COMMUNICABLE DISEASE NURSING RN2024

TERMINOLOGIES Method of disinfection when the patient is still

Infection the source of infection.
Implantation and success replication of an
organism in the tissue of the host resulting to Terminal
signs and symptoms as well as immunologic It is applied when the patient is no longer the
response. source of infection
This is done after patient is discharged from
Carrier the hospital to prepare the room for the next
patient.
An individual who harbors the organism and is
capable of transmitting it to a susceptible host
without showing manifestations of the disease.
Habitat
It is a place where an organism lives or where
an organism is usually found.
Communicable Disease
It is an illness caused by an infectious agent or Host
its toxic products that are transmitted directly It is a person, animal or plant on which a
or indirectly to a well person through an parasite depends for its survival.
agency, and a vector or an inanimate object.
Contact Infectious Disease
It is transmitted not only by ordinary contact
It is any person or animal who is in close but requires direct inoculation of the organism
association with an infected person, animal or through a break on the skin or mucous
freshly soiled materials. membrane.

Contagious Disease Isolation

it is the separation from other persons of an
It is a term given to a disease that is easily individual suffering from a communicable
transmitted from one person to another through disease during the period of communicability.
direct or indirect means.
Quarantine
Disinfection It is the limitation of freedom of movement of
It is the destruction of pathogenic persons or animals which have been exposed
microorganism on inanimate objects by directly to communicable disease/s for a period of
applying physical or chemical means. time equivalent to the longest incubation
period of that disease.
Concurrent Reservoir
it is a method of disinfection done immediately It is composed of one of more species of animal or
after the infected individual discharges plant in which an infectious agent lives and
infectious material/secretions. multiplies for survival and reproduces itself in such
a manner that it can be transmitted to man.
EPIDEMIOLOGY
It is study of occurrences and disturbance of
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Biological
diseases as well as the distribution and Social
determinants of health states of events in Physical
specified population and application of this
study to the control of health problems.
Foundation of preventing disease Patterns of Occurrence and Distribution
Sporadic
Uses Intermittent occurrence of a few isolated and
Study the history of the health population and unrelated cases in a given locality.
the rise and fall of disease and changes in their Cases are few and scattered
character. E.G. Rabies
Diagnose the health of the community
Mode
Study ofof transmission
the work health services with a view of Endemic
improving them Continuous occurrence throughout a period of
Estimate the risk of disease, accident, defects time, of the usual number of case in a given
and the chances of avoiding them. locality.
Complete the clinical picture of chronic disease The disease is therefore always occurring in the
and describe their history locality and the level of occurrence is more or
less constant through a period of time.
Epidemiologic Triangle Examples:
Consists of three components – host, Schistosomiasis (Leyte & Samar)
environment and agent Filariasis (Sorsogon)
Malaria (Palawan)
Host Epidemic (Outbreak)
Any organism that harbors and provides Unusually large number of cases in a relatively
nourishment for another organism short period of time.

Agent Pandemic
Intrinsic property of microorganism to survive The simultaneous occurrence of epidemic of
and multiply in the environment to produce the same disease in several countries.
disease. E.G. HIV/AIDS and SARS

Environment
It is the sum total of all external conditions and
influences that affect the development of an
organism which can be:
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CHAIN
OF INFECTION
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4.Mode of Transmission
It is the means by which the infectious agent
passes through from the portal of exit of the
reservoir to the susceptible host.
Easiest link to break the chain of infection
Contact Transmission
Most common mode of transmission
Direct Contact
Refers to a person to person transfer of
organism.
Indirect Contact
1. Causative Agent Occurs when the susceptible person comes in
contact with a contaminated object.
Any microbe capable of producing a disease
Bacteria, spirochete, virus, ricketssia, chlamydiae,
Droplet Spread
fungi, protozoa and parasites It is the transmission through contact with
respiratory secretions when the infected
2. Reservoir of Infection person coughs, sneezes or talks.
Transmission is limited within 3 feet.
Refers to the environment and objects on
which an organism survives and multiples Airborne Transmission
3. Portal of Exit Occurs when fine microbial particles or dust
particles containing microbes remain
suspended in the air for a prolonged period.
It is the path or way in which the organism Transmission can be more than 3 feet.
leaves the reservoir.
Common portals of exit: Vehicle Transmission
Respiratory System It is the transmission of infectious disease
Genitourinary Tract through articles or substance that harbor the
Gastrointestinal Tract organism until it is ingested or inoculated into
Skin and Mucous Membrane the host.
Placenta
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Vector-borne Transmission
Occurs when intermediate carriers, such as
fleas, flies and mosquitoes transfer the
microbes to another living organism.

4. Portal of Entry
It is the venue the organism gains entrance
into the susceptible host.
The infective microbes use the same avenues
when they exit from the reservoir.

5. Susceptible Host
When the defenses are good, no infection will
take place.
However, in weakened host, microbes will
launch an infectious disease.

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IMMUNITY RN2024
NATURAL Passive
Active Acquired through the administration of
antitoxin, antiserum, convalescent serum, and
Acquired through recovery from a certain immunoglobulins
disease
Passive
Uses
Acquired through placental transfer
TYPES
OF ANTIGEN
Inactivated (killed organism)
Not long lasting
Multiple doses needed
Booster dose needed

Attenuated (live, weakened organism)

Single dose needed
Long lasting immunity
ARTIFICIAL
Active
Acquired through the administration of
vaccine and toxoid

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ISOLATION RN2024
Separation of patients with communicable
disease from other so as to prevent or reduce Enteric Isolation
transmission or infectious agent directly or For infection with direct contact with feces
indirectly.
Reverse/Neutropenic Isolation
Categories Recommended in An immunocompromised client is separated to
Isolation: prevent contracting infection from environment.
Strict Isolation Standard Precaution
Prevents highly contagious or virulent infections To prevent infections that are transmitted by
direct or indirect contact with secretions or
Contact Isolation drainage (except sweat) from another person.
Universal Precaution + Body Substance
Prevents the spread of infection primarily by Isolation (BSI)
close or direct contact
Universal Precaution
Respiratory Isolation Intended to prevent parenteral mucous
membrane and non-intact skin exposure of
Prevents the transmission of infectious diseases health care workers to blood borne pathogens
over short distance through the air
Transmission Based Precaution
Second Tier of precaution
Applicable to patient who are highly
contagious
Three types: Contact, Airborne, Droplet

TB Isolation
For TB patients with positive smear or with
chest X-ray which strongly suggests active
tuberculosis.

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CHICKEN POX
OTHER TERM: VARICELLA ZOSTER
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Description Congenital varicella
Acute infectious disease of sudden onset with results in:
slight fever, mild constitutional symptoms and Hypoplastic, deformities and scarring of limb
eruptions which are maculopapular for a few Retarded growth
hours, vesicular for 3-4 days and leaves CNS and ophthalmic manifestation
granular scabs.
Etiologic agent: Nursing considerations
Human (alpha) herpes virus 3 Strict Isolation
Exclusion from school for 1 week after eruption
(Varicella-zoster virus) first appears and avoid contact with
Source of infection susceptible
Concurrent disinfection if throat and nose
Secretions of respiratory tract of infected discharge
persons Tell the patient not to scratch the lesions
Lesions (little consequence) Teach the child and the family how to apply
Scabs are not infective topical antipruritic medication correctly

Mode of transmission Susceptibility, Resistance

Direct contact & Occurrence
Contact with contaminated linen and fomites Universal among those not previously attacked
Airborne Severe in adults
An attack confers long immunity
Incubation period Second attacks are rare
2 to 3 weeks Prevention
Period of communicability Vaccine:
Cases are infectious for up to 2 days before the Varicella – zoster Immune Globulin (VZIG)
onset of the rash until 5 days after the first
crop of vesicles. It should be given
Diagnostic Test within 10 days of
exposure
Isolation of the virus from the vesicular fluid
within the first 3 to 4 days of the rash
Serum antibodies is present in 7 days after
onset

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MEASLES
OTHER TERMS: Rubeola/Morbili/7-day
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measles
Description Clinical manifestations
Koplik spots - pathognomonic
sign
1. Pre-eruptive Stage
Fever
Catarrhal Symptoms (cough, conjunctivitis,
coryza)
Photophobia
Stimson’s line (red line on the lower
conjunctiva)
it is an acute contagious and exanthematous
disease that usually affects children who are
2. Eruptive Stage
susceptible to Upper Respiratory Tract Infection Maculo-papular rash
(URTI) High grade fever
Anorexia and irritability
Etiologic agent: Throat is red and extremely sore
Paramyxoviridae 3. Convalescence Stage
Rashes fade away
Source of infection Fever subsides
Secretions of nose and throat of infected Desquamation begins
persons Symptoms subside and appetite is restored
Nose and Throat Swab
Mode of transmission Urinalysis
Blood exams (Single raised IgM or rise on IgG)
Droplet Spread / Direct Contact with Infected
person
Indirect Contact (articles with secretions)
Treatment modalities
Airborne Anti-viral drug (Isoprenosine)
Antibiotics
Incubation period Oxygen Inhalation
IV fluids
1-2 weeks
Complications
Period of Communicability Bronchopneumonia
Starts just before the prodrome and lasts until 4 Otitis Media
days after the rash appears. Pneumonia
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 Nephritis
Encephalitis RN2024
Nursing management
Isolation
Maintain standard and airborne precautions.
Place the patient on a negative pressure room
Tepid Sponge Bath (TSB)
Treatment Modalities
Skin care
Oral and nasal hygiene
Eye care (photosensitivity)
Ear care
Daily elimination (Mild laxative)
During febrile stage, limit the diet to fruit juices,
milk, and water.
Give medication as ordered by the physician
(Penicillin)

Preventive measures
Immunization with:
Anti-measles at the age of 9 months as a single
dose
MMR vaccine (15 mos.); 2nd dose (11 to 12 years
old)

Measles vaccine should not be given

to pregnant women, or to persons
with active tuberculosis, leukemia,
lymphoma or depressed immune
system .

