ETIOLOGY: •Pertussis or whooping cough, is an acute respiratory disease caused by Bordetellapertussis. •Pertussis remains endemic and epidemic peaks recur every 3-5 years.it affect adolescents and specially young adults •a highly contagious disease caused by the bacteriumBordetellapertussis. •It derived its name from the "whoop" sound made from the inspiration of air after a cough. A similar, milder disease is caused by B. parapertussis. •Although many medical sources describe the whoop as "high-pitched", this is generally the case with infected babies and children only, not adults. •Despite generally high coverage with the DTP and DTaP vaccines, pertussis is one of the leading causes of vaccine-preventable deaths world-wide.
INCUBATION PERIOD: • The incubation period(the time between infection and onset of symptoms) for pertussis is usually 7-14 days, but can be as long as 21 days.
Sign&symptoms: •Rhinitis •Irritability •Loss of appetite •Reported + profuse phlegm •Vomiting commonly follows coughing •Runny nose •Headache •Mild cough •Reported fever •Presence of hoarseness •Tickling or itching of the throat •Weakness
•Tickling or itching of the throat•Weakness•Dyspnea•Popping out of eyeball•Tongue protrudes•Profuse sweating•Congestion of the neck•Scalp veins•Involuntary urination•Reported discomfort
Pathophysiology: Pertussis (BordetellaPertussis) ↓ Virus transmitted direct contact(droplet) ↓ Virus will incubate for 7-10 days as long as 21 days ↓ Lodge in bronchii and bronchioles ↓ Presence of principal lesions ↓ Focal necrosis of basal portio of the pseudotratified Columnar mucosa ↓ Out poching of leuocytes and mulopurulent Exaution in the sub mucosal tissue ↓ Pulmonary lesion ↓ Virus invade the cilia of the bronchial epithelium
↓ Pathogomonic of the disease ↓ Whooping cough
Pharmacologic management: • Erythromycin ›inhibits protein synthesis; usually bacteriostatic but may be bactericidal in the eye concentration or against highly susceptible organism. • Azithromycin ›binds to the 50s subunit of bacterial ribosomes blocking protein synthesis; bacteriostatic or bactericidal depending on concentration. • Clarithromycin ›binds to the 50s subunit of bacterial ribosomes blocking protein synthesis; bacteriostatic or bactericidal depending on concentration.
OTHER HEALTH TEACHING: •Elevate the head and shoulder of the patient by means of pillow often to relieve labored breathing and lessen cough. •Increased fluid intake •Do not bring outdoors, especially by the seashore •Bed rest when paroxysms are severe •Isolation of the patients; indicated during period of communicability •Avoid excitement dust, smoke and sudden changes in temperature •Instruct to have adequate and sufficient intake of fluid and elimination to lessen the occurrences of tympanites
•Pulmonary tuberculosis is an infectious disease caused by slow- growing bacteria that resembles a fungus, Myobacterium tuberculosis, which is usually spread from person to person by droplet nuclei through the air. The lung is the usual infection site but the disease can occur elsewhere in the body. Typically, the bacteria from lesion (tubercle) in the alveoli. The lesion may heal, leaving scar tissue; may continue as an active granuloma, heal, then reactivate or may progress to necrosis, liquefaction, sloughing, and cavitation of lung tissue. The initial lesion may disseminate bacteria directly to adjacent tissue, through the blood stream, the lymphatic system, or the bronchi.•Most people who become infected do not develop clinical illness because the body’s immune system brings the infection under control. However, the incidence of tuberculosis (especially drug resistant varieties) is rising. Alcoholics, the homeless and patients infected with the human immunodeficiency virus (HIV) are especially at risk. Complications of tuberculosis include pneumonia, pleural effusion, and extrapulmonary disease.
ETIOLOGY: • Infection of lungs caused by Mycobacterium tuberculosis, an acid-fast bacterium. • Causes tubercles, fibrosis, and calcification within the lungs. • Tubercle bacillus may be communicated to others by means of droplet formation (inhalation), ingestion, or inoculation.
INCUBATION PERIOD: • 4-6 weeks to develop after the initial contact.
SIGNS&SYMPTOMS/MANIFESTATIONS: • Initial symptom: typically asymptomatic, early infection is of no significance, clinically, at the time, but is of importance in that it sensitizes the body tissues to the tuberculo-protein as evidenced by a positive tuberculin reaction. • Fever lasting two or three weeks/a low-grade fever. • Persistent night sweat and chills. • Drowsiness. • Easy fatigability. • Chest pain that maybe pleuritic or dull. • Loss of weight. • Loss of appetite or anorexia. • Chronic dry cough or non-productive or productive cough. • Difficulty of breathing/dyspnea. • Digestive disturbances.
