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CONTAGIOUS DISEASE
Disease that is easily transmitted from one person to
another
INFECTIOUS DISEASE
Disease transmitted by direct inoculation through a break in
the skin
INFECTION
-Entry and multiplication of an infectious agent into the tissue of the
host INFECTIOUS AGENT
INFESTATION
- Lodgement and development of arthropods on the surface of the
Any microorganism capable of producing a disease
RESERVOIR
body
Environment or object on which an organism can survive
ASEPSIS and multiply
- Absence of disease – producing microorganisms PORTAL OF EXIT
SEPSIS The venue or way in which the organism leaves the
- The presence of infection reservoir
MODE OF TRANSMISSION
MEDICAL ASEPSIS The means by which the infectious agent passes from the
- Practices designed to reduce the number and transfer of portal of exit from the reservoir to the susceptible host
pathogens PORTAL OF ENTRY
- Clean technique Permits the organism to gain entrance into the host
SURGICAL ASEPSIS SUSCEPTIBLE HOST
A person at risk for infection, whose defense mechanisms
- Practices that render and keep objects and areas free from are unable to withstand invasion of pathogens
microorganisms
- Sterile technique STAGES OF THE INFECTIOUS PROCESS
Incubation Period – acquisition of pathogen to the onset of
CARRIER – an individual who harbors the organism and is signs and symptoms
capable of transmitting it without showing manifestations of the Prodromal Period – patient feels “bad” but not yet
disease experiencing actual symptoms of the disease
CASE – a person who is infected and manifesting the signs Period of Illness – onset of typical or specific signs and
and symptoms of the disease symptoms of a disease
Convalescent Period – signs and symptoms start to abate
SUSPECT – a person whose medical history and signs and and client returns to normal health
symptoms suggest that such person is suffering from that particular
disease MODE OF TRANSMISSION
CONTACT TRANSMISSION
CONTACT – any person who had been in close association
Direct contact – involves immediate and direct transfer
with an infected person
from person-to-person (body surface-to-body surface)
HOST
Indirect contact – occurs when a susceptible host is
exposed to a contaminated object
- A person, animal or plant which harbors and provides nourishment
DROPLET TRANSMISSION
for a parasite
RESERVOIR Occurs when the mucous membrane of the nose, mouth or
- Natural habitat for the growth, multiplication and reproduction of conjunctiva are exposed to secretions of an infected person within a
microorganism distance of three feet
VEHICLE TRANSMISSION
ISOLATION Transfer of microorganisms by way of vehicles or
- The separation of persons with communicable diseases from other contaminated items that transmit pathogens
persons AIRBORNE TRANSMISSION
QUARANTINE Occurs when fine particles are suspended in the air for a
- The limitation of the freedom of movement of persons exposed to long time or when dust particles contain pathogens
communicable diseases VECTOR-BORNE TRANSMISSION
Transmitted by biologic vectors like rats, snails and
STERILIZATION – the process by which all microorganisms mosquitoes
including their spores are destroyed
TYPES OF IMMUNIZATION
DISINFECTION – the process by which pathogens but not
ACTIVE – antibodies produced by the body
their spores are destroyed from inanimate objects
NATURAL – antibodies are formed in the presence of
CLEANING – the physical removal of visible dirt and debris active infection in the body; lifelong
by washing contaminated surfaces ARTIFICIAL – antigens are administered to stimulate
antibody production
CONCURRENT PASSIVE – antibodies are produced by another source
- Done immediately after the discharge of infectious materials / NATURAL – transferred from mother to newborn through
secretions placenta or colostrum
TERMINAL ARTIFICIAL – immune serum (antibody) from an animal or