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LEPROSY
OTHER TERMS: Hansen’s
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Disease/Hansenosis
Description Affects the peripheral nerves and sometimes the
surrounding skin, especially on the face, eyes
and testes as well as the nerves and the skin.
Lepromin Test is positive, but the organism is
rarely isolated from the lesions
Macules are elevated with clearing at the center
and more clearly defined than the lepromatous
form.
Borderline (dimorphous)
Incubation period
The incubation period varies from a few
months to many years. Lepromatous patients
It is a chronic systematic infection characterized Congenital Rubella
may be infectious for several years.
by progressive cutaneous lesions. Mode of transmission
Etiologic agent: Airborne
Prolonged skin-to-skin contact
Mycobacterium leprae
Clinical manifestations
Three distinct forms Early
Lepromatous (Multibacillary) Changes in skin color (reddish/white)
Loss of sensation on the skin/Anesthesia
leprosy Decrease/loss of sweating and hair growth
Most serious type over the lesion
Not infectious Thickened/painful nerves
Causes damage to the respiratory tract, eyes Muscle weakness
and testes and well as the nerves and the skin. Redness of the eye
Lepromin test is negative, but the skin lesion Nasal Obstruction
contains large amount of Hansen’s bacillus Ulcers that do not heal
Slow involvement of the peripheral nerves, with
some degree of anesthesia and loss of Late
sensation and gradual destruction of the nerves. Madarosis
Tuberculoid (Paucibacillary) (Loss of eyebrow and eyelashes)
Leprosy Lagopthalmos
(inability to close eyelids)
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 Contractures
Sinking of the nose bridge
Gynecomastia
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Diagnostic tests
Slit skin Smear
Blood Test (Inc. RBC & ESR; Dec, Ca, albumin &
Cholesterol level)
Treatment
Treatment Modalities
modalities
Sulfone Therapy
Rehabilitation, Recreational and Occupational
Therapy
Multiple Drug Therapy
Multibacillary (Rifampicin,
Clofazimine, Dapsone)
Infectious Type
Duration of treatment (12 months)
Paucibacillary (Rifampicin and
Dapsone)
Tuberculoid & indeterminate
Non-infectious types
Duration of treatment (6-9 months)

Nursing management
Isolation and Medical Asepsis should be carried
out
Diet: Full, nutritious diet
Give antipyretic, analgesics and sedative as
needed.
Provide emotional support throughout treatment
and rehabilitation of affected extremities
Patients with eye dryness need to use a tear
substitute daily and protect their eyes to
prevent corneal irritation and ulceration.
Tell the patient with an anesthetized leg to
avoid injury by not putting to much weight on
the leg, testing water before entering to prevent
scalding, and wearing appropriate footwear.
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SCABIES RN2024
Description Burrows (lesions) seen in
webs of the fingers, wrists
and elbows
Burrows in immunocompromised, infants, young
children and elderly appears in face, neck, scalp
and ears
Complications
Persistent pruritus
Intense scratching can lead to excoriation,
tissue trauma and secondary bacterial
It is a highly transmissible skin, infection that is Incubation
infection. period
characterized by burrows, pruritus, and
excoriations with secondary bacterial infection. Diagnostics procedure
Etiologic agent: Congenital
Superficial scraping Rubella
and examination under a
low-power microscope of material from a
Sarcoptes scabei var homonis burrow.
Treatment
Source of infection Aqueous Malathion lotion
Human skin Permethrin derma cream left on the skin for 8-
Mode of transmission 12 hours
Benzyl Benzoate
Skin to skin contact Sulfur in petrolatum
Direct contact with fomites Ivermectin – Anti-helminthic drug is effective in
resistant cases
Incubation period Antipruritic emollient or topical steroid for
itching
The itch mite may burrow under the skin and lay
ova within 24 hours of an original contact. Nursing interventions
Period of communicability Have the patient’s fingernails cut short to
This disease is communicable for the entire minimize skin breaks from scratching
period that the host is infected. Instruct patient on proper application of the
drugs
Clinical manifestations Contaminated clothing or beddings should be
dry-cleaned or boiled
Intense itching that becomes Advise patient to report any skin irritation
more severe at night
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Advise family member and other people who
had close contact with the patient be checked
for possible symptoms and be treated if
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necessary
Practice contact precaution
Terminal disinfection should be carried out
Encourage the patient to verbalize his/her
feelings
Treatment
Prevention Modalities
Good personal hygiene
Avoid contact with infected persons
All members of the household, including close
contact should be treated

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GERMAN
MEASLES
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OTHER TERMS: Rubella / Three-day
Measles
Description Eruptive Phase
Forchheimer’s spot (pinkish rash on the soft
palate)
Eruption appears after the onset of adenopathy
Children usually present less or no constitutional
symptoms
The rash may last for one to five days and
leaves no pigmentation nor desquamation
Testicular pain in young adults
Transients polyarthralgia and polyarthritis may
occur in adults and occasionally in children.

It is a mild viral illness caused by rubella virus Congenital Rubella

It causes mild feverish illness associated with
rashes and aches in joints. Classic Congenital Rubella
It has a teratogenic effect on the fetus. Syndrome
Etiologic agent: Rubella virus Intrauterine growth retardation
Infant has low birth weight
Mode of transmission Thrombocytopenic purpura known as “blueberry
muffin” skin
Droplet transmission
Transplacental transmission in congenital rubella Intrauterine Infection
Incubation period: 2 to 3 weeks May result in spontaneous abortion
Birth result in spontaneous abortion one or
multiple birth anomalies such as:
Clinical manifestations - Cleft palate, talipes and eruption of teeth
Prodromal Period - Cardiac defects (patent ductus arteriosus,
Low grade fever atrial septal defect)
Headache - Eye defects (glaucoma, retinopathy,
Malaise micropthalmia)
Mild coryza - Neurologic (Microcephaly, mental
Conjunctivitis retardation, psychomotor retardation,
Post-auricular, sub-occipital and posterior vasomotor instability)
cervical lymphadenopathy which occurs on the
3rd to the 5th day after onset.
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Diagnostic test
Clinical observation
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Cell cultures of the throat, blood, urine and Prevention
cerebrospinal fluid confirm the presence of the Administration of live attenuated vaccine (MMR)
virus Pregnant women should avoid exposure to
Convalescent serum that shows a fourfold rise patients infected with rubella virus
antibody titer supports that the diagnosis Administration of Immune Serum Globulin one
week after exposure to rubella
Treatment Modalities
Acetaminophen for fever and joint pain.
Isolation

Complications
Encephalitis
Neuritis
Arthritis
Arthralgias
Rubella syndrome manifested by:
- Microcephaly
- Mental retardation
- Cataract
- Deaf-mutism
- Heart Disease

Nursing considerations
Provide comfort
Make sure female patients understand how
important it is to avoid exposure to this disease
when pregnant.
Report confirmed cases of rubella to local public
health officials
Warn the patient about possible mild fever, slight
rash, transient arthralgia, and arthritis.
If lymphadenopathy persists after the initial 24
hours, suggest a cold compress to promote
vasoconstriction and prevent antigenic cyst
formation.
Patient’s room must be darkened to avoid
photophobia
Patient’s eyes should be irrigated with warm
saline to relieve irritation
Good ventilation is necessary.
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PEDICULOSIS RN2024
Description Pubic lice will be found attached to the base of
the pubic hair and the infestation generally
Any human infestation of lice results in severe itching
May occur anywhere on the body
Diagnostic tests
Types Wood’s light examination (fluorescence of the
adult lice)
Pediculosis capitis Microscopic examination (presence of nits on
Lice feed on the scalp and rarely, on the skin the hair shaft)
under the eyebrows, eyelashes and beard
Treatment modalities
Pediculosis Corporis Permethrin (Eliminate) /Pyrethin
Lice feed on the scalp and rarely, on the skin (Rid Mousse)
under the eyebrows, eyelashes and beard Initial treatment of choice
Pediculosis pubis Congenital
For PediculosisRubella
Topical insecticide
capitis & Pediculosis pubis
Lice are found primarily in pubic hairs but may Fine-tooth comb dipped in vinegar
extend to the eyebrows, eyelashes and axillary Washing hair with ordinary shampoo
or body hair. Oral Anthelminthics (Ivermectin, Levamisole,
Albendazole) are effective against head lice
Mode of transmission infestation
Prevention of head reinfestation
Head-to-head contact Clothes and bed linens must be washed
Fomites in hot water, ironed or dry cleaned.
Sexual activity Storing clothes or linens for more than
Incubation period 30 days or placing them in dry heat of
140 F (60 C) kills lice
3 to 7 days
Clinical manifestations Complications
Pruritis (most common symptom of infestation) Excoriation
Tickling sensation of something moving in the Secondary bacterial infections
hair may be noticed If left untreated, pediculosis may result in dry,
Head lice and their nits are most commonly hyperpigmented, thickly encrusted, scaly skin,
found behind the ears and on the hairs of the with residual scarring
neck and occiput.
Body lice are found on clothing seams

