scaly fissures between toes, vesicles on sides of feet ·
pruritus · burning and erethema · lymphangitis and cellulites may occur
TINEA CORPORIS or TINEA CIRCINATA · intense itching · appearance:
begins as scaling erythematous lesions advancing to rings of vesicles
with central clearing and appears on exposed areas of body. TINEA
Signs and symptoms CRURIS · dull red brown eruption of the upper thighs and extends to
form circular plaques with elevated scaly or vesicular borders. · itching ·
seen most in joggers, obese individuals and those wearing tight
undercoating. TINEA CAPITIS · reddened, oval or round areas of alopecia
· presence of kerion: an acute inflammation that produces edema,
postules and granulomatous swelling
TINEA PEDIS · direct examination of scrapings (skin, nails, hair) ·
Diagnostic
isolation of the organisms in culture TINEA CAPITIS · wood’s lamp ·
procedure
microscopic evaluation
Management TINEA PEDIS
1. Prevention: instruct client to keep feet dry such as by using
talcum powder.
2. Management:
o Drugs: topical agent, clotrimazole, miconazole, tolnaftate
o Systemic anti-fungal therapy: griseofulvin, ketoconazole
o Elevate feet for vesicular type o pain infection.
TINEA CORPORIS or TINEA CIRCINATA
1. Prevention: infected pet is a common source and should be
inspected and treated by a veterinarian.
2. Management
o see treatment for tinea pedis
o wear clean cotton clothing next to skin
o use clean towel daily
o dry all areas and skin folds thoroughly
o use self monitoring for signs of re-infection after a course of
therapy.
TINEA CRURIS
1. Prevention: avoid nylon underclothing, tight-fitting underwear and
prolonged wearing of wet bathing suit.
2. Management:
o Drugs – topical therapy (miconazole cream); griseofulvin
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(oral)
o avoid excessive washing or scrubbing; wear cotton
underwear.
TINEA CAPITIS – same with other fungal infection
GASTROINTESTINAL DISORDERS
TYPHOID FEVER (ENTERIC FEVER)
A general infection characterized by the hyperplasia of the lymphoid
tissues, especially enlargement and ulcerations of the Peyer’s patches
Description:
and enlargement of the spleen, by parechymatous changes in various
organs and liberation of an endotoxin in the blood.
Salmonella typhosa, prevalent in temperate climates, high incidence in
Etiology:
fall, and mostly affected are the males and in youth and infant.
Mode of
Infected urine and feces and intake of contaminated food and water
transmission:
The organism enters the body via the GI tract and invades the walls of
the GI tract leading to bacteremia that localizes in mesenteric lymph
nodes, in the masses of lymphatic tissue, in the mucus membrane of the
intestinal wall (Peyer’s patches) and in small, solitary lymph follicles in
Pathophysiology:
the ileum and colon thus ulceration of the intestines may result.
Complication: · perforation of the intestine – from erosion of one of the
ulcers · intestinal hemorrhage – from erosion of blood vessels · relapse ·
thrombophlebitis · urinary infection · meningitis
1. Gradual onset
o severe headache, malaise, muscle pains, non-productive
cough
o chills and fever, temperature rises slowly
o pulse is full and slow
o skin eruption – irregularly spaced small rose spots on the
abdomen, chest and back; fades 3-4 days
Signs and symptoms
o splenomegally
2. Second week
· fever remains consistently high · abdominal distention and tenderness,
constipation or diarrhea · delirium in severe infection · coma-vigil look;
pupils dilate and patient appears to stare without seeing · sultus tendium
–twitching of the tendon sets
3. Third week
· gradual decline in fever and symptoms subsides
· white blood cell counts · blood or bone marrow culture · positive urine
Diagnostic
and stool cultures in later stage · blood serum agglutination – (+) at the
procedure
end of scond week
Management
1. Prevention: decontamination of water sources, milk
pasteurization, individual vaccination of high risk persons, control
carriers.
