UNIVERSITY OF SANTO TOMAS College of Nursing COMMUNICABLE DISEASES NURSING I. Terminology a. Communica Communicable ble diseases diseases – can be transmitte transmitted d through through direct, direct, indirect, indirect, break break in the skin integrity i. Mode Mode of tran transm smis issi sion on 1. Horizonta Horizontall Transmiss ransmission ion a. Direct Direct – a erson erson to erso erson n – face to face face encount encounter er i. !issing ii. ii. "e#u "e#ual al cont contac actt iii. iii. "kin "kin to to skin skin con conta tact ct i$. i$. Drolet Drolet %" &irborn &irborne'Ind e'Indire irect( ct( 1. "our "ource ce of of infe infect ctio ion n a. D) resira resiratory tory drole drolett – drolet drolet nuclei) nuclei) sneezing sneezing,, coughing, singing b. & – resi resirat ratory ory dro drol let et also also *. "ize "ize of sour source ce of inf infect ection ion++ a. D) bigger bigger – it remains remains in a surface surface b. & – small smaller er – sus susen ended ded in air air . Distan Distance ce to to become become inf infect ected ed a. D) -ithin feet of the atient) &H11, meningococcemia b. & – no limita limitatio tion n -ith rega regard rds s to distanc distance e – you cannot sto the breeze of air i. T/, T/, meas measles les,, chic chicke keno no# # c. &irborn &irborne e is more more e#tensi$ e#tensi$e e than than drole drolett b. Indirect Indirect – -ith intermedia intermediary ry ob0ect – there there is a bridge bridge that connects connects you to the indi$idual i. %ehicle ehicle borne) borne) linens, linens, catheter, catheter, bed bed ans, ans, urinal urinal – inanimate inanimate ob0ects ii. %ector borne borne – insects, insects, anthrood anthroods s and rodents rodents,, rats – li$ing things, non human c. /reak in skin integrity– inoculation – blood transfusion, contaminated shar and needles d. &irb &irbo orne *. %ertical ertical Transmiss ransmission ion a. Mother to child transmission – erinatal transmission translacental translacental transmission transmission b. Infectious Infectious diseases diseases – there there is a resenc resence e of li$ing microbes microbes in the body -hich -hich may not be transmitted through ordinary contact c. Contagiou Contagious s diseases diseases – diseases diseases that that can easily easily be transmit transmitted ted d. &ll communic communicable able diseases diseases are are infectious infectious but but not contagious contagious.. i. Tetanus etanus – infec infectio tious us only only ii. DH2 – commu communic nicabl able e and infec infectio tious us e. Three Three factors factors to consi consider der in eide eidemeolo meologic gic triad triad i. Host – either either man or animals animals 3 consider consider the suscetib suscetibility ility of the the host –ertain –ertaining ing to the degree of resistance 1. If resista resistance nce is lo-er lo-ered ed – rone rone to infect infection ion *. Tyes a. 4atie 4atient nt – indi$i indi$idu duals als -ho are infect infected ed -ith signs signs and symto symtoms ms – least source of infection b. Car Carrier – -ho harb arbors ors the the micr icrobes bes but -ith ithout out sign igns and symtoms) -ith higest otential to infect others c. "us "usec ect) t) -hos -hose e medi medica call hist histor ory y and and sym symto toms ms that that he may may be de$eloing a seci5c infection 1
UNIVERSITY OF SANTO TOMAS College of Nursing
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d. Cont Contac actt – -ith -ith clos close e asso associ ciat atio ion n in cont contac actt or e#o e#ose sed d to an infected indi$idual ii. ii. &g &gen entt – micr microb obes es 1. ot all micro microbes bes ossess ossesses es atho athogen genici icity ty)) caac caacity ity of the microbe microbes s to cause an infection *. ot all microbes microbes ossesses ossesses $irulence $irulence – strength strength and o-er of the the microbes microbes to cause an infection . Most Most common common)) bacter bacteria ia and $iru $irus s 6. %irus %irus – only multily multily in li$ing li$ing things7 things7 $ery limited limited anti$iral anti$iral agent agent a. Can ass ass thru thru 5lter in the body body – $ery $ery $ery $ery small small i. /loo /lood d bra brain in barr barrie ierr ii. ii. 4lac 4lacen enta tall b bar arri rier er 1. 8er 8erman man Meas Measle les s – fatal fatal to the reg regna nant nt in 1 st to *nd st trimester7 more fatal in 1 trimester b. "elf limiti limiting ng disease diseases s – kusang kusang gumagali gumagaling ng i. Colds Colds – aden adeno$i o$irus rus,, rhino rhino$ir $irus us 1. *) *) days days – reco$ eco$er ery y *. 9atery atery nasal nasal dis discha charg rge e ii. In:uenza 1. ;eco$ eco$er ery y – < day days s *. If longe longerr – coml comlica icatio tion n – 4M 4M iii. Measles 1. ;eco$ eco$er ery y – * -ee -eeks ks *. If longer longer – comli comlicati cation) on) 4M 4M or enceha encehalitis litis c. 4erma ermane nent nt immu immuni nity ty =. /act /acter eria ia a. Can multi multily ly in li$ing li$ing and non non li$ing li$ing things things i. 9ith 9ith seci5c seci5c antibiotic antibiotics s to seci5c seci5c bacter bacteria ia b. >asy >asy to trea treatt c. Cannot Cannot thru thru 5lters 5lters in the the body body – large large molecules molecules i. "yh "yhil ilis is ) Treo reone nema ma all allid idum um – can can ass ass thru thru lac lacen enta tall th barr barrie ierr – only only afte afterr 1? -eek -eek &@8 &@8 – seco second nd half half of * nd trimester – third trimester7 more fatal in third trimester d. Temora emorary ry immu immunit nity y ?. 4rotozo tozoa a a. 4las 4lasmo modi dium um – mal malar aria ia b. &moe &moeb biasi iasis s <. 2ungi a. ;ing ;ing -orm -orm – Tin Tinea ea i. 4edis edis – feet eet ii. ii. Cor Coror oris is – bod body y iii. iii. Cai Caiti tis) s) head ead i$. i$. Cruci Crucis s – 0oc 0ock k itch itch – had hadhad had $. Angui Anguium um – onych onychomy omycos cosis is – nails nails $i. $i. /arbae /arbae – barb barberB erBs s itch itch – /eard /eard b. Tinea Tinea :a$ia or tinea tinea $ersicul $ersiculor or – malassezi malassezia a furfur furfur – an)an . ;ickettsi ;ickettsia a – tyhus fe$er fe$er – roazek roazeki, i, chuchuga chuchuganami nami iii. >n$iron >n$ironment ment – conduci conduci$e $e and fa$orabl fa$orable e to the gro-th gro-th of micro microbes bes 1. C. tetan tetanii – anaer anaerobi obic c Immunity Immunity – state state of being being resis resistant tant to infec infection tion and and or free free from from infection infection i. atural – inherent inherent in the indi$iduals indi$iduals body body tissues tissues and body :uid) :uid) innate, inborn 1. ;ace ii. &cuir &cuired ed – common, your your body -as able able to roduce roduce antibodi antibodies es or body -as able able to get antibodies *
UNIVERSITY OF SANTO TOMAS College of Nursing 1. &cti$ &cti$e e –an actual actual artic articia iatio tion n of indi$i indi$idua dualBs lBs body tissues tissues and :uids :uids in roducing immunity a. 4;@DAC 4;@DAC> > antibo antibodi dies es yours yourself elf b. atu atura rall lly y acu acuir ired ed – your your body body -as -as able able to rod roduc uce e the the &/ by natural means, unintentionally unintentionally i. "itu ituatio tions to acuir uire+ e+ 4re$i e$ious ous infec fectio tion , subc ubclin linica ical immu immuni nity ty – &/ rod roduc ucti tion on due due to cons consta tant nt e#o e#osu surre to infection c. &rti &rti5c 5cia iall lly y acu acuir ired ed – your your body body -as -as able able to rod roduc uce e the the &/ by arti5cial means, intentionally done i. %accine accines s – attenuat attenuated ed microbe microbes s – a$oid a$oid alcohol alcohol in cleanin cleaning g sites ii. To#oid o#oid – attenuat attenuated ed or -eakened -eakened to#ins to#ins *. 4assi assi$e $e –de$ –de$el elo o due due to res resen ence ce of anti antibo bodi dies es -ith -ithin in the the seru serum m not not coming from himself a. 8>T 8>T &TI &TI/ /@DI> @DI>" " b. aturally aturally acuir acuired ed – by natural natural means, means, unintent unintentiona ionall i. 4lac lacent ental tran trans sfer fer of mate materrnal anti antib bodie odies s – ? mon months ths rotection 1. 1 months months – stay stay of &/ from from the the mother mother ii. /rea /reas stmil milk – col colostr ostru ums – Ig& Ig& – trans ransfe ferr of Ig& Ig& to the the colostrum c. &rti5cial &rti5cially ly acuired acuired – arti5cial arti5cial means, means, intentio intentionall nally y gi$en i. &nti serum ii. &nti to#i to#in n iii. iii. 8amm 8ammag aglo lobu buli lin n i$. i$. Immu Immuno nogl glob obul ulin in g. Immu Immuni niza zati tion on i. &c &cti$ ti$e e – to stimu stimulat late e &/ rodu roduct ction ion 1. 9eakene eakened d micro microbes bes *. 9eak eakened ened to#i to#in n . >Eect+ >Eect+ 6)< days – delayed delayed roduct roduction ion 6. 4roduc 4roduce e &/ as long long as as you you need need it =. Fong Fong lastin lasting g immu immuni nity ty ?. >4I $accines $accines – anti anti rabies rabies $accine, $accine, tetanus tetanus to#oi to#oid, d, ii. 4assi$e 1. 8i$e 8i$e anti antibod bodies ies itself itself *. 4ro$i 4ro$ide de high high titer titer of of &/ &/ . 4ro$ 4ro$id ide e trea treatm tmen entt 6. >Eec >Eect+ t+ imme immedi diat ate e =. "hort "hort li$ed li$ed immuni immunity ty ?. &n &nti ti rabi rabies es seru serum, m, teta tetanu nus s anti antito to#i #in, n, anti anti teta tetanu nus s seru serum, m, ert ertus ussi sis s immunoglobulin, immunoglobulin, hea / gammaglobulin iii. TT and and &T" &T" – IM – deltoid, deltoid, one one in each area area,, searate searate syringe syringe i$. i$. T. To# To#oid oid gi$en gi$en to regna regnant nt 1. >Eect >Eect to /aby+ /aby+ acuire acuired, d, assi$e, assi$e, natur natural al *. >Eect >Eect to regnan regnant+ t+ acti$e acti$e arti5cial arti5cial h. Chain of infec infectiou tious s roces rocess s – cycle i. Causat Causati$e i$e agent agent – micr microbe obes s 1. DH2 DH2 – Deng Dengue ue $iru $irus s *. Mala Malari ria a – 4lasm 4lasmod odiu ium m ii. ;eser$o eser$oir ir – -her -here e it can can multi multily ly 1. Treonema reonema allidum allidum – Human Human a. 8enitals *. &h &h1n 1n1 1 – ani anima mals ls
UNIVERSITY OF SANTO TOMAS College of Nursing
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. Clostrid Clostridium ium Tetani )soil )soil 6. Meas Measle les s – hum human an a. aso asoh har aryn yn# # =. Meningoco Meningococcus ccus – human human – nasohary nasoharyn# n# ?. "almonell "almonella a tyhosa tyhosa – human – intestin intestines es – 4eyerBs 4eyerBs atches atches 4ortal 4ortal of e#it e#it – -ay out to infect infect others7 others7 indi$id indi$idualBs ualBs body body system system 1. Measle Measles) s) resi resira rator tory y *. T. allidum) allidum) rerod reroducti ucti$e $e . "almon "almonell ella a – digest digesti$e i$e 6. Meningoco Meningococcem ccemia ia – resira resiratory tory Mode Modes s of tran transm smis issi sion on)) mann manner er hoho- the the micr microb obes es is acu acuir ired ed )Mea )Means ns of transortation7 diEerent from $ehicle of transmission'source of infection( 1. Meas Measle les s – air airbo born rne e *. ;abies ;abies – bites, bites, scrat scratch, ch, lickin licking g of -ound -ound . "yhil "yhilis is – se#ua se#uall conta contact ct 6. Tyhoid yhoid – fecal oral transmi transmissio ssion n ingestion ingestion a. %ehicle ehicle – feces feces,, fomites fomites,, food 4ortal 4ortal of entry entry – system7 system7 -ay to to enter enter the indi$ indi$idua iduall 1. Measle Measles) s) resi resira rator tory y *. Tyho yhoid id)) 8I . "yh "yhil ilis is)) re rerro 6. Mening Meningoc ococc occemi emia) a) resi resira rator tory y "usc "usce eti tibl ble e host host In breaki breaking ng – any link link – mode of of transmis transmission sion is is the -eake -eakest st link link 1. 2ecal oral oral – -ent from from the the anus anus 33 -ent to the the mouth mouth *. @ral @ral fec fecal factor factor to consi consider der in carin caring g the client client 1. !no!no- the the Caus Causati ati$e $e agen agentt *. !no- the the body secre secretion tion that that harbors harbors the the microbes microbes . !no!no- the mode mode of of trans transmis missio sion n 8ene 8enera rall urs ursin ing g Car Care 1. 4re$ent 4re$enti$e i$e – you you do not ha$e ha$e infect infection ion yet yet a. Health Health educat education ion – chang change e in kno-led kno-ledge, ge, skills skills and attitud attitude e 33 change in beha$ior to-ard health i. 4erson erson that is ultima ultimatel tely y res resons onsibl ible e for Health Health >ducat >ducation ion – MD ii. !ey ro$ide ro$iderr – ; – -e -e al-ays al-ays remind remind the client client b. Immu Immuni niza zati tion on i. >#an >#anded ded 4rogr 4rogram am Immuniz Immunizati ation on – 4D GG? – Marcos Marcos – under under years old ii. Cory &uin &uino o – A goal – uni$er uni$ersal sal child child – 4roc 4roc o. ? – Ander Ander ? years old iii. ;amos) ;amos) health health for 2ili 2iliinos inos – 4roc 4roc o. 6? 6? – under = years years old – national immunity day i$. i$. 4re$e 4re$ent nt < child childho hood od disea diseases ses 1. /C8) T/ *. D4T . Measles 6. @4% =. &M% ?. C Cho hole lera ra,, Dyse Dysent nter ery y , Tyho yhoid id –CDT –CDT – gi$e gi$en n only only during eidemics – gi$es only ? months immunity <. &n &nti) ti) ;abie ;abies s %acc %accine ine – gi$en gi$en to animals animals – bring bring to barangay – barangay catains a. ** ** – 4hili 4hiliine ines s ;abie ;abies s 2ee 2ee 6
UNIVERSITY OF SANTO TOMAS College of Nursing b. *1) *1) Cebu Cebu – rabie rabies s free free . 2 2lu $ac $accin cine – gi$e i$e 5rs 5rst to hea health lth -or -orkers ers 33 regnant 33 elderly , young children G. not not included included in >4I >4I but gi$en gi$en free from from health health center center $. Cont Contra rain indi dica cati tion ons s 1. 4erma ermane nent nt a. &llergy i. MM; MM; – eggs eggs or eom eomyc ycin in – chic chick k embry embryo o and neomycin ii. H/% – bakerBs yeast – both ha$e saccharomyces cere$isiae 33 anahyla#is iii. 2lu $acci $accine) ne) chick chicken en or chicke chicken n roduc roducts ts – egg, feather, meat i$. i$. I4% I4% – inac inacti ti$a $ate ted d oli olio o $acc $accin ine e – "& "&F! F! $accine – allergy to neomycin, stretomycin b. >ncehaloathy -ithout kno-n cause or con$ulsion -ithin < days after ertussis $accine i. Con$u on$uls lsio ion n – indi ndicat cation ion of reac eaction tion in ertussis comonent of drug –DT $accine only7 only7 can cause cause erman ermanent ent neuro neurolog logic ic disorder – encehaloathy ii. ii. >nce >nce halo haloa ath thy y – *6 hour hours s afte afterr D4T, D4T, child is crying in consolably *. Temora emorary ry – reso resol$e l$e 5rst the roble roblem m befor before e gi$ing gi$ing $accine a. 4reg 4regna nanc ncy y i. Cann Cannot ot be gi$e gi$en+ n+ li$e li$e $acc $accin ines es – aEec aEectt fetal 8 and D – MM;, @4%, /C8, %ari$a# – $arice $aricella lla $accin $accine7 e7 %J %JI8 I8 – chick chicken eno# o# if -ith acti$e infected house members b. %ery se$ere se$ere diseas disease, e, se$ere se$ere febril febrile e dis diseas eases es – se$ere 4M c. Immuno Immuno)co )comr mromi omised sed situa situatio tion n i. Cortic Corticos oster teroid oids s thera theray y d. ;ecent ;ecently ly recei$ recei$ed ed blood blood roduc roducts) ts) /T i. 9ait ait for for *) *) mont months hs befo beforre cont contin inui uing ng immunization ii. ii. MM;, MM;, &M% &M%,, %ar %ari$ i$a# a# c. >n$ir >n$ironm onment ental al "anita "anitatio tion n i. 4D =? 1. 8onor 8onorrh rhea) ea) *# er er mont month h *. "yhi "yhilis lis)) 1# 1# er er month month ii. 4roer 4roer diso disosal sal of garbag garbage e – anti litter littering ing la- – 4D 4D *= 1. If thro-in thro-ing g a litter) litter) 5ne of*)=! and and imrison imrison from from ?)1* months d. 4roer 4roer suer suer$isi $ision on of food handlers handlers i. ;eso esons nsib ibil ilit ity y of D@H D@H – sani sanita tary ry ins insec ecto torr – ins insec ects ts the the remises of food establishment ii. 2D& – as of "etem "etember ber *G) *G) food food and drug drug assoc associatio iation n *. Control Control – there there is infection infection77 limit the srea sread d of infection infection a. Iso Isolati latio on – sear earat atio ion n of inf infecte ected d ers erson duri uring eri eriod of communicability =
UNIVERSITY OF SANTO TOMAS College of Nursing
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i. "trict "trict Isolation Isolation – rotect rotect other other ersons ersons becaus because e microbes microbes -ill -ill be -ithin the atient ii. ;e$erse e$erse Isolation Isolation 4rotect 4rotecti$e i$e Isolation Isolation – rotect rotects s the atient7 atient7 the microbes should be a-ay from the atient Kuaran Kuarantin tine e – limit limitati ation on of freed freedom om of mo$eme mo$ement nt of a -ell -ell erson erson during the longest incubation eriod7 searation of -ell yet e#osed indi$idual Disinf Disinfect ection ion)) killin killing g of atho athogen genic ic micro microbes bes by hysic hysical al –boili –boiling, ng, -ashing) or chemical means7 i. "teri "teriliz lizati ation on – includ includes es the the sore sores s Disinfes Disinfestati tations ons – killing killing of undesirabl undesirable e small animal animal forms such such as arthroods and rodents by hysical or chemical means 2umim umimga gati tion on – uses uses gase gaseou ous s agen agents ts77 kill kills s the the arth arthrrood oods s and and rodents Medica Medicall asesis asesis – hand-ash hand-ashing ing – most racti ractical cal -ay -ay and eEecti$e eEecti$e to re$ent sread of infection – 1)1= seconds – 2;ICTI@) most imortant factor of eEecti$e H9 i. Medical Medical ases asesis is – hands hands are lo-er lo-er than than elbo-s elbo-s 1. Ase of barrie barrierr reca recauti utions ons – 44> ersona ersonall rote rotecti cti$e $e euiment) use in direct contact -ith atient7 use 4; a. "euence+ "euence+ go-n 3 mask mask 3 goggl goggles es 3 glo$es glo$es b. ;emo$i ;emo$ing+ ng+ go-n go-n 3 glo$es glo$es 3 do hand hand -ashing -ashing 3 goggles, mask 3 hand -ashing *. 4rinci 4rincile le of 4lacar 4lacarding ding – signage signage in the the bed ii. "urgica "urgicall asesis asesis – hands hands are are higher higher than than elbo-s elbo-s Isolation Isolation recau recautions tions – to re$ent re$ent nosocom nosocomial ial infectio infections ns i. Categ atego ory seci5 eci5c c iso isolatio ation n – 5rst isol isolat atio ion n reca ecauti ution concetualized 1. 4robl 4roblem+ em+ you cannot cannot imleme imlement nt if not diagno diagnosed sed and categorized *. ;esi esira rato tory ry . >nteric 6. 9ound ound reca recauti utions ons ii. Ani$er i$ers sal /loo /lood d and /ody 2luid uid isol isolat atio ion n – Ani$ ni$ers ersal 4reca 4recauti utions ons – imlem imlement ented ed to atie atients nts -ith -ith blood blood borne borne recautions iii. iii. /" /"II – /ody /ody substan substance ce isola isolatio tions ns i$. i$. ;e$ised e$ised isola isolatio tion n recaut recaution ion 1. "tan "tanda darrd rec recau auti tion ons s – rim rimar ary y stra strate tegy gy us used ed in re$e re$enti nting ng nosoco nosocomia miall infec infectio tion n 7 it has taken taken the lace of uni$ersal recaution a. &lie &lies s to the follofollo-ing ing i. &ll atie atients nts regar regardles dless s of their diagnosi diagnosis s ii. ii. /loo /lood d and and body body :uid :uids, s, e#cr e#cret etio ions ns and and secretions e#cet s-eet iii. iii. on on int intac actt ski skin n i$. i$. Muco Mucous us memb membra rane ne b. >sse >ssent ntia iall eleme element nts s i. Ase Ase barrie barrierr reca recauti ution on – used used 4; 4; ii. 4re$ent inad$ertent ercutaneous e#osure – needle stick and shar 7 D@ @T – reca reca, , bend, bend, mani maniula ulate, te, break break needles – one hand recaing iii. iii. Immed Immediat iate e hand -as -ashin hing g and -ashi -ashing ng of other skin surface area ?
