Malaria

Acute and chronic parasitic disease transmitted by the bite of infected mosquitoes and it is confined mainly to tropical and subtropical areas

Etiology Incubation period

P. falciparum, P. vivax, P. malariae, P. ovale

12-30 days

Bite form Anopheles species mosquito

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology
injection n the skin of Sporozoite travels in the bloodstream and live/mature in the liver release of merozoites in the bloodstream

Clinical Manifestations
Pathognomonic sign: P-rofuse sweating H-epatomegaly A-nemia S-pleenomegaly E-levated temperature Fever Shaking chills muscle pains back pain nausea headache Myalgia, with feeling of well-being in between Vomiting Changes in sensorium Orthostatic hypotension

manifestations of Signs and Symptoms

invasion of RBCs

CBC_Low Hemoglobin, low hematocrit Malarial Smear_ presence of malarial antigen Rapid diagnostic test(RDT)_ detect malarial parasite antigen in the blood

RBC's lyse and release new parasites

Anti-malarial drugs Chloroquine Quinine Sulfadoxine for the resistant P. falciparum Primaquine for relapse of P. vivax & ovale Erythrocyte exchange transfusion for rapid production of high levels of parasites in the blood

Monitor VS Monitor I and O, Bilirubin and parasitic levels TSB during febrile periods Offer large amount of fluids Monitor for quinine toxicity Monitor for bleeding

invasion of new RBC's by the newgen parasites

Take up by Anopheles mosquito

Health Teaching

Advise to avoid being bitten by mosquitoes, use long clothes, and avoid using perfumes of colognes, and use repellants such as lotions, etc. especially during dusk to dawn.

Meningitis
Inflammation of the lining around the brain and spinal cord caused by a bacteria or virus.
Neisseria meningitides

Etiology Incubation period

thru droplet transmission of pharyngeal secretions penetrating head or spinal wound direct invasion from otitis media

Diagnostic Exams

Medical Management

Nursing Management

1 to 10 days

Pathophysiology
Entry of microorganism in the bloodstream

Clinical Manifestations
Pathognomonic sign: nuchal rigidity neck, shoulder and back stiffness opisthotonus + kernigs sign +brudzinskis sign Headache Fever w/ chills Photophobia petechial, purpuric, or ecchymotic hemorrhages alteration in LOC eat foods rich in protein teach patient the purpose of his isolation Provide support to the family and patient. Lumbar Puncture/CSF Gram staining-low glucose, high protein, high WBC CT/MRI-see shift in skull contents Cephalosphorins(ceftriaxone) Ampicillin Aminoglycosides Digitalis Acetaminophen Mannitol anticonvulsants

crossing the blood brain barrier

proliferation of microorganism in the CSF

release of cell wall fragments and pollysaccharides

monitor vital signs monitor neurologic status maintain adequate nutrition and elimination follow strict aseptic technique when carrying out procedure isolation

inflammation

increase ICP

Health Teaching

Dengue Hemorrhagic Fever

an acute febrile disease caused by infection with one of the serotypes of dengue virus

Etiology Incubation period

Bite of mosquito (Aedes specie)

3-14 days commonly 7-10 days

Diagnostic Exams Clinical Manifestations

Pathognomonic Sign S hock H igh fever and H emoptysis A bdominal pain M elena E pistaxis Bleeding gums Purple blanched skin with rash convulsions Anorexia Vomiting Myalgia Tourniquet testfragile veins Rumpel Leads testmore than 20 petechiae in a square inch CBC-low platelet count, elevated hematocrit Guaiac stool exampresence of blood

Medical Management

Nursing Management

Pathophysiology
virus deposited in the skin

replication of virus at site of infection and lymphatic tissue

viremia 4-5 days after onset of symptoms

Analgesics except aspirin IV fluids for replacement Oxygen therapy

macrophages are the initial site of infection

Monitor vital signs Apply cold ice pack to patients nose bridge and forehead during epistaxis Keep patient in a mosquito free environment Position patienttrendelenburg; Avoid puncturing the patients skin isolation

increase in vascular permeability, hypotension, hemoconcentration, thrombocytopenia, with increased platelet agllutinability and moderate DIC

hypovolemic shock

Health Teaching

Avoid too many hanging clothes outside the house Change water in the vase everyday, dont leave clean water unsealed Use insecticides Use mosquito repellants

Chickenpox/Varicella
An acute and highly contagious disease caused by Varicella zoster, characterized by vesicular eruptions on the skin and mucous membrane with mild constitutional symptoms.