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Nursing considerations
Contact precautions should be maintained until
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treatment is complete to prevent spreading the
infection
Have the patient’s fingernails cut short to
prevent skin breaks and secondary bacterial
infections caused by scratching.
Be alert for possible adverse reactions to
Treatment
Prevention Modalities
treatment with an antiparasitic, including
sensitivity reactions and in some cases, central
nervous system (CNS) toxicity.
To prevent self-infestation, avoid direct contact
with the patient’s hair, clothing and bedsheets.
Use gloves, a gown, and a protective head
covering when administering delousing
treatment.
After each treatment, inspect the patient for
remaining lice and eggs.
Teach the patient and family how to inspect and
identify lice, eggs and related lesions
Instruct the patient and family about the use of
the creams, lotions, powders and shampoos that
eliminate lice.
Instruct the patient in the proper application of
lindane, which can be absorbed by the skin and
cause CNS complications.

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HERPES
ZOSTER
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OTHER TERMS: Shingles
Description Severe deep pain, pruritus, and paresthesia and
hyperesthesia, usually on the trunk and
occasionally on the arms and legs
Small, red, nodular skin lesions (Unilateral) erupt
on the painful areas up to 2 weeks after first
symptoms
Vesicles filled with fluid or pus
Cranial nerve involvement

Complications
Generalized central nervous system infection
Acute transverse and ascending myelitis
It is acute unilateral and segmented inflammation Intractable neurologic pain
of the dorsal root ganglia caused by Congenital Rubella
reactivation of the herpes varicella-zoster virus, Diagnostic procedure
which also causes chickenpox Differentiation of herpes zoster from herpes
Usually occur in adults simplex virus through fluorescent light
Etiologic agent: Tissue culture technique
Smear of vesicle fluid
Varicella virus Microscopy

Incubation period Management

Unknown, but it is believed to be 13-17 days Antiviral therapy – Acyclovir
Analgesics to control pain
Anti-inflammatory
Period of communicability
Communicable a day before the appearance of Nursing interventions
the first rash until 5-6 days after the last crust Airborne and contact precautions
If vesicles rupture, apply a cold compress as
Mode of transmission ordered
To minimize neuralgic pain, administer
Airborne analgesics as ordered and evaluate their
Droplet effects
Direct contact Instruct the patients to avoid scratching the
Clinical manifestations lesions
Keep the patient comfortable and maintain
Begins with fever and malaise meticulous hygiene
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Nursing considerations
Vaccination against varicella
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Avoid exposure to patients with varicella
infection

Treatment
Prevention Modalities

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DIPHTHERIA RN2024
Description Variable until virulent bacilli has disappeared
from secretions and lesions

Types
Nasal
With foul – smelling serosanguinous secretions
from the nose
Tonsillar
Low fatality rate
Lesions are confined to the tonsils only but
tend to spread over the pillars, into the soft
Acute febrile infection of the tonsil, throat, nose, palate and uvula
larynx or wound marked by patches of grayish
membrane from which the diphtheria bacillus is Nasopharyngeal
readily cultured Cervical lymph nodes are swollen
Neck tissues are edematous
Etiologic agent:
Corynebacterium, diphtheria Laryngeal
Most commonly found in children ages 2 to 5
(Klebs-Loeffier bacillus) years old
It is considered as most severe and more fatal
Source of infection type due to anatomical reason
There is moderate hoarseness; voice is
Discharges and secretion from mucus surface of diminished until it is finally absent.
nose and nasopharynx and from skin and other Most fatal
lesions
Reservoir = Man Wound / Cutaneous
Mode of transmission Affects to mucous membrane and any break in
the skin.
Contact with a patient or carrier or with articles
soiled with discharges of infected persons.
Milk (vehicle) Clinical manifestations
Bull neck formation
Incubation period (swelling of the soft tissues of the neck)
2 to 5 days Exudates forming the membrane are grayish in
appearance (Pseudomembrane)
Period of communicability
2 weeks to more than 4 weeks
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 RN2024
Nursing care
Fatigue / malaise Follow prescribed dosage and correct
Slight sore throat technique in administering anti toxin
Breathing difficulty Provide comfort
Husky voice Soft-food diet; small frequent feedings
Prevention
Swelling of the palate
Low-grade fever
Ice collar applied to the neck
- Visiting bag should be set up outside the
room of the patient of should be far from the
Prevention bedside of the patient
Active immunization of all infants and children Watch for signs of shock, which can develop
with 3 doses of DPT suddenly as a result of systematic vascular
Pasteurization of milk collapse, airway obstruction, or anaphylaxis.
Education of parents If neuritis develops, tell the patient it’s usually
Reporting of case to the Health Officer of proper transient. Be aware that peripheral neuritis
medical care may not develop until 2 to 3 months after the
onset of illness.
Diagnostic tests Explain how to properly dispose of
nasopharyngeal secretion and teach proper
Swab from the nose and throat infection precautions
Schick Test
Involves giving an injection of 0.1 mL of dilute
diphtheria toxin intradermally.
Area is checked in 3-4 days and the reaction is
documented
Positive Test is indicated by inflammation or
induration at the point of injection. This
indicates that the client lacks antibodies to
diphtheria.
Virulence Test
Moloney Test
A test to detect a high degree of sensitivity to
diphtheria toxoid is given intradermally.
Treatment modalities
Penicillin
Anti-toxin
Erythromycin
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PERTUSIS
OTHER TERMS: Whooping Cough
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Description Complications
Acute infection of the respiratory tract
characterized by repeated attacks of spasmodic
Most dangerous: bronchopneumonia
Convulsion
coughing which consists of a series of explosive Umbilical hernia
expirations, producing a crowing sound, “the Otitis media
whoop”, and usually followed by vomiting. Severe malnutrition and starvation
Etiologic agents: Diagnostic tests
Haemophilus pertussis Nasopharyngeal swabs (Positive for B.
Bordet Gengou bacillus pertussis)
Bordetella pertussis Sputum culture
CBC (leukocytosis)
Source of infection Chest Radiography may reveal infiltrates or
pulmonary edema with atelectasis
Discharges from laryngeal and bronchial mucous
membrane of infected persons. Treatment modalities
Incubation Period Supportive Therapy
7-10 days but may occasionally be up to 3 Fluid & electrolyte replacement
weeks Adequate nutrition
Oxygen therapy
Period of communicability Antibiotics
Seven days after exposure to three weeks after Erythromycin
typical paroxysms Ampicillin
Mode of transmission Post Exposure Treatment:
Direct spread through respiratory and salivary Hyperimmune convalescent serum / gamma-
contacts globulin
Client manifestations Nursing management
Violent coughing Isolation and medical asepsis
Nose bleeding Suction Equipment should be present at
Distended neck veins bedside
Periorbital edema Provide warm baths
Conjunctival hemorrhage Keep the bed dry and free from soiled linens

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I & O should be closely monitored
General care of nose and throat discharges
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Instruct patients to cover their mouths when
they cough or sneeze and to wash their hands
immediately afterwards.

Prevention
Any case of pertussis should be reported
Treatment Modalities
Patient should be isolated for 4 to 6 weeks
Previously immunized children should be given
reinforcing injection

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INFLUENZA
OTHER TERMS: La Grippe
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Description Myocarditis
Sudden Infant Death Syndrome
It is an acute infectious disease affecting the Myoglobinuria
respiratory system
Diagnostic Procedures
Etiologic agents: Blood examinations
Influenza virus A, B, C Usually normal but leukopenia has been
noted
Source of Infection Viral Culture
Discharges from the mouth and nose of infected (oropharyngeal washing or swabbing during the
persons first few days of illness)
Mode of Transmission Viral Serology
Droplet Complement Fixation Test
Direct contact through droplet infection It is an immunological medical test that can
Indirect contact (fomites) be used to detect the presence of either
Incubation Period specific antibody or specific antigen in a
patient’s serum
1 to 3 days, occasionally up to 5 days Chest Radiography
may reveal bilateral symmetrical interstitial
Period of Communicability infiltrates indicative of pneumonia
Infectious period lasts from 1 day before until 3- Arterial Blood Gas Testing
5 days after onset of symptoms in adults. may reveal hypoxemia in severe cases
Clinical Manifestations Laboratory Tests
Chilly sensation may reveal leukopenia, lymphopenia, and/or
Hyperpyrexia thrombocytopenia.
Severe aches and pain usually at the back
associated with severe sweating Management
Vomiting Stay at home
Sore throat Teach the patient about proper disposal of
Coryza and cough tissues and good handwashing technique
Complications Drink plenty of fluids
Fever Management
Hemorrhagic pneumonia
Encephalitis
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 Paracetamol
Ibuprofen
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Maintain contact and droplet precautions
Limit strenuous activities
Watch for signs and symptoms of developing
pneumonia such as crackles, another
temperature increase , or coughing accompanied
by purulent or bloody sputum
Treatment Modalities
Instruct patients who are sick with flu-like
symptoms to avoid contact with others for at
least 24 hours.
Preventive Measures
Active immunization with influenza vaccine
Education of the public as to sanitary hazard
from spitting, sneezing and coughing
Avoid crowded places
Avoid use of common towels, glasses and eating
utensils.