- Applied when the patient is no longer the source of infection human is injected to a person
BACTERICIDAL SEVEN CATEGORIES OF ISOLATION
- A chemical that kills microorganisms STRICT- prevent highly contagious or virulent infections
BACTERIOSTATIC Example: chickenpox, herpes zoster
- An agent that prevents bacterial multiplication but does not kill
CONTACT – spread primarily by close or direct contact
microorganisms
Example: scabies, herpes simplex
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RESPIRATORY – prevent transmission of infectious KERNIG’S SIGN
distances over short distances through the air Place the patient in a supine position, flex his leg at the hip and knee
Example: measles, mumps, meningitis then straighten the knee; pain and resistance indicates meningitis
TUBERCULOSIS – indicated for patients with positive
smear or chest x-ray which strongly suggests tuberculosis
ENTERIC – prevent transmission through direct contact with
feces
Example: poliomyelitis, typhoid fever
DRAINAGE – prevent transmission by direct or indirect
contact with purulent materials or discharge
Ex. Burns
UNIVERSAL – prevent transmission of blood and body-fluid
borne pathogens
Example: AIDS, Hepatitis B
DIAGNOSTIC EXAM
Informed consent
Empty bowel and bladder
Fetal, shrimp or “C” position
Spinal canal, subarachnoid space between L3-L4 or L4- L5
After: bedrest
Flat on bed to prevent spinal headache
RABIES
PRODROMAL/INVASION PHASE
Fever
Anorexia
Sore throat
Pain and tingling at the site of bite
Difficulty swallowing
EXCITEMENT OR NEUROLOGICAL PHASE
Hydrophobia (laryngospasm)
Aerophobia (bronchospasm)
Delirium
Maniacal behavior
Drooling
TERMINAL OR PARALYTIC PHASE
Patient becomes unconscious
Loss of urine and bowel control
Progressive paralysis
Death
POLIO
ABORTIVE TYPE
Does not invade the CNS
Headache
Sore throat
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RESPIRATORY SYSTEM
NURSING MANAGEMENT
BIRD FLU
WHAT TO DO WITH A PERSON SUSPECTED TO HAVE BIRD
FLU
• Isolation
• Face mask on the patient
• Caregiver: use a face mask and eye goggles/glasses
• Distance of 1 meter from the patient
• Transport the patient to a DOH referral hospital
REFERRAL HOSPITALS
• National Referral Center – Research Institute for Tropical
Medicine (RITM) (Alabang, Muntinlupa)
• Luzon – San Lazaro Hospital (Quiricada St., Sta. Cruz,
Manila)
• Visayas – Vicente Sotto Memorial Medical Hospital
(Cebu City)
• Mindanao – Davao Medical Center (Bajada, Davao City)
SARS
SUSPECT CASE
1. A person presenting after 1 November 2002 with a history of:
High fever >38 0C AND
Cough or breathing difficulty AND
One or more of the following exposures during the 10 days
prior to the onset of symptoms:
Close contact, with a person who is a suspect or
probable case of SARS
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History of travel, to an area with recent local • Begins with respiratory infection, sneezing, cough and
transmission of SARS fever
Residing in an area with recent local transmission of • Cough becomes more frequent at night
SARS PAROXYSMAL STAGE
2. A person with an unexplained acute respiratory illness resulting • Lasts for 4 to 6 weeks
in death after 1 November 2002, but on whom no autopsy has been • Aura: sneezing, tickling, itching of throat
performed : • Cough, explosive outburst ending in “whoop”
AND • Mucus is thick, ends in vomiting
One or more of the following exposures during the 10 days • Becomes cyanotic
prior to the onset of symptoms: • With profuse sweating, involuntary urination and
Close contact, with a person who is a suspect or exhaustion
probable case of SARS CONVALESCENT STAGE
History of travel, to an area with recent local • End of 4th-6th week
transmission of SARS • Decrease in paroxysms
Residing in an area with recent local transmission of
SARS
PROBABLE CASE
1. A suspect case with radiographic evidence of infiltrates consistent
with pneumonia or respiratory distress syndrome on Chest x-ray.
