Understanding Communicable Diseases: Symptoms, Causes, and
School
Our Lady of Fatima University**We aren't endorsed by this school
Course
NCMB 312
Subject
Nursing
Date
Dec 12, 2024
Pages
15
Uploaded by SuperHumanGuanacoPerson1316
WEEK 13 NAME OF COMMUNICABLE DISEASE CAUSATIVE AGENT INCUBATION PERIOD MOT PATHOGNOMIC SIGN COMPLICATIONS DIAGNOSTIC EXAM MEDICATION 1. Hepatitis A 2. Hepatitis B3. Hepatitis C 1. fecal-oral, oral-anal sex 2. percutaneous, sexual contact, mother to child. 3. percutaneous, sexual intercourse chronic hepatitis, cirrhosis 1. Hepatitis Profile 2. Liver function test 3. Liver UTZ (NO ORDER) lamivudine, interferon CHOLERA (Violent Dysentery) (blue death) - As long as microorganisms are present in the bowel excreta Vibrio coma or vibrio cholera From a few hours to 5 days (average of 3 days) Rice-watery stool (3 DEFICITS) 1. Severe dehydration and ECF volume deficit 2.Hypokalemia 3. Metabolic acidosis (Washer- woman’s hand) 1. Stool or vomitus culture 2. Serum electrolytes 3. Dark field or Phase 4. Microscopy Tetracycline (drug of choice) SHIGELOSIS (Bacillary Dysentery) Shigella dysenteriae +/- fever +/- vomiting Abdominal pain (colicky or cramping) Diarrhea with tenesmus Mucus and Blood streaked stool Cotrimoxazole AMOEBIASIS (Amoebic Dysentery) Entamoeba histolitica +/- fever +/- vomiting Abdominal pain Diarrhea with tenesmus Muco-Metronidazole
purulent blood streaked stool TYPHOID FEVER (bacillus Eberthella typhi) - As long as the bacilli appears in the excreta Salmonella Typhi 1 –3 weeks, average: 2weeks Fecal –oral route Ingestion of contaminated food and water 5 F’s –fingers, feces, flies, food, fomites (clinical manifestation) Gradual onset A,B,C,D,E,F,G,H (ROSE SPOTS) CBC Widal test Typhidot exam Blood culture Urine and stool culture RED TIDE POISONING dinoflagellates and diatoms paralytic shellfish poisoning (PSP) - A. catanella (clinical manifestation) The initial sign is tingling of the lips and tongue - ALCOHOL CONSUMPTION 1. The patient is induced to vomit. 2. Charcoal hemoperfusion is a process done by pumping the arterial blood through an activated charcoal filter to remove the toxin. 3. Alkaline fluids, such as sodium bicarbonate, are thought to be helpful because the toxins in unstable in alkaline condition. 4. Artificial respiration is required if the patient exhibits respiratory stress LEPROSY (“Living dead”)Mycobacterium leprae 1. Intimate skin to skin contact 2. Droplet Late Manifestation 1. Lagophthalmos –inability to close eyelids o 2. Madarosis –loss of eyebrows o Sinking of the bridge of the nose Multi drug therapy (MDT) RA 4073 A. Paucibacillary: Rifampicin(600mg) /once a mo Dapsone (100mg) OD (6-9 mos) B. Multibacillary: Rifampicin, dapsone,
3. Leonine face 4. Contractures (clawing of fingers and toes) 5.Gynecomastia lamprine Day 1: R-600 D-100 C-300 once month Day 2-28: Dapsone 100 OD Clofazimine (Lamprine) TETANUS (LOCK JAW) Clostridium tetani 3 days –3 weeks in adult 3 –30 days in new born Through breaks in the skin and mucous membranes Risus sardonicus (sardonic smile) (clinical manifestation) Neonates - Malaise, high fever - Difficulty in sucking - Excessive of crying - Stiffness of jaw ADULT - Trismus –lock jaw - Opisthotonus - Muscular spasm - Low grade fever, diaphoresis Clinical manifestations History of wound - ATS, TAT, TIG - Pen G,Metronidazole - Diazepam - Muscle relaxant POLIOMYELITIS - more on males - not heredity - under 10 years