Definition:

Disease Process CAUSATIVE AGENT: Leptospira pyrogenes L. macilae (commonly found ) L. canicola Period of communicability: none but leptospira are found in the patients urine between 10 to 20 days after onset INCUBATION PERIOD: 6 to 15 days (WEILS DISEASE, MUDFEVER, SWINEHERDS

Clinical Manifestations
muscle aches, eye pain with bright lights, followed by chills and fever. Watering and redness of the eyes occurs

DISEASE,CANICOLAFEVER) - infection carried by animal both domesticated and wild whose excreta is contaminated or food which is ingested or inoculated thru skin or mucus membrane

PATHOPHYSIOLOGY
Predisposing Factor: Dirty environment, age, seasons, males, geographic areas Rodents, wild animals Infected urine or carcasses Man Incubates for 6 to 15 days Profileration and widespread dissemination Organ systems are affected Leptospirosis Complications: Pneumonia Optic Neuritis Peripheral neuritis

DIAGNOSTIC EXAM
total WBC count slightly elevated with neutrophilia. Rising titer of leptospiral antibodies is found from thei second week onwards. Increased erythrocyte sedimentation rate (about 60 mm). throbocytopen ia

MEDICATIONS
PENICILIN G drug of choice. TETRACYCLINE S (Doxycycline)

Nursing Management:
isolation of patient: urine must be properly disposed Darken the patients room because light is irritating to the eyes of the patient. Observe meticulous skin care to ease pruritus. health teachings: keep a clean environment

. Urinalysis with proteinuria.

Disease Process CAUSATIVE AGENT: Neisseria meningitidis ( other strains: Haemophilus influenza common in young children, Streptococcus pneumonia common in adults, Straphylococcus aureus ) PERIOD COMMUNICABILIT Y -until meningococci are no longer present in the mouth and nasal discharges. INCUBATION PERIOD : 3 6 days MODE OF TRANSMISSION : respiratory droplets

Definition:

is an acute infection of the meninges usually caused

by pneumococci, streptococci, Haemophilus influenza, or aseptic agents (usually viral).

PATHOPHYSIOLOGY
bacteria

Increased body temperature and increased WBC count crossing to the blood-brain barrier (since it has no WBC for immunity infection progresses) meninges, inflammatory response /reaction Edema in the meninges affects the intracranial nerves

Clinical Manifestations NUCHAL RIGIDITY pathogno monic sign Neck shoulder and back stiffness Opisthoto nus Positive Kernig and Brudzinski s sign

MEDICATIONS Mannitol Dexamethason e Dilantin/pheny toin Pyretinol/ence phabo L

DIAGNOSTIC EXAM: CBC with differentialelevated white blood cell count, neutrophils Blood cultures- may indicate organism Lumbar puncture with CSF cultureselvated cell count, may indicate organism

Brudzinzkis sign Kernigs sign ,Photophobia increased ICP > pain the head

Nursing Management:
Isolate the patient quiet and darkened room Prevent stress provoking factors Prevent injury during episodes of convulsions Maintain fluid and electrolyte balance Provide balanced diet, low fat

Disease Process

Definition: -Highly contagious disease caused by herpes virus characterized by vascular eruptions on the skin and mucous membrane.

Clinical Manifestations Mild fever and malaise Rash start from the truck and spread to other parts, progression completed in 6 to 8 hours macule lesion that is flat papule an elevated lesion vesicle filled with clear fluid crust a scab lesions caused by secretions of a vesicle drying on the skin pustule vesicle affected and filled with pus

MODE OF TRANSMISSION : direct thru droplet infection or airborn; indirect thru linen and fomites. INCUBATION PERIOD : 10 to 21 days

PATHOPHYSIOLOGY
Inhalation of contaminated respiratory droplet Infection in the conjunctivae or the mucosa of the upper respiratory tract Viral proliferation in regional lymph nodes Primary viremia 2nd viral replication in the internal organs Secondary viremia Infection of cells of the malpighian layer Intercellular & intracellular edema/vesicles Pre-eruptive manifestations; Mild fever and malaise. Eruptive stage; Rash starts from the trunk., Appearance of rashes through following stages: macule, papule, vesicle, pustule, crust, All stages are present simultaneously before all are covered with scabs, known as Celestial map.