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ANTHRAX
OTHER TERMS: Wool-sorter’s Disease /
RN2024
Systemic symptoms may include rigors’
Ragpicker’s Disease headache and vomiting
Description The sore is usually diagnostic: 20% cases are
fatal.
An acute bacterial disease usually affecting the
skin but which may very rarely involve the
oropharynx, lower respiratory tract, mediastinum
or intestinal tract.
Etiologic Agent:
Bacillus anthracis
ModeofofTransmission
Mode transmission Inhalational Anthrax
Cutaneous infection is by Spores are inhaled with subsequent invasion of
mediastinal lymph nodes.
contact with: Abrupt onset of flu-like illness, rigors, dyspnea
Tissues of animals (cattle, sheep, goats, and cyanosis followed by shock and usually
horses, pigs and others) dying of the disease death over the next 2-6 days.
Contaminated hair, wool, or products made Most Fatal
from them such as drums or brushes
Soil associated with infected animals or
contaminated bone meal used in gardening.
Intestinal Anthrax
Occurs following ingestion of meat from
infected animals and is manifested as violent
Incubation Period gastroenteritis with fever, vomiting, bloody
Inhalation Anthrax (1 to 7 days) usually within 48 stools and then septicemia
hours Poor prognosis
Cutaneous anthrax (1 to 7 days rarely up to 7
weeks Diagnostic Tests
Ingestion (1 to 7 days)
Polymerase Chain Reaction
Clinical Manifestations (PCR)
Cutaneous Anthrax Definitive test for B. anthracis
Most common (over 90% of cases) Swabs from cutaneous lesions
Infection is through the skin Blood cultures
Over a few days a sore, which begins as a Lymph node or spleen aspirates
pimple, grows, ulcerates and forms a black CSF shows characteristic bacilli on staining
scab, around which are purplish vesicles with polychrome methylene blue.

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 Chest radiology may show fluid surrounding the
lungs or widening of the mediastinum RN2024
Treatment Modalities Alcohol-based hand sanitizers do not kill anthrax
spores; wash hands with soap and water.
Antibiotics
Penicillin Prevention
Ciprofloxacin (DOC) Pretreatment of animal product and good
Doxycycline occupational health cover are the mainstays of
Treatment of cutaneous anthrax is oral antibiotic control
for 7 to 10 days Animals believed to have died of anthrax
Length of treatment for GI anthrax is 60 days, but should be disposed of under supervision.
safety has not been evaluated beyond14 days Mass vaccination of animals may reduce
disease spread
Non-cellular vaccines for human use are
Complications available for individuals at risk from
occupational exposure
Cutaneous Anthrax Workers handling potentially infectious raw
Septicemia materials should be aware of the risks.
Inhalational Anthrax
Hemorrhagic meningitis
Pleural Effusions
Mediastinitis
Shock
Acute Respiratory Distress Syndrome
GI Anthrax
Hemorrhage
Shock
Nursing considerations
Obtain culture specimens before starting
antibiotic therapy
Supportive measures are geared toward the
type of anthrax exposure
Teach the patient and family that anyone who
has been exposed to anthrax must see a
doctor immediately.
Instruct the patient to take antibiotics as
prescribed and until completed.
Instruct the patient with cutaneous anthrax not
to scratch at the lesions.
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PNEUMONIA RN2024
Description Mode of Transmission
Droplet infection
Indirect contact (fomites)

Clinical Manifestations
Rhinitis
Chest indrawing
Rusty sputum
Productive cough
High fever
Vomiting
Convulsions
Flushed face
Dilated pupils
Congenital Rubella
Pain over the affected lung
Highly colored urine with reduced chlorides
and increased urates

Complications
Emphysema
Endocarditis
An acute infectious disease of the lungs usually Pneumococcal meningitis
caused by the pneumococcus resulting in the Otitis Media
consolidation of one or more lobes of either one Jaundice
or both lungs.
Etiologic Agent: Diagnostic Test
Chest X-ray
Streptococcus pneumonia Sputum Analysis
Staphylococcus aureus Blood/Serologic Exam
Dull percussion note on affected side
Haemophilus influenzae
Pneumococcus of Friedlander Management
Bed Rest
Incubation Period Adequate salt, fluid, calorie, and vitamin intake
TSB
2 to 3 days Frequent turning from side to side

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Prevention and Control
Prevent common colds, influenza and other
RN2024
upper respiratory infections
Immunization with pneumonia vaccine
Eliminate contributory factors such as exposure
to cod, pollution, and physical conditions of
fatigue and alcoholism.

Treatment Modalities

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TUBERCULOSIS
OTHER TERMS: Koch’s Disease / Phthisis /
RN2024
Galloping Consumption Disease
Description Incubation Period
3 to 8 weeks (occasionally up to 12 weeks)

Period of Communicability
As long as the tubercle bacilli are being
discharged in the sputum
Clinical Manifestations
Cough of two weeks or more
Afternoon rise of temperature
Chest or back pains
Hemoptysis
TOP 8 highest cases of TB in the world Significant weight loss
(Philippines) Fatigue
It is a chronic sub –acute or acute respiratory Body malaise
disease commonly affecting the lungs Shortness of breath
Characterized by the formation of tubercles in Night sweating
the tissue which tend to undergo ceseation Sputum positive for AFB
necrosis and calcification
Diagnostic Tests
Etiologic Agents: Sputum Analysis for AFB
Mycobacterium tuberculosis Confirmatory
M africanum Chest X-ray
M bovis
Tuberculin Testing (for TB
Source of Infection exposure)
Sputum Mantoux Test (PPD)
Blood from Hemoptysis Tine Test
Nasal discharge Heaf Test
Saliva
Mode of Transmission
Airborne
Direct / Indirect contact with infected persons

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Treatment Modalities RN2024
Short – course chemotherapy Hepatotoxic
Not recommended for children (below 6 years
Six-month treatment (Isoniazid, Rifampicin, old); can cause optic neuritis

S
Pyrazinamide and Ethambutol)

RIPES treptomycin

R
Treatment Modalities After meals
Report Oliguria – nephrotoxic
ifampicin Ototoxic
Neurotoxic
Empty stomach
Body fluid discoloration (red-orange) Direct Observation Treatment
Hepatotoxic (metabolism)
Nephrotoxic (elimination) Short Course

I
Strategy to prevent non-compliance
soniazid
Empty stomach
Nursing management
Peripheral Neuropathy Maintain respiratory isolation
Avoid alcohol Administer medicines as ordered
Hepatotoxic Educate patient all about PTB
Nephrotoxic Stop smoking
Increase intake of Vitamin B6 Cough or sneeze into tissue paper and

p
dispose secretion properly
Provide the patient with a well-balanced,
yrazinamide high-calorie diet, preferably in small, frequent
meals to conserve energy.
Before meals Allow ret periods
Monitor s/sx of liver impairment Caution the patient who is taking an oral
Anorexia contraceptive that the contraceptive may be
Fatigue less effective while she’s taking rifampin.
Dark urine
Photosensitivity Prevention and Control
Liver Function Studies Submit all babies for BCG (Bacille Calmette-
Causes hyperuricemia Guerin) immunization

E thambutol
Not affected by food
Avoid overcrowding
Improve nutritional and health status
Persons who have been exposed (Receive
Tuberculin Test)
Report visual disturbances

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BIRD FLU
OTHER TERM: Avian Influenza
RN2024
Description Nursing Care
It is an infectious disease of birds ranging Isolation precaution
from mild to severe form of illness. Infected Control
Early recognition of cases of highly pathogenic
Source of Infection Avian Influenza during outbreak among poultry
Viruses that normally infect only birds and less
commonly pigs
Incubation Period
3 to 5 days

Clinical Manifestations
Fever
Body weakness / muscle pain
Cough
Sore throat
May have difficulty of breathing in severe
cases
Sore eyes

Susceptibility, Resistance
& Occurrence
All birds are susceptible to infection but
domestic poultry flocks are especially
vulnerable to infection that can rapidly reach
epidemic proportion.