of age - Risk of spreading the microorganism is highest during the prodromal period 1. Brunhilde 2. Lansing 3. Leon Legio debilitans 7 –14 days - fecal-oral: through saliva, vomitus and feces - Direct contact from one person to another - Ingestion through of contaminated food (fecal-oral route) Blood and throat culture, Lumbar tap (pandy’s test), EMG, Stool exam Pain relievers (like ibuprofen) A ventilator (a device that helps breathing) Physical therapy that can help keep the muscles working. Bed rest and fluids for flu-like symptoms. Antispasmodic medications to relax muscles. Antibiotics for urinary tract infections. A heating pad for muscle aches and spasms
MENINGITIS - Cerebrospinal fever - Hib- for children (prevention) * SIGNS OF INCREASED ICP - SIGNS OF MENINGEAL IRRITATION * LATE SIGN - Neisseria meningitides - Streptococcus pneumonia - Haemophilus influenza - Streptococcus agalactae and - Listeria monocytogenes 3 –6 days - Respiratory droplets through nasopharyngeal mucosa - Direct invasion through otitis media - May result after a skull fracture, penetrating head wound NUCHAL RIGIDITY - Bronchitis - Pneumonia - Otitis media/ Mastoiditis - Blindness - Hydrocephalus (clinical manifestation) - fever - petechial/purpuric rashes Cerebrospinal fluid drawn from between two vertebrae * ANTIBIOTICS - Penicillin G- drug of choice - Alternative: Chloramphenicol * Mannitol * Pyrentinol/Encephabol CNS stimulant * Anticonvulsant - Diazepam - Phenytoin (Dilantin) * Corticosteroid ◦Prednisone ◦Dexamethasone * Rifampicin- prophylactic treatment Alternative: Ciprofloxacin LEPTOSPIROSIS - Weil’s disease- Canicola Fever - Mud Fever - Hemorrhagic jaundice - Swineherd’s Disease 1. Septic Stage -febrile 2. Immune or Toxic Stage Leptospira interrogans 6-15 days 1) Ingestion or contact with the skin and mucous membrane of the infected urine or carcasses of wild and domestic animals. 2) Through the mucous membrane of the eyes, nose, and mouth, and 1. Meningitis 2. Respiratory Distress 3. Renal interstitial tubular necrosis that result to renal failure (Weil’s disease)4. Cardiovascular problems 1) Blood urea-nitrogen and urea 2) Enzyme Link Immuno-sorbent Assay (Elisa) 3) Leptospira Antigen-antibody test (LAAT) 4) Leptospira Antibody Test (LAT) 5) Liver function test ●Penicillin G –drug of choice ● Ampicillin, Amoxicillin ●For prophylaxis, doxycycline Peritoneal Dialysis
3. Convalescent Stage -4thto 5thweek through a break on the skin. 3) Direct human to human transmission is rare. Encephalitis - FLAVIVIRUS VECTOR Culex tritaenorhynchus Culex vishnui Culex gelidus 4 to 21 days * Detection of Antigen from serum or cerebrospinal fluid to detect virus specific IgM 1. Compliment Fixation Test- detect antibodies for infection 2. Neutralization Test- detect presence of virus infections 3. Immunofluorescence Assay- to detect antigen & antibodies Tentative diagnosis - ELISA Definitive diagnosis - CSF sample, brain - For patients with mild symptoms, the best treatment is rest, plenty of fluids, and Tylenol (paracetamol) for fever and headaches. - Antiviral agents - acyclovir; success is limited for most infections except when the condition is due to herpes simplex. - Corticosteroids - to reduce the brain’s inflammation, especially in cases of post-infectious (secondary) encephalitis. - Anticonvulsants - seizures. (if Dilantin - check for WBC) - Sedatives –also, effective for seizures, restlessness, and irritability.