NASAL DIPHTHERIA
• Bloody discharge from the nose
• Excoriated nares and upper lip
TONSILOPHARYNGEAL DIPHTHERIA
• Low grade fever
• Sore throat
• Bull-neck appearance
• Pseudomembrane- Group of pale yellow membrane over
tonsils and at the back of the throat as an inflammatory
response to a powerful necrotizing toxins
LARYNGEAL DIPHTHERIA
• Hoarseness
• Croupy cough
• Aphonia
• Membrane lining thickens à airway obstruction
• Suffocation, cyanosis or death
WOUND OR CUTANEOUS DIPHTHERIA
• Yellow spots or sores in the skin
PERTUSSIS
CATARRHAL STAGE
• Lasts for 1 to 2 weeks
• Most communicable stage
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MUMPS
MAIN PROBLEM
An acute contagious disease, with swelling of one or both of the
parotid glands
ETIOLOGIC AGENT
Filterable virus of paramyxovirus group
INCUBATION PERIOD
12-26 days
MODE OF TRANSMISSION
Respiratory droplets
PERIOD OF COMMUNICABILITY
6 days before and 9 days after onset of parotid swelling
SIGNS AND SYMPTOMS
PRODROMAL PHASE
F-ever (low grade)
H-eadache
M-alaise
PAROTITIS
F-ace pain
E-arache
S-welling of the parotid glands
COMPLICATIONS
• Orchitis – the most notorious complication of mumps
• Oophoritis – manifested by pain and tenderness of the
abdomen
• CNS involvement – manifested by headache, stiff neck,
delirium, double vision
• Deafness as a result of mumps
NURSING MANAGEMENT
1. Prevent complications
Scrotum supported by suspensory
Use of sedatives to relieve pain
Treatment: oral dose of 300-400 mg cortisone followed by
100 mg every 6 hours
Nick in the membrane
2. Diet
- Soft or liquid diet
- Sour foods or fruit juices are disliked
3. Respiratory isolation
4. Comfort: ice collar or cold applications over the parotid glands may
relieve pain
5. Fever: aspirin, tepid sponge bath
6. Concurrent disinfection: all materials contaminated by these
secretions should be cleansed by boiling
7. Terminal disinfection: room should be aired for six to eight hours
GASTROINTESTINAL TRACT
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INTEGUMENTARY SYSTEM
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- Soft palate to mucus membrane
Sarcoptes scabiei
1. Yellowish white in color
2. Barely seen by the unaided eye
3. Female parasite burrows beneath the epidermis to lay eggs
4. Males are smaller and reside on the surface of the skin
SIGNS AND SYMPTOMS
• Thin, pencil-mark lines on the skin
• Itching, especially at night
• Rashes and abrasions on the skin
PRIMARY LESIONS
NODULAR LESIONS
SECONDARY LESIONS
TREATMENT MODALITIES
• SCABICIDE : Eurax ointment (Crotamiton)
• PEDICULICIDE : Kwell lotion (Gamma Benzene
Hexachloride) – contraindicated in young children and
pregnant women
• Topical steroids
• Hydrogen peroxide : cleanliness of wound
• Lindane Lotion
NURSING MANAGEMENT
• Apply cream at bedtime, from neck to toes
• Instruct patient to avoid bathing for 8 to 12 hours
• Dry-clean or boil bedclothes
• Report any skin irritation
• Family members and close contact treatment
• Good handwashing
• Terminal disinfection
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SIGNS AND SYMPTOMS (Candidiasis)
ONYCHOMYCOSIS
• Red, swollen darkened nailbeds
• Purulent discharge
• Separation of pruritic nails from nailbeds
DIAPER RASH
• Scaly, erythematous, papular rash
• Covered with exudates
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• Appears below the breasts, between fingers, axilla, groin
and umbilicus
THRUSH
• Cream-colored or bluish-white patches on the tongue,
mouth or pharynx
• Bloody engorgement when scraped
MONILIASIS
• White or yellow discharge
• Pruritus
• Local excoriation
• White or gray raised patches on vaginal walls with local
inflammation
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VECTOR-BORNE DISEASES
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FILARIASIS
MAIN PROBLEM
A parasitic disease caused by an African eye worm
ETIOLOGIC AGENT
Wuchereria bancrofti
Brugia malayi
Brugia timori
INCUBATION PERIOD
8 to 16 months
MODE OF TRANSMISSION
Person-to-person by mosquito bites
ACUTE STAGE
• Lymphadenitis (inflammation of lymph nodes)
• Lymphangitis (inflammation of lymph vessels)
• Male genitalia affected leading to funiculitis, epididymitis
and orchitis (redness, painful and tender scrotum)
CHRONIC STAGE
• Develop 10-15 years from onset of first attack
• Hydrocele (swelling of the scrotum)
• Lymphedema (temporary swelling of the upper and lower
extremities)
• Elephantiasis (enlargement and thickening of the skin of
the upper and lower extremities, scrotum and breast
LABORATORY EXAMINATIONS
• Nocturnal blood examination (NBE) – taken at patient’s
residence/hospital after 8PM
• Immunochromatographic test (ICT) – rapid assessment
method; an antigen test done at daytime
TREATMENT
• Diethylcarbamazine Citrate (DEC) or HETRAZAN – an
individual treatment kills almost all microfilaria and a good
proportion of adult worms.
PREVENTION AND CONTROL
• Measures aimed to control vectors
• Environmental sanitation such as proper drainage and
cleanliness of surroundings
• Spraying with insecticides
PREVENTION AND CONTROL
• Measures aimed to protect individuals and families:
• Use of mosquito nets
• Use of long sleeves, long pants and socks
• Application of insect repellants
• Screening of houses
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