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2. Drugs
o chloramphenicol
o ampicillin
o sulfamethoxazole
o trimethoprim
o furazolidone
3. intravenous infusion – to treat dehydration and diarrhea
4. Nursing care
o give supportive care
o position the patient to prevent aspiration
o use of enteric precautions
o TSB for high fever
o encourage high fluid intake
o monitor for complications
5. intestinal decompression procedure, IV fluids and surgical
intervention – for perforation
6. withhold food, blood transfusions and bowel resection – for
intestinal hemorrhage
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DYSENTERY
BACILLARY DYSENTERY (shigellosis, bloody flux) – caused by shigella
dyseteriae and shigella paradysenteriae coming from bowel discharges
Etiology: of infected persons and carriers. VIOLENT DYSENTERY (Cholera) –
caused by vibrio cholera, vibrio comma (ogawa and inaba) from infected
feces or vomitus.
BACILLARY DYSENTERY – eating of contaminated foods, hand to mouth
transfer of contaminated material, flies, objects soiled with discharges of
Mode of
infected person, contaminated water. VIOLENT DYSENTERY – direct or
transmission:
indirect fecal contamination of water or food supplies by soiled hands,
utensils or mechanical carriers such as flies.
BACILLARY DYSENTERY – 1-7 days (average of 4 days) · period of
communicability – during acute phase and until (-) stool exam VIOLENT
Incubation period: DYSENTERY – from a few hours to five days (average 3 days) · period of
communicability – until the infectious organism is absent from the bowel
discharges (7-14 days) ·
BACILLARY DYSENTERY · chills · fever · nausea and vomiting ·
tenesmus · severe fiarrhea accompanied by blood and mucus ·
alternating episodes of diarrhea and constipation (chronic) VIOLENT
DYSENTERY
1. Onset
o acute colicky pain in the abdomen
o mild diarrhea (yellowish)
o marked mental depression
Signs and symptoms o headache, vomiting
o fever, may or may not be present
2. Collapse stage – after 1 or 2 days
· profuse watery stools (grayish white or rice water) · thirst ·
severe/violent cramps in the legs and feet · thickly furred tongue ·
sunken eyeballs · ash-gray colored skin
3. Reaction stage – after 3 days
· increased consistency of stools · skin becomes warm and cyanosis
disappear · peripheral circulation improves · urine formation increases
BACILLARY DYSENTERY
• stool exam
Diagnostic
• serologic test
procedure
VIOLENT DYSENTERY
• (+) stool exam/vomitus
Management BACILLARY DYSENTERY
1. Methods of control and prevention
o recognition of disease and reporting
o concurrent disinfection from bowel discharges
o investigation of source of infection (food, water and milk
supplies, general sanitation and search for carriers)
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14 – 21 days
Incubation period:
• period of communicability: before the glands is swollen to the time
present of localized swelling
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PARASITISM
Description:
· PINWORM (Enteropiasis) – oxyuris vermicularis, occurs from fomites,
autoinfection, fecal contamination, affects one in family and invariably
infects entire family. · GIANT INTESTINAL ROUNDWORMS (Ascariasis) –
ascaris lumbricoides, from sputum and ova in soil. · THREADWORM –
strongyloides stercoralis, from fecal soil contamination · WHIPWORM
(trichuriasis) – from fecal soil contamination · HOOKWORM
Etiology:
(ancylostomiasis) – from larvae in fecal soil contamination · TAPEWORM
(taeniasis) Types:
• hymenolepis nana – from fecal contamination
• taenia saginata (beef) – from insufficiently cooked meat
• taenia solium (pork) – contaminated meat
• diphyllobothrium latun – poorly cooked infested fish
PINWORM – mouth GIANT INTESTINAL ROUNDWORMS – mouth
Mode of
THREADWORM – enter usually through the skin or feet WHIPWORM –
transmission:
mouth HOOKWORM – through skin of the feet TAPEWORM - mouth
PINWORM
• eosinophilia, itching around the anus, convulsions in children.
GIANT INTESTINAL ROUNDWORMS
• chest pain, cough after two months, malnutrition, indigestion,
diarrhea, colicky abdominal pain.