Control Measures
Rapid destruction, proper disposal of
carcasses and quarantining and rigorous
disinfection of farms
Restrictions on the movement of live poultry

@RNurseGuides
SARS
SEVERE ACUTE
RN2024
RESPIRATORY SYNDROME
Description Preventive Measures and Control
Earliest known case (Guangdong Province, Screen patents for travel hx, symptoms and/or
China, November, 2002)
Outbreak and Worldwide Surveillance Clinical Manifestations
close contact ith cases
Isolation of suspected probable case
(March 12, 2003) Barrier nursing technique for suspected and
First case in the Philippines (April 11, 2003) probable cases

Etiologic Agent: Nursing Care

Human coronavirus Maintain Isolation Measures
Utilize Personal Protective Equipment (PPE)
Mode of Transmission Apply principle of hand washing
Droplet Contact

Incubation Period
Mean incubation period is 5 days (range 2-10
days) and may reach up to 14 days

Clinical Manifestations
Prodromal Phase
Fever > 38o
Chills (Initial Sign)
Malaise
Myalgia
Headache

Respiratory Phase
Dry, non-productive cough with or without
respiratory distress
Hypoxia
Crackles
Dullness on percussion
Decreased breath sounds on physical
examination
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CHOLERA
OTHER TERMS: El Tor
RN2024
Description Diagnostic Tests
It is an acute bacterial enteric disease Rectal swab
characterized by profuse diarrhea, vomiting, Darkfield or phase microscopy
massive loss of fluid and electrolytes that can Stool exam
result to hypovolemic shock, acidosis and Blood test
death. - Elevated BUN & Creatinine Levels
- Increase in serum lactate, protein and
Etiologic Agent: phosphate levels
Vibrio El Tor Treatment Modalities
Source of Infection IV treatment
Oral Therapy Rehydration
Vomitus and feces of infected persons Coconut water
Give ORESOL
Antibiotics
Mode of Transmission - Tetracycline
Food and water contaminated with vomitus - Furazolidone
and stools of patients and carriers - Chloramphenicol
- Cotrimoxazole
Incubation Period Nursing management
6 to 48 hours Medical Aseptic protective Care (Hand
washing)
Period of Communicability Enteric Isolation
VS
Cases are infectious during the period of I & O monitored accurately
diarrhea and up to 7 days after Personal hygiene
Proper excreta disposal
Clinical Manifestations Environmental sanitation
Rice-watery stool
Washer-woman’s hands
Prevention
Food and water supply must be protected from
Vomiting fecal contamination
Diarrhea Water should be boiled and chlorinated
Deep, rapid breathing Milk should be pasteurized
Oliguria Sanitary disposal of human excreta is a must

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THYPOID RN2024
FEVER
Description
It is a systemic infection characterized by
continued fever, anorexia, involvement of
lymphoid tissue, especially ulceration of
Peyer’s patches.

Etiologic Agent: Typhoid State

Salmonella typhi or Typhoid bacillus Coma vigil
Subsultus tendinum
Sources of Infection Carphologia
Feces and urine of infected persons Delirium
Mode of transmission Complications
Incubation
Fecal-oral TransmissionPeriod Hemorrhage/Perforation (most dreaded
Contaminated Urine complications)
Direct/indirect contact with infected person Peritonitis
Ingestion of contaminated food, water and milk Bronchitis and Pneumonia
Typhoid spine
Incubation Period Septicemia
Reiter’s syndrome – joint pain, eye irritation
1 to 3 weeks; average (2 weeks)

Period of Communicability Diagnostic Tests

As long as typhoid bacilli appears in excreta Typhidot – confirmatory
ELISA
Clinical Manifestations Widal
Rectal swab
Onset Bone Marrow Aspiration (identifies S. typhi)
Headache
N/V Treatment Modalities
Ladder-like fever
Chloramphenicol – drug
Rose spots on the abdomen of choice

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Ampicillin
Co-trimoxazole
Ciprofloxacin
RN2024
Cefixime / Azithromycin
Ceftriaxone (recommended for complicated
cases)

Nursing management
Treatment
Isolation
Modalities
Maintain standard precautions unless the patient
is incontinent or in diapers or if an outbreak
develops in an institution.
Give nourishment fluids in small quantities at
frequent intervals
Monitor VS
Prevent further injury
Watch out for:
intestinal bleeding / bowel perforation, including
sudden pain in the lower right side of the
abdomen and abdominal rigidity.
Provide good skin and mouth care
Turn the patient frequently and perform mild
passive exercises, as indicated.
Apply mild heat to the abdomen to relieve
cramps.
Prevention and Control
Sanitary and proper disposal of excreta
Proper supervision of food handlers
Enteric isolation
Provision of safe drinking water supply
Detection and supervision of typhoid carriers

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BACILLARY
DYSENTRY
RN2024
OTHER TERMS: Shigellosis / Bloody Flux Colicky or cramping abdominal pain associated
with anorexia and body weakness
Description Bloody-mucoid stool
Rapid dehydration
It is an acute bacterial infection of the intestine
characterized by diarrhea, fever, tenesmus and in Diagnostic Tests
severe cases, bloody and mucoid stools.
Microscopic examination of a fresh stool
Etiologic Agents: specimen may reveal mucus, red blood cells,
and polymorphonuclear leukocytes.
Shigella sonnei (most common Direct immunofluorescence with specific
antisera will demonstrate Shigella.
species in Western Europe) Sigmoidoscopy or proctoscopy may reveal
Shigella flexneri typical superficial ulcerations
Stool culture must rule out other causes of
Shigella boydii diarrhea, such as enteropathogenic Escherichia
Shigella dysenteriae coli infection, malabsorption disease, and
amebic or viral diseases.
Incubation Period Treatment Modalities
12 to 96 hours, but may be up to 1 week Antibiotics
Ampicillin
Period of Communicability Ceftriaxone
Trimethoprim-sulfamethoxazole
The patient can transmit the microorganism during Ciprofloxacin
the acute infection until the feces are negative of
the organism. IV Therapy
Low Residue Diet
Mode of Transmission Contraindicated
Ingestion of contaminated food Anti-diarrheal drugs (they delay fecal
Drinking contaminated water / milk excretion that can lead to prolong fever)
Feco-oral transmission

Clinical Manifestations Prevention and Control

Fever Sanitary disposal of human feces
Tenesmus Adequate personal hygiene, particularly
N/V handwashing after defecation.
Headache
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Sanitary supervision of processing, preparation
and serving of food (raw)
Fly control and protection against fly
RN2024
contamination
Isolation (Acute Stage)
Protection and purification of public water
supply
Routine cooking kills shigella

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PARAGONIMIASIS RN2024
Prevention and Control
Treatment of infected person
Anti-mollusk campaigns
Educated of the population
Etiologic Agents: Avoid eating infected foods
Lung Fluke
Paragonimus westermani
Paragonimus siamenses
Mode of Transmission
Ingestion of raw / uncooked crabs/crayfish
Contamination of Food
Using meat / juice of infected animals Congenital Rubella
Reservoir of Hosts
Cats
Dogs
Rats
Pigs
Clinical Manifestations
Cough of long duration
Recurrent blood-streaked sputum
Chest/back pain
PTB – like signs/symptoms not responding to
anti-TB medication
Diagnostic Test
Sputum Microscopy
Immunology
Cerebral Paragonimiasis
Treatment
Praziquantel (Billtrizide)
@RNurseGuides
MUMPS
OTHER TERMS: Infectious Parotitis /
RN2024
Epidemic Parotitis
Description Clinical Manifestation
Sudden headache
Earache
Loss of appetite
Fever
Swelling of the parotid
gland (between the
earlobe and angle of the
mandible)
It is a acute viral disease manifested by swelling
of one or both parotid glands, with occasional Complications
involvement of other glandular structures, Orchitis
particularly the testes in male. Oophoritis
Mastitis
Etiologic Agent: Nuchal rigidity
Deafness
Paramyxoviridae Meningoencephalitis
Pancreatitis
Source of Infection Myocarditis
Nephritis
Secretion of the mouth and nose
Diagnostic Tests
Mode of Transmission Serum amylase Determination
Direct contact (most useful test in making early presumptive
Indirect contact with the articles freshly soiled diagnosis of mumps); elevated amylase level
with secretion from the nasopharynx.
Complement Fixation Test
Period of Communicability Hemo-agglutination Inhibition
Cases are infectious for up to a week (normally Test
2 days) before parotid swelling until 9 days Used to determine the immune status
after.
48 – hours period immediately preceding onset of Neutralization Test
swelling is considered the time of highest Determines immunity to mumps
communicability.
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 Viral Culture RN2024
Treatment Modalities
Analgesics for pain
Antipyretics for fever
IV Fluid Replacement
Hot and Cold Application
Treatment Modalities
Nursing Management
Medical Aseptic Protective Care
Single-occupancy room
Oral Care and Personal Hygiene (warm salt-
water gargles)
General Management of the
disease
Bed rest
Diversional Activities
Eye care
Provide extra fluids
Diet
No restriction of food
Soft bland and semi-solid is easily managed
Acid foods (fruit juices) increases discomfort

Prevention and Control

Active Immunization (MMR)
Reporting of cases to health authorities
Isolation of patient