DIAGNOSTIC EXAM:
Examination of vesicle fluid under electron microscope( shows round particles ) Scrapings of the floor of the vesicles colored by Giemsa. ( Tzanck smear )( shows multinucleated giant cells ) Four fold rise in antibody titre Detection of viral DNA by PCR Fluorescent Antibody to Membrane Antigen

MEDICATIONS

Nursing Management:
Isolation until crust have fallen off Calamine lotion over rashes Antipyretics for fever. Handwashing and cutting of fingernails

Acyclovir/z ovirax Diphenhydr amine (Benadryl)

Disease Process 2 TYPES OF RABIES VIRUS: a. STREET VIRUS natural virus invading / transmitted in the saliva b. FIXED VIRUS do not usually invade the salivary glands with constant incubation period of 4 to 6 days INCUBATION PERIOD: a.In dogs and cats - 1 week to 7 month b.In man - 4 to 8 weeks MODE OF TRANSMISSION: contamination of a bite/scratch or other break in the skin from saliva

Definition:
(LYSSA, HYDROPHOBIA ) - severe viral infection of the CNS that is communicated to human in the saliva of infected animals or human caused by rabies virus (RHABDOVIRUS) filterable virus and inactivated by sunlight

Clinical Manifestations >Presence of NEGRI BODIES in brain tissues (round or oval bodies found in the cytoplasm of neurons in animal with rabies

PATHOPHYSIOLOGY
Rabies virus transmission via animal bites Virus travels along the nerves to the spinal cord and to the brain Virus multiplication happened Travels alomg other nerves to the salivary glands and into the saliva Short period of depression, restlessness, malaise and fever Paralysis in the lower legs, spasm of the muscles, in the throat and voice box Coma and death

MEDICATIONS

LYSSAVA VERORAB

DIAGNOSTIC EXAM:
1. History of exposure bites 2. Development of characteristic symptoms 3. Microscopic exams presence of NEGRI BODIES in brain tissue and saliva 4. Flourescent rabies antibody (fra) techique

Nursing Management:
Treatment of wound with soap and water or zephiran betadine Isolate patient provide restful, quiet and semi dark environment Cover IVF with paper bag no sight of water Provide comfort

Disease Process MODE OF TRANSMISSION: 1.Person to person thru bites of an infected mosquito 2.Parenterally blood transfusion or contaminated syringes and needles

Definition:
( MARSH FEVER) - an acute or chromic disease caused by protozoa plasmodia transmitted to man by the bite of infected female anopheles mosquito ( Anopheles minimus flavirostris ) which is a night biting and breeds in flowing clear and shaded stream

PATHOPHYSIOLOGY
3.Mingling of infected maternal blood with that of the infant during delivery 4.Transplacental ( congenital malaria ) very rare INCUBATION PERIOD (varies depending on greater or lesser resistance of individual ) female Anopheles mosquito bites, injecting saliva containing sporozoites sporozoites enter liver cells and multiply sporozoites change to merozoites merozoites are released from the liver and enter the bloodstream merozoites attack red blood cells multiply in RBCS RBCs burst and release the merozoites which invade other RBCs and cause recurring chills and fever

Clinical Manifestations A.PRODROMAL PHASE P. falciparum fatigue, vague abdominal pains, muscle aches, highly colored urine, orthostatic hypotension, hepatomegaly an spleenomegaly P. vivax headache, photophobia, muscle aches, anorexia, nausea and vomiting P. ovale and P. malariae not significant

DIAGNOSTIC EXAM:
urine reveals small amounts of protein liver function tests reveals elevated transaminase level and increase in indirect serum bilirubin

MEDICATIONS

NURSING MANAGEMENT: Isolation Supportive care PREVENTION: Eliminate breeding places of mosquitoes Advise travelers of high risk areas Screening of windows

4 Aminoquinolines (Choloroquine, Aminodiaquine and Quimine ) Primaquine pyrimethamineSULFADOXINE (FANSIDAR) safest during pregnancy.

