HOLY NAME UNIVERSITY COLLEGE OF NURSING CITY OF TAGBILARAN

TYPHOID FEVER

Area Date Time No. of Hours

: Community Health Nursing (Booy District, Tagbilaran City, Bohol) : March 4-5 & 11-13, 2013 : 7:30 am 2:00 pm : 1- 2 hours

Course Description : Typhoid Fever- definitions, causes, sign & symptoms, complications, nursing and medical management. General Objective : After the discussion on the topic, the student nurses will be able to add in their knowledge about Typhoid Fever.

Specific Objectives

Contents

Teacher

Learner

Time Allotted

Resources

Evaluation

After 2 hour of discussion, the students nurses will be able to; Define Typhoid Fever Describe the causes, sign and symptoms, complications, nursing and medical management of Typhoid fever. Formulate nursing diagnoses that address the needs of the patient and her/ his family.

-definition of typhoid fever -causes, sign and symptoms, complications, nursing and medical management of Typhoid fever -base on the complication

Discussion

Active Listening

15 min.

Public Health Nursing in Question and the Philippines answer

Discussion Active Listening 55 min.

Discussion

Active Listening

15 min.

www.mayoclinic.com www.medlineplus.com

10 item quiz

TYPHOID FEVER

Definition
Typhoid fever is an infection that causes diarrhea and a rash -- most commonly due to a type of bacteria called Salmonella typhi (S. typhi).

Causes
The bacteria that cause typhoid fever -- S. typhi -- spread through contaminated food, drink, or water. If you eat or drink something that is contaminated, the bacteria enter your body. They travel into your intestines, and then into your bloodstream, where they can get to your lymph nodes, gallbladder, liver, spleen, and other parts of your body. A few people can become carriers of S. typhi and continue to release the bacteria in their stools for years, spreading the disease.

Intubation Period
Average of 2 weeks usual range 1 to 3 weeks

Sign and Symptoms

Early symptoms include fever, general ill-feeling and abdominal pain. A high (typically over 103 degrees Fahrenheit) fever and severe diarrhea occur as the disease gets worse. Some people with typhoid fever develop a rash called "rose spots," which are small red spots on the abdomen and chest. Other symptoms that occur include: Abdominal tenderness Agitation Bloody stools Chills Confusion

Difficulty paying attention (attention deficit) Delirium Fluctuating mood Hallucinations Nosebleeds Severe fatigue Slow, sluggish, lethargic feeling Weakness

Complications
Intestinal bleeding or holes The most serious complication of typhoid fever intestinal bleeding or holes (perforations) may develop in the third week of illness. About 5 percent of people with typhoid fever experience this complication. Intestinal bleeding is often marked by a sudden drop in blood pressure and shock, followed by the appearance of blood in your stool. A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening emergency requires immediate medical care.

Other, less common complications

Other possible complications include: Inflammation of the heart muscle (myocarditis) Inflammation of the lining of the heart and valves (endocarditis) Pneumonia Inflammation of the pancreas (pancreatitis) Inflammation of the gallbladder (cholecystitis) Kidney or bladder infections Infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis) Psychiatric problems such as delirium, hallucinations and paranoid psychosis With prompt treatment, nearly all people in industrialized nations recover from typhoid. Without treatment, some people may not survive complications of the disease.

Medical Management
A complete blood count (CBC) will show a high number of white blood cells. A blood culture during the first week of the fever can show S. typhi bacteria. Other tests that can help diagnose this condition include: ELISA urine test to look for the bacteria that cause Typhoid fever Fluorescent antibody study to look for substances that are specific to Typhoid bacteria Platelet count (platelet count will be low) Stool culture

 Fluids and electrolytes may be given through a vein (intravenously), or you may be asked to drink uncontaminated water with electrolyte packets. Appropriate antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic.

Nursing Management
Health Teaching Teach members of the family how to report all symptoms to the attending physician especially when patient is being cared for at home Teach, guide and supervise members of the family on nursing techniques which will contribute to the patients recovery Interpret to family nature of disease and need for practicing preventive and control measures. Management Demonstrate to family how to give bedside care such as tepid sponge, feeding changing of bedlinen,use of bedpan and mouth care Any bleeding from the rectum, blood in stools sudden acute abdominal pain restlessness, falling of temperature should be reported at once to the physician or the patient should be brought at once to the hospital. Take vital signs and teach patient family member how to take and record same.