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BOTULISM RN2024
Description Incubation Period
Rare but severe form of poisoning caused by a 12 to 72 hours but extremes of 2 hours to 10
gram-positive, anaerobic bacteria. days are reported.
It is an illness of descending paralysis and
autonomic dysfunction due to a neurotoxin Clinical Manifestations
Etiologic Agent: Double or blurred vision
Droopy eyelids
Clostridium Botulinum Dry mouth
Difficulty swallowing and talking
Foodborne Botulism Difficulty breathing
Wound Botulism Flaccid paralysis (descending)
Infant Botulism Deep tendon reflexes are decreased or absent
Initial vomiting or diarrhea followed by
Source of Infection constipation
Untreated water
Undercooked and improperly preserved canned Diagnostic Tests
foods, especially those with a low acid content A toxicity screen may identify C. botulinum.
Home-canned vegetables Stool culture may identify C. botulinum.
Cured pork and ham The suspected food may also be cultured to
Smoked or raw fish isolate C. botulinum.
Honey and corn syrup Electromyography will show little response to
nerve stimulation in the presence of botulism.
Diagnostic tests should be conducted as
needed to rule out diseases that may be
confused with botulism, such as myasthenia
gravis and Guillain-Barre syndrome.
A mouse-inoculation test will be positive and is
the most direct way to confirm a diagnosis of
botulism.
Complications
Mode of Transmission Aspiration
Weakness and nervous system problems can
Incubation
Spores may resist 100 Period
Ingestion (or injection) of preformed toxin
degree Celsius for many
be permanent
Death
hours
Inhalation of toxin may also cause disease
Introduction of spores into the wound
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Treatment Modalities
Botulinus antitoxin- IV, IM
RN2024
Infants – inducing vomiting or giving an enema
IV fluid can be administered
Nasogastric tube
Endotracheal intubation – respiratory distress
Nursing Consideration
Obtain a careful history of foods eaten in the
past several days.
Monitor respiratory and cardiac function
carefully
Perform frequent neurologic checks
Purge the GI tract as ordered
If giving the botulinus antitoxin, check the
patient’s allergies, perform a skin test first.
Educate the patient and family about the
importance of proper hand hygiene
Teach the patient and family to cook food
thoroughly before ingesting.
Instruct the patient who eats home canned food
to boil the food for 10 minutes before eating to
ensure that it is safe to consume.
Teach patient and families to see their doctors
promptly for infected wounds and to avoid
injectable street drugs.

Suggested on-call action

Ensure that the case is admitted to hospital
Obtain food history as a matter of urgency
Obtain suspect foods
Identify others at risk
Inform appropriate local and national authorities

@RNurseGuides
AMOEBIASIS RN2024
Period of Communicability
Communicable for the entire duration of the
illness or until cysts are present in the stool

Clinical Manifestation
Acute Amoebic Dysentery
Slight attack of diarrhea altered with PD of
constipation
Watery foul-smelling stools containing blood
Description streaked mucus
Protozoal infection that initially involves the Gaseous distension of the lower abdomen
colon but may spread into the liver and lungs Nausea, flatulence
by lymphatic dissemination Tenderness in the right iliac region

Etiologic Agent: Chronic Amoebic Dysentery

Entamoeba Histolytica Diarrhea for several days, succeeded by
constipation
2 stages: Anorexia, weight loss, weakness, fatigue
Cyst – considered to be the infective stage Watery, bloody mucoid stool
and the resistance to environmental conditions Flatulence and irregular bowel movement
and can survive for few days outside the body Abdomen loses its elasticity
Trophozoites / vegetative form – Facultative Severe cases – scattered ulceration is seen
parasites that invades the tissue through sigmoidoscopy

Source of Infection Diagnostic Procedures

Contaminated food and water Stool exams – cyst (plenty of amoeba on the
Flies stool)
Blood exams – leukocytosis
Mode of Transmission Sigmoidoscopy
Fecal-oral
Oral-anal Management
Incubation Period Metronidazole (Flagyl) 800mg TID x 5 days
Incubation Period Tetracycline, Ampicillin, Streptomycin,
Severe infections: 3days Chloramphenicol
Average 2-4 weeks
Nursing Interventions
Observe isolation and enteric precautions
RN2024
Proper collection of stool specimen
- No oil prep for 48 hours
- Large portion of stools containing blood
mucus
- Label specimen properly
- Send specimen immediately to the
laboratory
Provide skin care and hygiene
Provide optimum comfort dysenteric patient
should never be allowed to feel cold
Diet fluid should be forced
- Cereals and strained meat broths without
fats
- Bland diet without cellulose or bulk producing
foods
- Chicken and fish may be added when
convalescence is established

Prevention
Health education and Fly control
Sanitary disposal of feces
Safe drinking water
Proper food preparation and food handling
Detection and treatment of carriers

@RNurseGuides
SCHISTOSOMIASIS
OTHER TERMS: Bilharziasis / Snail Fever
RN2024
Description Clinical Manifestations
Slowly progressive disease caused by blood 1st stage
flukes Pruritic rash known as “swimmers itch” occurs
24 hours after penetration of cercariae in the
skin

Causative Agent
Schistosoma japonicum
endemic in the Philippines and China
Schistosoma mansoni 2nd Stage
South America, the Caribbean, Africa and Bloody mucoid stools (on and off for weeks)
countries of the Arab Middle East
Katayama Fever
Schistosoma haematobium – clinical constellation of the following:
Africa and the Middle East Fever, headache
Cough, chills and sweating
Source of Infection Lymphadenopathy and hepatosplenomegaly

Stool and urine of infected persons or animals 3rd (Chronic) Stage

Granulomatous reactions to egg deposition in
Mode of Transmission the intestine, liver, bladder
Inflammation of the liver
Ingestion of contaminated water
Penetration through the skin pores Icteric and jaundice
Oncomelania hupensis quadrasi is the intermediary Bulging of the Abdomen
host Enlargement of the Spleen
Incubation Period Sometimes the brain is affected that caused
epilepsy
At least 2 months Eggs are deposited in the bladder wall,
leading to hematuria, bladder obstruction

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Hydronephrosis and recurrent urinary tract infection
Pale and marked muscle wasting RN2024
Complications Proper waste disposal
Control of stray animals
Liver cirrhosis and portal hypertension Safe and adequate water supply for bathing,
Bleeding esophageal varices laundering and drinking
Bladder cancer Foot bridges over snail-infested streams
Pulmonary hypertension Health education about mode of transmission
Treatment Modalities
Heart failure
Ascites
and prevention
Renal failure
Cerebral schistosomiasis

Diagnostic Procedure
Fecalysis
Liver and rectal biopsy
ELISA
Circumoval precipitation
test (COPT) – confirmatory test
Management
Drug of choice:
PRAZIQUANTEL for 6 months
1 tab 2x a day for 1st 3 mos
1 tab a day for next 3 mos
Alternative: Ovamniquine
Nursing Interventions
TSB
Skin care
Provide comfort
Proper nutrition

Prevention and Control

Reduce snail density
- Molluscicides
- Stream Cleaning Vegetation (expose the snails
to sunlight)
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SYPHILIS
OTHER TERMS: Sy, Bad blood, The Pox,
RN2024
Lues Venereal, Morbus Gallicus
Description Incubation Period
Varies, but typically lasts about 3 weeks

Period of Communicability
Variable and indefinite

Mode of Transmission
Sexual Contact
Indirect contact with the articles freshly soiled
with discharges or blood
Transmission via placenta

Clinical Manifestation
Primary
Painless chancre (sore) at site of entry of
germs, swollen glands
it is an acute, chronic infectious disease caused Chancres disappears after three to six weeks
by spirochete and is acquired through sexual even without treatment
contact
Etiologic Agent Secondary
Rash can be macular, papular, pustular or
Treponema pallidum nodular
Macules often erupt between rolls of fat on
Source of Infection the trunk and on the arms, palm, sole face and
scalp
Discharges from obvious or concealed lesions of Alopecia (temporary)
the skin or mucous membrane
Mode of Transmission
Semen
Nails become brittle and pitted
Blood
Tears Latent
Urine Patient is asymptomatic for a few months
Mucous discharge from the nose, eyes, genital tract Dormancy stage of bacteria
Surface lesions

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Late
Varies from no symptoms to indication of
RN2024
damage to body organs such as brain and heart
and liver

Diagnostic Tests
Dark Field Illumination Test identifies T. pallidum
from lesion exudates and provides an immediate
diagnosis
Fluorescent treponemal antibody absorption test
Venereal Disease Research Laboratory (VDRL)
test detects nonspecific antibodies that become
reactive within 1 to 2 weeks after the primary
syphilis lesion appears or 4 to 5 weeks after the
infection begins
CSF analysis, identifies neurosyphilis when the
total protein level is higher than 40 mg/dL

Treatment Modalities
IM Penicillin G benzathine
Tetracycline
Doxycycline

Nursing Considerations
Stress the importance of completing the
treatment even after the symptoms subside
Practice universal precaution
In secondary syphilis, keep the lesions dry as
much as possible

Prevention and Control

Report cases to the Department of Health
Control prostitution
Require sex worker to have check up
Proper sex education

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TRICHOMONIASIS
OTHER TERMS: Trich
RN2024
Etiologic Agent: Physical Examination
The OSOM Trichomonas Rapid Test identifies
infection within 10 to 45 minutes, but it is less
sensitive and specific than culture.