Disease Process common in children 6 months to 5 years ( rare below 6 mos. due to immunity passed from the mother ) MODE OF TRANSMISSION: 1.Direct contact of mouth secretions 2.Indirect thru toys an clothing that are contaminated INCUBATION PERIOD: 2 to 6 days PERIOD OF COMMUNICABILIT Y 1 to 2 days in treated patients

Definition:
characterized by formation of pseudomembranre commonly in the faucial area and tonsils by the exotoxin produced by Corynebacterium diphtheriae (KLEBSLOEFFLER BACILLUS)

Clinical Manifestations Pathogno monic sign: Pseudomembrane Irritating nasal discharge usually serosang uenous Bullneck apperanc e Dyspnea

PATHOPHYSIOLOGY
causative agent : Cornybacteruim diptheriae Enters the body via direct and indirect contact Produces exotoxin Absorbed into the mucous membranes Causes destruction of the epithelium Inflammatory response takes place Accumulation of inflammatory cells, necrotic epithelial cells, and organism debris, which form the characteristic adherent grey pseudomembrane Attempts to remove the pseudomembrane result in bleeding and expose an inflamed

MEDICATIONS

DIAGNOSTIC EXAM: Nose and throat swab Shicks test

-reveals local circumscribe d area of redness usually 4 to 3 cm in

Penicillin (Permapen) erythromycin (E-mycin)

NURSING MANAGEMENT:
CBR prevent complications Oral hygiene Maintain fluids an d electrolytes Adequate nutrition Ice colar relieve pain

diameterMaloney s test- reveals erythema

Disease Process MODE OF TRANSMISSION: -direct contact from droplet spread from infected child during incubation period and catarrhal stage PERIOD OF COMMUNICABILIY: days after exposure to 3 weeks after of typical paroxysms INCUBATION PERIOD : 7 to 14 days ( dis. is only about 6 weeks )

Definition: -characterized by repeated attacks or spasmodic coughing

which consist of a series of explosive expiration, typically ending in a long drawn force inspiration which produces the characterized crowing sound the whoop & usually followed by vomiting.

Clinical Manifestations A.CATARRHAL

STAGE ( last about 1 to 2 weeks ) -nasopharyngeal secretions -wheezing and cough -low grade fever -stage of hypercommunicabil ity B.PAROXYSMAL STAGE -beginning at the end of 2nd week and last for 4 to 6 weeks -spasmodic cough whoop which is provoked by eating, crying and exertion -subconjunctival hemorrhage rupture of capillaries

PATHOPHYSIOLOGY B. pertussis is transmitted by droplets Attach to pharyngeal epithelial cells Release number of antigens, toxins, and other substances Triggers the immune system nasopharyngeal secretions,wheezing and cough

DIAGNOSTIC EXAM
Nasal swab and sputum cultures shows B. pertussis only WBC-is usually increased fluorescent antibody screening of nasopharyng eal smearspositive for Pertussis

NURSING MANAGEMENT
CBR Increase fluid intake not during attacks Abdominal binders to prevent abdominal hernia No large nipples to prevent aspiration No feeding during attacks Strict isolation High calorie/ bland diet Proper positioning

MEDICATIONS Penicillin Erythromycin (Erythrocin) chlorampenico l

Disease Process

Definition:
Tuberculosis: CAUSATIVE AGENT: Mycobacterium tuberculosis MODE OF TRANSMISSION: droplet infection INCUBATION PEROID: 2-10 weeks

is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can also damage other parts of the body

Clinical Manifestations
general malaise, anorexia , easy fatigability, apathy, irritability, indigestion tachycardia, dyspnea, cyanosis fever late in the afternoon night sweats acute exudates involvement ( advanced cases ) loses weight malaise hemoptysis