• Pulse is frequently rapid. • Chest tightness. • Examination of the sputum will frequently reveal the presence of tubercle bacilli. • If the disease remains unchecked, erosion of a blood vessel by the pathogenic process may occur. • Hemoptysis results with the expectoration of small or, at times, large amounts of blood that occasionally a massive hemorrhage. • Crackles • Malaise • Increasing amounts of sputum (first mucoid and later purulent appear). • Cavities • Pleuritic pain may result from extension of the infection to the pleural surfaces.
PATHOPHYSIOLOGY: Droplets enter the lungs; Bacteria from a tubercle lesion ↓ The body’s defense system encapsulate the tubercle leaving scar ↓ If without encapsulation, bacteria may enter the lymph system ->lymph nodes->inflammatory response (granulomatous inflammation) ↓ Primary lesions form ↓ Become dormant but can be reactivated and may become a second degree infection when re-exposed ↓ Active phase ↓ Necrosis and cavitation in the lesions ↓ Rupture and spread of necrotic tissue ↓ Damage to various body parts
MEDICAL-SURGICAL MANAGEMENT: • Chest X-ray • Sputum Test • Mantoux Test
PHARMACOLOGIC MANAGEMENT: • DOTS – Direct Observe Treatment Scheme • ISONIAZID (INH, LANIAZID, Nydrazid) Action: Hydrazide of isonicotine acid with highly specific action against Mycobacterium Tuberculosis. Postulated to act by interfering with biosynthesis of bacterial proteins, nucleic acid, and lipids. Indication: Treatment of all forms of active tuberculosis caused by susceptible organisms and as preventive in high- risk persons.
Nursing Responsibilties: • Administer on an empty stomach 1 hour before or 2 hours after meals for maximal effect if tolerated; may be given with meals to reduce GI effects. • Monitor adverse effects. › numbness and tingling of the extremities (most likely to occur in malnourished, alcoholic, or diabetic clients). › Hepatoxicity, as evidenced by abnormal liver function studies and sclera jaundice. › Hypersensitivity reactions, such as rash, drug fever, or evidence of anemia, bruising, bleeding or infection related to agranulocytosis.
• ETHAMBUTOL (Myambutol) Action: Mode of action not completely understood but it appears to inhibit RNA synthesis and thus assess multiplication or tubercle bacilli. Indication: In conjunction with at least one other anti-tuberculosis agent in treatment of PTB. Nursing Responsibilities: • Record a baseline visual examination prior to therapy. Schedule periodic eye exams during the course of treatment. • Administer with meals to reduce GI effects. • Monitor liver and renal function studies and neurologic status while taking the drug. Notify the physician of abnormal findings or significant changes.
• STREPTOMYCIN Action: Aminoglycoside antibiotic derived from streptomycesgriseus, with bactericidal and bacteriostatic actions. Indication: Only in combination with other antitubercular drugs in treatment of all forms of active tuberculosis caused by susceptible organisms. Nursing Responsibility: • Administer by deep intramuscular injection into the large muscle mass, rotating sites to minimize tissue trauma. • Monitor urine output, weight, and renal function studies (including BUN and serum creatinine) to detect early signs of nephrotoxicity. Report the significant changes to the physician. • Maintain fluid intake at 2000 to 3000ml per day to minimize the concentration of drug in the kidney tubules. • Assess hearing and balance frequently. Have audiometric testing performed as indicated.
• PYRAZINAMIDE (Tebrazid, PZA) Action: Pyrazinoic acid amide, analog of nicatinamide which is bacteriostatic against mycobacterium tuberculosis. Indication: Short-term therapy of advanced tuberculosis before surgery and to treat patients responsive to primary agents. Nursing Responsibility: • Administer with meals to reduce GI effects. • Monitor liver function studies and serum uric acid levels. Notify the physician if changes are noted.
• RIFAMPICIN (Rifapentine) Action: Inhibits DNA- dependent RNA polymerase activity in susceptible bacterial cells thereby suppressing RNA synthesis. Indication: PTB in conjunction with at least one other anti- tubercular agent. Nursing Responsibility: • Administer on an empty stomach. • Monitor CBC, liver functions studies, and renal functions studies for evidenced of toxicity. • Reduces the effect or oral contraceptives, quinidine, corticosteroids, warfarin, methadone, digoxin, and hypoglycemic. Monitor for the effectiveness of these drugs.