UNIVERSITY OF SANTO TOMAS College of Nursing *. Transmiss ransmission ion based recautio recaution) n) instituted instituted to atients atients infe infect cted ed -ith -ith a high highly ly tran transm smis issi sibl ble e infe infect ctio ion n – communicable disease a. 4reca 4recauti utions ons beyon beyond d those those set forth in standar standard d recaution b. &irbor &irborne ne reca recauti utions ons i. ;esi esira rato tory ry rot rotec ecti tion on )ar )arti ticu cula late te resirator resirator – G=) ultra 5ltrable mask ii. ii. H>4 H>4& 5lte 5lterr – high high eLci eLcien ency cy art artic icul ulat ate e air:oiii. iii. >#+ measl measles, es, T/, T/, $aricel $aricella, la, "&;", "&;", a$ia a$ian n :u or bird :u c. Drolet Drolet recau recaution tion –be –be sure sure for the micr microbes obes -ill -ill not ha$e contact -ith con0uncti$a and nasal or oral mucosa i. 8ogg 8oggle les s and and mask mask ii. >#+ meni eningitis, Hib infections, 4M, lerosy, lerosy, &h11, in:uenza, D4, mums d. Contact recaution – rotect self -hen erf erfor ormi ming ng acti acti$i $ite tes s that that reui euirre hysi hysica call contac contactt and and contac contactt -ith -ith inanim inanimate ate ob0ect ob0ects s – glo$es and go-n i. 8i infections) cholera, tyhoid, skin infec infectio tions ns,, scabi scabies, es, ring ring -orm, -orm, heres heres zoster, "TIs, ebola II.
C" Infections a. /acteria i. Tetanus etanus – ainful ainful muscula muscularr sasm sasm – leg crams crams 1. &!& &!&+ Foc Fock0 k0aa*. C&+ Clost Clostridi ridium um tetani tetani – anaer anaerobic obic –soil –soil a. ormal ormal habitat+ habitat+ intesti intestines nes of herbi$or herbi$orous ous animals animals b. "ore) formed -hen outside outside body body – should undergo undergo sterilization sterilization c. 9hen in the the body+ body+ transfor transforms ms into a $egetati$ $egetati$e e form – destro destroyed yed by o#ygen . M@T+ M@T+ -ound – break break in skin skin integrity integrity – any kind kind of -ound -ound a. Tetanus etanus neona neonator torum um – -ound -ound is in the stum stum of the AC – due to oor cord care 6. ;eleases eleases to#in to#in that that -ill bring bring about about systemic systemic symtoms symtoms a. Tetanolysi etanolysin n – dissol$es dissol$es the the ;/C ;/C 33 anemic anemic b. Tetanosas etanosasmin min – muscle sasms7 sasms7 acts of the myo)neural myo)neural 0unction 0unctions s of the muscles and internuncial 5bers of the sinal cord and the brain – sasm of all muscles of the erson =. Incubatio Incubation n eriod eriod – days to 1 month a. "horter "horter the I4, oor oorer er rog rognosi nosis s b. Initia Initially lly,, -ound -ound in:amm in:ammati ation on i. ;ubor, ubor, calor, calor, dolor, dolor, tumor, tumor, 2ACTI@ 2ACTI@ F@"" F@"" ?. "ign "igns s and and sym symt tom oms s a. Initially Initially sigs of -ound -ound in:ammatio in:ammation n b. Increased Increased muscle muscle tone tone near near the -ound -ound c. Tachycard achycardia, ia, rof rofuse use s-eati s-eating ng d. FoFo- grad grade e fe$e fe$err e. 4ainfu 4ainfull muscular muscular sasms sasms – in$oluntar in$oluntary y muscle contrac contraction tion f. Musc Muscle les s aEec aEecte ted+ d+ i. Masset Masseter er muscle muscle – mastica masticatio tion n muscle muscle 3 lo- 0a- trism trismus us – rigidity of 0a- muscles <
UNIVERSITY OF SANTO TOMAS College of Nursing ii. ii. 2acial acial muscle muscle – ;isus ;isus "ardon "ardonicu icus s – "ardo "ardonic nic "mile "mile – giti giting ng aso) smiling -ith eyebro-s raised iii. >#tensor >#tensor muscles muscles of the sine) sine) oistho oisthotonu tonus s osition) osition) archin arching g of the back back ) naka)liyad naka)liyad 1. "ide "ide lyi lying ng os osit itio ion n <. Diagnostics+ Diagnostics+ no seci5c7 clinical obser$ations and history history of of -ound -ound a. 4atient 4atient -ith -ith rigidity rigidity of 0a0a- muscle muscle – ask if she has -ound, -ound, bluok bluok na ngiin or nagkaroon ng sugat . Medi Medica call manag managem emen entt a. @b0e @b0ec cti$e ti$e++ i. eut eutra rali lize ze the the to to#in #in 1. &T") anti tetanus tetanus serum T& T&T – Tetanus anti to#in to#in a. "kin test *. TIg – teta tetanus nus immun immunogl oglobu obulin lin a. Huma Human n seru serum m ii. ii. !ill !ill the the micr microb obes es 1. &n &nti tiob obio ioti tic) c) 4C 4C *. Dail Daily y clea cleans nsin ing g of the -oun -ound d – beta betadi dine ne -ith -ith "", "", hydrogen ero#ide a. Thin Thin dr dressi essing ng iii. iii. 4re$e 4re$ent nt and and con contr trol ol sas sasm m 1. Musc Muscle le rela# ela#an ants ts a. 4arenteral – Diazeam – I%4 or I% Dri 'regulation+ 'regulation+ according according to freuency freuency of sasm – more freuent, faster dri( – should be al-ays in $ein – irritating to the $ein b. Table ablett for form m i. Methocarb Methocarbamol amol – ;obo ;obo#in #in or or ;oba#i ;oba#isan san ii. ii. Fior Fiores esal al – /ac /aclo lofe fen n iii. iii. >er >eris ison one e – Myo Myona nall G. urs ursin ing g car care e a. Maintain Maintain adeu adeuate ate air-a air-ay y and $entilatio $entilation n b. Maintain Maintain an an I% line line – for emerg emergency ency drugs drugs c. Monitor Monitor clien clients ts for for signs signs of arr arrhyth hythmia mia d. 4re$ent 4re$ent client client from from ha$ing ha$ing sasm sasm – reduce reduce stimuli stimuli i. >#te >#terroce oceti ti$e $e – outs outsid ide e – brig bright ht ligh lightt and and nois noise, e, air air from from electric fans ii. Interoce Interoceti$e) ti$e) -ithin -ithin the the atient atient – :atulence, :atulence, stress, stress, ain ain iii. iii. 4ro 4rorio rioce ceti$ ti$e e – artic articia iatio tion n of atien atientt and others others)) 0arrin 0arring g the bed, touching the ain, turning the atient 1. 8entle 8entle Hand Handlin ling g the the atien atientt *. Minima Minimall handling handling of the atient atient – a$oid a$oid unneces unnecessa sary ry disturbing the atient a. @rganiz @rganize e and clust cluster er care care – do all all in one one setting setting e. 4re$e 4re$ent nt clien clientt from from in0ur in0ury y i. 2alls alls)) mos mostt com commo mon n ii. ii. e$er e$er lea$e lea$e atie atient nt alone alone iii. iii. 4added added side side rails rails and and call call light light i$. i$. 2ract ractur ure e f. 4ro$ 4ro$id ide e comf comfor ortt measu measurres 1.4re$ention a. Immu Immuni niza zati tion on i. D4T 1. ? -ee -eeks ks aft after er birt birth h *. doses doses -ith -ith 6 -eeks -eeks inte inter$a r$all
UNIVERSITY OF SANTO TOMAS College of Nursing . 6. =. ?. <.
.= cc IM – %astus astus Fatera Fateralis lis >#ect >#ect fe$er fe$er to set set in @bser$e @bser$e for for con$ul con$ulsion sions s -ithin -ithin < days days &ly &ly -arm comr comress immedi immediate ately ly – $asod $asodila ilatio tion n to enhance absortion . &fter ter * minu minute tes) s) cold cold com comrress ess – %C to decr decrea ease se s-elling G. If -ith loca locall tendern tenderness ess,, %C 5rst 5rst then after after *6 hours hours hot comress ii. ii. Tetan etanus us to to#oid oid nd 1. * trimester – regnancy *. * rimar rimary y doses doses -ith -ith 1 month month inter$a inter$all . /oos /ooste terr dose doses s dee deend nds s on mother mother77 e$er e$ery y time time she she gets regnant 6. IM – Del Delto toiid =. .=cc ?. 2irst irst dos dose e – toda today y nd <. * – one month after . rd – ? months G. 6th – 1 year 1.=th – 1 year 11.Fo- risk – booster dose e$ery 1 years 1*.High risk – /D e$ery = years b. 4ro 4roer er -ou -ound nd car care e i. 9ash) ash) soa soa and runnin running g -ater -ater ii. ii. Thin Thin dres dressi sing ng iii. iii. /and /and aid and and Medi Medilas lastt are alloallo-ed ed c. &$oid $oid -oun -ounds ds b. Meninigit Meninigits) s) in:amm in:ammation ation of menin meninges ges i. C&+ 1. %irus – CM% – Cytomegalo$irus Cytomegalo$irus – not athogenic7 athogenic7 oortunistic oortunistic infections *. 2ungus ungus – Crytococ Crytococcal cal Meningitis Meningitis – Crytococc Crytococcus us eoformans eoformans – e#creta e#creta of birds – oortunistic infections . /act /acter eria ia a. T/ meningiti meningitis s – in:ammation in:ammation of meninges meninges caused caused by tubercle tubercle bacilli bacilli b. "tahyloc "tahylococcu occus s aureus aureus – secondar secondary y to skin infecti infection on c. 4n 4neu eumo moco cocc ccal al meni mening ngit itit its) s) ". neu neumo moni nia a – seco second ndar ary y to resi esi infection d. Mening Meningoc ococc occal al meningit meningitis is – mening meningoco ococc ccemi emia a "ott "otted ed fe$er fe$er – most fatal and highly contagious) caused by+ . meningitides i. @nly tye tye of meningi meningitis tis -here -here in in $ascular $ascular system system is aEected aEected 33 at risk for DIC 33 intra$ascular bleeding 33 $ascular collase 33 death ii. ii. @nly @nly 1 1 ar are dyi dying ng iii. iii. "igns "igns and symtom symtoms+ s+ -ater -aterhou house se fride frideri richs chsen en – fulmin fulminant ant tye tye of meni mening ngoc ococ occe cemi mia a 33 ?)*6 ?)*6 hour hours, s, ati atien entt die7 die7 intra$ascular bleeding, uncontrolled ii. M@T+ M@T+ Drol Drolet et – Direct Direct iii. iii. IC+ IC+ *)1 *)1 days days i$. i$. "igns "igns and symtoms symtoms – Meningo Meningococc coccemia emia ) etechi etechiae ae and and ecchymos ecchymoses es 1. asoh asohar aryn# yn# 33 A;TI A;TI 33 colds, colds, cough, cough, body body malais malaise e 33 /loods /loodstr tream eam 33 $ascular system aEectation 33
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UNIVERSITY OF SANTO TOMAS College of Nursing a. 33 4etechia 4etechiae e formation formation – in oint oint red red sots sots on the skin, skin, Narang Narang kagat kagat ng langga langgamO, mO, aly aly ress ressur ure e – the redne redness ss dis disa aea ears rs – insect bite7 the redness remains – etechiae i. Tumbler umbler test – clear clear glass glass to chest for for etechia, etechia, side side of glass glass alied to the susected etechial formation formation b. 33 >cchymosi >cchymosis s – blotchy ururi ururic c lesions lesions – antal antal antal – reddish reddish $iolet *. 33 meninges meninges 33 nuchal nuchal rigidity rigidity – stiEenin stiEening g of the neck, you cannot cannot :e#, :e#, hyere#tend or turn to side to side the neck a. 33 !ernigBs !ernigBs sign sign – lace lace the atient atient in suine suine osition osition 33 :e# :e# the knees to-ards the abdomen 33 e#tend the leg i. 4osit ositi$ i$e+ e+ ati atien entt -ill -ill com comla lain in of ain ain or diL diLculty lty in e#tending the legs after :e#ion of the knees – ain on the hamstring – back of thigh b. 33 /rudzin /rudzinski ski sign sign – lace lace atient atient in suine suine ositio osition n 33 2le# 2le# the neck i. ega egati ti$e $e++ no react eactio ion n ii. 4ositi$ 4ositi$e+ e+ in$olunt in$oluntary ary dra-ing dra-ing u u of the e#tre e#tremity mity or the the his uon :e#ion of the neck . 33 increa increase se IC4 – decreased decreased absorti absortion on of C"2 C"2 a. "e$ere H& b. 4ro0ect 4ro0ectile ile $omit $omiting ing – *) feet feet a-ay a-ay c. < <er ered ed %" %" – cush cushing ingBs Bs tria triad d i. Pteme Ptemerat ratur ure e – infec infectio tion n ii. Dec ;; an and 4; 4; iii. Psystolic Psystolic,, normal normal diastoli diastolic c – -idening -idening ulse ulse ressur ressure e d. "eizure and con$ulsion) con$ulsion) altered altered ressure ressure in the intracranial intracranial ca$ity e. Diloia Diloia – chokin choking g of the otic otic disk disk – double double $ision $ision i. Test usi using ng 5nge 5ngerr count counting ing f. &F@C $. Diag Diagno nost stic ics s 1. Fumbar Fumbar unctur uncture e – asir asiration ation of C"2 C"2 a. Color+ i. Qello-ish, ello-ish, turbid, turbid, cloudy cloudy – infection, infection, bacteri bacterial al etiology etiology ii. ii. Clear Clear C"2 – norm normal, al, may be $ira $irall b. Fabo Fabora rato tory ry e#am e#am++ i. Caused Caused by bacter bacterial+ ial+ e#ect e#ect that that the the C"2 -ill -ill ha$e incr increase eased d CH@, 9/C and decreased sugar ii. ii. %iral %iral++ PCH@, PCH@, P9/C, P9/C, norm normal al sugar sugar c. Culture Culture and and sensiti$it sensiti$ity y – to determine determine the the seci5c seci5c microbes microbes and and the aroriate drug d. CI> CI>) Coun ounter ter Immu Immun no >lectr ectro ohor hores esis is – to deter etermi min ne if the the causati$e agent is a $irus or rotozoa e. CI+ highly highly increased increased IC4) IC4) could could cause brain brain herniatio herniation n 33 death *. /lood Cultu Culture re – microbes microbes can can tra$el to the the bloodstr bloodstream eam $i. $i. Medi Medica call Man Manag agem emen entt 1. &ntimi &ntimicr crobi obial al thera theray y *. &nti)in:a &nti)in:ammato mmatory ry – Corti Corticost costero eroids ids a. o rednis rednisone one – does not not cross cross /// – causes causes a retenti retention on b. De#ametha De#amethasone sone or Hydrocort Hydrocortison isone e '"olu)cort '"olu)cortef( ef( . @smo @smoti tic c diu diurretic etic a. Mannitol i. Chec Check k I and and @ – 5rs 5rstt ii. Check Check /4) /4) "> of manni mannitol tol is hyotens hyotension ion 6. &ntic &nticon$ on$uls ulsant ant – sho short rt term term 1