Etiology Incubation period

Airborne and contact with infected person 10-21 days

Diagnostic Exams

Medical Management

Nursing Management
Respiratory Isolation is a must until all vesicles have crusted. Prevent secondary infection of the skin lesion through hygienic care of the patient. Linens must be disinfected under the sunlight or through boiling. Cut fingers nails short and wash hands more often. Provide activities to keep child occupied to lessen pruritus

Pathophysiology
entry of virus(inhalation)

Clinical Manifestations
pre-eruptive mild fever and malaise Eruptive Stage a. Rash starts from the trunk, then spread to other parts of the body. b. Initial lesions are distinctively redpapules where contents become milky and a pus-like within 4 days.

viral replication in regional lymph nodes

production of immunoglobulins

Complement Fixation Test to determine the V-Z Virus Electron Microscopic Exam of the vesicular fluid

Zoverax Oral antihistamine Calamine lotion Antipyretic

spread of viral particles over the skin

appearance of vesiculo-papular rash

crusting(convalescence)

Health Teaching

tepid bathing or cool compresses may help to alleviate itching Advise stay away from work or school until fully recovered

Influenza
An acute viral infectious disease affecting the respiratory system caused by influenza virus A,B, and C.

Etiology Incubation period

Airborne and contact with infected person and indirectly through articles 24-72 hours

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations

entyr of microorganism in the body Fever headache, myalgia lethargy coryza sore throat cough nausea vomiting diarrhea Croup

bacteria travels in the bloodstream

bacteria damages the epithelium of the tracheobronchial tree

CBC-elevated WBC PCR testing-presence of influenza virus Influenza specific antibody

Antipyretics

Monitor VS TSB Encourage enough fluid intake-replace fluid loss Promote bed rest Encourage to deep breathe Give antipyretics

activation of immune processes

fever and other signs and symptoms

Health Teaching

Encourage proper body hygiene and regular hand washing Advise family no to use same things as the patient Advice not to use aspirin.

Leptospirosis
Zoonotic infectious bacterial disease carried by animals, both domestic and wild, whose urine contaminates water or food which is ingested or inoculated through the skin.
Leptospira interrogans

Etiology Incubation period

Urine of animals (esp. rats) contaminated with this bacteria

Diagnostic Exams

Medical Management

Nursing Management

24-72 hours

Pathophysiology
entry of bacteria through broken skin or mucous membrane damage in the blood, kidney and liver parenchyma

Clinical Manifestations
Serologic Test: Microscopic Agglutination test (MAT) Isolation of Leptospires: = 1 7 days - from blood = 4 10 days - from CSF (during acute stage = after 10th day - from urine

activation of antibodies and immune cascade

lysis of the infected cell

Fever lasting 4 7 days Chills, headache, anorexia, abdominal pain With or without jaundice Convulsions

Penicillin G Na Tetracycline erythromycin Peritoneal Dialysis Administration of fluid and electrolyte and blood as indicated.

Isolate the patient, urine must be properly disposed of. Keep patient under close surveillance. For home care, dirty places, pools, and stagnant water must be cleaned. Eradicate rats and rodents.

malfunction of the affected organs and blood

blood stream invasion of leptospire and retention to other tissues

Health Teaching

Encourage proper body hygiene Tell how the disease is acquired and the possible prevention methods.

Pertussis/Whooping cough
infectious disease characterized by repeated attacks of spasmodic coughing which consists of a series of explosive expirations, typically ending in a long-drawn forced inspiration which produces a crowing sound, the whoop & usually followed by vomiting

Etiology Incubation period

Bordetella pertussis
7-14 days

Contact with respiratory droplets

Diagnostic Exams

Medical Management

Nursing Management
Isolation and asepsis should be carried out. Should not leave the patient alone. Suctioning equipment should be ready at all times for emergency use to avoid airway obstruction. Sunshine & fresh air are important. Provide warm baths, keep the bed dry & free from soiled linens. Intake & output should be closely monitored.

Pathophysiology
entry of bacteria through airways

Clinical Manifestations

attachment to bronchial epithelium

Pathognomonic Sign: Whooping cough Coryza Sneezing Lacrimation Cough low-grade fever

proliferation of bacteria

inflammation mucopurulent discharges which can lead to sanguinous discharges compromised airways

PCR test-Positive for B.pertussis RNA Nasopharyngeal swabs Sputum culture CBC (Leukocytosis)

Fluid & electrolyte replacement adequate nutrition oxygen therapy Antibiotics (erythromycin & ampicillin) DPT vaccine

respiratory failure

Health Teaching

Advise to submit to immunization

Measles/Rubeolla/Morbilli
An acute, contagious and enanthematous disease caused by Morbilivirus that usually affects children which are susceptible to URTI.