DF MOSQUITO - Day biting - Breeds in stagnant water - Dotted mosquito - Usually bite a person in motion OTHER Name: 1. Breakbone fever 2. Dandy fever 3. Infectious Thrombocytopenic purpura 4. H-fever Aedes aegypti (Etiologic Agent) -Group B Arbovirus (I,II,II,IV) - Flavivirus - Chikungunya virus - Zika virus 3 –14 days Shock ----> DEATH Tourniquet Test- Presumptive diagnosis; detects capillary fragility ●Platelet Count: Confirmatory test🡪Result: <100,000 cells/mm3 Hemoconcentration- Increase in 20% Hematocrit Count ● Dengue NS1 Ag ● Dengue Duo Antipyretic/ Analgesic: Do not administer NSAID for Fever Intravenous Fluid Therapy a. Protocol for Fluid correction with NO SHOCK● IVF Crystalloids- D5LR or D5 0.9 NaCl or PLR at 5-7 ml/kg/hr b. Protocol for fluid correction with SHOCK● IVF Crystalloids- PLR or P 0.9 NSS at 20ml/KBW IV bolus in c. if no improvement◦Colloids- Dextran, Haemacel, Haesteril at 10ml/kg bolus in <10 minutes d) Still no improvement ◦Fresh Frozen Plasma at 15cc/kg in 2 hours and start inotropes Dopamine 7-15 ug/kg/m MALARIA - Night biting Anopheles p. FALCIPARUM- 7-14 Dys P. vivax- 12-17 days Bite of infected female ANOPHELES mosquito Cerebral Malaria: most severe neurological complication of Malarial smear: Confirmatory test - best done during the height of fever For P.Vivax –Chloroquine, Primaquine ◦For P.Facipanum –Pyrimethamine, Primaquine ◦ For mixed
- Breeds in clear, flowing and shaded streams - Brown colored and bigger in size - Usually do not bite a person in motion OTHER NAME “AGUE”King of Tropical and Sub-tropical Diseases P. ovale- 9-18 days P. malaria- 13-40 days - Through blood transfusion - Contaminated needles and syringes - Congenital transmission (RARE) infection with Plasmodium falciparum malaria. It is a clinical syndrome characterized by seizures and coma Blackwater fever: also called malarial hemoglobinuria, one of the less common yet most dangerous complications of malaria. The distinctive color of the urine (dark) is due to the presence of large amounts of hemoglobin, released during the extensive destruction of the patient's red blood cells by malarial parasites that leads to kidney failure. (clinical manifestation) - malaise - splenomegaly - hepatomegaly Quantitative Buffy Coat (QBC)/ Rapid Diagnostic Test (RDT) o Detects malarial antigen o taken anytime, the faster test causative agents –Quinine, Primaquine oChloroquine - DOC oPrimaquine –prevents relapse oPyrimethamine –good for pregnant mother but used wit First line: Artemether-lumefantrine combination tablet Second line: Chloroquine, Primaquine Pyrimethamine and Sulfadoxine
FILARIASIS Wuchereria bancrofti Brugia malayi Brugia timori Loa loa 8-16 months Bite of Aedes poecilius Nocturnal blood exam Immunochromatographic test (ICT) Diethlycarbamazine citrate (Hetrazan)
WEEK 16- COLORECTAL CANCER COLORECTAL CANCER - 3RDleading vause of cancer death in the US and PHILIPPINES - cancer in colon or rectum - colon is the large intestine or large bowel RECTUM - passageway that connects the colon to the anus OCCUR - young adults and teenagers - MAJORITY- older than 50 AVERAGE AGE AT TIME PF DIAGNOSIS - MEN: 68 - WOMEN: 72 COLON AND RECTUM - 9% SCREENING PROGRAMS - yearly mammography and yearly clinical breast exam for WOMEN older that 40 years old - breast self exam every month for women 20-39 years old - COLONOSCOPY- age 50 years and then every 10 years - yearly fecal occult blood test in adults of all ages - yearly prostate specific antigen (psa) test and digital rectal examination for men over age 50 - yearly pap smear and pelvic exam for women 18 years and up RISK ASSESSMENT - increasing age - family history: ADENOMATOUS POLYPOSIS Meaning - (FAP) an inherited disorder characterized by cancer of the large intestine (colon) and rectum - people with the classic type of (FAP) may begin to develop multiple noncancerous (benign) growths (polyps) in the colon as early as their teenage years. OTHER RISK FACTORS: 1. PREVIOUS COLON CANCER OR POLYPS 2. HISTORY OF IBD