UNIVERSITY OF SANTO TOMAS College of Nursing a. 4h 4hen enyt ytoi oin n ) Dila Dilant ntin in i. 4er oral oral – do fre freue uent nt oral oral car care and and mass massag age e – can can caus cause e gingi$al hyerlasia) gum o$ergro-th ii. ii. 4er I% I% – "and "and-ic -ich h it -ith -ith "" "" 1. Crystall Crystallizati ization on of the the drug drug in the the I% tubin tubing g b. Hyda Hydant ntoi oin n $ii. $ii. urs ursin ing g car care e 1. &ss &ssess ess neur neurolo ologic gic funct function ions s *. Mainta Maintain in adeu adeuate ate nutri nutritio tion n and eliminat elimination ion – to re$e re$ent nt consti constiat ation ion – strain ) PIC4 . >nsur >nsure e clien clientBs tBs comfor comfortt a. H& – di$ersio di$ersional nal – soft soft music7 music7 no readin reading g and -atchi -atching ng T% i. >le$a >le$ate te H& H& of of bed bed – *) *) angle angle ii. on stimu stimulatin lating g en$iro en$ironment nment – dim and and uiet uiet room room iii. 8entle 8entle nursing nursing massage massage)) etrissage etrissage or fricti friction on – inde# inde# 5nger and middle 5nger 6. "ymto "ymtomat matic ic and and syo syorti rti$e $e $iii $iii.. 4re$ 4re$en enti tion on 1. Immun Immuniza izatio tion n – /C8, /C8, Hi$ Hi$ *. 4roer 4roer disos disosal al of nasohar nasoharyngea yngeall secretion secretions s a. /est /est -ay -ay++ s-al s-allolo-ing ing b. CM% and and T/ – do not s-all s-alloo- – can can aEect aEect stomach stomach . Co$ering Co$ering nose nose and mouth mouth -hen -hen sneezin sneezing g and coughin coughing g c. >ncehalit >ncehalitis) is) in in:amma :ammation tion of of brain brain and ence encehalo halon n i. &!& &!&+ bra brain in fe$e fe$err ii. C&+ &rbo$irus &rbo$irus – arthr arthrood ood borne borne $irus $irus iii. iii. Clas Classi si5c 5cat atio ions ns 1. 4rimary 4rimary >. – the $irus $irus aEects aEects the brain brain directly directly ) communi communicabl cable e a. "t. "t. Fouis ouise e b. Ra Raanes anese e/ c. &u &us stra tralia lian S d. >uine >uine – >aster >astern n and 9ester 9estern n >ncehal >ncehalitis itis e. M@T+ i. Mos Mosui uito to bite bites s 1. &ede &edes s soll sollic icit itan ans s *. Cule Cule# # tars tarsal alis is ii. ii. Ticks icks of hors horses es iii. iii. Migr Migrat ator ory y /ird /irds s *. "eco "econd ndar ary y >. – befo beforre the the brai brain n -as -as infe infect cted ed,, ther there e -as -as a re$ re$io ious us infection a. & comlicatio comlication n of a certain certain disease disease – measles, measles, chicken chickeno o#, #, mums, ost $accine encehalitis – anti ;abies $accine . To#ic o#ic > – not caused caused by $irus, caused caused by metal oison oisoning ing – mercury mercury and lead oisoning i$. i$. Manifesta Manifestation tions+ s+ same as meningit meningitis is 1. Initia Initially lly – beha$i beha$iora orall chang changes es – &F &F@C @C – letha letharg rgy y – abnor abnormal mally ly slee sleey y or diLcult to a-aken $. Diagno Diagnost stics ics++ same as men mening ingiti itis s 1 . F4 a. Clea Clearrs C"2 C"2 b. Increase Increase CH@, CH@, increa increase se 9/C, 9/C, normal normal glucose glucose *. >>8 – to to determi determine ne e#tent e#tent of brain brain in$ol$emen in$ol$ementt a. 9ith 9ith resid residual ual eile eilesy sy or brain brain damage damage $i. Medica Medicall manage managemen ment+ t+ symto symtomat matic ic $ii. $ii. ursin ursing g Care+ Care+ same same as menin meningit gitis is 11
UNIVERSITY OF SANTO TOMAS College of Nursing $iii $iii.. 4re$ 4re$en enti tion on 1. >radicate mosuito ) insecticide, insecticide, insect reellant, reellant, screen -indo-s *. CF>& a. Chemically Chemically treated treated mosuit mosuito o net – ermethrin ermethrin soluti solution on – soak for 1) * days – air dry for *) days7 can be used for )? months b. Far$a eating eating 5sh 5sh – lar$ lar$i$or i$orous ous 5shes c. >n$ironmen >n$ironmental tal sanitatio sanitation n – 64M habit habit d. &nti &nti mosu mosuito ito soa soa – basil basil soa soa e. eem eem tree tree >uca >ucaly lytus tus tree tree d. 4olio oliomy myel elit itis is i. &!&+ 1. Infant Infantile ile araly aralysi sis s *. &cute &cute 2laccid 2laccid 4aral 4aralysis ysis – athogm athogmnomo nomonic nic sign sign a. "oft "oft,, :abb :abby y and and lim lim . Heine) Heine) MedinB MedinBs s Dise Diseas ase e ii. C&+ 4olio 4olio$irus $irus – Fegio Fegio Debilit Debilitans ans – enter entero$ir o$irus us 1. Tye 1 – /runhilde /runhilde – causes causes ermane ermanent nt immunity immunity *. Tye II) II) Fansing Fansing – temora temorary ry immunity immunity . Tye III) III) Feon – temorary temorary immun immunity ity iii. iii. Ho- to acu acuir ire e and and M@T M@T+ 1. >arl >arly y+ Duri During ng the 5rst 5rst 6 days days of infe infect ctio ion n – micr microb obes es can can be found found in haryngeal area) drolet direct *. Fate+ =th day on-ard) on-ard) intestines – fecal oral transmission i$. i$. 1 years years old old and and belo-) belo-) more more susc suscetib etible le $. 4oliomy oliomyeli elitis tis 33 33 1 years years old old 33 1. In$asi$e In$asi$e stage stage or &borti$e &borti$e stage – microbes microbes -ill -ill in$ades in$ades the body7 body7 atient -ill reco$er, aborting the infection a. 33 nasoh nasohary aryn# n# 33 tonsi tonsils ls 33 resi resirat ratory ory infectio infections ns symto symtoms ms 33 "ore throats, fe$er, chills, H&, body malaise b. 33 Mouth Mouth 33 4ayers 4ayers atche atches s 3. 8I symtoms symtoms 33 abdom abdominal inal ain ain and anore#ia, %, diarrhea or congestion *. 4re) 4re) ara araly lyti tic c stag stage e – ati atien entt has has in$o in$ol$ l$em emen entt -ith -ith C" C" but but -ith -ithou outt aralysis a. 33 CF) CF) cer$ cer$ica icall lymh lymh node node b. 33 MF MF – mesen mesenter teric ic lymh lymh node node c. CF and and MF MF 33 bloo blood d stream stream 33 33 C" C" i. 33 se$e se$erre musc muscle le ain ain – -ar -arm bath bath or -ar -arm com comrress7 ess7 narcotic analgesic – Codeine – does not in$ol$e resiratory deression ii. ii. 33stiE 33stiEnes ness s of hamstr hamstring ing iii. iii. 33 HoyneBs HoyneBs sign sign – head dro dro – lift shou should ld of atien atientt -hen in suine – head -ill be lagging or droing i$. i$. 33 4oke 4okerr "ine "ine – oisth oisthotonu otonus s -ith -ith head head retrac retraction tion ) cannot cannot assume sitting osition $. 33 Tri Triod od ositi osition on – to assume assume sittin sitting g osition osition – use both hands to suort the back . 4aral aralyt ytic ic "ta "tage ge a. Tyes yes of of ara aralys lysis is i. /ulbar /ulbar – crani cranial al ner$es ner$es)) any of of the 1* – most most fatal fatal 1. Most aEected aEected++ G and 17 $agus $agus – resi resirato ratory ry symtoms symtoms ii. ii. "in "inal al tye tye)) most most comm common on 1. &n &nte teri rior or hor horn cell cell – moto motorr func functi tion on – e#tr e#trem emit itie ies s ara araly lysi sis, s, eith either er ue uerr and and lo-e lo-er, r, ara araly lysi sis s of intercostals intercostals muscles iii. iii. /u /ulb lbo) o)s sin inal al 1*
UNIVERSITY OF SANTO TOMAS College of Nursing 1. &n &nte teri rior or HC and and C C 6. &s long as the atien atientt did not enter enter the aralytic aralytic stage, stage, the rogno rognosis sis is good. $i. $i. Diag Diagno nost stic ic e#a e#am m 1. Fumbar Fumbar unctur uncture) e) same same as enceh encehalit alitis is *. Throat Throat -ashing -ashing or throa throatt culture culture – limitati limitation+ on+ only in the the 1 st 6 days . "too "tooll e#a e#am m – =th day on-ards $ii. $ii. Medi Medica call man manag agem emen entt 1. "ymto "ymtomat matic ic and and suo suorti rti$e $e *. If -ith resira resiratory tory aralysi aralysis s – M% – Iron Fung Machine Machine – egati$e egati$e 4ressur 4ressure e breathing a. o uer uer clothing clothing)) check check for rise rise and and fall of chest chest $iii $iii.. urs ursin ing g car care e 1. "u "uor orti$e ti$e *. 4sych 4sycholo ologic gical al care care i#. i#. 4re$ 4re$en enti tion on++ 1. Immu Immun nizat izatio ion n a. @4% @4% – "abi "abin n i. ? -eek -eeks s afte afterr birt birth h ii. ii. dose doses s -ith -ith 6 -eeks -eeks inter inter$al $al iii. iii. *) *) gtt gtts s orem orem i$. i$. o feed feeding ing for minu minutes tes $. If $omi $omited ted – ree reeat at $acc $accin ine e $i. $i. If -ith -ith diar diarrh rhea ea,, gi$e gi$e the $acci $accine ne but do not count count it as a dose $ii. /e careful careful in handl handling ing the the stool – only only $accine $accine that that the $irus $irus -ill be eliminated in the stool $iii. $iii. If -ith immun immune)com e)comro romised mised family family member member,, do not gi$e gi$e the $accin $accine e leuk leukemia, emia, stero steroid id thera theray) y) to rote rotect ct the other other family members to be infected 1. Instea Instead d gi$e gi$e I4% '"alk( '"alk( a. ? -eek -eeks s afte afterr bir birth th b. .=cc c. IM *. &$oid $oid M@T e. ;abies – disease of a lo- form form of animal – -arm blooded blooded animals – dogs, cats, cats, raccoon, skunk ,bat accidentally transmitted to man i. &!&+ &!&+ hydro hydrohob hobia, ia, Fyssa, yssa, Fa ;age ;age ii. C&+ ;habdo ;habdo $irus $irus 'neur 'neurotr otroic oic)) high aLnity aLnity to neurons( neurons( iii. M@T+ M@T+ Contact Contact -ith -ith sali$ sali$a a of a rabid rabid animal animal i$. i$. 4athath-ay ay of $iru $irus s 1. ;habdo ;habdo $irus 33 eriher eriheral al ner$es ner$es 33 central central ner$ous ner$ous system 33 egri egri /odies – athologic lesions that are formed as microbes multily 7 if there is no multilication – no egri bodies *. ;hab ;habdo do $iru $irus s 33 33eE eEer eren entt ner$ ner$es es33 33 sali sali$a $ary ry glan gland d – -her -here e sali sali$a $a is roduced $. I4 1. &n &nim imal als s – ) ) -ee -eeks ks a. Dumb Dumb stage stage – comle comlete te change change in dis disos ositi ition on or beha$ior beha$ior – either either become becomes s -ithdr -ithdra-n a-n ) stays stays in one corn corner, er, stays stays uiet uiet @; $ery $ery aEectionate – -alks in and fro – manic b. 2urious urious stage stage – animal is easily easily agitated agitated 33 easily easily bite 33 $icious $icious look, drooling of sali$a, animal -ill die *. Humans Humans – 1 days)y days)year7 ear7 *1 *1 years7 years7 a$erage a$erage + 1) 1) months months a. In$asi In$asi$e $e stage stage – $agu $ague e symto symtoms ms 1
UNIVERSITY OF SANTO TOMAS College of Nursing i. /it /ite e -ill -ill be numb, numb, itchy itchy or or ainf ainful ul ii. 2lu like like symtoms symtoms – fe$er, fe$er, sore sore throat throat iii. iii. Mark Marked ed inso insomn mnia ia i$. i$. ;estless, estless, arehens arehensi$e, i$e, irritab irritable le $. !aag !aag bite alang, alang, not not caable caable of infec infecting ting other others s b. >#ci >#cite teme ment nt sta stage ge i. &ero eroho hob bia ii. ii. Hydr Hydro oho hob bia iii. Can cause cause haryn haryngo)lar go)laryngo yngosas sasm m ainf ainful ul i$. i$. "-allo-i "-allo-ing ng can can cause cause sas sasms ms – ainful ainful $. Droo Drooli ling ng of sali sali$a $a $i. $i. Maniac Maniacal al beha$io beha$iorr – rabid animal animal – easily easily agitat agitated, ed, $iolen $iolent, t, climb the -alls and 0um in the -indo1. &ntis &ntisych ychoti otic c agent agents s a. Halo Haloeri erido doll – Haldol Haldol )IM b. /enadryl /enadryl – sedati$e sedati$e hynotic hynotic eEect eEect – IM IM c. 4aral aralyt ytic ic "ta "tage ge i. o sasms ii. ii. 4aralys aralysis is -ill set it – raid raid and rogre rogress ssi$e i$e aralys aralysis is – from from toes going u $i. 9ithin 9ithin *6)<*, *6)<*, atient atient -ill -ill die – after after the the symtoms symtoms aear aear $ii. Diagnost Diagnostics ics – done befor before e signs and and symtoms symtoms aear7 aear7 all done done to animals animals 1. /rain /rain biosy biosy – resenc resence e of egri egri bodies bodies *. D2& D2& test) Direct 2luorescent 2luorescent antibody antibody test for rabies) rabies) con5rmatory con5rmatory . @bser$ati @bser$ation on of animals animals '1 days( days( a. If dog dog died died -ithin -ithin 1 1 days days – animal animal is rabid rabid b. 2actors actors if dog -ill be obser$ obser$ed ed i. "ite "ite of the the bite bite – mm er hour hour 7 if -aist -aist u, u, no need need for obser$ation ii. ii. >#te >#tent nt of the bite bite – big bite, bite, dee dee bite, bite, multi multile le bite bite – no need to obser$e, instead $accine iii. ;eason eason for the the bite bite – :ight :ight or 5ght 5ght reso resonse nse of the the dog 1. 9as the dog dog ro$ok ro$oked ed or unro unro$ok $okedU edU a. 4ro$o 4ro$oke ked) d) no need need to to -orry -orry b. Anro Anro$ok $oked ed – 9@;; 9@;;QV $iii $iii.. Medi Medica call mana manage geme ment nt – ost ost e#o e#osu surre ro rohy hyla la#i #is s – less lessen ens s chan chance ces s of de$eloing rabies but not 1 guarantee 1. &cti$e &cti$e immuni immunizati zation on – anti anti rabie rabies s $accine $accine a. 4%;% 4%;% – 4uri5ed %ero Cell %accine %accine – %erorab %erorab – .=ml .=ml b. 4D>% – 4uri5ed 4uri5ed Duck Duck >mbryo %accine %accine – Fyssa$ac Fyssa$ac – 1cc 1cc $ial c. 4C>% – 4uri5 4uri5ed ed chick chick embryo embryo $accine $accine – ;abi ;abiur ur – 1cc $ial $ial d. 8i$e 8i$en n er er IM i. Do skin skin test testin ing g e. 8i$en er er intrade intraderma rmall – no need need for skin testin testing g f. "ite+ i. &d &dult ult++ Delto Deltoid id are area a – IM or or ID ii. ii. Child Child++ %ast %astus us latera laterali lis s g. "chedule i. doses ii. Day , , day <, day day *1 – al-ays al-ays add add from from the 5rst dose iii. IM 1. Day – * $ials $ials – one one for each each side side *. Day Day <) <) 1 $ia $ial . Day Day *1 *1 – 1 $ia $iall 16
UNIVERSITY OF SANTO TOMAS College of Nursing 6. If comlete comleted d doses doses – immunity immunity for for years7 years7 if bitten bitten – gi$e only booster doses =. If dog got got lost lost,, kill killed ed – 5nis 5nish h the the dose doses s W boos booste terr doses ?. /oost /ooster er dose dose – day day G – 1 $ial $ial i$. ID 1. .1cc on each site '%erorab( .* cc 'Fyssabac;abiur( a. D b. D c. D< *. 1 cc on on 1 site site .* cc 'Fyssa 'Fyssabac; bac;abi abiur( ur( a. D*) b. DG *. 4ass 4assi$e i$e immun immuniza izatio tion n a. Coming Coming from from anim animal al seru serum m b. >;Ig – euine euine ;abies ;abies Immunoglo Immunoglobuli bulin n i. &;" &;" –ant –antii ;ab ;abie ies s "er "erum um ii. Hyer;ab iii. 2a$irab i$. i$. "kin "kin test test befo before re gi$in gi$ing g 1. If osit ositi$e, i$e, ro$ide ro$ide human human serum serum a. H;Ig) H;Ig) human human rabies rabies immunoglo immunoglobuli bulin n i. Imogram ii. ;abuman c. Dosa Dosage ge is com comut uted ed accor accordi ding ng to /9 – the the mor more -t, -t, the the mor more amount i. .*cc .*cckg kg /9 – anima animall seru serum m 1. &;" *. Hyer;ab . Imogam ii. ii. .1c .1cc c kg kg /9 /9 – human human serum serum 1. Imogram *. ;abuman d. 8i$en 8i$en only only -ithin -ithin < days days e. 8i$en 8i$en IM IM – $ent $entro roglu glutea teall i. If -ith -ith dee, dee, multile multile and and big bite bite – di$ide di$ide the the dose then then one one is gi$en $entrolgluteal7 other is in0ected around the bite – 6 oint site in0ection 1. eck eck u bite bite – MD MD *. eck eck do-n do-n bite bite – ; ; i#. i#. urs ursin ing g Car Care 1. !ee -ater -ater out of site site *. "ymto "ymtomat matic ic and and suo suorti rti$e $e . Dim and uiet uiet en$ironmen en$ironmentt – hotosensiti hotosensiti$e $e and easily easily agitated agitated 6. ;oom should be be a-ay from from sub utility utility room room – -here -here -e -ash -ash articles =. ;estrain estrain the atient atient befor before e maniacal maniacal beha$ior beha$ior sets sets in ?. 4ro$ision 4ro$ision of comfort comfort measures measures – let atient die die -ith dignity dignity and comfort #. 4re$en e$enttion ion 1. /e a res resons onsibl ible e et et o-ner o-ner *. Ha$e Ha$e the anim animals als immun immunize ized d . If one dog dog is rabid rabid in a community – gi$e &;% &;% to all dogs in the community community 6. !ee a-ay from from stray animals animals – greater greater chance of e#osure e#osure to $irus =. !ee anim animals als cage caged d or chain chained ed #i. %irus %irus can can die after after ?C heat for = = seconds seconds.. 1=
UNIVERSITY OF SANTO TOMAS College of Nursing III.