Etiology Incubation period

Droplet spread of infected person or indirectly through soiled articles 10-14 days

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations

entry of virus through the upper respiratory

Pathognomonic Sign: Kopliks spot 3 Cs: Conjunctivitis, Coryza and Cough Fever Red blotchy rash appears on the 3rd day to 7th day in cephalocaudal direction Hot Skin Sore throat

multiplication and spread of virus to lymphatic tissue

establishment of infection in the skin and tissues of resp. tract.

CBC Anti-measles IGM Measles RNA Nose and throat swab

Anti-viral drugs (Isoprenosine) Antibiotics if with complication Supportive therapy

Monitor VS Isolate the patient(strict isolation) Provide Enough fluids TSB for fever Oral hygiene and skin care

koplik's spots

development of rashes

Health Teaching

Advise to submit to immunization

Leprosy/Hansens Disease
a slowly progressive bacterial infection involving the cooler body tissues, skin, superficial nerves, nose, pharynx, larynx, eyes and testicles
Mycobacterium leprae

Etiology Incubation period

Through droplet transmission and thru break in the skin and mucous membrane

Diagnostic Exams

Medical Management

Nursing Management

9 months to 20 years

Pathophysiology

Clinical Manifestations
skin color change- red or white sensation loss Loss of sweating and hair growth Thickened and painful nerves Muscle weakness or paralysis Pin and redness of the eyes Nasal obstruction/ bleeding Ulcers that do not heal Late Signs: Madarosis Loss of eyebrows lagophthalmos Clawing of fingers and toes Contractures Chronic ulcers Sinking of the nosebridge gynecomastia

M. lerprae enters the system upon droplet or prolonged contact Agent spreads out in the system and navigates the body through thermoreceptors into cell membrane of the bacteria M. leprae proliferates to cooler areas of the body avoiding the warm interior areas in the viscera M. leprae accumulates and duplicates to the peripheral nerves, mucosa, epidermis, surface of the nose and mouth Bacteria attacks the skin and produces skin lesions, light-colored patches of skin that often develop anesthesia, or loss of sensation Trauma/injury aggravates these skin lesions and the body fails to develop to respond and repair to the injury These lesions lead to severe disfigurement of the patient

Slit Skin Smear determines the presence of M. leprae; Lepromin Test determines susceptibility to leprosy (+)tuberculoid;(-)lepromatous. Mitsuda Reaction

PAUCIBACILLARY Rifampicin Dapsone MULTIBACILLIARY Rifampicin Dapsone Lamprene

Monitor patients vital Maintain a clean environment to avoid secondary infection Avoid contact with children/infants Avoid prolonged skin to skin contact with the patient Maintain balance nutrition, sleep and rest

Health Teaching

Advice vaccination-BCG Advice to maintain a good hygiene

Tetanus/ Lock Jaw

A highly fatal disease caused by anaerobic bacteria characterized by muscle spasm and rigidity.

Clostridium tetani

Etiology Incubation period

Indirect contact ,soil, street dust, animal and human feces, punctured wound 3 days to 1 month

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations

entry of bacteria Maintain an adequate airway Adequate fluid and electrolytes No restraints Proved quiet semi dark environment Skin test before administering serums

production of toxins

Pathognomonic Sign:
Risus Sardonicus / Sardonic Smile Lock jaw/ Trismus Opisthotonus Laryngeal/ pharyngeal spasm Generalized muscular rigidity No Specific diagnostic exam, only a history of punctured wound ATS Tetanus Toxoid Diazepam Pen G

circulation of the toxins through the body

entry of the toxins in the spinal cord uptake by neuromuscular junction of the toxin after 3 days to 1 month- muscle spasm

signs and symptoms

death

Health Teaching

Advise patient to always clean wounds with soap and water.

