OLIVAREZ COLLEGE

Dr. A. Santos Avenue, San Dionisio, Parañaque City

PACUCOA Accredited
COLLEGE OF HEALTH RELATED SCIENCES
DEPARTMENT OF NURSING

____________________________________________________________________________________

TYPHOID FEVER and

HUMAN
IMMUNODEFICIENCY

VIRUS

Submitted by:

Garciano, Alexandria E.

Submitted to:

Mrs. Rosa Reyes

TYPHOID FEVER:

● Typhoid is an infection caused by the bacterium S. typhi. The bacterium lives in

the intestines and bloodstream of humans. It spreads between individuals
through direct contact with the feces of a person with an infection.
● No animals carry this disease, so transmission is always from human to human.
S. typhi enters through the mouth and spends 1–3 weeks in the intestine. Then, it
makes its way through the intestinal wall and into the bloodstream.
● From the bloodstream, it spreads into other tissues and organs. The immune
system of the host can do little to fight back, because S. typhi can live within the
host’s cells, safe from the immune system.

HISTORY: Mary Mallon "Typhoid Mary"

● Mary Mallon, who is also commonly known as Typhoid Mary, was the most widely
known carrier of typhoid fever. She was the first person in the United States to be
identified as a carrier of the pathogen responsible for the disease, although she
did not experience any symptoms related to the condition.
● Mary Mallon worked as a cook and throughout her career and is thought to have
infected 51 people, of which 3 cases proved fatal. She was forcibly isolated for
quarantine purposes twice in her life, once in 1907 and again in 1915. The
second time she was not released and later died in isolation at the age of 69.

PATHOGNOMONIC SIGN

● Rose Spots
○ Blanching pink macular spots 2-3mm over trunk

SIGNS AND SYMPTOMS

● Diarrhea may occur

● Active infection
● Severe headache
 ● Generalized Abdominal pain
● Anorexia
● Fever (usually higher in the evening)
● Intermittent fever initially
● Sustained fever to high temperature later

SEVERE CASE s/s:

● Ulcers on the intestinal wall

● Shock
● Delirium
● Stupor

DIAGNOSTIC PROCEDURE:

● CBC
● Tourniquet test - It assesses fragility of capillary walls and is used to identify
thrombocytopenia (a reduced platelet count)
● Typhi dot test (if the illness is 4 days or longer)
● Malarial Smear
● Chest X-ray
● Urinalysis
● Widal Test- an advanced way to check for antibodies that your body makes
against the salmonella bacteria that causes typhoid fever. It looks for O and H
antibodies in a patient's sample blood (serum). This test helps detect
life-threatening illnesses like typhoid fever.

TREATMENT

● The only effective treatment for typhoid is antibiotics. Doctors most commonly
use ciprofloxacin (Cipro) for nonpregnant people.
● Other antibiotics a doctor may use are:
● chloramphenicol (Chloromycetin)
● ampicillin (Ampi, Omnipen, Penglobe, and Principen)
● sulfamethoxazole/trimethoprim (Bactrim)
● Corticosteroids. Dexamethasone may decrease the likelihood of mortality in
severe typhoid fever cases complicated by delirium, obtundation, stupor, coma,
or shock if bacterial meningitis has been definitely ruled out by cerebrospinal fluid
studies.
NURSING CARE

● Encourage increase in fluid intake. Monitor the status of hydration as needed;

monitor the fluid intake daily; encourage an increase in fluid intake; and
collaborate with other medical team for IV fluid administration.
● Improve nutritional intake. Monitor the amount of caloric intake; monitor weight
loss; provide a comfortable environment during meals; and encourage an
increase in protein and vitamin C intake to meet nutritional needs.
● Reduce or diminish pain. Assess the level of pain, location, duration, intensity,
and characteristics; provide warm compresses on areas with pain; and
administer analgesics as prescribed.
● Improve body temperature. Monitor patient temperature degree and patterns;
observe for chills and profuse diaphoresis; provide tepid sponge baths and avoid
the use of ice water and alcohol; and administer antipyretics as prescribed.

