CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,

INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS

(ACUTE & CHRONIC)

NCMB 312 FINALS TRANSES { week 15)

Anthrax Causative agent S&S

is a serious - Bacillus Anthracis ✓ Can cause severe illness both human and
infectious disease animals
caused by gram- MOT: breath in spores, eat Cutaneous Symptoms
positive, rod- food or drink water ✓ Group small blister, bumps that may itch
shaped bacteria contaminated, get spores in ✓ Painless skin sore ( ulcer) with black center
known as a cut or scrape in the skin. appears
Bacillus anthracis. ✓ Usually on the face, neck, arms or hands
( dormant spore Types of Anthrax:
not active) Cutaneous: most common Pathognomonic: Painless sore with black center
form, handle contaminated
Cause by Bacteria animal product spores get Inhalation Symptoms
into open wounds ✓ Fever & chills
Can live in the soil 1-7 days after ✓ Chest discomfort
exposure ✓ SOB
When spore get Inhalation: most deadly, ✓ Confusion, dizziness
into the body human breath spores ✓ Cough nausea & vomiting
person or animals through nose into lungs ✓ Stomach pain
a place with rich Develop week after ✓ Headache, Body ache
and waters, sugars exposure, or can take ✓ Sweats ( often drenching)
and other nutrients up to 2 months ✓ Extreme tiredness
they can be Incubation
activated turn into • 2-7 days
growing cells ( uncommon for people to get
infected ) Pathophysiology
When active the
bacteria multiply
and spread poison
cause severe
illness and death
 CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

Diagnostics Management
- Patient history (
exposure) DOC:
If inhalation suspected ֍ Antibiotics & Antitoxin
- Chest X-ray ( most o IV antibiotics: penicillin doxycycline,
common) tetracycline, erythromycin,
- CT scans chloramphenicol & ciprofloxacin (
To confirm mediastinal Most DOC)
widening or pleural effusion ֍ Continuous fluid drainage
֍ Help breathing mechanical ventilation
Only to confirm ֍
- Measure antibodies
or toxins in blood
- Test directly B.
Anthracis (blood,
skin lesions swab,
spinal fluids &
respiratory secretion.
-
( samples taken before begins
taking antibiotics )
PEDICULOSIS Causative Agent S&S
Pediculosis capitis- head ✓ Intense pruritus’, leads secondary excoriation
Infestation of the lice ✓ Eggs ( nits) attached to hair shaft
hairy parts of the Pediculosis Corporis /
body or clothing Humanus - body lice Pathognomic: Maculae Cerulae
with eggs, larvae or Phthirus pubis- pubic or
adults of lice crabs lice Parasitic Infection
- Scabies: infestation of skin by Sarcoptes
Cause by Parastics scabiei mites
Organism o Intense itching
o Superficial burrows ( between fingers,
the surface or wrist and axilla)

MOT: direct contact, o Redness, swelling may noted

beddings, towel, clothes and Management
hairbrush
 CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

DOC:
a. Pediculosis
o Permethrin 1 % ( Nix)
o Pyrethrine compounds (Rid)
b. Scabies
o Permethrin 5 % cream ( Elimite)

Nursing Management
Home Care:
✓ All family members close contact need to
treated
✓ Concurrent Disinfection
o Daily washing worn clothes, towel &
bedding
o

SCHISTOSOMIASIS Causative Agents

Endemic Schistosoma japonicum-

protozoans Quadrasi Snail ( common)
infection affects Schistosoma Mansoni-
liver and GIT Biophalaria snail
Schistosoma
Haematobium- same on
Mansoni
Also known
Bilharziasis Stages
Blood Fluke - Adult female and
male parasites
Discover by - Ova
German physician - Miracidium- Infective
Theodor Bilharz stage in snail S&S
- Cercaria- Infective ADSPA
Intermediate Host stage in man and ✓ Abdominal pain
Snail ( animals ✓ Diarrhea with bloody stools
Oncomelania ✓ Portal hypertension
quadrasi) MOT: about 2-6 weeks from ✓ Sign of liver cirrhosis
skin penetration by cercaria ✓ Anemia