NURSING DIAGNOSIS: • Ineffective airway clearance related to copious tracheobronchial secretions. • Activity intolerance • Imbalanced nutrition: less than body requirements • Deficient knowledge of preventive health measures and treatment regimen.
NURSING MANAGEMENT: Promoting Airway Clearance • Instruct patient about best position to facilitate drainage. • Encourage increased fluid intake. Promoting Activity and Adequate Nutrition • Devise a complementary plan to encourage adequate nutrition. A nutritional regimen of small, frequent meals and nutritional supplements may be helpful in meeting daily caloric requirements.
Advocating Compliance and Prevention• Explain that TB is a communicable disease and that taking medications is the most effective way of preventing transmission.• Instruct about hygiene measures, including mouth care, covering mouth and nose when coughing and sneezing.• Instruct about medications, schedule, and side effects.
OTHER HEALTH TEACHING: 1. Teach client to provide for scheduled rest periods. 2. Teach which foods to include in the diet and which are nutritious between meal supplements. 3. Teach the importance of adhering, without variation, to the drug program that has been established. 4. Teach the proper techniques to prevent spread of infection. 5. Encourage client to participate in developing a schedule of activities and therapy and follow the schedule once established.
6. Instruct client to be alert to the early symptoms of hemorrhage, such as hemoptysis, and to contact the physician immediately if any occur.7. Encourage client to follow prescribed program for productive coughing and deep breathing.8. Instruct client to avoid any medications such as cough syrups without physician’s approval.9. Expect and accept client’s expression of feelings related to the disease.10. Help client plan a realistic schedule for taking the large number of necessary medications.
ETIOLOGY: •Is an acute viral infection of salivary gland particularly the parotids, with constitutional manifestation of varying degrees. An acute contagious disease, the characteristics feature of which there is swelling of one or both of the parotid glands, usually occurring in epidemic form.
PREDISPOSING FACTOR:•Filterable Virus(paramyxovirus) INCUBATION PERIOD: • 2-3 week; average of 18 days
SIGNS&SYMPTOMS: • Slight malaise • Low-grade fever • Headache • Loss of appetite • Pain below the ear, particularly on moving the jaws • Anorexia • Parotid gland is swollen, painful enlarged and tender in varying degrees • Submaxillary and sublingual glands may also be affected • Dysphagia
PATHOPHYSIOLOGY: Mumps (epidemic parotitis) ↓ Filterable virus (paramyxovirus) ↓ Entry of virus through droplet or airborne ↓ The virus will incubate within 2-3 weeks or 18 days ↓ Viremia will occur with primary multiplication In upper respiratory ↓ Virus will invade the salivary gland and other organs ↓ Glands are edematous and hyperemic with Small hemorrhage in the capsule ↓ The duct obstructive by swelling of the lining ↓ Acinar cells may be necrosed but it will generate Without fibrosis ↓ Sub maxillary and sublingual gland is affected parotid Gland is swollen, painful and enlarged
DIAGNOSTIC TESTS: • Blood examination- leukocyte count which shows leucopenia with relative lymphocytes. • Viral culture- isolation of virus from saliva, mouth swab or urine and if associated with meningoencephalitis. • Viral Serology- complement fixation test, neutralization test and hem agglutination inhibition test; a four-fold increase of anti-V antibodies with a little change in the titer of anti-S antibodies in convalescent serum.
OTHER HEALTH TEACHING: • Give active immunization • Put hot or cold applications that may be used on swollen jaws • Frequent mouth care • Maintain adequate diet • Bed-rest should be maintained until complete recovery: if mumps develop after puberty • Mild, bland, semi- solid foods better tolerated than sour or spicy foods
› Also known as the itch, is a contagious ectoparasiteskininfection characterized by superficial burrows and intense pruritus (itching). › It is caused by the miteSarcoptesscabiei. The word scabies itself is derived from the Latin word for "scratch" (scabere). › Other names for the condition include Mite, Itch Mite, Mange, Crusted Scabies, Norwegian Scabies, Sarcoptesscabiei, or The Seven-Year Itch.
ETIOLOGY: • The causative factor is the itch mite, Sarcoptesscabei. The female parasiteis easily visible with a magnifying glass and measures 0-33 to 0.45 mm. In length by 0.25 to 0.33 in breath. She burrows the epidermis to lay her eggs, and sets up an intense irritation. The male is smaller and resides on the surface. The disease is transmitted by contact with infected individuals or their clothing and bedding. • Anyone may become infected or re-infected. Initial infections are followed by a marked resistance to subsequent re-infection. It is a common disease of troops in the field under wartime conditions.