Circulatory "ystem a. %irus rus – DH2 DH2 b. 4rot 4rotoz ozoa oa – Mal Malar aria ia c. DH2 i. ot the the same same as as hemor hemorrh rhagi agic c fe$er fe$er ii. C&+ &rbo$irus &rbo$irus – arthr arthrood ood borne borne $irus $irus 1. Dengue Dengue %irus %irus 1,*,, 1,*,,6 6 *. @nyo @nyong ngyo yong ng %ir %irus us . Chiku Chikungu ngunya nya %iru %irus s 6. 9est est ile ile =. 2la$i$irus 2la$i$irus – eidemic eidemic in the the 4hili 4hiliines ines iii. iii. M@T M@T+ mosu mosuit ito o bite bite 1. &edes &edes &egyti &egyti – biological biological transmit transmitter ter – after )11 )11 days, the mosuito mosuito can sread the $irus – nagiging art na ng system ng lamok yung $irus *. Fife Fife san san of of mosu mosuito ito++ 6 months months . >$en the lar$a lar$a contain contains s the the $irus $irus 6. Day bitin biting g – no no seci5c seci5c time of the the day day =. Clear Clear stagn stagnant ant -ater -ater ?. FoFo- :yin :ying g mos mosui uito to <. 8eog 8eogra rah hic ical al loca locati tion on – urba urban n area areas7 s7 any any art art of the the 4h 4hil ili ii ine nes s is a Dengue risk area i$. i$. %irus 33 blood stream 33 multily multily 33 multile multile lesions lesions in blood stream stream 1. 33 inc increas eased ca cailla llary frag fragiilit lity 33 eas easy bleed eeding – dec decreas eased thrombocytes *. 33 increas increased ed cailla caillary ry ermeab ermeabili ility ty 33 alloallo- :uid shift shift 33 edema 33 ascites 33 lasma leakage – blood is concentrated – hemoconcentration $. Mani Manife fest stat atio ions ns 1. Dengue Dengue -ithout -ithout -arn -arning ing signs signs – Dengu Dengue e grade 1 a. High High grade grade fe$er fe$er – )= day day i. &ntiyretics &ntiyretics – ;TC) TC) decline in Temerature, gradual b. 4ain 4ain – H&, retro retro)or )orbit bital al ain – behind behind eyes, eyes, 0oint 0oints s and bone bone ains ains,, abdominal ain c. aus ausea ea and and $om $omit itin ing g d. 4etec 4etechia hiae e format formation ion Herman Herman sign sign – genera generaliz lized ed redness redness of the skin, generalized :ushing e. D>8 D>8A A> 2>%> 2>%>; ; @F @FQ – no act actual ual bleedi eedin ng – D&D &DQ fe$er e$er,, /;>&!/@> fe$er *. Dengue Dengue -ith -ith -arning -arning signs signs – -ith -ith actual actual bleedin bleeding g a. ose ose – eista eista#is #is,, gum blee bleedin ding g b. Hema Hemate teme mesi sis, s, mele melena na c. Hema Hemato tocc cche hezi zia a . 4rese 4resence nce of se$e se$ere re DH2 a. "igns "igns of circu circulat latory ory failu failure re i. Cold Cold clam clammy my skin skin ii. ii. Cold Cold e#tr e#trem emit itie ies s iii. 4rolon 4rolonged ged cailla caillary ry re5ll re5ll – seconds seconds or more more – sluggish sluggish 1. ormal ormal – 1)* secon seconds7 ds7 less less than than seconds seconds i$. %" 1. Dec Decreas ease /4 *. ;aid ;aid but but -eak -eak uls ulse e – thread thread . ;aid ;aid resi resirat ration ion 6. Dengue Dengue shock shock syndr syndrome ome a. Hyo Hyo$o $ole lemi mic c shoc shock k $i. $i. Diag Diagno nost stic ic++ 1?
UNIVERSITY OF SANTO TOMAS College of Nursing 1. Tourniuet ourniuet or ;umel Feede Feede Test Test – test for caillary fragility7 resumti$e resumti$e test a. Chec Check k on /4 /4 of at atie ient nt b. &dd " and D c. Di$ide by by * d. Kuotient Kuotient – amount amount of in:ati in:ation on of the /4 /4 cuE e. In:a In:ate te for i. Chil Childr dren en – = minu minute tes s ii. ii. &dult dult – 1 1 min minut utes es f. De:ate g. &ssess &ssess for res resence ence of etec etechiae hiae format formation ion h. Count Count etechia etechiae e in one suare suare inch i. Mor More than than or eua euall to * ete etech chia iae e in one sua suarre inch inch – ositi$e result i. Criteria Criteria befor before e erforming erforming Tourniu ourniuet et Test+ Test+ i. &g &ge e of atien atientt is ? months months or older older – -ith rote rotecti ction on agains againstt infection ii. ii. 2e$er e$er of of more more than than days days iii. o other other signs signs of DH2 DH2 – fe$er fe$er is the the only only comlain comlain *. /lood >#am – latelet latelet count count – lolo- – con5rma con5rmatory tory a. Hematocrit Hematocrit – hemocon hemoconcent centrati ration on – high $ii. ii. Mana Manag gemen ementt 1. "ym "ymto toma mati tic c a. o as asiri irin n – anti anti latel latelet et b. 4ro$ 4ro$id ide e coag coagul ulan ants ts i. %itam itamin in ! ) met metha hadi dion one e c. Incr Increa eas se @2I @2I d. @resol @resol to maintain maintain Intra$asc Intra$ascular ular $olume $olume $iii $iii.. urs ursin ing g car care e 1. 4re$ent 4re$ention ion and and contr control ol of of bleedin bleeding g *. Incre Increase ase body body resi resista stance nce . o dark dark colo colore red d food foods s 6. &$oid &$oid red meat – in rearation rearation for occult blood blood test) days before before e#am a. /eef /eef and and li$ li$er er i#. 4re$en e$enttion ion 1. >rad >radic icat ate e mosu mosuit ito o *. CF>& CF>& 4rog 4rogra ram m d. Malaria i. &!&+ ag ague ii. !ing !ing of of tro troi ical cal dis diseas eases es iii. iii. C&+ C&+ 4roto 4rotozoa zoan n – las lasmod modium ium 1. %i$a# %i$a#)) common common in in 4hili 4hilii ines nes *. 2alciaru alciarum m – most fatal – microbe microbe -hich -hich has a tendency tendency to multily multily $ery raidly7 common in 4hiliines . @$ale 6. Mala Malarriae i$. M@T+ 1. mos mosuito ito bite – &nohe ohele les s mos mosuito ito – fema emale – sucks blood lood for for reroduction7 biological transmitter a. ight ight biting biting – suns sunset et to sunrise sunrise b. Clear sloslo- :o-ing :o-ing -ater – rural rural areas – mountain mountainous ous and forested forested areas i. < ro ro$in $inces ces)) endemi endemic c in mala malaria ria *. /loo /lood d tran transf sfus usio ion n . Contamina Contaminated ted shars shars and needles needles 1<
UNIVERSITY OF SANTO TOMAS College of Nursing $. 4lasmo 4lasmodiu dium m 33 /loo /loodst dstre ream am 33 1. ;/C ;/C – -her -here e some some micr microb obes es -ill -ill be rer eroduc oducin ing g 33 rut rutur ures es afte afterr reroduction 33 anemia7 ruturing chills 33 fe$er – microbes -ill be back to the /" *. Fi$er – -ill -ill not destroy destroy the li$er, li$er, -ait for the li$er li$er to release release ;/C ;/C for them to enetrate a. not all microb microbes es -ill enetra enetrate te the ;/C7 ;/C7 tambay tambay lang yung yung iba) can li$e for )= years $i. $i. Mani Manife fest stat atio ions ns ) chil chills ls bef befor ore e fe$e fe$err 1. "tages a. Cold Cold "tag "tage– e– 1)1 1)1= = minut minutes es i. Chill Chilling ing sensa sensatio tion n – shakin shaking g of the body body or shatte shatterin ring g of the lis ii. !ee the atient atient -arm -arm – blanket blanket,, hug, ro$id ro$ide e -arm drinks drinks,, e#ose atient to dro light, alication of hot -ater bag in the soles b. Hot Hot "tag "tage e – 6)? 6)? hou hours rs i. 4res 4resen ence ce of of fe$e fe$err 1. H&, abdo abdomin minal al ain ain and and $omiti $omiting ng ii. ;+ ;+ lo-er do-n do-n the the body temera temeratur ture e – T"/, cold cold comres comress, s, light loose clothing, :uids – you cannot immediately increase the :uid intake of atient7 if -ith neurologic sign, no need 33 increase IC47 antiyretics c. 9et stage i. >#cessi >#cessi$e $e s-eat s-eating, ing, feeling feeling of -eakne -eakness ss ii. ;+ 1. Make Make atien atientt comfort comfortable able – rest rest *. !ee atien atientt -arm -arm and dry . Incr Increa ease se @2I @2I *. 2e$er e$er – normal normal or or subnor subnormal mal a. @ther infectiou infectious s diseas diseases es –high –high fe$er . "e$e "e$erre anem anemia ia 6. Cer Cerebra ebrall hyo hyo#i #ia a a. ;estlessness, ;estlessness, confusion, delirium, F@C, coma, con$ulsions =. /lac /lack k -ate -aterr 2e$er e$er – ass assin ing g out out blac black k urin urine e or dark dark red urin urine e – rai raid d destruction of ;/C) falciarum $ii. $ii. Diag Diagno nost stic ics s 1. Malari Malarial al "mear "mear)) before before fe$er fe$er *. K/C –Kuantita –Kuantitati$e ti$e /uEy Coat) Coat) raid test test for malaria) malaria) immediately immediately e#trac e#tractt blood $iii $iii.. Medi Medica call mana manage geme ment nt 1. &n &nti ti mal malar aria iall a. Chloroui Chlorouine ne – mainst mainstay ay drug drug for treatme treatment nt b. 4rim 4rima aui uine ne c. 2ansidar d. &tab tabrin rine e. Kuin Kuinin ine e – $ery $ery 5rst 5rst de$el de$elo oed ed77 reser eser$e $ed d drug drug – gi$e gi$en n only only if in se$ere stage i. If -ith -ith resista resistance, nce, gi$e &rtemesia &rtemesia &nnua &nnua f. &rte &rteme meth ther er – from from arte arteme mesi sia a annu annua) a) 5rst 5rst line line of anti anti mala malari rial al agents) IMCI g. &borti &bortifac facien ientt agent agents s i. Cautio Cautious usly ly used used for re regna gnant nt -omen -omen ii. ii. ot ot a contr contrai aind ndic icat atio ion n iii. eonatal eonatal malari malaria a – child child from from an untreated untreated malari malarial al mother mother 1
UNIVERSITY OF SANTO TOMAS College of Nursing
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1. "e$er "e$erely ely anemi anemic c 33 die i#. 4re$ent 4re$ention+ ion+ >radicate >radicate the mosuito mosuito Integumentary "ystem a. /acteria i. Ferosy b. %irus – >ruti$e >ruti$e 2e$er 2e$er – manifested manifested by erutions erutions and rashes i. Measles ii. ii. 8er 8erman man Mea Measl sles es iii. iii. Chic Chick ken o# o# i$. i$. Her Heres es Jost Joster er $. If erution erutions s are found found in in mucous mucous membrane membrane – enanth enanthem em $i. >rut >rution ions s of skin skin – e#an e#anthe thema ma $ii. $ii. >rut >rution ions s ) chara characte cteri risti stics cs 1. Macu Macule le – :at :at ras rashe hes s *. 4au 4aule le – ele$ ele$ate ated d rash rashes es . %esicle esicle – ele$ated ele$ated rashes rashes 5lled 5lled -ith -ith :uid :uid 6. 4us 4ustule) tule) ele$ated ele$ated rashe rashes s 5lled 5lled -ith -ith us us c. Ferosy i. &!&+ &!&+ Hansen HansenBs Bs Diseases Diseases Hansen Hansenosis osis ii. Hansen Hansenite ites s – aEected aEected -ith -ith ler lerosy osy iii. C&+ acid fast bacilli bacilli – Mycobacte Mycobacterium rium lerae lerae i$. M@T+ 1. 4rolon 4rolonged ged intima intimate te skin skin to skin contact contact *. Drolet Drolet – high concent concentrati ration on in resirato resiratory ry secretion secretions s $. IC+ IC+ =.= =.= mont months hs – yea years rs $i. $i. Car Cardina dinall sig signs ns 1. 4erihe 4eriheral ral ner$e ner$e enlarge enlargement ment *. Foss of sensat sensation ion – not all all body body arts arts . 4ositi$ 4ositi$e e skin smear smear test test for mycobac mycobacteri terium um lerae lerae $ii. Tyes+ 1. 4aucib 4aucibacil acillary lary tye) tubercu tuberculoid loid a. on infect infectious ious)) less less tenden tendency cy to infect infect b. /en /enign ign tye tye – mild mild mani manife fes stati tatio ons7 reco$ eco$er ery y is good ood 7 good ood rognosis c. Mild d. 1)= skin skin atc atches hes and and nodul nodules es *. Multibaci Multibacillar llary y – leromato leromatous us tye a. Infectious Infectious)) highly highly communic communicable able b. Mali Malign gnan antt tye tye c. "e$ere "e$ere manifes manifestatio tations ns 33 33 Could Could cause cause death death d. More More than than = skin atches atches or or nodules nodules . ;egardles egardless s of tye) tye) same manifesta manifestation tions s $iii $iii.. "ign "igns s and and "ym "ymto toms ms 1. >arly a. Color chang changes es in skin skin that do not not disaear disaear e$en e$en -ith -ith treatment treatment – hyoigmentation – namumuti yung balat ng atien7 mistaken for Nan)anO b. "kin lesions lesions that does not heal e$en e$en -ith treatment– treatment– ring -orm like7 like7 mistaken for fungal infection c. 4ain 4ain and and redn redness ess of the the eyes eyes d. Muscle Muscle -eakness -eakness and and aralys aralysis is of the e#tr e#tremiti emities es e. asal asal obstru obstructio ction n and and nose nose bleed bleeding ing f. &Eected area i. Foss oss of sens sensat atio ion n ii. ii. Foss Foss of hair hair gr gro-th o-th 1G
UNIVERSITY OF SANTO TOMAS College of Nursing iii. iii. &n &nhy hydr dros osis is *. Fate a. Fago Fagot thl hlam amus us)) inab inabil ilit ity y to clos close e the the yeli yelids ds – tulo tulog g na er ero dila dilatt arin yung mata or half oen b. Madarosis Madarosis – loss of eyebro eyebro-s -s eyelash eyelashes es c. "adlle)no "adlle)nose se Deform Deformity ity ) "inking "inking of the the bridge bridge of the the nose i. &s art art of the disea disease se roce rocess ss)) ther there e is absor absort tio ion n of the smal smalll bone bones s – brid bridge ge of the the nose nose,, cart cartil ilag age e of the the ears ears,, 5ngers and toes 33 they undergo natural amutation – no need to bring to @; – it comes by nature, no ain 'loss of sensation( d. Feonin Feonine e face – resem resembl bling ing a face of a lion lion – no eyebro eyebro-s, -s, trian triangle gle nose e. Contractur Contracture e – cla-ing cla-ing of of the 5ngers 5ngers and the the toes f. Chr Chronic onic ski skin n ulc ulcer ers s i. 4rob 4roblem lem++ skin skin infect infection ions s g. Male+ -ith -ith gynecoma gynecomastia stia – enlar enlargemen gementt of the breast breast i#. Diagnosis 1. "kin "kin "me "mear ar Test est *. "kin Fesion Fesion /iosy /iosy – to rule rule out out malignan malignancy cy . Fer Ferom omin in tes testt a. Rust Rust like like skin skin test testing ing i. In0e In0ect ct the the anti antige gen n in the arm arm 33 see the reac reacti tion on of the the atient b. To determi determine ne tye tye of ler lerosy osy 6. /lood lood e#am #am a. 9asser asserman mann n ;eact ;eaction ion test test #. Medi Medica call Mana Manage geme ment nt 1. Multi Multile le Drug Drug Ther Theray ay 'MDT( 'MDT( a. 4rinci 4rincile+ le+ combinati combination on of drugs drugs i. it -ould -ould re re$en $entt drug drug resist resistanc ance7 e7 ii. ii. it -ould -ould hasten hasten reco$ reco$ery ery77 iii iii. to les lessen erio eriod d of comm commu unica nicab bilit ility y 'af 'after * -ee -eeks of treatment, atient -ill be non communicable( b. & &r roa oach ches es i. 4auciba aucibacil cillar lary y Treatm reatment ent 1. ;ifam ;ifamici icin n – @nce @nce a mon month th *. Fam Famrrene ene – @D . ?)G mont month hs ii. ii. Multib Multibaci acilal lalry ry Tre Treatm atment ent 1. ;ifam ;ifamici icin n – once once a mon month th *. Da Dasone one – @D @D . Fam Famrrene ene @D @D 6. 1* 1*)1 )1 mon month ths s c. "hould "hould go to the the health health center center e$ery * days days – D@H d. 4atient should be be atient enough enough to go go to the health center center.. e. >#ected >#ected side side eEects that that are consid considere ered d to be harmless harmless i. ;ifamic ;ifamicin in – orange orange urine urine,, tears, tears, sali$a, sali$a, s-eat s-eat,, stool ii. Famrene Famrene – hyerig hyerigment mentation ation of of the skin skin – darkenin darkening g of the skin f. >#ected >#ected side side eEects eEects because because of the the to#in to#in releas released ed by the death death of microbes i. Ferae Ferae reacti reaction on – micr microbes obes are are starting starting to die die 1. Do not not disc discont ontin inue ue the the drug drug *. 8o to HC to treat treat symtoms symtoms symto symtomati maticall cally y *