Management
Diagnostic Exam ֍ Praziquantel ( Bilttricide) – drug of choice
֍ Kato Katz- Specimen ֍ Oxamniquine ( vansil) metrifonate
is stool
 CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

֍ Circumoval Precipitin Prevention

tes( COPT)- specimen ✓ Travelers to endemic area should avoid
blood exposure to fresh water ( contaminated)
֍ HBT- UTZ ✓ Note: No vaccine current available
֍ Liver function test ✓ Eradication of snail

HELMINTHES Causative Agent Management

Nematodes ✓ Anthelmintic drugs
CAUSE BY MOT: Ingestion & Skin Notes: used must be under steroid
PARASITE Penetration cover
ORGANISIM Adults aged 18 yrs albendazole
INGESTION 15mg/kg given once daily for 8 days
lives on or in a Pinworm- Enterobius, Seat Praziquantel 50 mg/kg given once
host organism and worm daily in divide d doses for 15 days
gets its food from S/S- Nocturnal itchiness of
or at the anus( female pinworm lays
expense of its host eggs on the anal sphincter) Nursing Management
Giant Roundworm ( ✓ Administration medication as ordered
Ascariasis) Potbelly ✓ Inform the side effect of pyrantel Stool may
Helminths are Whipworm( Trichuriasis) be Bright red and cause vomiting
large, Tapeworm Cestodes
multicellular Taenia saginata- raw beef Diagnostics
organisms that are Taenia Solium- raw pork ▪ Scotch Tape test ( pinworm)
generally Diphyllobothrium latum- ▪ Stool Exam
visible to the raw fish
naked eye in their Lung fluke- paragonimiasis
adult stages MOT: raw mountain crab

SKIN PENETRATION
Hookworm-
(ancyclostomiasis)
Threadworm-
(strongyloidiasis)
 CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

RABIES Causative Agent S&S

Rhabdo Virus Rabid Animals
RA 9482 - Bullet shaped virus ✓ Dumb Stage- quit, stay in corner with copious
Anti-Rabies Act of with affinity to CNS salvation
2007, which tissue ✓ Furious Stage- easily agitated, hydrophobia
manadates MOT: Bite of infected Rabid Man
National animals, licking of open ✓ Prodromal / Invasion Stage- mental
Prevention and wounds, scratch, man to depression, headache sore throat, low-grade
Control Program man transmission fever, Copious salivation and Quiet
( NRPCP) It ✓ Excitement Stage- Restless, irritable,
eliminated rabies in Source of Infection hydrophobic, Aero phobic, Drooling of saliva
the country and Saliva of infected animals or ✓ Paralytic- Flaccid ascending symmetric
declare the human paralysis Coma, Death
Philippines rabies
free by the year Incubation
2020 Common Carrier of rabies 10-14 days (dogs)
֍ Bat 1days-5yrs ( human)
Executive Order ֍ Fox Incubation based on period depends of ff factors
No. 84 series of ֍ Cat ▪ Distance of the bite to the brain
199 March is rabies ֍ Skunk ▪ Extensiveness of the bite
awareness Month ֍ Dog ▪ Species of the animals
▪ Richness of the nerve supply in the area
Diagnostic EXAM ▪ Resistance of the host
o Fluorescent rabies
Knows as Lyssa, anti body ( FRA)-
Hydrophobia Confirmatory test
o Braiin biopsy of the
animals ( Negris
Bodies)
Louis Pasteur o 14 days observation
developed earlist of animals
vaccine against
rabies on 6 July Category of exposure to
1885 Suspect rabid animals

Joseph Meister Category 1- touching or

first receive anti feeding animals, licks on Notes: the farther away from brain, the longer virus
rabies vaccines intact skin takes to spread
- Post exposure- NONE Virus Spread through central nervous System
Category 2- nibbling of
uncovered skin, minor Medical Management
scratches or abrasion - No specific Treatment
without bleeding - Prevention is best treatment
CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