Signs and symptoms THREADWORM
• intermittent diarrhea
WHIPWORM – nausea and vomiting, diarrhea, anemia, stunted growth;
may cause prolapse of rectum in children and occasionally appendicitis.
HOOKWORM – anemia, diarrhea, stunted growth, bronchial symptoms,
obstruction of the biliary and pancreatic duct.
PINWORM – adults and ova in stool GIANT INTESTINAL ROUNDWORMS
Diagnostic – adults and ova in stool THREADWORM – larvae WHIPWORM – ova in
procedure stool HOOKWORM – ova in stool TAPEWORM – ova and segments of the
worm in the stool
Management THREADWORM – Prevention: wear shoes and use sanitary toilets
• use of sanitary toilets
• provide hygiene education of the family
• dispose of the infected stools carefully
• meticulous cleansing of skin especially anal region, hands and
nails
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HEPATITIS
Widespread inflammation of the liver tissue with liver cell damage due to
hepatic cell degeneration and necrosis; proliferation and enlargement of
Description:
the Kuffer cells and inflammation of the periportal areas thus may cause
interruption of bile flow.
TYPE A (infectious hepatitis) – occurs in crowded living conditions; with
poor personal hygiene or from contaminated food, milk, water or
shellfish. Common occurrence during fall and winter months usually
Etiology:
affecting children and young adults. TYPE B (serum hepatitis, SH virus,
viral hepatitis, transfusion hepatitis, homologous serum jaundice) TYPE
C (non-A, non-B hepatitis)
TYPE A – fecal/oral route TYPE B – blood and body fluids (saliva, semen,
Mode of vaginal secretions), often from contaminated needles among IV drug
transmission: abusers, intimate/sexual contact. TYPE C – by parenteral route, through
blood and blood products, needles and syringes
TYPE A – 15-45 days
• period of communicability – 3 weeks prior and one week after
Incubation period:
developing jaundice
TYPE B – 50-180 days TYPE C – 7-50 days
Pathophysiology: -
a. Pre-icteric stage · anorexia · nausea and vomiting · fatigue ·
constipation or diarrhea · weight loss · right upper quadrant discomfort ·
hepatomegaly · spleenomegaly · lymphadenopathy b. Icteric stage ·
Signs and symptoms
fatigue · weight loss · light colored stools · dark urine · jaundice · pruritus
· continued hepatomegaly with tenderness c. Post-icteric stage · fatigue
but increased sense of well being · hepatomegaly: gradually decreasing
a. All 3 types · SGPT, SGOT, alkaline phospatase, bilirubin, ER – all
increased in pre-icteric · leukocytes, lymphocytes, neutrophils – all
decreased · prolonged PT b. HEPA A: Hepa A (HAV) in stool before onset
· Anti-HAV (IgG) – appears soon after onset of jaundice, peaks in 1-2
Diagnostic months and persist indefinitely · Anti-HA (IgM) – positive in acute
procedure infection lasts 4-6 weeks c. HEPA B · HbsAG (surface antigen) – positive,
develops 4-12 weeks after infection · Anti-HbsAg – negative in 80% cases
· Anti-HBC associated with infectivity, develops 2-16 weeks after
infection · ABeAG – associated with ineffectively and disappears before
jaundice · Anti-Hbe – present in carriers, represents low ineffectivity
Management a. Prevention I. Type A · good hand washing · good personal hygiene ·
control and screening of food handlers · passive immunization – ISG, to
exposed individuals and prophylaxis for travelers to developing
countries II. Type B · screen blood donors HB3Ag · use disposable
needles and syringes · registration of all carriers · passive immunization
– ISG · active immunization – hepatavax B vaccine and formalin treated
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FOOD POISONING
A gastroenteritis often produced by the presence of a disease organism
Description:
or its toxins.