Diphtheria
characterized by formation of pseudomembranre commonly in the faucial area and tonsils by the exotoxin produced by Corynebacterium diphtheriae

Etiology Incubation period

Corynebacterium diphtheria thru droplet 2-5 days

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology
absorption of toxins in the mucous membrane

Clinical Manifestations

destruction of epithelium
Pathognomonic Sign: Pseudomembrane Bull neck Dysphagia Dyspnea

superficial inflammation

formation of pseudomembrane( necrotic epithelium, leukocytes, fibrin)

schicks test determine susceptibility or immunity nose and throat swab maloneys test determine hypersensitivity to diphtheria toxoid

Diphtheria Antitoxin Penicillin or Erythromycin Tracheostomy for laryngeal obstruction

Assess the patients ability to swallow before giving medications Provide ice packs to relieve pain Isolate patient with respiratory precautions

bacilli continue to produce toxins

parenchymatous degeneration, fatty inflitration, necrosis of heart muscles, liver, kidney, adrenals Advise to take adequate fluids Encourage to maintain oral hygiene Encourage to deep breath and cough effectively

nerve damageparalysis of soft palate, eye muscles and extremities

Health Teaching

Rabies/Lyssa/Hydrophobia
severe viral infection of the CNS that is communicated to human in the saliva of infected animals or human caused by rabies virus

Etiology Incubation period

Rhabdovirus of the genus lyssavirus

2-8 weeks

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations
Pathognomonic Sign: hydrophobia paralysis fever PRODROMAL Headache Sore throat Unusual salivation Diaphoresis Low grade fever EXCITEMENT Increased anxiety Hydrophobia Pharyngospasm Photophobia Aerophobia due to laryngospasm Maniacal behavior PARALYTIC Die of paralysis Respiratory or cardiac arrest

1.

entry of virus in the body

attachment of viral glycoprotein in the nicotinic acetylcholine receptor of muscle

initial replication in the myocytes

virus spreads until it reach the spinal cord and CNS

virus spreads in the skin, intestine, salivary glands(shed in saliva)

negri bodies in the brain 2. history of exposure 3. flourescent RABIES ANTIBODY (FRA) TECHIQUE highly preferred diagnostic exam wherein the fluorescent rabies antibody is allowed to react with its specific antigens in culture or smear and the result is in precipitate form positive

Immunizations Anti-rabies vaccine Human diploid cell vaccine (hdcv) Duck embryo vaccine RABUMAN HYPER RAB IMOGRAM Symptomatic treatment/no cure

Monitor patient for signs and symptoms Administer the prescribed immunization

deterioration of CNS

death

Health Teaching

Tell patient to wash bite wounds with soap and water and immediately go to a health center Advise patient to take care of their animals

Tuberculosis
An infectious disease that primarily affects the lung parenchyma and can be transmitted to other parts of the body.

Etiology Incubation period

Mycobacterium tuberculosis
4 6 weeks

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations

bacteria is inhaled by the host

travels in the airways and in the blood stream

Pathognomonic Sign: Blood-tinged sputum Fever and chills Night sweats Dyspnea Non-productive /productive cough with purulent sputum Loss of appetite Weight loss

damages the lung parenchyma

Sputum examination or the Acid-fast bacilli (AFB) / sputum microscopy Chest X-ray Tuberculin Test purpose is to determine the history of exposure to tuberculosis

Rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin

Isolate patient Monitor vital signs Maintain a patient airway Collaborate with dietician for diet

macrophages and lymphocytes attack the bacteria

production of mucopurulent and blood tinged sputum

other bacteria proliferates in the lymphatic tract and in the blood stream which damages other organ and systems

Health Teaching

Encourage patient to adhere to treatment regimen Promote activities and encourage rest between deeds

German Measles/Rubella
An acute contagious virus disease that is in milder form compared to measles but is damaging to the fetus when occurring early in pregnancy and is caused by togavirus.

Etiology Incubation period

RUBELLA VIRUS thru direct or indirect contact 3 days

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology
entery of bacteria directly, indirectly or transplacentally travels in the blood stream

Clinical Manifestations

Pathognomonic Sign: Forscheimer spots Maculopapular rashes Headache Low-grade fever Sore throat lymphadenopathy

initiation of inflammation

Rubella Titerindicates susceptibility to rubella

MMR Analgesic and antipyretics

nasal congestion

TSB for fever Oral hygiene Give enough fluids Provide skin care Promote bed rest

swelling of the glands and fever

travels in the skin and produces rash Advise the mother not to get pregnant three months after receiving MMR Tell the patient that the disease is self-limiting

in the placenta, it prodeuces congenital anomalies

Health Teaching

Hepatitis B
A fatal hepatitis that tends to persist in the blood serum and is transmitted by contact in infected blood and body fluids.