UNIVERSITY OF SANTO TOMAS College of Nursing . Mild Mild – ;>"T >"T a. ;edden ;eddening ing in in and around around the the nodule nodule b. >dema c. "udden "udden incr increase ease in number number of of lesion lesions s d. Tenderness enderness and ain ain on the the ner$es ner$es 6. "e$er e$ere e )I" )I"& & a. Iritis Iritis – in:a in:amma mmatio tion n of the the iris iris b. "udden "udden acute acute araly aralysis sis c. &cute &cute orchit orchitis is – in:ammatio in:ammation n of testes testes ii. ii. Manage Managemen mentt – symto symtomat matic ic treat treatmen mentt g. "ide eEects eEects that that -ould -arra -arrant nt disconti discontinuan nuance ce of drug drug i. ;ifam ;ifamic icin in – heato heatoto to#ic #icity ity ii. Dasone Dasone – generali generalized zed rashes rashes or or itchin itchiness ess iii. Famrene Famrene – dryness dryness or :aking :aking of the the skin skin #i. #i. urs ursin ing g Car Care 1. 4sycholo 4sychologica gicall asect of care care – lo- self self esteem, altere altered d body image, social social stigma *. "kin "kin car care . 4ro$ 4ro$id ide e or >nco >ncour urag age e hys hysic ical al e#er e#erci cise se – to str strengt engthe hen n musc muscle les s and and re$ent contracture 6. 4ro$i 4ro$ide de drug drug infor informat mation ion #ii. #ii. Does Does not cros cross s the lacen lacental tal barrie barrierr – 0ust 0ust delay delay the treat treatmen ment) t) -ait for the mother to deli$er because drugs ha$e teratogenic eEect #iii #iii.. 4re$ 4re$en enti tion on 1. Immu Immuni niza zati tion on – /C8 /C8 *. &$oid $oid M@T d. Measles i. &!&+ &!&+ ;ubeol ;ubeola, a, Morbili, Morbili, Hard Hard Measl Measles, es, Fittle Fittle ;ed Disease Disease,, < day day measle measles, s, G day st measles, 1 disease 1. ? common common rash rash forming forming diseases diseases in A" A" a. 1) Mea Measles les b. *) "carlet "carlet fe$er fe$er "carlatin "carlatina a – stra-ber stra-berry ry tongue tongue c. ) 8er 8erman man mea measl sles es d. 6) DukeB DukeBs s Disease Disease 2ilat 2ilato$ o$ Disease Disease e. =) Hun Hungar garian ian Meas Measlles "la lae ed Chee Cheek k Disea iseas se >ryth ythema ema Infectiosum f. ?) ;oseo oseola la Infa Infant ntum um >#an >#anth them em Crit Critic icum um >#an >#anth them em "ubi "ubitu tum m Tigdas Hangin – children children ? months u u to years old old g. ) comm common on in 4hi 4hili lii ines nes ii. C&+ C&+ 4aran 4aranas aso o $irus) $irus) ru$e ru$eola ola $iru $irus s iii. iii. M@T M@T+ air airbo born rne e i$. "tages 1. 4re) 4re)er eru uti ti$e $e a. /efor /efore e rash rashes es aear aears s b. High High grade grade fe$er fe$er for for )6 days days c. Cs i. Cough ii. Colds iii. Con0unc Con0uncti$it ti$itis is – in:ammatio in:ammation n of the con0unc con0uncti$a ti$a – uLness uLness of of eyelids, e#cessi$e nasolacrimal discharge 'muta( d. 4h 4hot otos osen ensi siti ti$i $ity ty e. !olic !olick k sots – 5ne red red sot -ith -ith bluish bluish -hite -hite sots sots at the center center – 4athogmnomonic sign7 seen in inner cheek, 0ust beside the molar – tabi ng bagang i. &fter fter *6 *6 hours hours 3 >rut >ruti$e i$e stag stage e *1
UNIVERSITY OF SANTO TOMAS College of Nursing *. >ru >ruti ti$e $e "ta "tage ge a. Macu Maculo) lo)a au ula larr rash rashes es – reddi eddish sh in colo color, r, blot blotch chy y ae aear aran ance ce – antal antal i. 2ollo ollo- the hair hair line line – 5rst 5rst in beh behin ind d the ears ears,, face face ,neck ,neck ,trunk e#tremities – Cehalocaudal ii. ii. 9hen 9hen to to aea aear+ r+ day of illn illness ess 1. 9ithin 9ithin to to *) days days entire entire body body -ill -ill ha$e ha$e rashes rashes . 4ost ost eru eruti ti$e $e sta stage ge a. ;ashes ;ashes -ill -ill disaear disaear by ha$ing ha$ing a 5ne, branny branny desuam desuamatio ation n – from red 3 bro-n 3 eel oE i. @nly the the rashes rashes -ill -ill be eeling eeling oE, oE, not the the -hole -hole skin skin b. In the the roa road d to reco$ reco$ery ery $. Diagnost Diagnostics+ ics+ Clinical Clinical @bser$ati @bser$ation on $i. $i. Mana Manage geme ment nt++ "ym "ymto toma mati tic c 1. &ntibiot &ntibiotics ics – treat or re$ent re$ent secondary secondary bacteri bacterial al infections infections a. Com Comli lica cati tion on++ i. bronc broncho ho 4M 4M – can cause cause deat death h ii. ii. ence enceh hal alit itis is iii. iii. otit otitis is medi media a $ii. ursing ursing care+ care+ "ymtoma "ymtomatic tic and and "uo "uorti$ rti$e e 1. Maintain Maintain and and increase increase body body resist resistance ance of of atient atient a. &d &de eua uate te nutri nutriti tion on *. !ee atient -arm -arm and and dry – to re$ent comlications like 4M . 4re$ent 4re$ent e#osur e#osure e to draf draft) t) hamog hamog 6. Can still still bath bathe e the the atie atient nt $iii. 9hen commun communicabl icable+ e+ 6 days before before and and = days after after aearan aearance ce of rashes rashes i#. Highly Highly communi communicabl cable+ e+ before before aea aearanc rance e of rashes rashes #. 4re$en e$enttion+ ion+ 1. Immu Immun nizat izatio ion n a. &M% &M% – G mo months ths i. .=cc ii. "K – Delto eltoid id iii. iii. May de$e de$elo lo fe$e fe$err – gi$e anti antiyr yreti etic c i$. i$. &fter &fter )6 days days the child child may e#er e#erience ience mild mild rash rash formatio formation n– normal reaction to the $accine – good reaction, childBs body -as stimulated to antibody reaction b. MM; i. 1*)1= *)1= mont months hs ii. "K iii. iii. Delt Deltoi oid) d) .= .=cc cc i$. i$. Can be gi$en gi$en to adult and adolesce adolescent nt $. If female female of childbe childbearin aring g age) no reg regnanc nancy y for months months 33 can cause congenital defect c. During During eidemi eidemic c – gi$e &M% &M% or MM; at the age age of ? months months but but the child -ould ha$e to be re$accinated at age of 1= months) booster dose *. 4roer 4roer disosal disosal of 4 4 secret secretions ions e. 8erm 8erman an Meas Measle les s i. &!&+ &!&+ day disease, disease, ;ubella, ubella, ;oteln ;oteln ii. C&+ 4seudo 4seudoara aramy# my#o$ir o$irus us – Toga Toga or ;ubel ;ubella la %irus %irus iii. iii. M@T M@T+ Dro Drole lett i$. "tages 1. 4re 4re eru erut ti$ i$e e a. 4resenc 4resence e or absence absence for fe$er fe$er – if resent, resent, only only for 1)* days b. *Cs) *Cs) cou cough gh and and col colds ds **
UNIVERSITY OF SANTO TOMAS College of Nursing
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c. >nanthem >nanthem – 2orsch 2orscheimer eimerBs Bs sot sot – 5ne red sots sots or etechial etechial sots sots – soft alate i. If seen seen 3 atient atient -ill -ill de$elo de$elo eruti eruti$e $e stage stage *. >ru >ruti ti$e $e "ta "tage ge a. 4resenc 4resence e of rashes – macula macula oular oular rashes rashes are inkish inkish in color color and discreet aearanc aearance e – smaller than in measles i. 9her 9here+ e+ aea aears rs in ceh cehalo alocau caudal dal 1. 2ace 3 neck 3 trunk trunk 3 e#trem e#tremities ities ii. ii. *6 hour hours s ent entir ire e bod body y b. >nlarge >nlargement ment of lymh lymh nodes nodes – one factor factor to diEerentia diEerentiate te M and 8M7 diEerential diagnosis i. "ubo "ubocc cci iat atal al lym lymh h nod node e ii. ii. 4osteri osterior or auricu auricular lar F iii. iii. 4osteri osterior or cer$ic cer$ical al F . 4ost ost >ru >ruti ti$e $e a. ;ashe ;ashes s disa disae ears ars on the the rd day of illness b. ;oad oad to to rec reco$ o$er er c. >nlar >nlarged ged F grad gradual ually ly subsi subsides des $. Diagno Diagnost stic ic e#am+ e#am+ same same as as measle measles s $i. Medica Medicall manage managemen mentt – same same as measl measles es $ii. $ii. ursin ursing g care care – same same as as measl measles es $iii. $iii. 4re$e 4re$ent ntion ion – same same as meas measles les i#. Communica Communicable+ ble+ durin during g entire entire cours course e of disea disease se st #. 2atal only if if in regnant regnant -omen -omen – during during 1 – *nd trimester 33 Congenital defects 1. Micr Microc oce eha haly ly *. Congenit Congenital al heart heart defect defect – T@2, T@2, %"D, %"D, 4D& 4D& . Congenit Congenital al cataract cataract – could could lead lead to blindn blindness ess 6. Deafne Deafness ss and mutism mutism =. >#osure >#osure only only can also redisose redisose your child to these these congenital congenital defects a. ;ecei$e ;ecei$e gamma gammaglob globulin ulin -ithi -ithin n <* hours hours or days days Chicken 4o# i. &!& &!&+ %ar %aric icel ella la ii. C&+ C&+ %ar %arice icella lla Jost Joster er %iru %irus s 1. Can be found found on the nasoha nasoharyn ryngea geall secre secretio tions ns and secre secretio tions ns of the rashes *. Can cause cause infectio infection n if it enters enters the naso nasohary haryn# n# . "kin to skin skin contact) contact) cannot cannot acuir acuire e chickeno chickeno# # iii. iii. M@T M@T+ &irb &irbor orne ne i$. i$. Mani Manife fest stat atio ions ns 1. 2or *6)6 hours hours – mild mild manifes manifestatio tations ns a. 4resence or absence of lo- grade fe$er – rior to rashes aearance b. H&, bod body y malais malaise, e, muscl muscle e ain ain *. %esiculo)u esiculo)ustul stular ar or $esiculo)a $esiculo)aular ular rashes rashes a. >arl >arlie ier+ r+ =)1 rashe rashes s that that are are :at :at muna muna)) macu macule le 33 ele$ ele$at ated ed – aule -ith another set of macule 33 $esicle 33 ustules b. Itchy i. Must Must tell tell atien atientt to take take a bath bath dail daily y 1. Fuke Fuke -arm -arm -ater bathe bathe – katam katamtaman tamang g lamig ng ng tubig tubig c. ;utu uturre+ Coul Could d de$e de$elo lo into into boil boil ) igs igsa, a, uru urunc ncle le)) big big boil boil , carbuncle) dikit dikit na gsa, cellulitis – skin infection, gangrene d. 4ermanen 4ermanentt scarr scarring ing 3 4ock 4ock marks e. Ho- distr distribu ibuted ted++ general generalize ized d i. Co$ered Co$ered arts arts of the body body – 5rst 5rst to aear aear – Trunk Trunk and and scal scal *
UNIVERSITY OF SANTO TOMAS College of Nursing f.
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&bunda &bun dant ntly ly found found in co$e co$erred arts arts than than in e#os e#osed ed arts arts of the the body g. 9ith 9ith unifocula unifocularr aearanc aearance) e) one focus focus – aears aears one at a time but ne$er fuses together i. !aag !aag nagd nagdiki ikitt dikit dikit – Here Heres s Joster Joster h. ;ashes ;ashes could could also be seen seen in mucous mucous membrane membrane – buccal, buccal, $agina $agina i. 9hen reco$e reco$ering ring++ rashes rashes -ill -ill star to crust crust 'dry(, 'dry(, falls falls oE 'eel 'eel oE( – by itself $. Diagnost Diagnostic) ic) clinical clinical e#amina e#amination tion $i. Medica Medicall manage managemen mentt – "ymto "ymtomat matic ic 1. &nti$iral &nti$iral agent agent)) decrease decrease durati duration on of illness illness a. Jo$ira# Jo$ira# ) &cyclo &cyclo$ir $ir – =# er day – < ) 1 days days i. Cream+ Cream+ re$ent re$ent skin infec infection tions s – not the ock ock marks marks *. &ntir &ntiruri uritic tic agents agents $ii. $ii. urs ursin ing g car care e 1. "u "uor orti$e ti$e a. "kin ca care b. &d &deu euate ate nutr nutriti ition on and and rest rest $iii. Communica Communicable+ ble+ until until all rashe rashes s ha$e crust crusted ed and dried dried i#. i#. 4re$ 4re$en enti tion on++ 1. Immu Immun nizat izatio ion n a. %aricella aricella $accine $accine ) %ari$ %ari$a# a# i. 1*)1 *)1 mont months hs ii. ii. .=c .=cc c – "K – Del Delto toid id iii. If less less th than an 1 years old – single single dose dose only only i$. i$. 1 and and abo$e abo$e – * doses doses -ith 1 month month inter$a inter$all $. 2e$er $i. $i. &fter fter )6 days days,, mild mild rash rash form format atio ion n – nor normal mal react eactio ion n to $accine *. 4roer 4roer disos disosal al of nasohar nasoharyngea yngeall secretion secretion g. Heres Heres Joster Joster – dormant tye tye of chicken chicken o#7 inacti$ inacti$e e tye – you cannot acuir acuire e HJ unless you ha$e had C4 i. Asual Asually ly infect infected+ ed+ adults adults ii. &!&+ &!&+ "ingl "ingles, es, Jona, Jona, &cute &cute 4oste 4osterio riorr 8angli 8anglioni onitis tis – gangl ganglion ion of oster osterior ior ner$e roots iii. iii. C&+ C&+ %ar %arice icella lla Jost Joster er %iru %irus s i$. i$. M@T+ M@T+ Dire Direct ct Dro Drol let et $. Mani Manife fest stat atio ions ns 1. "ame "ame as as chi chick cken en o o# *. %esicu esiculo) lo)a aula ularr rashes rashes a. 4ainful b. Itchy c. >$en atient atient has has reco$er reco$ered, ed, ain ain may ersist ersist u u to * months months d. o genera generaliz lized ed distri distribut bution ion e. 9ith 9ith unila unilater teral al distribu distributio tion n – rashes rashes follo-s follo-s the ner$e ner$e ath-a ath-ay y – longitudinal, longitudinal, $ertical f. & &e ear ars s in in c clu lust ster er g. ot only only in the skin) skin) can be be on mucous mucous membran membrane e – hard hard alate alate $i. Diagno Diagnost stics ics++ Clini Clinical cal @bser$ @bser$ati ation on $ii. $ii. Medica Medicall Managem Managemen ent+ t+ symtom symtomati atic c $iii. $iii. ursin ursing g care care++ suo suorti rti$e $e i#. 4re$e 4re$ent ntion ion++ same same as chick chicken en o# o# ;esiratory "y "ystem a. /acteria i. Dihtheria *6
UNIVERSITY OF SANTO TOMAS College of Nursing ii. 4ert ertus uss sis iii. iii. 4neumo eumoni nia a i$. i$. Tuber ubercu culo losi sis s b. %irus i. Colds ii. In:uenza c. Dihth Dihtheri eria a – contagi contagiou ous s diseas disease e i. &Eec &Eects ts all all age age grou grous s ii. Causes Causes gener generali alized zed to#e to#emia mia iii. C&+ Coryneb Corynebacter acterium ium dihthe dihtheria ria – klebs klebs FeoXer FeoXer /acillu /acillus s i$. i$. M@; M@;+ Direc Directt dro drole lett $. Mani Manife fest stat atio ions ns 1. asal asal ty tye a. Irrit Irritati ating ng nasal nasal dis discha charg rge e – sero)s sero)sang anguin uinou ous s secre secretio tions ns -ith -ith foul foul mousy odor b. Aer Aer li li and and nasal nasal e#coria e#coriation tion c. 4seudomem 4seudomembran brane e is found in nasal nasal setum setum –needs –needs nasal seculu seculum7 m7 co$ered by irritating nasal discharge i. 8rayis 8rayish h -hite -hite memb membra rane ne – ash ash lik like e *. 4h 4har aryn ynge geal al fauc faucia iall a. "or "ore thr throa oatt b. Dys Dyshagi hagia a c. &reciat &reciated ed 4seudomem 4seudomembran brane e – soft alate, alate, u$ula, u$ula, illars illars of tonsils tonsils d. ec eck edem edema a – anter terior ior uer er asec ect of the nec neck+ /ull ull eck eck &earance i. In:amm In:ammati ation on of cer$ic cer$ical al F . Faryngeal Faryngeal – M@"T M@"T 2&T&F a. &Eec &Eects ts $oic $oice e bo bo# b. Hoarsenes Hoarseness s of $oice, $oice, ahonia ahonia 'loss 'loss of $oice( – temora temorary ry c. D@/, D@/, dysne dysnea7 a7 to comen comensa sate+ te+ use of accessor accessory y muscle muscles s – chest chest retractions, chest indra-ing d. /arking, /arking, dry dry metallic, metallic, crouy, crouy, dry dry husky husky cough cough e. ;esir ;esirator atory y distre distress ss or or arres arrestt $i. Diagn iagnos osttics ics 1. ose and thr throat oat s-ab s-ab – con5r con5rmator matory y test *. "chick test test – to determine determine immunity immunity or suscetibil suscetibility ity to Dihtheria . Moloney Test – to determine hyersensiti$ity hyersensiti$ity to Dihtheria Dihtheria antito#in antito#in $ii. $ii. Medi Medica call Mana Manage geme ment nt 1. @b0e @b0ect cti$ i$es es++ a. eutra eutraliz lize e the the to#in to#in i. 8i$e 8i$e anti anti diht dihther heria ia seru serum m '&D"( '&D"( b. !ill !ill the the micr microb obes es i. &n &nti tibi biot otic ic – 4C 4C c. 4re$ent 4re$ent resira resiratory tory obstruct obstruction ion i. >merg >mergenc ency y trach tracheos eostom tomy y ii. >T tube – may damage laryn# sten stenos osis is resiratory damage $iii $iii.. urs ursin ing g car care e 1. 4ro$id 4ro$ide e client C/; – to re$ent re$ent the comlica comlication+ tion+ myocar myocarditi ditis s a. To#in released has secial secial aLnity aLnity to the heart muscle b. Manifestat Manifestations ions of myocardi myocarditis tis i. Mark Marked ed faci facial al all allor or ii. ii. %ery irr irregu egular lar ul ulse se rate rate iii. iii. Hyo Hyote tens nsio ion n i$. i$. Ches hest a ain