- Post Exposure- - Anit- rabies vaccination of animals and

immediate exposed individual
vaccination and local
treatment of wound Nursing Management
Category 3- single or - Provide a dim, quiet and non-stimulating
multiple transdermal bites, room for patients
or scratches, lick on broken - Weak gown, mask, and goggles
skin - All noise no matter how minor should be
- Post exposure- avoided
immediate - Restrain the patient when needed
vaccination and - Stimulation of any senses by fluids must be
administered rabies avoided
immunoglobulin: - Anti rabies vaccines
local treatment
wounds Medication
- Person never been vaccinated should get 4
doses of rabies vaccine
Dosage of Drugs - Human rabies Immune globulin (HRIG)
HRIG- 20 IU/kg body weight
Post-exposure prophylaxis {PEP)
Equine rabies Immune- 1st dose right away of exposure
globulin ( ERIG)- 40 IU/kg 3,7,14 days vaccine will be given again
body weight
Person not having vaccinated against rabies
administered .(PEP) should always include
administration of both HRIG and rabies
vaccine.

The combination of HRIG and vaccine

recommended on both bite & non-bite
exposures.
Prevention
- Immunization
- Keep away from stray
animals
 CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

BUBONIC PLAGUE Causative Agent 3 main forms

Yersinia pestis
Black death/ Blue - Gram – nonmotile rod
sickness/ La pest? shaped
The Great coccobacillus with no
Mortality spores
MOT: Anaerobic organism,
Greek boubon can infect human via the
meaning groin oriental rat flea, directed
contact with infectious body
fluids,
Swollen lymph
nodes Pneumonic Plague
transmitted inhalation of
aerosolized infective
droplets, can spread person S&S
to person Day 1- Painful
Day 2- victim vomited and developed a fever
Diagnostics Exam Day 3- bleding under the skin caused dark blothches
- Bacteriology ( Gold all over the obdy
Standard) Yersinia Day 4- attacked nervouse system, caused suffer
pestis Culture spasms and terrible pain
- Rapid Dipstick Day 5- sometimes burst, and foul smelling, black
testing (confirm liquid oozed fro mthe open boils.
present of Yersinia
Antigen) Comon Symptoms ( Lymphadenitis)
- Serum
Examination(verified
(presence infection)

Florence antibody positivity

observed bright intense
green staining around the
cells wall of Yersinia pestis
the plague bacillus

✓ May experince, fever, vomiting, bleeding organ

failure open sources
✓ If not being treated it can spread to blood
stream can cause sepsis / septicemic plague
CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)

✓ If infect the lungs can cause pnemonia,

Incubation pnemonic plague
✓ Without treatment can cause 60 percent of
Period of Communicability- death
fleas remain infective for
months Complication Signs And Symptoms of ( Septicemic
Plague)
2-6 days after being infected • Hemorrrhagic changes in skin called
become ill with bubonic purpuric lession
plague. • Disseminated Intravascular coagulation
• Extremities gangrene ( BLACK DEATH)
Confirmatory of plague
required lab testing best is to Treatment
get sample of pus from a ✓ Antibiotics
bubo, blood or sputum ✓ Aminoglycosides ( streptomycin, getamicin,
tretracyclines. Doxycycline, fluoroquinolone
ciprofloxacin
✓ Peope infected need a immediate treatment
Pathognomic Sign should given antibiotics within 24 hours of
Characterized painful the first symptoms
swollen Lymph nodes or ✓ Administed oxygen, IV fluids and
buboes respirstory support

Managing the Plague Outbreaks

- Find stop the source of infection
- Identify the area where human was exposed
and pally appropriate intervention and control
procedures and rodent control
- Protect health care workers inform them on
prevetion & control ( wear standard
percaution) chemoprophylaxis with
antibiotics for the duration of seven days or
at least as long as they are exposed to infected
patients
- Ensure correct treatment
- Isoalte the patient pneumonic plague ( not to
infect vis air droplets)
- Provide mask for pnemonic patient can
reduced spread.
- Disinfection. Routine hand washing
- Safe burial pracrice
-
CARE OF CLIENTS WITH PROBLEMS IN OXYGENATION, FLUID & ELECTROLYTES,
INFECTIOUS, INFLAMMATORY & IMMULOLOGIC RESPONSE, CELLULAR ABERRATIONS
(ACUTE & CHRONIC)