Treatment
Metronidazole (Flagyl)
– treatment of choice
Tinidazole (Tindamax)
Complication
Cervical cancer
Mode of Transmission Nursing Considerations
Direct sexual contact Follow standard precautions
Indirect contact (towels, wash clothes, douching Assist with obtaining appropriate specimen for
equipment) culture or testing
Tell the patient to avoid ingesting alcohol while
taking metronidazole (and for 48 hours after
Incubation Period completing the prescription), as the
5 to 21 days combination may cause severe nausea and
vomiting, abdominal pain, headaches, and
flushing.
Clinical Manifestations
Female:
White or greenish – yellow odorous discharge;
vaginal itching and soreness, painful urination.
Male:
Slight itching of penis, painful urination, clear
discharge from penis.
Diagnosis
Microscopic slide of discharge
Culture of urethral tissue, urine or semen

@RNurseGuides
CHLAMYDIA RN2024
Etiologic Agent: Nucleic acid probe will be positive for C.
trachomatis
Treatment
Tetracycline
Erythromycin
Azithromycin
Complications
Sterility
Prematurity
Chlamydia trachomatis Stillbirths
Infant pneumonia
Mode of Transmission Eye Infections (infants)
Vaginal / Rectal intercourse
Oral-genital contact
Nursing Management
Observe standard precautions
Incubation Period HIV testing for both partners
Assess newborn for signs of chlamydial
7 to 14 days infection
Case will remain infectious until treated Urge the patient to inform sexual contacts of
his or her infection so they can receive
Clinical Manifestations appropriate treatment.
Stress the importance of completing the
Cervical erosion course of antibiotics even after symptoms
Mucopurulent discharges subside.
Dyspareunia Teach the patient to follow meticulous
Pain and tenderness of the abdomen personal hygiene measures
Chills Instruct the patient to avoid touching any
Fever discharge and to wash and dry the hands
Dysuria thoroughly before touching the eyes to
Urinary frequency prevent eye contamination.
Painful scrotal swelling
Diarrhea
Tenesmus
Diagnostic Tests
Culture of the site of infection will reveal C.
trachomatis
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GONORRHEA
OTHER TERMS: Clap / Flores Blancas /
RN2024
Gleet / Drip
Description Complications
It is a sexually transmitted bacterial disease Sterility
involving the mucosal lining of the genitor- Pelvic Infection
urinary tract, the rectum, and pharynx Epididymitis
Arthritis
Etiologic Agent: Endocarditis
Conjunctivitis
Neisseria gonorrhoeae Meningitis

Incubation Period Diagnostic Tests

2 to 5 days Gram staining
Culture of cervical & urethral smear
Mode of Transmission
Direct contact through sexual intercourse Treatment
Direct contact with contaminated secretions of Ceftriaxone (IM)
the mother during vaginal delivery Azithromycin or Doxycycline (po)
Indirect contact (fomites)

Clinical Manifestations Nursing Considerations

Female: Standard precautions
Sexual abstinence until he/she recovers from
80% are aysmptomatic the disease
Burning sensation and frequent urination For gonococcal arthritis (apply moist heat to
Yellowish purulent vaginal discharge relieve pain)
Redness and swelling of the genitals
Male: Prevention and Control
Dysuria with purulent discharge Sex education
Rectal infection Case finding
Inflammation of the urethra Report cases of gonorrhea
Prostatitis
Pelvic Pain

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CANDIDIASIS
OTHER TERMS: Candidosis / Moniliasis
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Description Oropharyngeal mucosa (thrush)
Superficial fungal infection that usually infects Cream-colored or bluish white curd-like
the skin, nails, mucous membrane, vagina, patches of exudates on the tongue, mouth, or
esophagus and GI tract pharynx that reveal bloody engorgement when
scraped
Etiologic Agent:
Candida albicans
Sources of infection
Candida are part of the normal flora of the GI
tract, mouth vagina and skin, They cause
infection when some changes in the body (such Esophageal mucosa
as increased blood glucose or Dysphagia
immunocompromised) occurs Treatment
Retrosternal pain, regurgitation
Occasionally, scales in the mouth and throat
Clinical Manifestations Vaginal mucosa
Skin White or yellow discharge, with pruritus and
Scaly, erythematous, popular rash, sometimes local excoriation
covered with exudates, appearing below the White or gray raised patches on vaginal walls,
breast, between the fingers, and the axillae, with local inflammation
groin, and umbilicus Dyspareunia
Lungs – hemoptysis, cough, fever
Kidney – fever, flank pain, dysuria, hematuria,
pyuria, cloudy urine
Brain – headache, nuchal rigidity, seizures,
focal neurologic deficits
Endocardium – systolic or diastolic murmur,
fever, chest pain, embolic phenomena
Eye – Endophthalmitis, blurred vision, orbital or
Nails periorbital pain, scotoma, exudates
Red, swollen, darkened nail bed Diagnostic Procedures
Occasionally, purulent discharge and the Blood Culture
separation of a pruritic nail from the nail bed Culture of vaginal scraping
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 Echocardiography if here is cardiac
involvement
Fundoscopy for patients with endophthalmitis
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Management
Antifungal: Nystatin,
Clotrimazole, Miconazole
Mutism
Coma
Diagnostic Tests
Enzyme linked Immuno-Sorbent Assay (ELISA) –
presumptive test
Western Blot – confirmatory test
Particle agglutination (PA)
Immunofluorescent Test

Treatment Modalities
Reverse transcriptase inhibitors (Zidovudine)
Protease inhibitors (Ritonavir)

Nursing Management
Avoid accidental wounds from infectious materials
used in HIV patients
Avoid contact of open skin lesions
Gloves should be worn when handling blood
specimens
Handwashing
Blood and other specimens should be labelled
prominently
Instruments with lenses should be sterilized after
use on AIDS patient
Needles should not be bent after use, placed it
under puncture – resistant
Patients with active Aids should be isolated
Care of thermometer – wash with warm soapy
water, Soak in 70% alcohol for 10 minutes, dry and
store.
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DENGUE
FEVER
RN2024
OTHER TERMS: Breakbone Fever/ Febrile / Invasive Stage
Hemorrhagic Fever/ Dandy Fever/ First 4 days
Infectious Thrombocytopenic Purpura High fever (39 – 40 C)
Abnormal pain
Headache
Later flushing

Toxic / Hemorrhagic Stage

Lowering of temperature
Severe abdominal pain
Vomiting
Etiologic Agents: Melena
Hematemesis
Dengue Virus Types 1, 2, 3, & 4
Chikungunya Virus Convalescent / Recovery Stage
Generalized flushing with areas of blanching
Mode of Transmission appetite
BP stable
Bite of female infected mosquito (Aedes aegypti)

Incubation Period Diagnostic Tests

3 to 15 days Tourniquet test (Rumpel – Leede Test)
Platelet count (decreased)
Period of Communicability Hemoconcentration (increased of at least 20%)
Occult blood
Unknown Hemoglobin determination
Presumed to be on the 1st week of illness Dengue NS1 Test (confirmatory)
(when the virus is still present in the blood)
Human-to0human spread of dengue has not
been recorded, but people are infectious to Treatment Modalities
mosquitoes during the febrile period Give analgesic (Don’t give Aspirin)
Rapid replacement of body fluids
Clinical Manifestations Oxygen Therapy
Oral Rehydration Solution
Herman’s sign Blood Transfusion (for severe bleeding)
Sedatives
(maculopapular rash with patches of normal
skin) – pathognomonic sign
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Nursing Management
Patient should be kept in mosquito-free
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environment
Monitor VS
Provide periods
Nose bleeding (apply ice bag on the forehead
and at the bridge of the nose)
Watch out for: signs of shock
Treatment Modalities
Diet: Low fat, low fiber, non-irritating, non-
carbonated

Prevention and Control

Health education
Early detection and treatment of cases
Treat mosquito nets with insecticides
House spraying
Avoid too many hanging clothes
Case finding

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MALARIA
OTHER TERMS: Ague and Marsh Fever
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Clinical Manifestations
Paxoysms with shaking chills
Rapid rising fever with severe headache
Profuse sweating
Myalgia
Splenomegaly
Hepatomegaly

Description Chemoprophylaxis
It is an acute and chronic parasitic disease
transmitted by bite of infected mosquitoes and it Chloroquine
is confined mainly to tropical and subtropical This must be taken at weekly intervals, starting
areas. from 1-2 weeks before entering endemic areas.