INCUBATION PERIOD: • It occurs within 24 hours from the original contact, the length of time required for itch mite to burrow on infected skin and lay ova. SIGNS&SYMPTOMS: • Itching • When secondarily infected, the skin may feel hot and burning but this is a minor discomfort • When large areas are involved and secondary infection is severe, there will be fever, headache and malaise. Secondary dermatitis is common.
PREDISPOSING FACTORS: • Institutions • Over crowding • Poverty • Poor hygiene • Sexual contact • Skin contact • Clothing • Beddings • Towels • Furniture • Child-to-child contagion • Using fomites of infected persons • Socio economicconditions
Predisposing Factors Etiology Institutions, Over Crowding, Poverty the mite, S.scabiei spreads diseases Poor Hygiene, Sexual Contact through direct and prolonged contact skin Contact, Clothing between host. Bedding,Towels Furniture, Child-to Child contagion Using fomites of infected persons Socio Economic condition ↓ After making, male mite dies. Female mite burrows into the epidermis, where she lays up to 3 eggs per day for duration of 30-60 days. Affected host harbors approximately 11 adult female mites during a typical infestation. Eggs hatch in 3-4 days. ↓ Reaction is responsible for the intense pruritus. Prior infestation can develop symptoms within an hour. ↓ Formation of lesions or wounds
PHARMACOLOGIC MANAGEMENT: • Topical • Permethrin 5% is topical medication of choice.Toxicity may resemble allergic reactions. It is applied to the skin before bedtime and left on for about 8 to 14 hours, then showered off in the morning. This is repeated until tube is finished or until rashes disappear (regardless of physician's instructions, it must be applied from the top of the head to the bottom of the feet). • Eurax (USP Crotamiton) This is not a cure but helps to relieve itch (pruritis) • Malathion Applied for 24 hours; effective in killing both adults and eggs. • Lindane (Kwellada): For use with patients where permethrin has failed or is contraindicated. • Lindane is FDA approved when used as directed for both scabies and lice. Serious side effects may result from product misuse Lindane is illegal in 17 countries, and 33 more countries have restricted its use.[ Assessment of lindane and other hexachlorocyclohexane isomers. February 8, 2006</ref> Lindane should be washed off with warm, and not hot, water to avoid absorption through the skin.Lindane has been indicated in one death from multiple topical applications for repeating mite infestations.
• There is some evidence[weasel words] that a 10% sulfur ointment in petroleum jelly applied topically is effective. It is cheap and readily available over-the-counter. It also has the advantage of being able to be used in pregnant women and infants under two months of age.• Neem oil is deemed very effective in the treatment of scabies although only preliminary scientific proof exists which still has to be corroborated, and is recommended for those who are sensitive to permethrin, a known insecticide which might be an irritant. Also, the scabies mite has yet to become resistant to neem, so in persistent cases neem has been shown to be very effective.• Tea tree oil at 5% was only partially effective and does not seem to be a viable solution for treatment. In one study, it was more effective than commercial medications against the scabies mite in an in vitro situation.
Oral • A single dose of Ivermectin has been reported to reduce the load of scabies but another dose is required after 2 weeks for full eradication. In 1999, a small scale test comparing topically applied Lindane to orally administered Ivermectin found no statistically significant differences between the two treatments.As Ivermectin is easily administered (not requiring a rub down of the whole body like lindane or permethrin twice per treatment), compliance is much better. Ivermectin is used in eradication programs of many parasites of both human and animal. Side effects may include mild abdominal pain, nausea, vomiting, myalgia and/or arthralgia, which subside. The product is considered safe for use in children over five months of age.
NURSING DIAGNOSIS: I. Deficient knowledge may be related to nature of condition II. Impaired Skin Integrity may be related to presence of infectious process and pruritus, possibly evidence by open/crusted lesions III. Pain/Discomfort may be related to cutaneous inflammation and irritation, possibly evidenced by verbal reports, irritability, and scratching IV. Risk for Infection risk factors may include broken skin and traumatized tissue V. Disturbed body Image may berelated to unsightly skin lesions and embarrassment
OTHER HEALTH TEACHING: Public health and prevention strategies › There is no vaccine available for scabies, nor are there any proven causative risk factors. Therefore, most strategies focus on preventing re-infection. All family and close contacts should be treated at the same time, even if asymptomatic. Cleaning of environment should occur simultaneously, as there is a risk of reinfection. Therefore it is recommended to wash and hot iron all material (such as clothes, bedding, and towels) that has been in contact with scabies infestation.