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UNIVERSITY OF SANTO TOMAS College of Nursing $. >ig >igas astr tric ic ain ain $i. otify MD &"&4 to treat myocarditis *. Mainta Maintain in air-ay air-ay atent atent a. Indee Indeende ndent nt nurs nursing ing++ i. 4ro 4roer er osi ositi tion onin ing g – folfol-er ers, s, uri urigh ghtt osi ositi tion on to main mainta tain in adeuate lung e#ansion ii. ii. Incre Increase ase @2I @2I – liuef liuefy y secre secretio tions ns iii. iii. >nco >ncour urag age e D/C> D/C> – to aid aid in the the e#u e#uls lsio ion n of res esir irat atou ou secretions i$. i$. C4T – to loose loosen n and and mobiliz mobilize e secret secretions ions $. 2reue euent nt turn turnin ing g to the the side sides s e$er e$ery y t-o t-o hour hours s to re$ re$en entt ooling of secretions b. Deend Deendent ent nursin nursing+ g+ i. Inha Inhala lati tion on ther thera ay y 1. @#ygenati @#ygenation, on, nebuli nebulizatio zation, n, steam steam inhalat inhalation ion ii. ii. "uctio "uctionin ning g as order ordered ed iii. iii. 4ostu ostura rall drain drainag age e . 4ro$i 4ro$ide de adeu adeuate ate nutri nutritio tion n a. "of "oft diet to lessen dyshagia 6. 4ro$i 4ro$ide de comfo comfort rt measu measure res s i#. 4re$en e$enttion ion 1. Immu Immun nizat izatio ion n *. 4roer 4roer disosal disosal of secretion secretions s . e$er e$er kiss kiss the the atien atientt 6. Co$er the the nose nose and mouth mouth -hen -hen sneezing sneezing and and coughing coughing d. 4ertu ertus ssis i. &!&+ &!&+ -hoo -hooin ing g cough cough,, Chin Chin coug cough h ii. Anlike Anlike D, ertu ertussis ssis aEect aEects s childre children n ? years old old and belobeloiii. C&+ /ordetella /ordetella ertussis, Hemohilus 4ertussis 4ertussis – both aerobic aerobic and and anaerobic anaerobic i$. i$. I4+ I4+ <)1 <)1 days days $. M@T+ M@T+ dir direct ect Drol Drolet et $i. $i. Mani Manife fest stat atio ions ns 1. Catarrha Catarrhall "tage "tage – highl highly y communi communicabl cable e a. Asua Asuall lly y 1 -eek -eek b. Cold, fe$er, fe$er, noctu nocturna rnall cough coughing ing c. Tiredness Tiredness and listlessness listlessness 'matamlay( – oosite oosite of of restlessness restlessness *. 4aro 4aro#ysma #ysmall stage stage sasmo sasmodic dic stage stage a. 4atho 4athogmn gmnomo omonic nic sig sign+ n+ =)1 =)1 succes successf sful ul forcef forceful ul coughi coughing ng,, -hich -hich ends in a rolonged Insiratory hase or a -hoo b. Conges Congested ted fac face e – maga maga yung yung mukha mukha c. Conges Congested ted tongu tongue) e) url urle e in color color d. Teary red red eyes -ith -ith rotrus rotrusion ion of eye balls balls e. Disten Distentio tion n of face face and and neck neck $eins $eins f. In$olu In$olunta ntary ry mictur micturiti ition on and and defeca defecatio tion n g. &b &bdo domi mina nall herni ernia) a) res ressu surre e#erte erted d on abdo abdomi mina nall -all -all -hen -hen coughing h. Choke Chokes s on mucu mucus s – $omit $omiting ing i. 2 and and > imb imbal alan ance ce . Con$ Con$al ales esce cent nt a. 4atient 4atient is no no longer longer communic communicable able b. "igns "igns and and symto symtoms ms subsi subside de c. @n the the road road to reco reco$er $ery y $ii. $ii. Diag Diagno nost stic ics s 1. asal asal s-ab -ab a. ;ecomme ;ecommended nded only only in catarrha catarrhall stage – many many discharg discharges es
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UNIVERSITY OF SANTO TOMAS College of Nursing *. Con5rmat Con5rmatory ory test+ test+ naso)a naso)ahryn hryngeal geal cultu culture re a. Three Three cult cultur ures es to to be done done i. /or /ordet 8en 8eng gou ii. &gar 4l 4late iii iii. Cough ough 4lat late $iii $iii.. Medi Medica call mana manage geme ment nt 1. D@C+ D@C+ >ryt >rythr hrom omyc ycin in 4C *. 4ertu 4ertussi ssis s Immuneg Immuneglob lobuli ulin n . 2 and and > re rela lace ceme ment nt 6. Codein Codeine e -ith -ith mild mild sedat sedation ion antitussi$e eEect, suress cough i#. i#. urs ursin ing g Car Care 1. 4ro$ 4ro$id ide e ati atien entt adeu adeuat ate e rest est conser$e conser$e energy of atient, atient, decrease decrease o#ygen demand and consumtion *. Mainta Maintain in 2 and > bala balance nce . 4ro$id 4ro$ide e adeuate adeuate nutri nutrition tion but -ith -ith "&4 "&4 a. Ari Arigh ghtt os osit itio ion n b. 4atient 4atient e#er e#erienc iences es cough, cough, hold hold the feeding feeding c. ile iles s in bottle bottle feeding feeding shou should ld only only ha$e small small holes holes medicine droer 6. 4ro$id 4ro$ide e abdominal abdominal binder binder to re$ent re$ent abdomina abdominall hernia hernia #. o ermanen ermanentt immunity immunity but second second attacks attacks are are rare – belobelo- ? years old old #i. 4re$en e$enttion ion 1. "ame "ame as as di diht hthe heri ria a e. 4n 4neum eumoni onia a – hard hard son songe ge i. In:amm In:ammati ation on of the the lung lung ar arenc enchym hyma a ii. C&+ 1. ot highly hly ath athogeni genic c – aEect Eects s lolo- body resis esista tan nce indi$ ndi$id idu uals als7 oortunistic oortunistic infections to suEering eole -ith &ID" a. %irus irus ) CM% CM% b. 4roto otozoa zoa i. 4C4 – 4neumocy 4neumocystic stic Carinii Carinii 4neumon 4neumonia ia *. /acter /acteria ia – mos mostt comm common on a. C&4 – common common tye of of 4M – stretoc stretococcu occus s 4M b. H&4 – hosital hosital acuire acuired d 4M – stahylococ stahylococcus cus 4M, 8ram 8ram negati$e negati$e bacteria '4seudomonas, !lebsiella( . Inhalatio Inhalation n of of no#iou no#ious ss subst ubstance ances s a. &s &si ira rati tion on 4M 4M b. Fiid 4 4M i. @il @il – oil oil base based d lubr lubric ican antt iii. iii. M@T M@T – Dir Direc ectt dro drole lett i$. i$. Mani Manife fest stat atio ions ns 1. 2e$er a. @nset+ @nset+ gradu gradual al or or abru abrutt *. "hak "hakin ing g chil chills ls ;igor . 4rod 4roduc ucti ti$e $e cou cough gh 6. "ut "utum um rod roduc ucti tion on a. ;usty – C& C&4 b. Cream Creamy y yelloyello- – "tahy "tahyloc lococc occus us c. Curran Currantt Relly Relly – !lebs !lebsiel iella la d. 8reen 8reenish ish – 4 4seu seudom domona onas s e. Clea Clearr – no infe infect ctio ion n i. 9ith 9ith 4M but but no no inf infect ection ion ii. ii. &s &si ira rati tion on or or lii liid d 4M 4M =. Chest Chest ain or leurit leuritic ic ain – frictio friction n bet-een bet-een leural leural layers layers a. &ggra &ggra$at $ated ed by coughi coughing ng
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UNIVERSITY OF SANTO TOMAS College of Nursing b. &li &licat cation ion of of chest chest bind binder er to re$ent friction of lung layers c. &ly &ly illoillo- or slinting slinting into into the chest chest -alls -alls to lessen lessen chest chest ain d. Turn atien atientt to side – aEecte aEected d side – to to slint slint i. IMCI IMCI++ ass asses ess s4 4M M 1. ;; a. 1 -eek -eek – * months months – ?b ?bm m b. * month months s – 1* 1* month months s – = = bm bm c. 1* mont months hs – = years years old old – 6bm 6bm *. "tridor "tridor – harsh harsh breath breath sound sound – insira insiration tion . Ches Chestt indr indraa-in ing g 6. 9heez 9heezing ing – e#i e#irat ration ion $. Diag Diagno nost stic ics+ s+ 1. CS; – de5niti de5niti$e $e – to check check if there there is stiEne stiEness ss in the the lungs lungs a. Fu Fung ng Cons Consol olid idat atio ion n b. 4atch atchy y In5lt In5ltra rate tes s *. "utum "utum >#am – in the the morning morning77 5rst thing thing in the morni morning7 ng7 uon uon rising rising lenty of resiratory secretion, coious a. =)1 =)1ml ml of sut sutum um b. Dee Dee brea breath thin ing g – times times hold breath breath forceful e#ectoration from the lungs c. Done Done for force cefu full lly y d. 4ut tong tongue ue at the the back back of the the lo-er lo-er teeth teeth $i. $i. Medi Medica call mana manage geme ment nt 1. &n &nti tibi biot otic ics s *. Inhalation theray – to loosen loosen resiratory resiratory secretion for easy easy e#ectoration e#ectoration $ii. $ii. urs ursin ing g Car Care 1. Maintain Maintain air-ay air-ay atent atent air-ay air-ay – IneEecti$e IneEecti$e air-ay air-ay clearan clearance ce *. 4ro$i 4ro$ide de adeu adeuate ate rest rest . 4ro$i 4ro$ide de adeu adeuate ate nutri nutritio tion n 6. 4ro$i 4ro$ide de comfo comfort rt measu measure res s $iii $iii.. 4re$ 4re$en enti ti$e $e 1. Immu Immun nizat izatio ion n *. "ame "ame as dih dihth ther eria ia Tuber ubercu culo losi sis s i. &!&+ !ochBs !ochBs infection, infection, 4hthisis 4hthisis – 8reek -ord -ord for T/, 8alloing Consumtion, 4T/ ii. C&+ &2/ – 1. Mycobacter Mycobacterium ium Tuber Tuberculo culosis sis hominis) hominis) human human 7 *. /o$is) /o$is) cattles cattles 'ineLcien 'ineLciently tly asteuri asteurized zed cattle cattle milk(7 milk(7 . &$is $is – bir birds – M&C) M&C) Myco Mycoba bact cter eriu ium m &$ium $ium Com Comle le# # oortunistic infections in atient -ho are suEering -ith &ID" articularly in abroad iii. iii. &fter fter 6) 6) -eeks -eeks – symto symtomat matic ic i$. i$. M@T M@T+ &ir &irbo born rne e $. Mani Manife fest stat atio ions ns 1. FoFo- grade grade fe$er fe$er,, night night s-eat s-eats s *. &nore#ia &nore#ia,, -eight -eight loss, loss, fatigab fatigability ility . /ody malaise, malaise, chest chest ain ain and and back back ain ain 6. 4roduc 4roducti$e ti$e cough cough,, hemotys hemotysis is and dysnea dysnea =. Hemot Hemotysi ysis s – eros erosion ion of lung lung cailla caillarie ries s no C4TV7 blood tinged sutum bloody sutum $i. $i. Diag Diagno nost stic ic e#a e#am m 1. Tubercul uberculin in testing testing – screening screening test test for T/7 a. 4ositi$e 4ositi$e result result – e#osur e#osure e to T/ b. Consiste Consistently ntly ositi$ ositi$e e – de$eloed de$eloed sensiti$ity sensiti$ity to the microbes microbes c. 6 thi thin ngs to knoknoi. 44D – uri uri5ed 5ed CH@ CH@ deri deri$at $ati$e i$e
f.
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UNIVERSITY OF SANTO TOMAS College of Nursing ii. ID iii. Interr Interreted eted after after 6)*< 6)*< hours hours – take take <* hours hours i$. i$. 4ositi$ 4ositi$e e – more more than 1mm indurati induration on $. 9ith 9ith HI%) HI%) =mm =mm – os ositi iti$e $e d. Techn echni iue ues s i. Mantou# Mantou# test test – ordina ordinary ry skin skin test – 44D – 6 to <* hours hours 1. Most Most accu accura rate te -ay -ay of tube tuberc rcul ulin in test testin ing7 g7 less less ain ain77 easy to erform ii. Tine Tine Test Test Multi) Multi) 4unctur 4uncture e Test Test 1. 8et a sterile needle soak soak need needle le in 44D for for )6 )6 hours hours unctur uncture e atient atient in circular circular manner manner for for ?) times *. Tine Tine test test kit) syring syringe7 e7 at ti, ti, you ha$e ha$e 6)? needles needles iii. %ollmer and 4iruet 4iruet Test "kin "cratch "cratch "kin 4atch 4atch Test 1. 8et a steri sterile le needl needle e to make make a scratch scratch in in your skin skin get get a gauz gauze e that that is soak soaked ed in a 44 44D D aly to the scratch kee for <*) G? hours after <*)G? hours, remo$e gauze o$er scratch, -ait for 6 to <* hours before you can ha$e the result a. ;esul esult+ t+ =)< =)< day days s *. "utum "utum e#am e#am – resenc resence e of &2/ – diagnost diagnostic ic test test . CS; – determ determine ine e#tent e#tent of disea disease se a. Min Minima imal 4T/ 4T/ b. Modera Moderatel tely y ad$a ad$ance nced d 4T/ 4T/ c. 2ar ad$a ad$anc nced ed 4T/ 4T/ $ii. $ii. Medi Medica call man manag agem emen entt 1. &nti T/ T/ agents agents – "CC "CC – "hort "hort Course Course Chemot Chemothera heray y a. To re$ent re$ent resista resistance nce b. ;I4>" i. ;ifa ;ifam mic icin in)) hea heato toto to#i #ic c – moni monito torr li$e li$err enzy enzyme mes, s, a$oi a$oid d alcohol 1. @ran @range ge uri urine ne,, tear tears s *. /efo /eforre star starti ting ng – ask ask if -ith ith cont contac actt lens lens77 remo$ emo$e e contact les, use eye glasses – could ermanently stain -ith orange ii. ii. Isonia Isoniazid zid)) heat heatoto oto#ic #ic also also 1. ">+ erih erihera erall neuri neuritis tis a. /?) 4yrido 4yrido#ine #ine to count counterac eractt erihera eriherall neuritis neuritis iii. iii. 4y 4yra razi zina nami mide de 1. ">+ ">+ hyer hyerur uric icem emia ia gout and kidney stones *. To rom romot ote e e#cr e#cret etio ion n of A&+ A&+ alak alakal alin iniz ize e the the urin urine e increase @2I, increase milk intake, increase $egetable intake i$. i$. >tham thamb butol tol 1. ">+ ">+ oti otic c neur neurit itis is irre$ersible *. @bser$e @bser$e for $isual $isual disturba disturbances nces notify MD . >ye >ye rob roble lems ms++ a. Color Color blin blindne dness ss – most most common common i. DiLculty DiLculty diEeren diEerentiat tiating ing red and green green $. "tr "treto etomy myci cin n 1. ">+ ">+ otot ototo o#ici #icity ty – th cranial damage7 nehroto#ic *. @bser$ @bser$e e for $erti $ertigo go and and tinnit tinnitus us . Moni Monito torr I and and @ 6. Monito Monitorr Creat Creatin inine ine and and /A /A $iii $iii.. urs ursin ing g Car Care e ) DD; DD;
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UNIVERSITY OF SANTO TOMAS College of Nursing 1. 4ro$i 4ro$ide de adeu adeuate ate rest rest *. 4ro$i 4ro$ide de adeu adeuate ate nutri nutritio tion n a. "mall "mall freu freuent ent feedin feeding g b. High Highly ly nutr nutrit itio ious us . >ncourag >ncourage e drug comlian comliance ce – most most imortant imortant a. D@T" i#. 4re$en e$enttion ion 1. Immu Immun nizat izatio ion n a. /C8 i. &t birt birth h – 1 dos dose e – . .=m =mll 1. ID – del delto toid id – ;ig ;ight ht ii. ii. Do not not mas massag sage e – si sill ll the the drug drug iii. There There -ill be abscess abscess format formation ion -hich -hich -ill -ill heal and and de$elo de$elo a scar 1. *) mont month hs i$. i$. If -ith -ith absc absces ess s – 6 mont months hs – Indo Indole lent nt absc absces ess s – !ochB ochBs s 4henomenon 1. ;easons a. 9rong 9rong techniu techniue e of administ administrati ration on b. >#o >#osu surre to a ers erson on -ho is acti$ acti$el ely y infe infect cted ed -ith T/ *. /rin /ring g at atie ient nt in in HC I and D7 a. 4ro 4rohy hyla la#i #is+ s+ ID) ID) ? mont months hs77 chil child d – G mont months hs77 immunocomromised – 1* months $. o booster booster doses doses – "chool "chool entrants entrants /C8 /C8 – de$eloed de$eloed clinical clinical immunity *. 4roe 4roerr disos disosal al of secre secretio tion n . "ame -ith other resira resiratory tory infec infection tions s 8ast astrointestinal "ystem a. /acteria i. Tyhoid ii. ii. Feto etos sir iros osis is iii. iii. /aci /acill llar ary y dysen dysente tery ry i$. Cholera b. 4roto 4rotozoa zoa – amebi amebiasi asis s c. Metazo Metazoan an)) schis schistos tosomi omiasi asis s d. %iru %irus s – he heat atit itis is e. Helmin Helminth thes) es) aras arasiti itism sm f. Tyhoid i. C&+ "almone "almonela la tyhi tyhi – can be found found on on urine urine or stoll stoll of an indi$i indi$idual dual 1. "our "ourc ces+ es+ a. 2ingers b. 2eces c. 2ood d. 2ly e. 2omites ii. ii. M@T M@T+ 2ec 2ecal al – @ral @ral iii. iii. Mani Manife fest stat atio ions ns 1. 2e$er, dull H&, abdomina abdominall ain ain *. %omiting, omiting, diar diarrhe rhea a consti constiatio ation n . 4ayers 4ayers atches) atches) target target orga organ n of "T 6. Clin Clinic ical al feat featur ures es a. Fadd Fadder er lik like fe$ fe$er er b. 4resence 4resence of rose sots –found –found in abdomen or or face 'children( 'children( i. Can Can ha$ ha$e e ulc ulcer erat atio ion n bleeding
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UNIVERSITY OF SANTO TOMAS College of Nursing c. 4rese 4resence nce of sl slen enome omegal galy y i$. i$. Diag Diagno nost stic ics s 1. /lood lood e#am #am a. /lood /lood cultu culture re – 5rst 5rst -eek -eek only only 1 -eek only in bloodstream b. 9idalBs 9idalBs Test – resenc resence e of antigen antigen i. &g@ – "omatic "omatic &ntigen &ntigen – resent resently ly infect infected ed ii. ii. &g &gH H – 2lagell 2lageller er antigen antigen – has been re$i re$ious ously ly been e#ose e#osed d to T27 had immunizations c. Tyhidot) yhidot) detects detects antibodie antibodies s i. IgM) IgM) r resen esentt infe infect ctio ion n ii. Ig8) reco$ery reco$ery eriod eriod and and some some form form of immun immunity ity $. Medi Medica call Man Manag agem emen entt 1. &n &nti tibi biot otic ic Ther Thera ay y a. D@C+ D@C+ Chlor Chloram amhen henico icoll *. 2 and and > re rela lace ceme ment nt $i. $i. urs ursin ing g Car Care 1. Mainta Maintain in 2 and > bala balance nce a. I and @ b. "ig "igns of DH i. /efore /efore 6 hours+ hours+ Y1 indicator indicator – -eight -eight loss 1. < < of of bod body y is :uid :uid *. 4ro$i 4ro$ide de adeu adeuate ate nutri nutritio tion n a. Fimit Fimit oily oily and fatty fatty food foods s aggra$ate diarrhea b. "mall freuen freuentt feedin feeding g if $omiting $omiting c. If ed ediatr iatric ic laced on 4@ 6) hours – to rest the 8I tract then clear liuids general liuids full diet d. o 4@ 4@ ffor or adult adult clie clients nts . 4ro$id 4ro$ide e atien atientt comfort comfort measure measures s $ii. $ii. 4re$ 4re$en enti tion on++ 1. Immu Immuni niza zati tion on – CDT CDT *. &$oid $oid the the 5$e 5$e 2s a. Hand Hand-a -ash shin ing g b. 2ood i. 4rea earat ration ion ii. Handling iii. "torage c. >rad >radic icat ate e :ie :ies s d. Do not not ut ut anyth anything ing in your mouth mouth g. Fet Fetos osi irrosis osis i. &!& &!&+ Mud Mud 2e$er e$er,, Can Canicol icola a 2e$er e$er,, "-am "-am 2e$er e$er,, 4re) 4re)ti tibi bial al 2e$er e$er,, Icte Icterro) hemorrhagica Disease, 9eilBs Disease, "-ineherdBs Disease ii. 2arm animals animals – dog, cats, cats, shee, shee, goat, rats 'not 'not gi$en immuniz immunizatio ations( ns( iii. iii. "ourc "ource e of infec infectio tion+ n+ Arine Arine of of rats rats i$. i$. C&+ C&+ siroch sirochete ete)) Fetos Fetosir ira a $. M@T+ M@T+ "kin enetr enetrati ation on,, mucous mucous membran membrane e no need need for -ound -ound can enter ores of the skin $i. @rganism enter blood stream aEects organs of the body – striated muscles, li$er and kidneys '-ith secial aLnity -ith kidney cells( high risk for kidney failure $ii. Incubatio Incubation n eriod+ eriod+ * days) days) 6 -eeks7 -eeks7 a$era a$erage+ ge+ =)? days days $iii $iii.. Mani Manife fest stat atio ions ns 1. 2e$er, H&, H&, $omiting, $omiting, anor anore#ia e#ia,, body malais malaise e *. Muscle Muscle tend tender ernes ness s and and ain ain calf muscles gastrocnemius does not like to -alk nor stand u . Raund Raundice ice -ith -ith hemo hemorr rrhag hage e orange eyes and skin
