Basilio Aya

Nov 12 2016

Reading

Gonorrhea is a very common sexually transmitted disease (STD) caused by the bacteria Neisseria
gonorrhea. It is estimated that 820,000 new cases of gonorrhea are diagnosed in the U.S. every year.
Gonorrhea is usually transmitted during vaginal, oral or anal sex or through sharing sex aids that have
not been washed or covered with a condom each time they are used. A mother can also pass the
infection onto her baby during childbirth, which can cause blindness in the infant. Common symptoms
in men include a burning sensation when urinating and a white, yellow, or green discharge from the
penis, although some men may have no symptoms. Women with gonorrhea do not usually have any
symptoms but initial symptoms may include pain or burning on urination, increased vaginal discharge,
vaginal bleeding between periods and abdominal and pelvic pain.

If a woman is left untreated,

infection can spread into the womb and fallopian tubes causing pelvic inflammatory disease which can
lead to infertility and an increased risk for ectopic pregnancy. In men, the disease can cause
epididymitis, a painful swelling in the back of the testicles that can also eventually lead to infertility.
Gonorrhea is identified using a urine test or swabs taken from a mans urethra or a womans cervix.
Antibiotics can be used to stop infection but cannot repair any permanent damage caused by the
disease.The World Health Organisation is urging countries to change how they cure Gonorrhea as
traditional means of treatment are quickly becoming ineffective. Health officials warn that sexually
transmitted infections around the world have developed a strong resistance to the drugs we use to we
use to treat them. "These STIs often go undiagnosed and are becoming more difficult to treat, with
some antibiotics now failing as a result of misuse and overuse," said the WHO in a Tuesday. Officials
say of the three most common sexually transmitted infections, Gonorrhea has developed the strongest
resistance to antibiotics. According to the CDC, nearly 820,000 new Gonorrhea cases occur in the
U.S. each year. Nearly one third of these cases are resistant to at least one type of drug. Gonorrhea is
the second most commonly reported infectious disease behind chlamydia.

http://www.sandiegouniontribune.com/news/data-watch/sd-me-stds-cdc-20161028-story.html

Basilio Aya
Name of

Nov 12 2016
Dosage

the Drug
Brand
Name:
Zithromax

Generic
Name
azithromyci
n

Drug class:
Macrolide
antibiotic
Pregnancy
Category B

Drug Study

Therapeuti

Indications

c Actions
ADULTS

Bacteriost

Unlabeled
uses:
atic or
Mild to
Uncomplicate
moderate
bactericida d gonococcal
acute bacterial
infections
l in
exacerbations
caused by N.
of COPD,
susceptibl gonorrhoeae;
pneumonia,
gonococcal
e bacteria.
pharyngitis and
pharyngitis
tonsillitis (as
caused by N.
second-line):
gonorrhoeae;
500 mg PO
chlamydial
single dose on
infections
first day,
caused by C.
followed by
trachomatis;
250 mg PO
prophylaxis
daily on days
after sexual
25 for a total
attack
dose of 1.5 g
or 500 mg/day
Prevention
PO for 3 days.
and treatment
Nongonococca
of
l urethritis and
disseminated
cervicitis due
Mycobacteriu
to C.
m avium
trachomati: A
complex
single 1-g PO
(MAC) in
dose.
patients with
Gonococcal
advanced
urethritis and
AIDS
cervicitis: A
single dose of
Treatment of
2 g PO.
nongonococca
Disseminated
l urethritis and
MAC
cervicitis due
infections: For
to C.
prevention,
trachomatis;
1,200 mg PO
treatment of
taken once
PID
weekly. For
Treatment of
treatment, 600
uncomplicated
mg/day PO
skin infections
with etambutol.
due to
Acute sinusitis:
Staphylococcu
500 mg/day
s aureus, S.
PO for 3 days.
pyogenes,
Streptococcus
agalactiae.

Adverse

Contra

Nursing

Effects

Indications

consideration
Teaching points

CNS:

Yellowing of

Dizziness,

Skin or Eyes

headache,

from Liver

vertigo,

Problems,

somnolence,

Myasthenia

fatigue

Gravis,

GI: Diarrhea,

Hearing

abdominal

Problem, Very

pain, nausea,

Rapid

You may

dyspepsia,

Heartbeat -

experience

flatulence,

Torsades de

these side

vomiting,

Pointes, Slow

effects: Stomach

melena,

Heartbeat,

cramping,

Take the full

course
prescribed. Do
not take with
antacids. Take
with food if GI
upset occurs.

pseudomembr Prolonged Q-T discomfort,

diarrhea; fatigue,
anous colitis
Interval on
headache
Other:
EKG,
(medication may
Superinfection Abnormal
help); additional
s,
EKG with QT
infections in the
angioedema,
changes from
mouth or vagina
rash,
Birth, Liver
(consult with
photosensitivit
y, vaginitis

Problems,

health care
provider for
treatment).
Report severe or
watery diarrhea,
severe nausea
or vomiting, rash
or itching, mouth
sores, vaginal
sores.