ASSESSMENT - SIGNS AND SYMPTOMS OF COLON CANCER INCLUDE: 1. A persistent change in your bowel habits, including DIARRHEA or CONSTIPATION or a change in the consistency of your stool 2. Rectal BLEEDING or blood in your stool 3. Persistent abdominal discomfort, such as cramps, gas or pain 4. A feeling that your bowel doesn’t empty completely (tenesmus)5. Weakness or fatigue 6. Unexplained weight loss NO SYMPTOMS - early stages of disease WHEN SYMPTOMS APPEAR - vary depending on the cancer’s size and location in your large intestine COLOR ASSESSMENT - black, tarry stools - loose, frothy stool - Flat, ribbon-shaped - Mahogany- colored SCREENING, DETECTION, DIAGNOSIS: - F.O.B.T (Fecal Occult Blood Test) 2. D.R.E. (DIGITALRECTAL EXAM) - AN EXAM OF THE RECTUM that may be done as part of a routine physical exam - a doctor or nurse insert a lubricated gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual 3. PROCTOSCOPY
4. DOUBLE CONTRAST BARIUM ENEMA - also called as DCBE or barium enema- it uses X-rays to find abnormal growths in the colon. - Barium, a silver-white metallic compound is used to outline the colon and rectum on the Xray. Air is then passed through the same tube to further enhance the X-ray 5. BARIUM ENEMA - not as accurate as colonoscopyor virtual colonoscopy. - can miss (fail to detect) polyps or sometimes even cancers - also has difficulty detecting colitis involving the superficial lining of the colon 6. F.SIG (FLEXIBLE SIGMOIDOSCOPY) DIIFERENCE OF F.SIG AND COLONOSCOPY 1. The partof the colon they allow the doctor to see. 2. Sigmoidoscopy is less invasivebecause it only looks at the lower part of your colon 3. Colonoscopy looks at the entire large intestine F.SIG COLONOSCOPY SCREENING, DETECTION, DIAGNOSIS: LABORATORY 1. CEA - a test used to check how well treatment is working in certain types of cancer, particularly colon cancer. Carcinoembryonic antigens are substance (usually proteins) that are produced by some types of cancer. In response to the antigens, the body produces antibodies to help fight them 2. CA 19-9- has been known as tumor biomarkerin the colon carcinoma for almost 40 years 3. CBC TO CHECK FOR POSSIBLE METASTASIS
1. CHEST X-RAY 2. ABDOMINAL CT SCAN 3. LIVER FUNCTION TEST (AST/ALT) SCREENING, DETECTION, DIAGNOSIS: DUKES’ STAGING SYSTEM- doctors use different system for staging bowel cancer. The most common system for bowel cancer is TNM staging. But you might hear your doctor talking about your bowel cancer as Dukes’ A,B,C or D.TNM STAGING SYSTEM stage 5 years survival rare 1 More than 95% 2 70% 3 50% 4 Less than 5% COMPLICATIONS 1. OBSTRUCTION 2. HEMORRHAGE 3. PERITONITIS 4. SEPSIS MEANS CAN TREAT WHOLE BODY (ASA PIC) 1.) RADIATION THERAPY - used alone or in combination with chemotherapy- neoadjuvant or adjuvant purpose RADIATION THERAPY METHODS 1. EBRT HEALTH TEACHINGS (ostomy client- additional care) 2. FREQUENCY AND LENGTH 3. SKIN MARKINGS AND SKIN CARE 4. POSSIBLE SIDE EFFECTS - headache - hair loss - nausea - vomiting - extreme tiredness (fatigue) - hearing loss
- skin and scalp changes - trouble with memory and speech 2. BRACHYTHERAPY 1-192 -Irdium Ir 192 is a radioactive isotope of iridium.Iridium-192 emits gamma rays and has a half-life of 74 days - A high dose rate can be used in brachytherapy to treat tumors by selectively delivering a cytotoxic dose of radiation to the tumor site 3. BRACHYTHERAPY Y90 - tiny glass or resin beads filled with the radioactive isotope yttrium Y-90 are placed inside the blood vessels that feed a tumor 2.) CHEMOTHERAPY - METASTASIS: FOLFOX REGIMEN - METASTASIS: FOLFIRI- is the name of the chemotherapy combination that includes: - folinic acid (also called leucovorin, calcium folinate or FA) - fluorouracil (also called 5FU) FOLFIRI also known as - irinotecan de Gramont or irinotecan modified de Gramont. It is a treatment for advanced bowel cancer and other digestive (gastric) cancers. - METASTASIS: CAPLRI (XELIRI)
- Caplri Regimen for Advanced and Metastatic Colorectal or Esophogastric Cancer IFL - Irinotecan plus fluorouracil/leucovorin (IFL) 3.) SURGERY - ENDOSCOPIC POLYPECTOMY 4. LAPAROSCOPIC COLECTOMY 5. COLON RESECTION WITH - ANASTOMOSIS 6. COLON RESECTION WITH - ABDOMINOPERINEAL RESECTION 7. COLON RESECTION WITH - COLOSTOMY COLOSTOMY CARE A- Able to regulate stool thru regular irrigations; should be the same time frame daily N- Not watery. The stools are formed and don’t leak on the clothes
U- U can do all u can do without the colostomy. Some foods will liquefy stools or cause noisy problems S- Swimming is ok showers and tub baths are also acceptable