PATHOPHYSIOLOGY
Repeated close contact w/ infected,Occupation,Indefinite substance abuse via IV,recurrence of infection Exposure or inhalation of infected Aerosol through droplet nuclei (exposure to infected clients by coughing,sneezing, talking) Tubercle bacilli invasion in the apices of the Lungs or near the pleurae of the lower lobes Bronchopneumonia develops in the lung tissue Necrotic Degeneration occurs drainage of necrotic materials into the tracheobronchial tree Lesions may calcify (Ghons Complex) and form scars and may heal over a period of time Tubercle bacilli immunity develops Acquired immunity leads to further growth of bacilli and development of active infection Dyspnea, chest tightness, hemoptysis, crackles Non-productive/productive cough. Hemoptysis Chest pain Chest tightness Crackles

DIAGNOSTIC EXAM:
Sputum acid fast bacilli staining RESULTS OF SPUTUM MICROSCOPY O negative for bacilli +- 1 4 bacilli ++- 5 10 bacilli +++ - 10 20 bacilli ++++ more than 20 bacilli Chest x-ray mantoux test

MEDICATIONS Rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin

NURSING MANAGEMENT
CBR adequate nutrition ambulatory chemotherapy npo hemoptysis oxygen inhalation blood transfusion coagulants - vit. k and hemostan

Disease Process MODE OF TRANSMISSION: bite of an infected Aedes aegypti mosquito which is day biting with limited flying movement INCUBATION PERIOD: 4 to 6 days HEMORRHAGIC FEVER is a result of: Increase capillary fragility strong immune complex reaction that produce toxic substance like histamine, bradykinin, which damage capillary wall

Definition:
acute tropical disease characterized by severe pain in the eye and in the joints and bones an accompanied by an initial erythema caused by dengue virus and transmitted by mosquito Aedes aegypti

Clinical Manifestations
Sudden onset of hyperpyre xia and headache, patient is flushed and acutely ill Anorexia, nausea and vomiting severe abdominal pain and tenderness Hepatome galy 50 to 60 % of cases

PATHOPHYSIOLOGY Predisposing factor: Bite of aedes aegypti mosquito carrying a virus Virus goes into the circulation Infect cells and general cellular response Initiates destruction on the platelet Potential for haemorrhage Stimulates intense inflammatory response Release of exogenous pyrogens Increase WBC (Neutrophils and macrophages) Release of endogenous pyrogens Reset of hypothalamic thermostat fever

DIAGNOSTIC EXAM:
Positive tourniquet test ( rumpel leed test ) increase capillary fragility. hematologic exam decrease Platelet determination count (150,000 to 400,000/cu.mm ) Hemagglutinationinhibition test most frequently used

MEDICATIONS Paracetamol (acetaminophe n)

NURSING MANAGEMENT
Epistaxis ice compress on bridge of nose, let patient bite something Gum bleeding ice chips, bristle toothbrush GI bleeding observe signs of bleeding, place o NPO. Avoid highly seasoned food DO NOT GIVE ASPIRIN causes platelet degeneration and may cause further bleeding.

Disease Process

Definition:
infectious disease caused by an anaerobic bacteria(cannot leave in the presence of oxygen) which produces a potent exotoxin

Clinical Manifestations >lockjaw or trismus >boardlike abdomen >photophobia eyes partially close >laryngeal / pharygeal spasm >irritability and restlessness >convulsions

MODE OF TRANSMISSION direct and indirect contamination of wound, umbilical stump in newborn INCUBATION PEROD: 3 days to 3 weeks with average of 10 days PERIOD OF COMMUNICABILIT Y: not transmitted persons to person directly

2 FORMS:

PATHOPHYSIOLOGY deep penetrating wound Clostridium tetani Produces the neurotoxin tetanospasmin(TS) at the site of tissue injury TS binds to the motor nerve ending and then moves by retrograde axonal transport to the CNS binds to GABA and blocks presynaptic release of GABA muscle spasm

MEDICATIONS

PEN G Na DIAGNOSTIC EXAM:

CSF is normal Blood exam normal or slightly elevated WBC ct.