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UNIVERSITY OF SANTO TOMAS College of Nursing i#. Diagn iagnos osttics ics 1. /lood lood e#am #am a. Fetosi Fetosira ra &gglutin &gglutinatio ation n Test Test – F&T F&T b. Fetosi Fetosira ra &ntigen &ntigen &ntibod &ntibody y Test Test – F&&T F&&T c. Microsco Microscoic ic &ggluti &gglutinati nation on Test Test – M&T M&T ) ad$anced ad$anced #. Medi Medica call Mana Manage geme ment nt 1. &ntibiot &ntibiotic ic theray theray – Tetracycli etracycline ne #i. #i. urs ursin ing g car care 1. "u "uor orti$e ti$e a. Moni Monito torr A@ of of ati atien entt i. Cons onsiste isten ncy ii. 2reu euenc ency iii. &mount i$. i$. &ny Chan Chang ge otify MD #ii. #ii. 4re$ 4re$en enti tion on 1. >radicat >radicate e the source source of infectio infection n – rats rats a. ;at ois oiso on h. Dys Dysente enterry i. Tyes+ /acillary %iolent) one after the other &mebic diarrhea "ynonym "higellosis Cholera, eltor &mebiasis /loody 2lu# C& "higella Dy Dysenteriae %ibri ibrio o Cho Cholera erae before 4rotozoa before "HI8& %ibrio Comma 'comma >ntamoeba hystolitca "trains+ shaed( "tages+ ) 2le#neri ) @ga-a ) Inacti$e+ Cy Cyst ) /oydii ) Inaba ) &cti$ cti$e+ e+ Troho ohozo zoit ites es ) "onnei ) >ltor 9hen 9hen outsi outside de the body body+ cyst M@T 2ecal @ral thru ingestion "igns and Mucoid "tool, could be ;ice, -atery stool one after Mucourulent blood symtoms blood streak -hen the other+ other+ athogmn athogmnomon omonic ic str streak eak stoo stools ls -ith -ith foul foul se$ere endoto#ins sign smell diss dissol ol$e $es s the the released thus, intestinal tissue destroying the 2ishy odor stool intestinal -all 2oul smell+ because of us >nters the /" release $ibriolytic substances stimulate eristalsis diarrhea
o bloo bloods dstr trea eak k – does does not not destroy the intestinal -all ;aid aid DH DH mani manife fest sted ed in skin integrity – 9asher-omanBs hand+ -rink -rinkled led,, oor oor skin skin turgor turgor,, dry skin 9aten aten bed bed – s sec ecia iall bed7 bed7 -ith hole and ail under the bed *
UNIVERSITY OF SANTO TOMAS College of Nursing Diagnostics
"tool e#am ;ectal s-ab "tool e#am ;ectal s-ab
"tool e#am ;ectal s-ab
2resh – -ithin minutes tro troho hozo zoit ites es ' minutes to 1 hour( transform transform into cyst &ntiamebic+ Metronidazole or Chlorouine 'anti rotozoan( @;T
Medical Manageme nt
&ntibiotics+ &ntibiotics+ Co) Co ) trimo#azole @;T @;T
&ntibiotics+ Tetracycline I%T continuous eristalsis nothing er orem
ursing "ame as tyhoid Care 4re$en e$enttion ion "ame ame as ty tyhoid hoid i. "chi "chis stos tosomia miasis i. &!&+ &!&+ "na "nail il fe$er fe$er,, /ilhar /ilharzia ziasis sis ii. ii. C&+ C&+ "chi "chist stos osom oma a 1. Raonicum Raonicum – intest intestinal inal symto symtoms) ms) aEects aEects man and and animal animal *. Mansoni Mansoni – intes intestine) tine) intes intestina tina symto symtoms ms ) man . Haematobi Haematobium um – urinary urinary symtoms) symtoms) urinar urinary y bladder bladder)) man iii. M@T+ M@T+ skin enetrat enetration ion mucous mucous membrane membrane – no need for -ound -ound i$. i$. >nte >nterr bod body y of of man man in airs male and female 1. Male Male – -ith -ith cana canall in the the middl middle e gynecooric canal -here female -ill enter -hen they -ill coulate female -ill stay inside until she is ready to lay her eggs after laying eggs go to ortal circulation to 5nd other artner to lay eggs $. "nail) "nail) inter intermed mediat iate e host host $i. $i. 2eces eces -ith -ith eggs eggs ruture Far$ae 'Miracidium( – not yet ready to infect man or animal7 *6 to 6 hours to 5nd snail snail 'incubator( @ncomelania Kuadrasi7 stay in snail for 6) -eek if the microbes is no- ready to infect man or animal get out of the snail thru resiratory tract of the snail in the form of lar$a 'Cercariae( skin enetration mucous membrane of man or animal $ii. $ii. Mani Manife fest stat atio ion n 1. Itchiness Itchiness at at site of of entrance entrance of the aras arasite ite *. 2e$er e$er – infe infect ctio ion n . Calf Calf and and mus muscl cle e ain ain 6. Dysentery Dysentery)lik )like e symtoms symtoms 'bacilla 'bacillary ry dysenter dysentery( y( a. Mucoid =. >macia >maciatio tion n – ayato ayatot7 t7 ?. &bdomina &bdominall distenti distention'l on'late ate sig sign( n( a. if alat alated, ed, sleno slenomegal megaly y and heatomeg heatomegaly aly <. lym lymh h aden adeno oat athy hy $iii $iii.. Diag Diagno nost stic ic e#am e#am 1. stool stool e#am e#am – deter determine mine egg of of arasit arasite e *. con5 con5rrmato matory ry++ a. /loo /lood d e#am #am i. Circum Circum @$a 4rec 4reciit iitin in Test Test – C@4T C@4T – egg of arasi arasite te ii. >FI"& test b. ;ecta ectall bio biosy sy i#. i#. Medi Medica call Man Manag agem emen entt 1. &ntib &ntibloo lood d 2luk 2luke e &gen &gentt a. 4razi 4raziua uante ntel, l, 2uadin uadin #. ursing ursing care+ care+ symto symtomatic matic and suort suorti$e i$e
UNIVERSITY OF SANTO TOMAS College of Nursing
0.
1. 4oor 4oor rogno rognosis sis in the the 4hili 4hiliine ines s #i. 4re$en e$enttion ion 1. "nai "naill cont contrrol a. Mollus Molluscid cides es – snai snaill oiso oison n b. 4roer irrigation irrigation and culti$ation culti$ation of land – destroy destroy breeding breeding laces laces of snail c. Create Create 5sh 5sh onds onds – snail snail eating eating 5sh 5sh – bangu bangus s *. >n$ir >n$ironm onment ental al sanit sanitati ation on a. 4roe 4roerr e#cr e#creta eta dis disosa osall b. !ee !ee all all animals animals caged caged or chained chained c. /uilt foot foot bridge bridges s – no need to to cross cross a snail snail infested infested -ater -ater d. 4roer 4roer -eari -earing ng of foot -ears -ears – boots boots . Heal Health th >duc >ducat atio ion n Heatitis – in:ammation in:ammation of li$er i. Causes 1. &lcoh lcoho olism ism *. Drug Drug into into#i #ica cati tion on . Chemical Chemical into#icat into#ications ions – arsen arsenic ic 6. Microbes =. %irus ii. %iral %iral Tye Tye – can be trans transferr ferred ed to another another 1. &/CD>8 *. Hea Heati tittis & a. &!&+ Infectious Heatitis Catarrhal Catarrhal 0aundice 0aundice eidemic eidemic Heatitis Heatitis b. C&+ C&+ Heati Heatitis tis & $irus $irus ';& ';&(( c. M@T M@T+ 2ec 2ecal al @ral @ral i. 2ood ood hand handle lers rs ii. Children iii. iii. 4ract 4ractice ices s anal anal oral oral se# se# d. I4+ I4+ *)? *)? -eek -eeks s . Hea Heati tittis / a. &!&+ &!&+ "erum Homologo Homologous us %iral %iral 'most fatal fatal and deadlie deadliest( st( b. C&+ C&+ Hea Hea / %iru %irus s 'D& 'D&(( i. /loo /lood d and and othe otherr body body :uid :uids) s) tear tears, s, sali sali$a $a,, s-ea s-eat, t, milk milk,, semen, cer$ical :uid, ericardial :uid+ "ource of Infection c. M@T+ i. 4aren arente terral 1. /T, contamina contaminated ted shars shars and and needle needles s ii. @ra @ral to to ora orall 1. "ali$a, "ali$a, freue freuent nt kisses) kisses) ?) ?) gallons gallons of of sali$a sali$a iii. iii. "e#u "e#ual al con conta tact ct 1. "emina "eminall and and cer$i cer$ical cal :uid :uid i$. i$. %erti ertic cal 1. Infe Infect cted ed moth mother er to born born child child during the child birth rocess d. I4+ I4+ ?)-e ?)-eek eks s – ? mon month ths s e. &t ri risk+ i. Drug addi ddicts cts ii. ii. 4romi 4romisc scuou uous s indi$i indi$idua duals ls iii. iii. Heal Health th -ork -orker ers s 6. Hea Heati tittis C a. &!&+ &!&+ 4ost 4ost Trans Transfusi fusion on Heatitis Heatitis b. C&+ C&+ Hea Hea C $iru $irus s i. /lood c. M@T+ M@T+ 4arenter 4arenteral al – contamina contaminated ted shars shars and needle needles s
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UNIVERSITY OF SANTO TOMAS College of Nursing d. &t risk i. Drug addi ddicts cts ii. ii. /loo /lood d reci eciie ient nts s iii. iii. Heal Health th -or -ork kers ers e. I4+ I4+ =)1 =)1* * -eek -eeks s =. Hea Heati tittis D a. Dorman Dormantt Tye Tye of Hea Hea / b. C&+ C&+ Delta Delta %iru %irus s Hea D $iru $irus s i. ote ote++ Delt Delta a $iru $irus s cann cannot ot multi multil ly y by itsel itselff in orde orderr to multily, it needs the resence of Hea / $irus ii. ii. @nce @nce you de$elo de$eloed ed Hea Hea /, e$en e$en reco$e reco$ere red d there -ill be left dormant $irus hel Hea D $irus to multily c. I4+ I4+ )1 )1 -ee -eeks ks ?. Hea Heati tittis > a. >nte >nteri ric c hea heati titi tis s b. C&+ C&+ Hea Heatit titis is > $iru $irus s i. feces c. M@T M@T+ fec fecal al oral oral d. I4+ I4+ )? )? -eek -eeks s <. Hea Heati tittis 8 a. C&+ He Hea 8 i. "our "ource ce of infect infection ion++ blood blood b. M@T+ M@T+ same same as hea heatit titis is C c. I4+ I4+ un unkno kno-n . 4artn artner ersh shi i iin n M@T M@T a. &)> b. /)D c. C) 8 iii. iii. Mani Manife fest stat atio ions ns 1. 4re)ict 4re)icteric eric)) before before 0aundice 0aundice aears7 aears7 lesser lesser degree degree a. 2e$er e$er)) infec infecti tion on b. ;AK ain ain – in:amma in:ammation, tion, in5ltrati in5ltration on of li$er li$er c. 2atig atigab abil ilit ity, y, -eig -eight ht loss loss,, body body mala malais ise e – inab inabil ilit ity y of the the li$e li$err to con$ert glucose to glycogen 'stored source of energy( i. CH@ amino acid should be de)aminase by the li$er ii. 2ats d. &nore#ia &nore#ia,, nausea, nausea, $omiting $omiting – inability inability to deaminase deaminase the CH@ e. &nemia &nemia – decrea decrease se life life san san of ;/C ;/C '1* days( days( *. Icte Icteri ric c ha hase se a. Raundi Raundice ce – inabi inabilit lity y of the li$er li$er to remo$e remo$e the normal normal amount amount of bilirubin b. &ccumula &ccumulation tion of bile bile salts salts on the skin skin ruritus itchiness c. Tea) ea) colo colorred urin urine e brobro-n n urine urine due to e#cess bilirubin thro-n out by the kidney to the urine d. &cholic &cholic stool stool – no no color7 color7 clay clay colore colored d stool stool i. Ancon0 Ancon0uga ugated ted bil biliru irubi bin n '/"( '/"( 1. some ome -ill go to li$er i$er con0ug con0ugate ated d biliru bilirubin bin intestine to gi$e rise for color of stool *. "ome -ill go to kidney urine color . 4ost ost icte icteri ric c stag stage e a. Raundi Raundice ce -ill -ill subsi subside de b. "igns "igns and and symto symtoms ms subsi subsides des c. >nergy >nergy le$el of atient atient incre increases ases77 it -ould take take )6 months for for the li$er to reco$er reco$er or regener regenerate+ ate+ Comlete Comlete li$er reco$ery reco$ery ;>"T7 a$oid alcoholic be$erages and @TC drugs for at least 1 year
=
UNIVERSITY OF SANTO TOMAS College of Nursing i$. Diagn iagnos osis is 1. Fi$e Fi$err enz enzym yme e tes testt a. &F &FT T – &lamine &lamine &minot &minotrans ransfera ferase se – "84T "84T i. Y1 iindi ndicat cator or of of li$e li$err ro roble blem m b. &"T – &sartate &sartate &minotrans &minotransfera ferase se – "8@T "8@T i. Increases Increases only uon onset onset of 0aundice 0aundice c. &F4 – & &lka lkalin line e 4hos 4hoshat hatase ase i. Incr ncreas eased obstructi$e 0aundice obstructi$e heatitis d. 88T – 8amma 8lutamyl 8lutamyl Trans Transfera ferase se i. Increased To#ic Heatitis – caused by+ alcohol, drugs or chemicals e. FDH) FDH) Factic Factic Dehydr Dehydroge ogenas nase e i. Incr ncreas eased li$er damage *. "erum "erum antig antigen en antibo antibody dy test test – -hat -hat $irus $irus causing causing infecti infection, on, chroni chronic c or acute heatitis a. H/s H/s&8 &8 –acute –acute heati heatitis tis / b. H/c&g) H/c&g) chronic chronic Hea / – Increasi Increasing ng H/s&g H/s&g c. H/e&g d. H&s&g H&s&g – e#osur e#osure e to the $irus – * -eeks -eeks after after e. &ntiH&% i. Ig8 Ig8 – res resen entl tly y infe infect cted ed ii. IgM f. &ntiH/ &ntiH/" " – -hile -hile reco reco$er $erin ing, g, it incr increas eases es g. &nti H/ H/e h. &ntiH/c . Arin Arinar ary y e#am e#am 6. 4T e# e#am =. ATJ ATJ of of li li$er $. Medi Medica call man manag agem emen entt 1. "ym "ymto toma mati tic c a. Hea Heati tic c rotec otecto torrs – hos hoshol holi iid id,, $it $itami amins and min minera eral – sulement – li$er -ill not e#ert eEort to metabolize allo- li$er for reco$ery i. >sse >ssent ntia iale le "il "ilym ymar arin in ii. ii. 4edia edia++ Reti Retia arr b. Chro Chroni nic c He Hea a/ i. anti anti$i $ira rall age agent nt 1. Fami Fami$u $udi din ne a. @D for for one one year year ii. ii. Immun Immune e stimu stimulan lantt – in0e in0ecta ctable ble 1. Inte Interrfer feron a. *)# *)# er er -eek -eek for ? month months s $i. $i. urs ursin ing g Car Care 1. ;est to decr decreas ease e metabol metabolism ism decrease load of li$er li$er rela# li$er reco$ery *. utr utritio ition n a. Fo- fat fat – no no enough enough bile released released by li$er li$er b. High CH@ – to sar sare e CH@ metabolis metabolism m i. CH@ amino acid ammonia encehaloathy encehaloathy ii. /utterbal /utterballl Diet – any any hard hard candy candy but not not chocola chocolates tes because because it contains fats c. CH@ CH@ – for for tiss tissue ue re reai airr i. If the atie atient nt is is infe infecte cted d moderate CH@ ii. ii. If at atie ient nt is is rec reco$ o$er ery y high CH@ iii. iii. If ati atient ent -ith -ith com comlic licati ation on Fo- CH@
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UNIVERSITY OF SANTO TOMAS College of Nursing $ii. $ii. @ 4>;M 4>;M& &> >T T IMMA IMMAIT ITQ Q $iii $iii.. 4re$ 4re$en enti tion on 1. Immu Immun nizat izatio ion n a. Hea Hea / $ac $acci cine ne i. doses ii. .=cc – IM iii. iii. >arly >arly infan infancy cy++ $astus $astus latera lateralis lis i$. i$. Fate Fate inf infan ancy cy + del delto toid id $. e$er gi$en in gluteus muscles adi diose ose tis tissues decrease absortion $i. )?)1 )?)16 6 -ee -eeks ks $ii. If the birth birth -eigh -eightt is less less than than *kg – e#tra e#tra dose dose 1 th -eeks *. &$oid $oid the the M@T M@T k. 4aras arasiitism ism i. Helminths 1. Inge Inges stion ion a. >nte >nterrobia obiasi sis s i. 4in-o 4in-orm rm infes infestat tation ion,, seat-o seat-orm rm ii. @#yu @#yurrias iasis iii. iii. >nter >nterobi obis s %erm %ermic icula ularis ris i$. i$. octurn octurnal al ani – itchin itchiness ess at night night 1. 9ell 5tted under-e under-ear ar at night night $. @nly aras arasitis itism m that cannot cannot be be diagnosed diagnosed by by stool stool e#am $i. Diagn iagnos osttics ics 1. "cotchta "cotchtae e test test Celloha Cellohane ne tae tae test) test) morning morning a. 8las 8lass s slid slide e -ith -ith ta tae e b. &s &sc cari ariasis asis i. &!&+ &!&+ giant intest intestinal inal round round-or -orm m – ascaris ascaris lumbricoi lumbricoides des ii. ii. Mani Manife fest stat atio ions ns 1. %omiting omiting and and assin assing g out of -orms -orms *. Intest Intestina inall obs obstru tructi ction on c. Trich richur uria iasi sis s i. 9hi 9hi-o -orrm – lati latigo go ii. Trichuris richuris Trichiuri richiuria a d. Trich richin inos osis is i. ;ound -o -orm ii. ii. Trich richin inia iasi sis s iii. iii. Trich richin inel ello losi sis s i$. i$. Trichin richinell ella a "irali "iralis s $. Ingest Ingestion ion of of ra- meat, meat, half half coo cooke ked d e. Taeni aenias asis is i. Taee-orm ii. ii. Ingest Ingestion ion of half half cook cooked ed foods foods iii. Taenia aenia saginata saginata – beef tae-o tae-orm rm – medium medium rare, rare, half cook cook i$. i$. Taenia aenia soli solium um – ork ork $. Dihyllo Dihyllobothr bothrium ium latum latum – 5sh tae-orm tae-orm –sushi –sushi,, sashimi sashimi $i. $i. Hymeno Hymenole lesis sis an ana a – d-arf d-arf tae-o tae-orm rm 1. 4erson 4erson to erson7 erson7 hand hand to mouth mouth transmis transmission sion $ii. $ii. 9ith ith segm segmen ents ts could regenerate f. 4arag aragon onim imia iasi sis s i. 2lat-orm ii. ii. @rie @rient ntal al Fu Fung ng :uk :uke iii. iii. 4aragon aragonimu imus s -ester -esterman manii i$. i$. InsuLcie InsuLciently ntly cooked cooked of of crab crab or cray5sh cray5sh $. 4roduc 4roducti$e ti$e cough cough and and hemotys hemotysis is
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UNIVERSITY OF SANTO TOMAS College of Nursing *.