Etiologic Agents: Preventive and Vector Control Measures

Plasmodium falciparum (most Insecticide – treatment of mosquito nets
common) House Spraying
On-stream seeding
Plasmodium vivax On-stream clearing
Plasmodium malariae Wearing of clothes that covers arms and legs in
the evening
Plasmodium ovale Avoiding outdoor night activities (9PM to 3AM)
Planting of Neem tree
Incubation Period Zooprophylaxis
P. falciparum (5 to 7 days)
P. vivax (6 to 8 days)
P. ovale (8 to 9 days)
P. malariae (12 to 16 days)
Mode of Transmission
Transmitted mechanically through bite of an
infected female Anopheles mosquito
Blood transfusion
Transplacental transmission

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MALARIA
OTHER TERM: Elephantiasis
RN2024
Acute Stage
Lymphadenitis
Lymphangitis
Epididymitis
Orchitis
Chronic Stage
Develop 10 to 15 years from the onset of the
first attack
Description Chronic Signs and
It is a parasitic disease caused by an African
eye worm, microscopic thread-like worm Symptoms:
Extremely debilitating and stigmatizing disease Hydrocele
Lymphedema
Etiologic Agents: Elephantiasis

Wuchereria bancrofti Diagnosis

Brugia malayi Physical examination
Brugia timori History taking
Loa loa Laboratory Examinations
Mode of Transmission Nocturnal Blood Examination (NBE)
Blood are taken from the patient’s residence
Mosquito bite (Aedes poecilius) (8pm)
Immunochromatographic Test (ICT)
Incubation Period Rapid Assessment Method
8 to 16 months Antigen test can be done at daytime

Clinical Manifestations Treatment

Asymptomatic Stage Diethylcarbamazine citrate (Hetrazan)
No clinical signs and symptoms of the disease

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Nursing Management
Health Education
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Environmental Sanitation
Psychological and emotional support
Personal hygiene

Prevention and Control

Mosquito net
Mosquito repellent
Yearly dose of medicine

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LEPTOSPIROSIS
OTHER TERMS: Canicola Fever / Hemorrhagic
RN2024
Jaundice / Mud Fever / Swine Herd Disease / Anuria
Flood Fever / Trench Fever / Spirochetal Severe cases (shock, coma, congestive, heart
Jaundice / Japanese Seven Days Fever failure)

Description Convalescence Phase

It is a zoonotic infectious bacterial disease Relapse may occur during the 4th to 5th
carried by animals, both domestic and wild, week
whose urine contaminates water or food which
is ingested or inoculated through the skin. Laboratory Tests
ELISA
Etiologic Agents: Liver Function Tests
Leptospira Antigen-antibody test
Leptospira interrogans Leptospira Antibody Test
Incubation Period Complications
7 to 13 days (range 4 to 19 days) Meningitis
Respiratory distress
Renal interstitial tubular necrosis
Mode of Transmission Cardiovascular problems
Direct contact on the skin through open wounds Treatment
Doxycycline (Prophylactic)
Penicillin
Tetracycline
Erythromycin
Administration of Fluid and Electrolyte and
Clinical Manifestations Blood
Leptospiremic Phase (4 to 7 days) Nursing Management
Nausea Isolate patient
Vomiting Darken patient’s room
Fever Observe meticulous skin care
Headache Wide Rat Eradication Program
Myalgia Encourage Oral fluid intake
Chest pain
Prevention & Control
Immune Phase (4 to 30 days) Environment Sanitation
Meningeal irritation Proper Drainage System and Control of Rodents
Oliguria Information - dissemination campaign
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RABIES
OTHER TERM: Hydrophobia / Lyssa Irritability
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Restlessness
Description Apprehensiveness
Melancholia
Sensitive to light and sound

Excitement/Neurological Phase
Marked excitation and apprehension
Nuchal rigidity
Involuntary twitching
Severe and painful spasm of the muscles of
the mouth, pharynx and larynx
Hydrophobia
Aerophobia
Profuse drooling of saliva
It is a specific, acute, viral infection
communicated to man by saliva of an infected Terminal / Paralytic Phase
animal.
Quiet and unconscious
Etiologic Agents: Loss of bowel and urinary control
Cessation of spasms and progressive
paralysis
Rhabdovirus (Bullet Shape Tachycardia; respiratory paralysis, heart
Virus) failure

Incubation Period Diagnostic Tests

3 to 8 weeks, but may be as short as 9 days or Virus isolation from the patient’s saliva /
as long as 7 years, depending on the amount of throat
virus introduced, the severity of the wound and Fluorescent rabies antibody (RFA) – most
its proximity to the brain definitive diagnosis
Presence of negri bodies in the dog’s brain
Susceptibility and Resistance
All warm-blooded mammals are susceptible Treatment Modalities
Clinical Manifestations Wash with soap and water
Application of antiseptics such as povidone
Prodromal / Invasion Phase iodine may be done
Patients should not be bathed and there
Fever should not be any running water in the room
Malaise
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Concurrent and terminal disinfection should be
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Prevention and Control
Vaccination of all dogs (immunized 3 months of
age and every year thereafter)
Confinement of any dog that has bitten a
person for 10 to 14 days
Provide public education

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TETANUS
OTHER TERM: Lock Jaw Spasm
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Increased muscle tone in the wound
Description Generalized
Marked muscles hypertonicity
Hyperactive deep tendon reflexes
Tachycardia
Profuse sweating
Low-grade fever
Painful, involuntary muscle contractions:
Neck and facial muscles
Lockjaw (trismus)
Painful spasms of masticatory muscles
It is an acute illness caused by toxin of the Difficulty opening the mouth
tetanus bacillus. This infection is usually Risus sardonicus
systemic; less commonly, it is localized.
Somatic Muscles
Etiologic Agents: Arched-back rigidity and board-like abdominal
rigidity
Clostridium tetani Intermittent tonic seizures lasting several
minutes, which may result in cyanosis and
Source of Infection sudden death by asphyxiation
Soil
Feces
Diagnostic Tests
Clinical features
Mode of Transmission Blood cultures and tetanus antibody tests are
Transmission occurs when spores are introduced often negative, only a third patients have a
in the body through positive wound culture
Cerebrospinal fluid pressure may rise above
- Dirty wound normal
- Injecting drug use and occasionally during
abdominal surgery Treatment Modalities
Incubation Period Drainage of ski abscesses
Administration of antibodies
3 to 21 days depending on the site of the wound
and the extent of contamination - Metronidazole (first-line agent)
- Pen G
Clinical Manifestation Administration of tetanus immunoglobulin (TIG)
Localized Sedatives

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Patients with severe, generalized or rapidly
progressing muscle spasm should be intubated
sedated and paralyzed if necessary
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Manage autonomic instability
- Labetalol
Complications
Atelectasis
Pneumonia
Pulmonary emboli
Acute gastric ulcers
Seizures
Flexion contractures
Cardiac Arrhythmias

Nursing Management
Maintain an adequate airway and ventilation to
prevent pneumonia and atelectasis
Suction often and watch for signs of respiratory
distress
Maintain an IV line for medications and
emergency care, if necessary
Monitor for arrhythmias
Record intake and output accurately and check
vital signs often
Keep the patient’s room quiet and dimply & Warn
visitors not to upset or overly stimulate the
patient
Give muscle relaxants
Perform passive-range-of-motion
Provide adequate nutrition to meet the patient’s
increased metabolic needs.
Stress the importance of maintaining active
immunization with a booster dose of tetanus
toxoid every 10 years
Teach the patient or family about proper wound
care.

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POLIOMYELITIS
OTHER TERM: Polio / Infantile Paralysis
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Description Tripod
(arms extended behind for support when
sitting up)
Hoyne sign
(head falls back when surprise and shoulders
are elevated)
Inability to raise the legs a full 90 degrees
from a supine position.
Diplopia
Dysphasia
Difficulty chewing
It is an acute communication disease caused by Inability to swallow or expel saliva
the poliovirus
Etiologic Agents: Diagnostic Tests
Viral culture = Stool sample
Poliovirus Types 1, 2 and 3 Convalescent serum antibody titers four
times greater than acute titers support the
Mode of Transmission diagnosis
CSF pressure and protein levels may be
Direct contact with infected oropharynges slightly increased, and the white blood cell
secretions or feces count elevated initially, thereafter
mononuclear cells constitute most of the
diminished number of cells.
Incubation Period Electromyographic findings in early
7 to 14 days poliomyelitis show a reduction in the
recruitment pattern and a diminished
Clinical
Fever
Manifestations interference pattern due to acute motor axon
fiber involvement.
Fibrillations develops in 2 to 4 weeks, and
Headache fasciculations also may be observed
Vomiting
Lethargy
Irritability Treatment Modalities
Pains in the neck, back, arms, legs and abdomen Analgesics (No Morphine)
Muscle tenderness, weakness an spasms in the Moist heat application
extensors of the neck, back, hamstring and other Bed rest is necessary only until extreme
muscles during range-of-motion exercises discomfort subsides
Tripod (arms extended behind for support when Physical therapy
sitting up)
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Corrective shoes RN2024
Complications
Respiratory failure
Pulmonary edema
Pulmonary embolism
Urinary Tract Infection
Urolithiasis
Atelectasis
Pneumonia
Cor Pulmonale
Paralytic shock

Nursing Considerations
Observe the patient for paralysis and other
neurologic damage
Maintain patent airway
Check blood pressure frequently
Provide an adequate, well-balanced diet
Good skin care and frequent repositioning
Inform ambulatory patients about the needs for
careful handwashing.
Instruct the patient or caregivers about
measures need to manage symptoms and
prevent complications.
Prevention
Administration of Oral Polio Vaccine
Boosters are required at 10-years intervals for
travel to endemic areas.

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