Diazepam (Valium) Baclofen (Lioresal)

NURSING MANAGEMENT
Proved quiet semi dark
environment Minimal handling Prepare tongue depressions Maintain an adequate airway Closely guard the patient Support during spasm and convulsions No restraints Adequate fluid and electrolytes High calorie liquid to soft diet

Disease Process

Definition:
Incubation Period: The incubation period is 50 to 189 days or two to five months with a mean equal to 90 days. Period of Communicability: latter part of the incubation period and during the acute phase. The virus may persist in the blood for many years. Mode of Transmission: Hepatitis B can be directly transmitted by person to person contact via infected body fluids. It can be transmitted though contaminated needles and syringes. Transmission can occur through DIAGNOSTIC infected blood or body fluids EXAM: introduced at birth. elevated serum transferase It can also be levels, AST and transmitted ALT through sexual contact. low blood levels of albumin an abnormally long prothrombin time

Clinical Manifestations Fever, malaise, and anorexia. Nausea, vomiting, abdominal discomfort, fever and chills. Jaundice, dark urine, and pale stools.

is the inflammation of the liver caused by hepatitis B virus.

PATHOPHYSIOLOGY
the virus enters a new host infect liver cells (hepatocytes) inflammation decrease liver function scarring or fibrosis occurs Fever, malaise & anorexia, Nausea, vomiting, abdominal discomfort, fever and chills, Jaundice, dark urine, and pale stools. Fulminant hepatitis; Fatal and manifested by severe symptoms such like ascites and bleeding

MEDICATIONS

NURSING MANAGEMENT
Encourage frequent small feedings of high-calorie, low-fat diet encourage eating meals on a sitting position to decrease pressure on the liver monitor intake and output provide frequent oral fluids as tolerated promote periods of rest during symptomatic phase

Entecavir (Baraclude) Lamuvidine (Epivir) Peginterfero n Alfa 2a (Pegasys)

Disease Process

Definition:

MODE OF TRANSMISSION: prolonged skin to skin contact, fomites and droplet infection INCUBATION PERIOD : 1 to 5 years or more (variable ) PERIOD OF COMMUNICABILIT Y : as long as there are open lesions

-chronic mildly communicable disease with insidious outset affecting the skin, mucus membranes and nervous tissue and eventually producing deformities and caused by Mycobacterium leprae (Hansens bacillus )

Clinical Manifestations
change in skin coloreither reddish or white loss of sensation on the skin lesion ulcers that do not heal loss of eyebrowmadarosis contractur

PATHOPHYSIOLOGY

DIAGNOSTIC EXAM:
Mean- from mucocutaneou s lesions Lepromin Skin Test has cross sensitivity to tuberculosis infection and BCG vaccination Mitsuda Reaction more useful for the determination of the type of disease and prognosis

M. Leprae attacks the peripheral nerves Ulnar, radial, posterior-popliteal, anteriortibial, and facial nerves Bacilli damage the skins fine nerves Cause anesthesia, anhidrosis, and dryness If they attack a large nerve trunk, motor nerve damage, weakness, and pain occur Peripheral anesthesia, muscle paralysis, atrophy

es

MEDICATIONS
Dapsone (Avlosuflon) Rifampin (Rifadin)

NURSING MANAGEMENT
Isolation Maintain balance nutrition, sleep and rest Help the family to understand and accept to remove social stigma Good personal hygience Handling of infants and young ones should be avoided

Clofazimine (Lamprene) Minocycline (Minocin)

Disease Process

Definition:

-caused by rubella virus and characterized exanthem

MODE OF TRANSMISSION : airborne droplet nuclei or close contact INCUBATION PERIOD: 10 to 21 days PERION OF COMMUNICABILIT Y: entire course of illness

Clinical Manifestations fever and malaise lymphade nopathy Eranthem : discrete rose spots on soft palate Exanhem : Variable; begins on face spreads quickly over entire body

and fever with minimal complications but has teratogenic effect on offspring during pregnancy

PATHOPHYSIOLOGY Contact with the infected person Maternal viremia Fetal viremia Disseminated infection involving many fetal organ Intrauterine growth retardation, blueberry muffin skin, lethargy and hypothermia Causative agent spreads through the cells and the

DIAGNOSTIC EXAM:
Hemagglutina tion-inhibition test (hi) Complement fixation test (cf) ELISA ( Enzyme Linked Immunosorbe nt Assay )

blood
Mild feverish illness associated with rash and aches and joint

NURSING MANAGEMENT
darkened room to relieve photophobia diet: should be liquid but nourishing warm saline solution for eyes to relieve eye irritation for fever: TSB and antipyretics prevent spread of infection, respiratory inhalation