PREVENTION

● Vaccinations. Inactivated injectable vaccine (lasting 2-3 years) and the Live
attenuated oral vaccine (lasting 5-7 years).
● Ensure food is properly cooked and still hot when served.
● Avoid raw milk and products made from raw milk. Drink only pasteurized or
boiled milk.
● Avoid ice unless it is made from safe water.
● When the safety of drinking water is questionable, boil it, or if this is not possible,
disinfect it with a reliable, slow-release disinfectant agent (usually available at
pharmacies).
● Wash hands thoroughly and frequently using soap, in particular after contact with
pets or farm animals, or after having been to the toilet.
● Wash fruits and vegetables carefully, particularly if they are eaten raw. If possible,
vegetables and fruits should be peeled.

HUMAN IMMUNODEFICIENCY VIRUS

● Is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV

weakens your immune system by destroying your T-cells until you are unable to
fight off even minor illnesses. You can have HIV without any symptoms. Getting
tested and starting treatment early gives you the best chance of living a long life.
 ● HIV is a retrovirus. All viruses invade your cells and then use your cells’
“machinery” to make more copies of themselves. HIV not only uses your cells to
make more of itself, but it also inserts its instructions into your DNA.

3 STAGES OF HIV

STAGE 1: ACUTE HIV

- Some people get flu-like symptoms a month or two after they’ve been infected
with HIV. These symptoms often go away within a week to a month.

STAGE 2: CHRONIC STAGE/ CLINICAL LATENCY

- After the acute stage, you can have HIV for many years without feeling sick. It’s
important to know that you can still spread HIV to others even if you feel well.

STAGE 3: AIDS

- Aids is the most serious stage of HIV infection. In this stage, HIV has severely
weakened your immune system and opportunistic infections are much more likely
to make you sick.
- Opportunistic infections are ones that someone with a healthy immune system
could typically fight off. When HIV has advanced to AIDS, these illnesses take
advantage of your weakened immune system.
- You’re more likely to get certain cancers when you have AIDS. These cancers
and opportunistic infections together are called AIDS-defining illnesses.
- To be diagnosed with AIDS, the patient must be infected with HIV and have at
least one of the following:
- Fewer than 200 CD4 cells per cubic millimeter of blood (200 cells /mm3)
- An AIDS-defining illness.

HISTORY

Scientists believe that HIV originally came from a virus particular to chimpanzees in
West Africa during the 1930s, and originally transmitted to humans through the transfer
of blood through hunting. Over the decades, the virus spread through Africa, and to
other parts of the world.

However, it wasn’t until the early 1980s, when rare types of pneumonia, cancer, and
other illnesses were being reported to doctors that the world became aware of HIV and
AIDS.
In the US, reporting of unusually high rates of the rare forms of pneumonia and cancer
in young gay men begins. The disease is initially called Gay-Related Immune Deficiency
(GRID) because it is thought it only affects gay men. Cases were also reported in
Injection Drug Users by the end of the year 1981.

Can you get HIV from kissing?

Since HIV is not spread through spit, kissing is not a common way to get infected. In
certain situations where other body fluids are shared, such as if both people have open
sores in their mouths or bleeding gums, there is a chance you could get HIV from deep,
open-mouthed kissing.

You also don’t get HIV from:

● Touching or hugging someone who has HIV/AIDS.

● Public bathrooms or swimming pools.
● Sharing cups, utensils or telephones with someone who has HIV/AIDS.
● Bug bites.
● Donating blood.