Etiology Incubation period

Hepatitis B virus thru blood, body fluids, placenta 45-100 days

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology

Clinical Manifestations

entry of virus in the body

virus travels in the bloodstream

activation of the antibodies

release of viral DNA in the hepatocytes

antibodies acts on the infected cells of the liver

infection

lysis of the infected cell

clay-colored stools jaundice steatorrhea right-sided abdominal pain yellowish sclera anorexia nausea and vomiting

Hepatitis B surface agglutination (HBSAg) test Liver enzymes, such as serum aspartate aminotransferase and alanine aminotransferase levels, are elevated

Hepatits immunoglobulin lamivudine [Epvir] adefovir [Hepsera

direct cell lysis

appearance of signs and symptoms

Promote a diet rich in protein, vitamins and minerals Monitor vital signs Promote bed rest Assess patient for bleeding tendencies Provide pain relief measures such as heat, back rubs, positioning, relaxation techniques, and age-appropriate diversion

appearance of signs and symptoms

Health Teaching

encourage patient to avoid greasy foods discuss ways to avoid acquiring the disease

Filariasis
It is a parasitic disease caused by an African eye worm, a microscopic thread-like worm. The adult worm can only live in human lymphatic system and can cause extensive disability and gross disfigurement. Wuchereria bancrofti
through the bite of Aedes mosquito 8 to 16 months

Etiology

Diagnostic Exams

Medical Management

Nursing Management

Incubation period

Pathophysiology
entry of worms in the mosquito's body after biting an infected person mosquito bites an uninfecetd person worms live for 7 years in the lymphatic system and releases microfilaria in the bloodstream the person can transmit again filariae via mosquito bites the larvae matures in the lymph nodes

Clinical Manifestations
monitor vital signs During chronic stages, provide safe environment to reduce incidence of injury Monitor intake and output and weigh daily for evaluation Reduce noxious environment to relieve pain and discomfort

Presence of filariae in the blood Lymphadenitis Lymphangitis Affectation of male genitalia Hydrocele Lymphedema Elephantiasis

Circulating filarial antigen- finger prick blood droplet, taken any time of the day and gives result in a few minutes Nocturnal blood examinationperformed at night time pass 8:00 pm

diethycarbamazine citrate (hetrazan) surgical treatment for hydrocele

the person must have several bites

damage in the kidney and lymph vessels

Reinforce compliance to treatment regimen Stress importance of good handwashing technique and proper body hygiene Stress importance of mobility during chronicity Use of mosquito repellents; Anytime fumigation Wear a long sleeves, pants and socks

swelling in the arms, genitals, legs enlargement of tissues due to blood vessel obstruction by the worms

Health Teaching

Bacterial Pneumonia
Disease of the lungs that is characterized by inflammation and consolidation of lung tissue followed by resolution is accompanied by fever, chills, cough, and difficulty in breathing and is mainly caused by infection.
Pneumococcus, streptococcus pneumoniae, staphylococcus aureus, Klebsiella pneumonia

Etiology Incubation period

Droplet transmission 2-3 days

Diagnostic Exams

Medical Management

Nursing Management

Pathophysiology
entry of microorganism in the body

Clinical Manifestations

travel of microorganism in the bloodstream

Pathognomonic Sign: Rusty sputum Chest pain Intercostal retraction tachypnea Nasal congestion Cough orthopnea

infection of the alveoli

production of exudates and cell-bacteria debris due cellular immunity which fill the alveolar spaces

Chest x-ray Sputum culture for confirmation Signs and symptoms Dull percussion of lungs

Oxygen inhalation Antibiotics Mucolytics Bronchodilators suctioning

Monitor vital signs Monitor O and I Promote bed rest Increase OFI TSB for fever Promote optimal positioning CPT

scattering of infection in the lungs

stiffening of the lungs due to scarring which can lead to hypoxemia Teach patient breathing and coughing exercise Tell the patient necessary precautions to avoid transmission Encourage to adhere to treatment regimen

hypoxemia and other signs and symptoms

Health Teaching

Cataracts are the leading cause of preventable blindness among adults in the United States. The incidence of cataracts in the United States is 1.2 to 6.0 cases per 10,000 people. A cataract is defined as
opacity of the normally transparent lens that distorts the image projected on the retina. The lens opacity reduces visual acuity. As the eye ages, the lens loses water and increases in size and density, causing compression of lens fibers. A cataract then forms as oxygen uptake is reduced, water content decreases, calcium content increases, and soluble protein becomes insoluble. Over time, compression of lens fibers causes a painless, progressive loss of transparency that is often bilateral. The rate of cataract formation in each eye is seldom identical. Without surgery, a cataract can lead to blindness.