MEDICATIONS Ibufrofen (Advil) naproxen (Anaprox) Ketoprofen (Actron)

Disease Process Direct transmission, when an infected person sneezes mucus directly into the eyes, nose or mouth of another person Airborne route, when someone inhales the aerosols produced by an infected person coughing, sneezing or spitting Hand-to-eye, handto-nose, or hand-tomouth transmission, either from contaminated surfaces or from direct personal contact such as a hand-shake

Definition:
is a viral infection that affects mainly the nose, throat, bronchi and, occasionally, lungs. Infection usually lasts for about a week, and is characterized by sudden onset of high fever, aching muscles, headache and severe malaise, nonproductive cough, sore throat and rhinitis.

Clinical Manifestations
Fever and extreme coldness (chills shivering, shaking (rigor)) Nasal congestion Body aches, especially joints and throat Fatigue Irritated, watering eyes Reddened eyes, skin nose etc Petechial Rash

PATHOPHYSIOLOGY
virus attaches to host viral RNA enters host cell viral RNA replicates within host cell new virus particles are released and assembled binding and destruction of epithelial cells from nasopharynx and alveoli local inflammatory response systemic body reaction (fever, muscle pain etc.)

MEDICATIONS DIAGNOSTIC EXAM:

Amantadine (symmetrel) rimantadine (flumadine) oseltamivir (Tamiflu) zanamivir (Relenza)

NURSING MANAGEMENT
administer analgesics, antipyretics, and decongestants, as ordered. Follow droplet and standard precautions. Provide cool, humidified air but change the water daily to prevent pseudomonas superinfection. Encourage the patient to rest in bed and drink plenty of fluids. Administer I.V. fluids as ordered. Administer oxygen therapy if warranted. Regularly monitor the patients vital signs, including his temperature.

flu testpositive molecular test resulthas influenza virus viral culturepositive

Disease Process

Definition:
( RUBEOLA ,7 DAY MEASLES, MORBILLI, & RED MEASLES ) -Contagious exanthematous disease of acute onset -Caused by measles virus ( paramyxovirus filterable virus )

Clinical Manifestations anorexia and irritability pruritus lethargy KOPLIK SPOTSpathognomon ic sign eruption on the skin; maculopapul ar rashes (red in color )

MODE OF TRANSMISSION : -droplet infection OR AIRBORNE. -indirect thru contaminated articles with respiratory secretions INCUBATION PERIOD: 10 to 22 days PERIOD OF COMMUNICABILIT Y : 5h day of incubation period until the day of the rash

PATHOPHYSIOLOGY measles virus transmitted via droplet s infects epithelial cells of the nose and conjuctivae virus multiplies extends to regional lymph nodes continues to replicate on epithelial and reticuloendothelial infections become established on the skin and other tissues including the respiratory tract Kopliks spot may develop in buccal mucosa rashes develop virus can be found in bone, skin, respiratory tract and other organs viraemia gradually decreases viraemia and presence of virus in tissue and organs ceases

MEDICATIONS

Vaseline
DIAGNOSTIC EXAM:
multinucleated giant cells in smears of nasal mucosa low white blood cell count and relative lymphocytosis in PB measles encephalitisraised protein, lymphocyte in CSF

Penicillin ribavirin (Virazole)

NURSING MANAGEMENT
SYMPTOMATIC AND SUPPORTIVE o Eye-care wash face and avoid direct sunlight o Oral hygiene o Skin-care no strong soaps and alcohol o Anti-pyretics for fever o Hypoallergenic diet o Vitamin A as ordered to protect the epithelial lining of the resp. tract, GIT and eyes.

Catanduanes State Colleges COLLEGE OF HEALTH SCIENCES Department of Nursing Virac, Catanduanes

Submitted by: Patricia Dawn G. Molina BSN 3A Submitted to: Dr. Alvin C. Ogalesco Ed.D Professor

February 14, 2012