NURSING CLIENT WITH ENDOCRINE ANDGENITOURINARY DISORDER AND COMMUNICABLE DISEASE
Typhoid fever is a systemic infection caused bySalmonella enterica serotype Typhi (S. typhi). Thedisease remains an important public health problem indeveloping countries.About 16 million cases of typhoid fever and 600,000deaths occur yearly worldwide and that more than90% of this morbidity and mortality occurred in Asia
What?An acute illness with fever caused by infection with the Salmonella typhibacteria contracted from contaminated water and food. Also called enteric fever, bilious fever and yellow jack .
•Virulent bacterium that cause illness1.Bacteria called Salmonella typhi. 2.Fecal- • spread through contaminated food or water and occasionally through directoral route contact with someone who is infected. • These people, called chronic 3.Typhoid carriers, shed the bacteria in their carriers faeces and are capable of infecting others.
work in or travel to areas where typhoid fever is endemicWork as a clinical microbiologist handling Salmonella typhibacteriaHave close contact with someone who is infected or hasrecently been infected with typhoid feverHave an immune system weakened by medications such ascorticosteroids or diseases such as HIV/AIDSDrink water contaminated by sewage that contains S. typhi
1st WEEK Poor appetiteFever, often as high as (39.4 or 40 C)
2nd WEEKContinuing high Extremely fever distended abdomen Diarrhea or severe weight loss constipation
Salmonella typhi contracted fromcontaminated water and food Ingested by human.The S.typhi survives the acidity of the stomach It will invades the payer’s patches of the intestinal wall The bacteria is within the macrophages and survives Bacteria spreads via the lymphatics while inside the macrophages
Access to reticuloendothelialsystem,liver,spleen,gallbladder and bonemarrow. 1st week: elevation of the body temperature 2nd week: abdominal pain, spleen enlargement and rose spot 3rd week: necrosis of the payer’s patches Leads to perforation, bleeding .And if left untreated, death is imminent
Blood culture (C&S)A blood culture during the first week ofthe fever can show S. typhi bacteriaComplete blood count (CBC)A complete blood count (CBC) will showa high number of white blood cells.
. Stool C&S stool culture may be positive for S.typhi several days after ingestion of the bacteria Widal test Test whereby bacteria causing typhoid fever are mixed with serum containing specific antibodies obtained from an infected individual
Brand name :Cipro USES: This medication is used to (Ciprofloxacin) treat a variety of bacterial Class of drugs :quinolone infections. antibiotics. Routes : per oral Side effect :nausea, vomiting,dizzinessDosage :Adult :500 mg orally ,blurred vision,feeling every 12 hours for 10 days nervous,sleep problems
Brand name :Rocephin (Ceftriaxone) Uses :It works by fighting bacteria in body group of drugs : cephalosporin antibioticsRoute : intravenousDosage:Pediatric :75 to 80 mg/kg IVonce a day for 5 to 14 days Side effect : Mild diarrhea, mildAdult:2 g IV every 24 hours pain, swelling, nausea,vomiting
COMPLICATION OF TYPHOIDGastrointestinal Gastrointestinal Bleeding Perforation Myocarditis
• Nursing Diagnosis :Hyperthermia related to increased metabolic rate, illness. • Goal : Client can maintain the normal body temperature without complication Nursing Intervention RationaleMonitor patient temperature degree and patterns Fever pattern may aids in diagnosing underlying disease.Observe for shaking chills and profuse diaphoresis Chills often precede during high temperature and in presence of generalized infection.Wash hands with anti-bacterial soap before and after Reduces cross contamination and preventseach care of activity and encourage proper hygiene. the spread of infection.Provide tepid sponge baths and avoid the use of ice May help reduce fever .Use of ice water andwater and alcohol. alcohol may cause chills and can elevate temperature.Monitor for signs of deterioration of condition or failure May reflect inappropriate antibiotic therapy.to improve with therapy.
• Nursing Diagnosis : Risk for imbalance nutrition related to disease process.• Goal : Patient will be maintain the nutrition balance and body weight status Nursing Intervention Rationale Monitor the Input & Ouput Chart To maintain nutrient status of patient Assess client’s nutritional patterns Offer client their favorite food to ensure patient taken the diet Recommend bed rest / activity restrictions during To minimize the pain and to maintain patient the acute phase, balanced body weight each day weight Record or report such things as nausea, vomiting, To do further management to reduce the symptom stomach pain and distension. Collaboration with a nutritionist for dietary To maintain patient taken diet well administration
• Nursing Diagnosis : Increase frequency of bowel movement related to disease process. • Goal : Client will maintain the hydration of body from over diarrhea Nursing Intervention RationaleMonitor the vital sign such as pulse and respiration To monitor patient from over dehydrationMonitor the Input & Output chart. To maintain the fluid balance in patient bodyEncourage the patient to eat more nutritious food such as To prevent patient from get constipationfruit & vegetable.Encourage pt to drink plenty of water at least 2.5 liters / To maintain hydration status of patient24 hours.Observe the drip infusion & administer the medication as To prevent infection and maintain fluid balanceordered by doctor.
Wash hand before and afterhandling somethingAvoid drinking untreated waterAvoid raw food and vegetablesChoose well-cooked food
Avoid popsicles and flavored ices that may havebeen made with contaminated water.Avoid eat the foods and beverages from thestreet vendorRemember taking antibiotics injection as doctorordersGetting vaccinated before travelling to anothercountry where common gets the typhoid.Follow up with the doctor
Salmonella Typhi causes a protracted bacteremicillness referred to as typhoid fever. Since humansare the only reservoir for S. Typhi, infection ismost often acquired through ingestion of food orwater contaminated by feces and urine of infectedpersons and chronic carriers. Typhoid fever is characterized by the gradual onset of fever, headache, malaise, anorexia, abdomi nal pain, hepatosplenomegaly, rose spots, and changes in mental status. Laboratory diagnosis can be made by culture of stool, blood and widal test.
Antimicrobial therapy is indicated for patients with typhoidfever. Typhoid fever cases should be excluded from foodhandling, and from direct care ofinfants, elderly,immunocompromised, and hospitalized orinstitutionalized patients. An individual may return to normalduties after 3 consecutive negative stool culture taken at leastone month apart, and at least 48 hours after completion ofantibiotic therapy. If without prompt treatment, it can causeserious complications and can be fatal.