SALMONELLA GASTROENTERITIS – salmonella typhimurium,
salmonella paratyphi A, B, and C; salmonella newport
Etiology: STAPHYLOCOCCUS GASTROENTERITIS – coagulase – positive, gram
positive: grows rapidly on food containing carbohydrates Recovery:
within 24 – 36 hours BOTILISM – clostridium botulinum
SALMONELLA GASTROENTERITIS – 6 to 48 hours after the ingestion of
Incubation period: contaminated food STAPHYLOCOCCUS GASTROENTERITIS – 2 to 6
hours after ingestion BOTILISM – 24 hours after the ingestion
SALMONELLA GASTROENTERITIS
• headache
• nausea and vomiting
• diarrhea (stools are usually fluid and contain mucus; bloody if in
severe infection)
STAPHYLOCOCCUS GASTROENTERITIS
• sudden abdominal pain
• excessive perspiration
Signs and symptoms
• vomiting
• diarrhea
• pallor weakness
BOTILISM
• peripheral nervous system
Ø vomiting Ø ataxia Ø constipation Ø ocular paralysis Ø aphonia Ø other
neufromascular signs
• paralysis of the respiratory system which may lead to death
Diagnostic SALMONELLA GASTROENTERITIS – history of illness after ingestion of
procedure certain foods
Management SALMONELLA GASTROENTERITIS/STAPHYLOCOCCUS
GASTROENTERITIS
• replacement of fluids and salts
• sedatives and anticholinergic to reduce hypermobility of the
intestine
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•painful urination
FEMALE
• burning sensation upon urination
• presence or absence of vaginal discharge
• pelvic pain
• abdominal distention
• nausea and vomiting
• urinary frequency
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Nurse Licensure Examination Review Handouts
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Nurse Licensure Examination Review Handouts
• diarrhea
• enlarged lymph nodes
• HIV encephalopathy: memory loss, lack of coordination, partial
paralysis, mental deterioration
• HIV wasting syndrome, emaciation
• positive test for HIV antibody
• positive test for presence of HIV itself
• opportunistic infection: neumocystic carinii, cystomegalovirus,
kaposi’s sarcoma
CHLAMYDIAL INFECTION
A sexually transmitted disease that is highly contagious caused by
Description:
chlamydial organism
Etiology: Chlamydia trachomatis
Mode of
2 -3 weeks for males
transmission:
Incubation period: Sexual intercourse
Pathophysiology: -
• pruritus in vagina
• burning sensation in vagina
Signs and symptoms
• painful intercourse
• pruritus of urethral meatus in men
• burning sensation during urination
Diagnostic
Culture of aspirated material from vaginal, anal or penile discharges
procedure
Management
• doxycycline or azithromycin (recommended for pregnant woman)
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Nurse Licensure Examination Review Handouts
TRICHOMONIASIS
Another type of sexually transmitted disease that may also be
Description: transmitted by other means such as handling of infected fomites. It is
caused by a protozoan parasites.
Etiology: Trichomonas vaginalis
Mode of Sexual intercourse, contact with wet towels and wash clothes infected
transmission: by the organism
Incubation period: 4 – 20 days, usually 7 days
• vaginal discharge
Signs and symptoms • burning and pruritus of vagina
• redness of the introitus
• usually asymptomatic in men
Diagnostic
culture of obtained specimen
procedure
• metronidazole
Management • sitz bath may relieve symptom
• acid douches
• tetracyclines may be given on male who are also infected
SMALL POX
For about two decades the WHO has declared that the world is already
Description: “small pox free”. Although eliminated in the world over, the specimen is
still kept in two laboratory facility in the United States.
Etiology: Variola virus (DNA virus)
Mode of
Direct contact or by droplet from person to person
transmission:
Incubation period: 12 days
Signs and symptoms
• high fever
• malaise
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Nurse Licensure Examination Review Handouts
• headache
• back ache
• maculopapular rash in the face, mouth and pharynx (the patients
are contagious after the appearance of the rash)
ANTHRAX
Also known as whoolsorters disease, the capsulated form of this
Description: organism is found in soil worldwide. The organism needs to take about
8,000 to 50,000 to put a person at risk of contracting the disease.
Etiology: Bacillus anthracis
• fever
• cough
Signs and symptoms
• rapid respiratory compromise
• dyspnea
• atelectasis
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Nurse Licensure Examination Review Handouts
• supportive treatment
Management
• provide ventilatory assistance
• use N95 mask to avoid infection
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