PULMONARY

TUBERCULOSIS
Causative Agent: Mycobacterium Tuberculosis
Host: Human; Cattle
Mode of Transmission: Airborne-droplet
Key Manifestations:
a. Night sweats
b. Weight loss
c. Late Afternoon fever
d. Hemoptysis
Common Manifestations:
Easy fatigability, cough that progressively
becomes worse
ïiagnostic Procedures:
a. CXR ± may reveal presence of
active or calcified lesions,
pleural effusion
b. ïirect Sputum Smear
Microscopy (ïSSM) ± presence
of acid fast bacilli, Primary
diagnostic tool
c. Matoux test/Purified Protein
ïerivatives (PPï)
Mantoux Test/PPï Testing
j Route of administration is
INTRAïERMAL
j Read after 48-72 hours (2-3
days)
j Result ± (+ ) Equal or Greater
than 10mm indurations
( - ) Less than 10 mm
indurations
Remember:
1. Immunocompromised clients
may not have a positive reaction
despite of being infected with
tubercle bacilli
2. Clients who have received bacilli
Calmette-Guerin (BCG) vaccine
will have a positive result
ANTI-TB ïRUGS (RIPES)
MULTIPLE ïRUG THERAPY
R-ifampicin ± orange discoloration
of urine
I-soniazid ± peripheral neuritis
P-yrazinamide ± hyperuricemia
E-thambutol ± decreased visual
acuity
S-treptomycin ± effects on VIII
cranial nerve
Remember: ISONIAZIï causes
VITAMIN B6 ïEFICIENCY
Therefore, GIVE Vit.B6 in
conjunction with Isoniazid
Prevention and Control
a. BCG immunization at birth
b. Early case finding and prompt
referral
Treatment:
a. ïomicilliary treatment
b. MïT
c. High-Carbohydrate, High-protein,
High Vit.B6
LEPROSY
Causative Agent:
Mycobacterium leprae

Mode of Transmission: Airborne;

Prolonged skin-to-skin contact

Clinical Manifestations:
Early and Late Signs
Early Signs:
j Loss of sensation on the skin
lesion
j ïecrease sweating and hair
growth
j Pain and redness of the eyes
j Ulcers that do not heal
j Nasal obstruction or bleeding
j Muscle weakness or paralysis of
extremities
Late Signs
j Madarosis ± loss of eyebrow
j Lagophthalmos ± inability to
close eyelids
j Clawing of fingers and toes
j Gynecomastia
j Sinking of the nose bridge
ïiagnostic Test: Slit Skin Smear

Anti-leprosy ïrugs (Cï-ROM)

Clofazimine, ïapsone,
Rifampicin, Ofloxacin,
Minocycline
Prevention and Control
a. Early case finding and prompt
referral

Treatment:
a. ïomicialliary treatment
b. MïT
SCHISTOSOMIASIS
Causative Agent:
Schistosoma japonicum
Schistosoma mansoni
Schistosoma hematobium
Host: Oncomelania quadrasi (SNAIL)
Mode of Transmission: Food-borne,
ïirect Contact
Clinical Manifestation: Spleenomegaly,
inflamed liver, diarrhea, bloody
stools, enlarged abdomen
ïrug of Choice: Praziquantel
(Biltricide)
Control and Prevention
a. Health Education
b. Proper waste disposal
c. Treat snail-breeding sites with
molluscicides
d. Use of rubber boots
FILARIASIS
Causative agents: Wuchereria bancrofti
Brugia malayi and Brugia
Timori
Host: Aedes poecilus
Mode of Transmission: Mosquito bites
Incubation Period: 8-16 months
Clinical Manifestations:
Hydrocoele ± swelling of the scrotum
Lymphedema ± temporary swelling of
upper and lower extremities
Elephantiasis ± enlargement and
ïiagnostic Tests:
a. Nocturnal Blood Examination ±
blood is taken after 8PM
b. Immunochromatographic Test ±
antigen test done during daytime
Treatment:
a. Mass treatment
b. Medical treatment
c. Surgical treatment
Medical Treatment:
ïiethylcarbamazepine
Citrate (ïEC)/Hetrazan

Prevention and Control

a. Environmental sanitation
b. Spraying with insecticides
c. Health education
MALARIA
Causative Agent:
Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae

Mode of Transmission:
Mosquito bites (Anopheles)
Clinical Manifestations:
Anemia, Hepatomegaly,
Spleenomegaly
Profuse sweating, fever, malaise,
recurrent chills

ïiagnostic Test:
Blood Smear
Prevention and Control:
a. Chemoprophylaxis
b. Zooprophylaxis
c. Insecticide
d. House spraying
e. On stream clearing
f. On stream seeding
Antimalarial Medications:
Chloroquine ± Oral
preparation
Quinine ± IM injection

For prevention, instruct the people

to avoid outdoor night activities
(9PM-3AM)
 ïengue
Hemorrhagic Fever
Causative Agent:
ïengue virus 1, 2,3,4
Chikungunya Virus
Incubation Period: 6 ± 11 days

Mode of Transmission:
Mosquito Bite (Aedes
Aegypti)
Clinical Manifestations:
a. First 4 days ± Febrile/Invasive
stage
high fever, abdominal pain and
headache, vomiting,
conjunctival infection, epistaxis
b. th
4 -7th days ± Toxic or
Hemorrhagic Stage
Lowering of temperature, severe
abdominal pain,
hematemesis or melena (signs of
bleeding),
hypovolemic shock
c.7th± 10thday ±
Convalescent/Recovery Stage
Stabilization of vital signs and
other sign and symptoms
ïiagnostic Test:
Torniquet Test (Rumpel Leads Test)

Prevention and Control:

1. Environmental Sanitation
Nursing Management:

Supportive and Symptomatic

treatment

a. Analgesic
b. Rapid Fluid Replacement
c. Blood transfusion
MEASLES
Causative Agent:
Filterable virus of measles
Mode of Transmission:
ïroplet spread by nose
and throat secretions
Incubation Period: 10-14 days

Clinical Manifestation:
a. Koplik spots
b. Erupted area of the cheeks
c. Branny desquamation
CHICKEN POX
Causative Agent: Varicella
Mode of Transmission: direct
contact or droplet spread

Incubation Period: 13-17 days

Period of Communicability: 1
day before and 6 days after the
appearance of first crop of
vesicles
Clinical Manifestations:
Slight Fever, Vesicular Rash,
granular scabs

Remember: Exclusion from

schools for 1 week after first
eruption appears
 MUMPS
(EPIïEMIC PAROTITIS)
Causative Agent: Paramyxovirus
Incubation: 13-26 days
Period of Communicability:
As long as glandular swelling
remains
Clinical Manifestations:
Painful swelling in front of ear,
angle of jaws and down the neck
Orchitis ± painful swelling of one or
both testicles
Treatments:
a. Active Immunization (MMR)
b. Active Treatment
c. ïiet ± Soft ïiet
d. Passive immunization
PNEUMONIA
Causative Agent: ïiploccocus
pneumoniae, Virus
Mode of Transmission: Airborne
Incubation Period: 2-3 days

Clinical Manifestations:
Chest indrawing
Fast breathing
Nursing Managements:
a. Bed rest
b. Nutrition
c. Increased fluid intake
d. Frequent turning from side to
side
CHOLERA
(EL TOR)
Causative Agent: Vibrio El Tor
Incubation Period: Few hours ± 5
days
Mode of Transmission: Foodborne
and Waterborne

Clinical Manifestations:
Rice Watery Stool
Severe ïehydration
Nursing Management:
a. Fluid Replacement
b. Electrolyte replacement
c. Proper Nutrition ± ³am´,
soup, Low residue diet
RABIES
(Lyssa)
Causative Agent:
Rhabdovirus, Lyssavirus
Incubation Period: 2 to 8 weeks
Mode of Transmission: ïog bites
Clinical Manifestation:
Hydrophobia
Sense of Apprehension
ïelirium and Convulsions
Paralysis
Nursing Management
a. Wound care
b. Post-Exposure Treatments
- active and passive
immunization
c. Health education to the public
BACILLARY
ïYSENTERY
Causative Agent: Shigella
Mode of Transmission: Food-
Borne, ïirect contact, Vector-
borne
Incubation Period: Less than 4
days

Clinical Manifestation:
Tenesmus ± painful spasm of the
anal sphincter
Nursing Managements:
a. Personal Hygiene
b. Proper ïiet and Nutrition
mTHE ENïm