Signs and Symptoms

● Night Sweats
● Mouth Ulcers
● Sore throat
● Swollen Lymph Nodes
● Chills
● Fever
● Skin Rashes
● Muscle aches
● Fatigue

DIAGNOSTIC PROCEDURES

● ELISA TEST. stands for enzyme-linked immunosorbent assay, is used to detect

HIV infection. If an ELISA test is positive, the Western blot test is usually
administered to confirm the diagnosis. If an ELISA test is negative, but you think
you may have HIV, you should be tested again in one to three months.
● WESTERN BLOT TEST. a method in which individual proteins of an HIV-1 lysate
are separated according to size by polyacrylamide gel electrophoresis. The viral
 proteins are then transferred onto nitrocellulose paper and reacted with the
patient's serum.
● VIRAL LOAD TEST. a type of HIV test that measures the amount of HIV genetic
material in the blood.
● CD4 LYMPHOCYTE CELL COUNT. which measures how HIV has affected your
immune system.

MEDICAL TREATMENT

ANTIRETROVIRAL THERAPY or ART. which work by stopping the virus replicating in

the body. This allows the immune system to repair itself and prevent further damage.

Two types of HIV treatment: pills and shots.

● Pills are recommended for people who are just starting HIV treatment. There are
many FDA-approved single pill and combination medicines available.
● People who have had an undetectable viral load (or have been virally
suppressed) for at least three months may consider shots.
● Shots. HIV treatment shots are long-acting injections used to treat people with
HIV. And are given once a month or once every other month, depending on your
treatment plan.

NURSING CARE

● Promote skin integrity. Patients are encouraged to avoid scratching; to use non
abrasive, non drying soaps and apply non perfumed moisturizer; to perform
regular oral care; and to clean the perianal area after each bowel movement with
nonabrasive soap and water.
● Promote usual bowel patterns. The nurse should monitor for frequency and
consistency of stools and the patient’s reports of abdominal pain or cramping.
● Prevent infection. The patient and the caregivers should monitor for signs of
infection and laboratory test results that indicate infection.
● Improve activity intolerance. Assist the patient in planning daily routines that
maintain a balance between activity and rest.
● Maintain thought processes. Family and support network members are
instructed to speak to the patient in simple, clear language and give the patient
sufficient time to respond to questions.
● Improve airway clearance. Coughing, deep breathing, postural drainage,
percussion and vibration is provided for as often as every 2 hours to prevent
stasis of secretions and to promote airway clearance.
● Relieve pain and discomfort. Use of soft cushions and foam pads may
increase comfort as well as administration of NSAIDS and opioids.
 ● Improve nutritional status. The patient is encouraged to eat foods that are easy
to swallow and to avoid rough, spicy, and sticky food items.

PREVENTION

Until an effective vaccine is developed, nurses need to prevent HIV infection by

teaching patients how to eliminate or reduce risky behaviors.

● Safe sex. Other than abstinence, consistent and correct use of condoms is the
only effective method to decrease the risk of sexual transmission of HIV infection.
● In March 2007, based on the results of three clinical trials, the WHO and UNAIDS
recommended that circumcision be recognized as an effective strategy to
reduce the risk of HIV acquisition in men.
● Sex partners. Avoid sexual contact with multiple partners or people who are
known to be HIV positive or IV/injection drug users.
● Blood and blood components. People who are HIV positive or who use
injection drugs should be instructed not to donate blood or share drug equipment
with others.

References:

TYPHOID FEVER:

https://nurseslabs.com/typhoid-fever/#:~:text=Monitor%20patient%20temperature%20degree%20and,and
%20administer%20antipyretics%20as%20prescribed.\

https://www.medicalnewstoday.com/articles/156859#prevention

https://www.slideshare.net/davejaymanriquez/typhoid-fever-1010734

HIV

https://nurseslabs.com/hiv-aids/

https://opentextbc.ca/clinicalskills/chapter/8-2-types-of-iv-therapy/

https://canfar.com/awareness/about-hiv-aids/history-of-hiv-aids/

https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html

https://my.clevelandclinic.org/health/diseases/4251-hiv-aids