Basilio Aya

Nov 12 2016

Patients Name: April Joy Impit

Age: 28 years old

DOB: June 7 1988

Address: Arroyo Compound, Matiina Pangi, Davao City

Prognosis/ Complaint: Early Stage Tuberculosis
Physician: Dr. Ann Tangilo
Medication Given: RIPE (900mg) for 56 days

Date of Consultation: 2014

RI (76mg) for 112 days

Test: Sputum and Xray

Family Data
Name

Age

Occupation

Illness
Experienced

TIme of
Illness

Diagnosis

Medication

Nenita Impit
(grandmother)

73

Housewife

High blood +
myocardial
infraction

2009

Lozartan maintenance

Labs

Purpose

Normal value

Significace of
abnormalities

Sputum

Test helps laboratory

technicians study the
bacteria or fungi that
might be growing in your
lungs and causing the
production of the sputum.
This can help them find
the cause of your illness.

The sample will be placed in a

special plate that encourages
the growth of the bacteria or
fungi. This is the sputum
culture. A bacterial infection
may require up to 48 hours to
grow. It may take a week or
more for fungi to reproduce.

If tuberculosis is
suspected, an acid-fast
stain should be
performed immediately,
and the sputum cultured
on special media, which
are incubated for at least
6 weeks.

Radiology
(X-rays)

The purpose of the

medical examination is to
identify applicants with
inadmissible healthrelated conditions such
as active tuberculosis.

In active pulmonary TB,

infiltrates or consolidations and/
or cavities are often seen in the
upper lungs with or without
mediastinal or hilar
lymphadenopathy.[1] However,
lesions may appear anywhere
in the lungs. In HIV and other
immunosuppressed persons,
any abnormality may indicate
TB or the chest X-ray may even
appear entirely normal

Abnormalities on chest
radiographs may be
suggestive of, but are
never diagnostic of, TB.
However, chest
radiographs may be used
to rule out the possibility
of pulmonary TB in a
person who has a
positive reaction to the
tuberculin skin test and
no symptoms of disease.

Basilio Aya

Nov 12 2016

Tuberculosis (abbreviated TB for tubercle bacillus or Tuberculosis) is a common and often

deadly infectious disease caused by mycobacteria, in humans mainly Mycobacterium tuberculosis.
Tuberculosis usually attacks the lungs (as pulmonary TB) but can also affect the central nervous
system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal
system, bones, joints, and even the skin. Other mycobacteria such as Mycobacterium bovis,
Mycobacterium africanum, Mycobacterium canetti, and Mycobacterium microti also cause
tuberculosis, but these species are less common in humans.
Tuberculosis is spread through the air, when people who have the disease cough, sneeze, or
spit. Most infections in human beings will result in asymptomatic, latent infection, and about one in ten
latent infections will eventually progress to active disease, which, if left untreated, kills more than half
of its victims. The classic symptoms of tuberculosis are a chronic cough with blood-tinged sputum,
fever, night sweats, and weight loss. Infection of other organs causes a wide range of symptoms.

Basilio Aya

Nov 12 2016

Nursing Diagnosis : Infection, risk for [spread/reactivation]

1. Review necessity of infection control measures. Put in temporary respiratory isolation if
indicated. It May help patient understand need for protecting others while acknowledging patients
sense of isolation and social stigma associated with communicable diseases. AFB can pass
through standard masks; therefore, particulate respirators are required.
2. Identify others at risk like household members, close associates and friends. Those
exposed may require a course of drug therapy to prevent spread or development of infection.
3. Instruct patient to cough or sneeze and expectorate into tissue and to refrain from spitting.
Review proper disposal of tissue and good hand washing techniques. Encourage return
demonstration. Behaviours necessary to prevent spread of infection.

Nursing Diagnosis : Airway Clearance, ineffective

1. Assess respiratory function noting breath sounds, rate, rhythm, and depth, and use of
accessory muscles. Diminished breath sounds may reflect atelectasis. Rhonchi, wheezes indicate
accumulation of secretions and inability to clear airways that may lead to use of accessory
muscles and increased work of breathing
2. Note ability to expectorate mucus and cough effectively; document character, amount of
sputum, presence of hemoptysis.Expectoration may be difficult when secretions are very thick as a
result of infection and/or inadequate hydration. Blood-tinged or frankly bloody sputum results from
tissue breakdown (cavitation) in the lungs or from bronchial ulceration and may require further
evaluation or intervention.
3. Clear secretions from mouth and trachea; suction as necessary.Prevents obstruction and
aspiration. Suctioning may be necessary if patient is unable to expectorate secretions.

Nursing Diagnosis : Nutrition: imbalanced, less than body requirements

1. Ascertain patients usual dietary pattern. Include in selection of food.Helpful in identifying
specific needs and strengths. Consideration of individual preferences may improve dietary intake
2. Encourage and provide for frequent rest periods.Helps conserve energy, especially when
metabolic requirements are increased by fever.
3. Encourage small, frequent meals with foods high in protein and carbohydrates.Maximizes
nutrient intake without undue fatigue/energy expenditure from eating large meals, and reduces
gastric irritation.