%II.
Through Through the skin of the feet – -alking -alking bare bare footed footed a. &n &ncy cylo lost stom omia iasi sis s i. Hook-orm ii. ii. &n &ncy cylo lost stom oma a Duod Duoden enal ale e iii. iii. eca ecatu tus s &me &meri rica canu nus s i$. i$. "ees "ees blood blood – =ml =ml of of blood blood is lost er day day b. "ton "tongy gylo loid idia iasi sis s i. Threa hread d-orm orm ii. ii. "trong "trongylo yloid ide e "ter "tercor corali alis s ii. ii. Mani Manife fest stat atio ions ns 1. %oracio oracious us aeti aetite te *. 9eaknes eakness, s, ot ot belly, belly, anemi anemia a . 9hen 9hen young young++ stunte stunted d gro-t gro-th h iii. iii. Diag Diagno nost stic ics s 1. "tool "tool e#am e#am e#ce e#cett for in-o in-orm rm i$. i$. Medi Medica call Mana Manage geme ment nt 1. &n &nti tihe helm lmin inth thic ic a. Mebe Mebend ndaz azol ole e b. &lbe &lbend ndaz azol ole e c. Thia Thiabe bend ndaz azol ole e d. Commercial Commercially ly reare reared+ d+ 4yrantel 4yrantel 4amoate 4amoate – Combantrin Combantrin $. ursing ursing Care Care++ symtomat symtomatic ic and and suorti suorti$e $e $i. 4re$en e$enttion ion 1. 4erso ersona nall hygi hygien ene e *. 4roe 4roerr rea reara ratio tion n of food food 8eni enito)u o)urinary sys system a. 8on 8onorr orrhea hea i. &!&+ &!&+ Cla, Cla, "train, "train, Rack, Rack, 8C, 8leet, 8leet, Morning Morning Dro Dro ) tulo tulo ii. C&+ C&+ eis eisser seria ia 8onor 8onorrh rhea ea iii. iii. M@T+ M@T+ "e#ua "e#uall Contac Contactt i$. i$. I4+ I4+ )*1 )*1 days days $. Mani Manife fest stat atio ions ns 1. 2emale+ emale+ cer$i# cer$i# – no aEectatio aEectations ns of the uret urethra hra *. Male+ Male+ ureth urethra rall in$ol$ in$ol$eme ement nt a. Areth Arethrit ritis is,, dysuri dysuria a b. ;ednes ;edness s and and edema edema of uret urethral hral meatus meatus c. 4urulen 4urulentt urethr urethral al disch discharg arge e ) morni morning ng d. 2reuent reuent gonorr gonorrhea+ hea+ formati formation on of scar in the eididym eididymis is obstruct serm :o- sterility . 2emale+ a. &s &sym ymt tom omat atic ic b. "igns "igns and symtoms symtoms if cer$i# cer$i# is aEected aEected 4ID c. If ur urethr ethra a is aEec aEecte ted d same as males d. 2reue euent nt++ nar narro-in o-ing g of the the fall fallo oia ian n tube tube steri sterilit lity y ectoi ectoic c regnancy 6. "ystem "ystemic ic – 8onococ 8onococca call setice seticemia mia a. 8ono 8onoco cocc ccal al rash rashes es – tend tender er ai aill llar ary y skin skin lesi lesion ons s 'us 'ustu tula lar, r, hemorrhagic and necrotic( b. Migratory Migratory olyarthra olyarthralgia lgia,, olyarth olyarthriti ritis, s, tenosyno$itis tenosyno$itis $i. Diagn iagnos osttic 1. C and and " – muc mucosa osall scra scraing ing a. They scrae scrae the dischar discharges ges coming coming from from the urethr urethral al mucosa mucosa of the atient b. If no dischar discharge ge – cer$ical cer$ical smear smear)) 4a "mear "mear $ii. $ii. Medi Medica call man manag agem emen entt
UNIVERSITY OF SANTO TOMAS College of Nursing 1. &nti ntibioti iotic c a. 4C – /enzath /enzathine ine 4en 4en 8 – 4enadu 4enadurr – ne$er gi$en gi$en er er I%7 IM use use only i. If gi$e gi$en n er er I% – dea death th ii. 8auge 8auge 1?)1G 1?)1G – fast ush7 ush7 drug drug easy easy to clog iii. &T/ also for for ;HD – rohyla rohyla#is #is against against infect infection ion – 4enadu 4enadurr b. Ceh Cehal alos oso ori rin n i. Ceft eftria# ia#one ii. Cefur efuro o#ime #ime c. If 4C and ceha cehalos loso orin rin treat treatmen mentt is not eEecti$ eEecti$e e atient may ha$e gonorrhea and chlamydial infection i. Chlamy lamyd dia trac rachomat omatis is)) -ith ith resi esistanc tance e -ith ith 4C 4C and and Cehalosoring ii. treat -ith Tetracycline – Do#ycline 1. Chlam Chlamydi ydia a –clear –clear dis discha charg rge e $iii $iii.. urs ursin ing g Car Care e 1. @ut @utat atie ient nt /asi /asis s *. 4sych 4sycholo ologic gical al Care Care a. FoFo- sel selff est estee eem m . Heal Health th edu educa cati tion on i#. 4re$en e$enttion ion 1. "afe se# ractices ractices accordi according ng to CDC a. o se# b. Fong term term mutual mutually ly monogamou monogamous s relation relationshi shi c. Mutual Mutual masturba masturbation tion -ithout -ithout direc directt contact contact d. &c &ccor cordin ding g to 2la$ 2la$ier ier ) &/C &/C i. &bstinence ii. ii. /e 2aith aithfu full iii. Condom *. >duca >ducatio tion n and and couns counseli eling ng . /eha$i /eha$ior or modi5c modi5cati ation on 6. Ase Ase of of con condo doms ms a. 4re$ent 4re$enti$e i$e only7 only7 not not a art art of of safe safe se# #. >Eect >Eect to to child child dur during ing re regna gnanc ncy y 1. @htha @hthalmi lmia a neon neonato atoru rum m blindness a. Cred CredeB eBs s 4rhy 4rhyla la#i #is s b. "yhilis i. &!&+ 4o#, 4o#, Fues, Fues, /ad /lood Disease'minimal Disease'minimal amounts of microbes microbes in the blood( blood( ii. C&+ "ir "irochet ochete e – Tre Treonema onema 4allid 4allidum um 1. Can ass ass thru thru lacen lacenta ta after after 1? 1? th -eek iii. M@T+ M@T+ "e#ual "e#ual Contac Contact7 t7 blood blood transfu transfusion sion i$. i$. I4+ I4+ 1) 1)G G days days 1. &$era $erage ge++ *1 *1 day days s $. Mani Manife fest stat atio ions ns 1. 4rima 4rimary ry "tag "tage e – chan chancr cre e a. Chancre i. 4ainl ainles ess, s, mois moistt ulce ulcerr that that heal heals s son sonta tane neou ousl sly y – -ith -ith or -ithout treatment ')? -eeks( ii. Asually Asually found found in genitals genitals,, face, lis, lis, tongue, tongue, under under the breast breast,, 5ngers b. 4resenc 4resence e of regiona regionall adeno adenoathy athy *. "econdar "econdary y stage stage – infect infectious ious stage stage a. High Highly ly commu communi nica cabl ble e b. 2lu) 2lu)li lik ke sym symto toms ms i. 2e$er, H&, body malaise, malaise, sore sore throat throat c. "kin "kin rashe ashes s ainful Condylomata lata condyloma lata
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UNIVERSITY OF SANTO TOMAS College of Nursing i. Fesi Fesion ons s that that are are fuse fused d toge togeth ther er,, high highly ly infe infect ctio ious us,, foun found d under the breast and on the genitals d. @ral @ral lesion lesion)) oral muco mucous us atch atches es e. Change Changes s in in hair hair gro-t gro-th h atchy aloecia f. Thin Thinni ning ng of ubi ubic c hai hairr g. 8enera 8eneraliz lized ed lymh lymh adenoat adenoathy hy . Fate Fatent nt 4h 4has ase e a. &sy &symt mtoma omatic tic for 1)* years years 6. Tertiar ertiary y late late stage stage a. o longer longer commun communica icable ble b. Fesions 8umma – in5ltrating in5ltrating tumor 'skin, 'skin, bone, li$er( li$er( seems like the body to be decaying7 found any art of the indi$idual c. C% ch changes i. &orti ortiti tis s and and aneu aneury rysm sm ii. reason for death d. C" C" dege degene nera rati tion on i. 4ares aresth thes esia ia,, s syc ycho hosi sis, s, deme dement ntia ia,, abno abnorrmal mal re:e# e:e#es es,, shooting ains $i. Diagn iagnos osttics ics 1. Dark Dark 2iel 2ield d micr microsc oscoe oe *. /lood lood >#ams ams a. 2T& 2T& &/ &/" " – :uor :uores esce cent nt Treon eonem ema a &n &nti tibo body dy &b &bso sor rti tion on Test est – con5rmatory b. %D;F – %ener %enereal eal Disease Disease ;esear ;esearch ch Faborator Faboratory y c. ;4; – ;ai ;aid d 4lasm 4lasma a ;eag ;eagin in $ii. Medical Medical Managemen Managementt – same as gonorr gonorrhea hea $iii. $iii. ursin ursing g Care Care – same as gono gonorr rrhea hea i#. 4re$e 4re$ent ntion ion – same same as as gonor gonorrh rhea ea #. Danger Dangerou ous s if re regna gnant nt -oma -oman n – rd trimester 1. 4ossi ossibl ble e defec defects ts++ a. Mother Mother may ha$e ha$e a stil stillbi lbirth rth b. Mother Mother may gi$e gi$e birth birth to to a syhili syhilitic tic baby baby lacenta is bigger than the baby i. /aby /aby -ill rese resembl mble e like like an old man7 -ith -ith linear linear scar scar at the angles of the mouth7 ha$e ersistent $esicular erutions and nasal discharges c. Mother Mother may gi$e gi$e birth birth -ith late late manifest manifestatio ations ns of syhili syhilis s i. ormal ormal but but chang change e * years years after after bir birth th 1. Hutchins HutchinsonBs onBs teeth) teeth) sasa- like like teeth *. &nteri &nterior or bo-i bo-ing ng of of the tibi tibia a– . Dactyl Dactyliti itis s – 5nger 5nger in:amm in:ammati ation on 6. "addle "addle nose nose -ith -ith high high alate alate – horse horse like like =. Deafness d. Mother Mother may gi$e birth birth -ith -ith normal normal baby baby only after * years c. HI% HI% inf infec ecti tion on &ID &ID" " i. HI% HI% is is no not &ID &ID" " ii. HI% infect infection ion – infec infected ted by a $irus7 $irus7 initial initial stage stage of of &ID" iii. iii. &ID") ID") infec nfecte ted d -ith ith $ir $irus -ith ith grou of sign igns and symt ymtom oms s and -ith -ith incometent immune system7 late stage of HI% i$. i$. C&+ %irus %irus – Human Human Immunode5c Immunode5ciency iency %irus %irus –retr –retro$ir o$irus us 1. %ery fragile fragile – can be easily destr destroyed oyed by alcohol alcohol <, chlori chlorine, ne, =?C, a hyochloride 'Jonro#, Chloro#, 4ure#( – no need to be concentrate '1 a Hyochoride+ 1 9ater( *. Caable Caable outsi outside de the the body body++ 6 hours hours . 8oes outsid outside e the body body -ith blood blood – $irus $irus is ali$e7 ali$e7 u to 1* 1* hours hours
6
UNIVERSITY OF SANTO TOMAS College of Nursing a. If ordin ordinary ary body body :uid :uid 6 hours 6. Death because because of of &ID"+ &ID"+ &s long long as the body body is humid humid $irus is ali$e – no embalming a. Cremated Cremated dire directly ctly burie buried d -ithin -ithin *6 hours hours M@T+ 1. /loo /lood d tran transf sfus usio ion n a. "ingle "ingle e#os e#osur ure+ e+ G *. "e#u "e#ual al con conta tact ct a. "ingle "ingle e#os e#osure ure++ .1)1 .1)1 to be infec infected ted . >#osur >#osure e to contaminat contaminated ed blood blood roducts roducts or tissu tissue e a. "ingle "ingle e#os e#osur ure+ e+ .1). .1).= = 6. 4erinat 4erinatal al or $ertical $ertical e#osur e#osure e a. o trea treatm tmen ent+ t+ b. 9ith 9ith Tre Treatm atment ent++ = =. Contamina Contaminated ted shars shars and needles needles a. "ingle "ingle e#os e#osur ure+ e+ .1). .1).= = ormal ormal immun immune e res resons onse+ e+ 1. Micr Microo oorrgani ganism sm detected macroha macrohage ge &lert &lert T cells cells "timulates / cells release of antibodies destroy the microbes a. &ntige &ntigen) n) antibo antibody dy reac reactio tion n signs and symtoms *. Cell Cell mediat mediated ed Immun Immunity ity a. In$ol$ In$ol$es es the the T cells7 cells7 i. T cells ser$es as the backbone of immune system – resonsible for secreting the lymhocytes – 5rst line against infections ii. ii. !iller !iller T cells Cytoto# Cytoto#ic ic cells cells – tracks tracks do-n do-n infected infected human human cell to destroy iii. Heler Heler T cells cells – inuutusa inuutusan n to stimu stimulate late / cells cells i$. i$. "ures "uressor sor T Cells Cells – -hen the the infection infection is under under contr control, ol, the "TC tells the killer T cells to sto . Humo Humora rall Immu Immuni nity ty a. In$o In$ol$ l$es es the the / cell cells s i. 4rod 4roduce uces s the antib antibodi odies es ii. ii. "timu "timulat lated ed by by the the Hel Heler er T cell cells s In HI%, HI%, defe defecti cti$e $e T cell cells s no immune defense HI% $iru $irus s has has aLni aLnity ty -ith -ith T cell cells s did not detect macrohage, so did not alert the T cells re$erse transcritase – resemble the T cells 9ell ell 9or 9orri ried ed 4er 4erso son n infected -ith HI% remains asymtomatic – takes time to roduce &/ after ? -eeks to ? months – ositi$e HI% infection – roduction of antibo antibodie dies s '9ind '9indoo- 4eri 4eriod) od) time time bet-ee bet-een n infect infection ion to the rodu roducti ction on of antibodies( ) &;C' &ID" related related comle#( symtoms &ID" 1. &;C+ a. fe$er -ith night night s-eats s-eats -itho -ithout ut a cause cause b. enlargem enlargement ent of the lymh nodes nodes -ithout -ithout a cause 'cer$ical 'cer$ical,, inguinal, inguinal, a#illary( c. memory memory loss W alter altered ed sleein sleeing g atterns atterns W alter altered ed gait *. &ID" &ID"++ mont months hs to to year years s a. &ID" &ID" de5nin de5ning g illnes illness s disea disease se i. Ma0or si signs 1. 2e$er) e$er) ersistent ersistent – 1 month month and abo$e abo$e – abalik abalik balik *. Chronic Chronic diarr diarrhea) hea) 1 month month and abo$e abo$e – abalik abalik balik balik . 1 1 -eig -eight ht loss loss 6. 2or edia edia++ stunte stunted d gro-t gro-th h ii. Mino Minorr sig signs ns 1. 4ersist 4ersistent ent cough cough – 1 month month and abo$e abo$e
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UNIVERSITY OF SANTO TOMAS College of Nursing *. 4ersist 4ersistent ent generali generalized zed lymh lymh adeno adenoathy athy . 8eneraliz 8eneralized ed ruritic ruritic dermatit dermatitis is 6. @roh @rohary arynge ngeal al candid candidias iasis is =. ;ecurr ecurrent ent Her Heres es Joste Josterr ?. 4rogr 4rogressi essi$e $e dessimin dessiminated ated Heres Heres "imle "imle# # iii. iii. &d &dult ult++ * ma0or, ma0or, 1 mino minorh rh i$. i$. Child Childre ren+ n+ * ma0or ma0or,, * min minor or b. Common Common @ortun @ortunisti istic c @rga @rganism nisms s months to years death i. CM%, 4C4 ii. !aosi !aosi sarcoma sarcoma – blood blood $essel $essel -all -all malignanc malignancy y manifested manifested in in the skin 1. 4in 4ink k or urle urle ainl ainless ess sots sots on on the skin skin *. Feoa eoarrd Foo Fook k iii. iii. Candid Candidias iasis is – @ra @rall Fesi Fesions ons i$. i$. @H; – oral oral hair hairy y leuko leukola lakia kia Diagn iagnos osttics ics 1. >FI"& >FI"& test test – screen screening ing test test a. * o ositi$ iti$e e 9/ *. 9ester estern n /lot /lot – con5rm con5rmato atory ry . /lood Test+ HI% %iral %iral Foad – sho-s sho-s the relication relication acti$ity acti$ity of the $irus 6. CD6 cell cell count+ count+ determine determine if the the stage of infecti infection on is &ID" &ID" or HI% a. or ormal+ mal+ 1* 1* cell cells s b. More More than than or eua euall to * * – HI% HI% c. Fess Fess than than * * – &ID" &ID" =. 2or edi edia+ a+ a. /lood culture culture for HI% HI% – detect detect the the microbes microbes b. Immu Immune ne Com Comle le# # Diss Dissoc ocia iate ted d *6 &s &ssa say y – dete detect ct res resen ence ce of antigen Medi Medica call mana manage geme ment nt 1. "ym "ymto toma mati tica call lly y *. 8i$ing of anti retro$iral retro$iral agents in combinations – 6 grous grous –Cocktail –Cocktail Drugs a. *1 tabl tablet ets s er er day day b. Does not alloallo- the $irus $irus to multi multily ly c. ;TI ;TI – ucleosi ucleoside de re$erse re$erse transcri transcritas tase e inhibitor inhibitor)) terminat terminates es $iral relication i. &JT) &JT) &zidothymi &zidothymidine dine,, Jido$udi Jido$udine, ne, ;etro ;etro$ir $ir 1. Check Check C/C C/C – ">+ agranulo agranulocytos cytosis is – &JT d. ;TI ;TI –on ucleoside ucleoside re$erse re$erse transcri transcritas tase e inhibitor inhibitor – blocks blocks the D& acti$ity of the $irus i. e$i e$ira rai ine ne %iram iramun une e e. 4roteas 4rotease e inhibitor– inhibitor– for the the maturation maturation of $irus) $irus) inhibits inhibits i. "au "auin ina$ a$ir ir – In$i In$ira rase se ii. ii. Indi Indina na$i $irr – Cri Cri#i #i$a $an n iii. iii. ;ito ;itona na$i $irr – o$i o$irr f. 2us usio ion n inhi inhibi bito torr i. 4re$ent 4re$ents s fusion fusion of the the $irus $irus to human human cell ii. ii. >nfu$ >nfu$irt irtid ide e – 2uzeon uzeon g. If -ith -ith hea heato toto to#i #ici city ty and and neh nehrroto oto#ici #icity ty sto sto treat treatmen mentt for a-hile urs ursin ing g Car Care 1. "ymto "ymtomat matic ic and and suo suorti rti$e $e *. Counseling) Counseling) better understanding understanding and and kno-ledge kno-ledge of of disease disease rocess7 rocess7 a. 4romo 4romote te ual uality ity of life life b. 4ro$i 4ro$ide de self self care care and and comfor comfortt 4re$ 4re$en enti tion on
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