Cleaning the environment should include: • Treatment of furniture and bedding. • Vacuuming floors, carpets, and rugs. • Disinfecting floor and bathroom surfaces by mopping. • Cleaning the shower/bath tub after each use. • Daily washing of recently worn clothes, towels and bedding in hot water, drying in a hot dryer and steam ironing. Itchiness during treatment • Options to combat itchiness include antihistamines such as chlorpheniramine. Prescription: Hydroxyzine (Atarax).
Name: Rachelle V. Delos Santos Age: 19 Birthday: August 8, 1989 Address: Sun Valley Parañaque Elementary Graduate: Goal Montessori Highschool Graduate: Goal Montessori E-mail Address: email@example.com Motto: “Beauty is USELESS… if the brain is EMPTY” Name: Jackielou B. Dela Cruz Age: 20 Birthday: August 20, 1988 Address: 2909 Lorenzo Delapaz, Pandacan, Beata, Manila Elementary Graduate: Bugalbon Central School Highschool Graduate: St. Andrew Catholic E-mail Address: firstname.lastname@example.org Motto: “What you saw, is what reap.” Name: Jessica Ablyn C. Huyo-a Age: 19 Birthday: September 19, 1989 Address: 2197 F. Handog St. Binakayan, Kawit, Cavite Elementary Graduate: St. Michael’s Institute Highschool Graduate: St. Michael’s Institute E-mail Address: pretty_purple_abLyn@yahoo.com Motto: “Give your smile to everyone, but your heart to only ONE.”
Name: Lanie M. Ibañez Age: 23 Birthday: December 4, 1985 Address: 1947 Christian compound Leveriza St. Pasay City Elementary Graduate: Soriano Memorial Elementary School Highschool Graduate: Roxas National Comprehensive Highschool E-mail Address: email@example.com Motto: Name: Mary Grace G. Inocencio Age: 21 Birthday: August 8, 1987 Address: 8076-F. Honradez St. Makati City Elementary Graduate: MaximoEstrella Elementary School Highschool Graduate: General Pio Del Pilar National Highschool E-mail Address: firstname.lastname@example.org Motto: “What you see, is what you get.” Name: Cristelle Anne D. Jastillano Age: 19 Birthday: July 1, 1989 Address: 238 Ligan St. San Miguel Manila Elementary Graduate: San Miguel Catholic School Highschool Graduate: St. Rita College, Manila E-mail Address: email@example.com Motto: “If there is a mountain of experience/failure, there is a fountain of success.”
Name: Aielynn B. Laureles Age: 21 Birthday: July 7, 1987 Address: 1438 Miguelin St. Sampaloc, Manila Elementary Graduate: Dominican School Manila Highschool Graduate: Siena College, Quezon City E-mail Address: firstname.lastname@example.org Motto: “Education is precious possession, so treasure it.” Name: Kimberly Sue T. Llamanzares Age: 19 Birthday: March 10, 1989 Address: 880 U.N Avenue Ermita, Manila Elementary Graduate: Little Shepherd Integrated Montessori Highschool Graduate: Little Shepherd Business and Science Highschool E-mail Address: email@example.com Motto: “Everything has a purpose.” Name: Aileen G. Mayuga Age: 30 Birthday: September 7, 1978 Address: 29 C Marang Project 3 Quezon City Elementary Graduate: Sampaga Elementary School Highschool Graduate: BNHS E-mail Address: firstname.lastname@example.org Motto: “You have to trust yourself, before anyone else.”
Name: Marienel B. Luna Age: 20 Birthday: June 21, 1988 Address: 178 Domingo St. Village-Bagbag Rosario, Cavite Elementary Graduate: Patnubay Academy Highschool Graduate: St. Joseph School E-mail Address: email@example.com Motto: “Time is gold” Name: Mary Grace R. Mendoza Age: 19 Birthday: November 6, 1989 Address: BLK1 Lot 64 Philhomes Village 1, Kawit, Cavite Elementary Graduate: Aurora A. Quezon Elementary School HighschoolGradutae: Rizal High School E-mail Address: firstname.lastname@example.org Motto: “Don’t love your life to the fullest.” Name: Michel V. Miguel Age: 20 Birthday: May 13, 1988 Address: BLK14 Lot 14 Palmeza Subdivision ConoangAntipolo City Elementary Graduate: FNHS Highschool Graduate: FEES E-mail Address: Finabhabes27@yahoo.com Motto: