Communicable di sease nursing workbook

A Workbook Compilation in:
COMMUNICABLE DISEASE NURSING
Compiled by:
Marc Ryan Portuguez, RN
Nursing Faculty
NGRTCI
Edited and updated by:
Christian Steve C. Valenzuela, RN
Nursing Faculty
NGRTCI
March 2013

35
REPRODUCTION IS STRICTLY PROHIBITED! N.G.R.T.C.I
Iloilo (033)320-2053 Bacolod (034)433-3353 Kalibo (036)268-2213
Communicable Disease Nursing
Instructions. Match column A (Disease) with column B (causative agent). Write the letter of your answer on the blank provided before each number. Answers may be repeated once only.
Column A Column B
______ 1. Tetanus A. Salmonella Typhi
______ 2. Poliomyelitis B. Rhabdo virus
______ 3. Measles C. Schistosoma Japonicum
______ 4. Leprosy D. Klebs-Loeffler bacillus
______ 5. Anthrax E. Corona Virus
______ 6. Mumps F. Niesseria Meningitidis
______ 7. Influenza G. Legio Debilitans
______ 8. Pneumonia H. Hansen’s bacillus
______ 9. Koch’s Disease I. Flavivirus
______ 10. Pertussis J. Leptospira Interrogans
______ 11. Diphtheria K. Sarcoptes Scabie
______ 12. Leptospirosis L. Streptoccocus Pneumoniae
______ 13. Malaria M. Chlamydia Trachomatis
______ 14. Dengue N. Bordet Gengou
______ 15. Rabies O. Rubi virus
______ 16. German measles P. Plasmodium Falciparum
______ 17. Chickenpox Q. Bacillus Anthracis
______ 18. Scabies R. Mycobacterium tuberculosis
______ 19. Typhoid fever S. Human T-Cell Lymphotrophic Virus III
______ 20. Amoebiasis T. Neisseria gonorrheae
______ 21. Schistosomiasis U. Dengue Virus 1-4
______ 22. AIDS V. Avian Influenza Virus
______ 23. Syphilis W. Varicella Zoster Virus
______ 24. Gonorrhoea X. Entamoeba histolytica
______ 25. Chlamydia Y. Paramyxovirus morbilli
______ 26. Trichomoniasis Z. Filterable Paramyxovirus morbilli
______ 27. SARS AA. Treponema Pallidum
______ 28. Bird’s Flu BB. Clostridium Tetani
______ 29. Meningococcemia CC. Trichomonas Vaginalis
______ 30. Encephalitis DD. Influenza virus
______ 31. Meningitis EE. Shigella flesner
______ 32. Shingles FF. Influenza Virus A
______ 33. Dysentery GG. Vibrio El tor
______ 34. Cholera
______ 35. Swine Flu
“Knowledge comes when you start to admit things you do not know.
But dreams are fulfilled when you do not have the knowledge on how to give up.”
- CSCValenzuela

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Communicable Disease Nursing
Identify the following described below.
1. _______________ - an infection that can be transmitted to many individuals quickly and easily.
2. _______________ - a disease caused by infection that can be transmitted from one person to another.
3. _______________ - occurs when harmful microorganism enters and multiply into the tissues.
4. _______________ - the lodgment of arthropods to the surface of the body.
5. _______________ - harbors the organism in their bodies but does not manifest signs and symptoms of the disease.
6. _______________ - harbors the organism presenting signs and symptoms of the disease.
7. _______________ - an individual whose medical history and signs and symptoms suggest an infection.
8. _______________ - an individual known to have sufficiently near and infected person who have been exposed to an infectious material.
9. _______________ - an alternate host or passive carrier of a pathogenic infection.
10. ______________ - a person, animal, or plant which harbors and provides nourishment for a parasite.
11. ______________ - the time during which a patient is infectious to others.
Define the following terms described below:
1. Isolation –
2. Quarantine –
3. Reverse Isolation –
4. Bacteriostatic –
5. Bactericidal –
6. Sepsis –
7. Asepsis –
8. Disinfection –
9. Sterilization –
10. Cleaning –

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The CHAIN OF INFECTION
Notes:
Notes:
Notes:
Notes:
Notes:
Notes:

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STAGES OF INFECTION:
CONTROL MEASURES:
1. STANDARD/UNIVERSAL PRECAUTION:
Hand Hygiene
Glove use
Needle stick Injury Prevention
Use of goggles, mask, gown
2. TRANSMISSION BASED PRECAUTION:
Isolation Categories:
Strict
Airborne
Droplet
Contact
Drainage
Enteric
Droplet
GENERAL PREVENTIVE MEASURES:
1. HEALTH EDUCATION
2. ENVIRONMENTAL SANITATION
4. PROPER FOOD AND WATER HANDLING
4. IMMUNIZATION
INCUBATION
PRODROMAL
ACUTE
CONVALESCENT

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COMMUNICABLE DISEASES affecting the NERVOUS SYSTEM
I. ENCEPHALITIS
Description: An inflammation of __________ tissue, typically accompanied by meningeal inflammation.
Etiologic Agents: Arbovirus; __________
MOT:
Vector: __________
Incubation Period:
Clinical Manifestations:
Diagnostic Tests:
1. LUMBAR PUNCTURE/ _______________
2. Electroencephalogram
3. Brain tissue biopsy
4. Polymerase Chain Reaction test
Lumbar puncture between L3-L4 vertebrae
Management:
Medical:
1. Administer corticosteroids as directed.
2. Anticonvulsants to manage seizures.
3. Administer mannitol (Osmitrol) as directed.
4. Supportive management.
Nursing:
1. Maintain quiet environment and provide care gently.
2. Maintain SZ precautions with side rails padded, airway and suction equipment at bedside.
3. Monitor vital signs frequently.
4. Administer medications as directed.
Prevention:
1. Eliminate mosquito breeding sites.
2. Maintain strict standard precautions.
Disruption of cellular functioning:
Perivascular congestion:
Inflammatory response:

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COMMUNICABLE DISEASES affecting the NERVOUS SYSTEM con’t…
II. MENINGITIS
Description: An inflammation of the meninges particularly the __________ and __________ that surrounds the brain and spinal cord.
Etiologic Agents: Viral: H. Influenza, non-polio enterovirus; Bacterial: N. meningitides, S. pneumoniae
MOT:
Vector: _______________
Incubation Period:
 Classical symptoms: fever, headache, nuchal rigidity
 Petechial rash
 Confusion, photophobia
 Children: behavioral changes, opisthotonos, blank stare, refusal to feed, SZ
 Adult: confusion, altered LOC
 (+) BRUDZINSKI’S and KERNIG’S signs
Diagnostic Tests:
1. LUMBAR PUNCTURE
2. Complete Blood Count
3. Blood culture
Management:
Medical:
1. Administer dexamethasone (Decadron) to manage inflammation.
2. Antibiotics as prescribed.
DOC: _______________
3. Anticonvulsants as needed.
Nursing:
1. Maintain quiet environment and provide care gently.
2. Maintain SZ precautions with side rails padded, airway and suction equipment at bedside.
4. Administer medications as directed.
5. Institute cooling measures for fever. Give antipyretics as ordered.
6. Avoid opoids!
7. Dim the lights if photophobia develops.
8. Measures to decrease ICP:
9. Isolate the patient.
Prevention:
1. Vaccine: _______________

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III. TETANUS
Description: Acute disease induced by toxin of tetanus bacillus growing anaerobically in wounds.
Etiologic Agent: _______________
MOT:
Source of infection:
Incubation Period:
 R
 O
 T
 C
 H
 I
 L
Diagnostic Tests:
1. _______________
2. Wound culture
Complications:
 Hypostatic Pneumonia
 Dysrhythmias
 Brain damage
Management:
Medical:
1. Administer ATS or HTIg as prescribed.
2. Antibiotics as prescribed.
DOC: _______________
3. Anticonvulsants as needed.
4. Wound care: cleaning, irrigation, debridement
5. Sedatives and muscle relaxants, with tracheostomy and mechanical ventilation.
6. Cardiac monitoring.
Nursing:
1. Maintain airway patency.
2. Provide a quiet, semi dark room.
3. MIO
4. Provide adequate nutrition.
Prevention:
1. DPT immunization.
2. TT Immunization
3. Health Education
Risus Sardonicus/ Evil Smile in patients with tetanus

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IV. RABIES
Other terns: Hydrophobia, Lyssa, Acute viral encephalomyelitis
Description: A fatal acute viral encephalomyelitis caused by the rabies virus.
MOT: Direct penetration to the skin; Inhalation
Incubation Period: depends on:
 N
 E
 R
 D
 S
Dogs:
Humans:
 Prodromal / _______________Phase
 Pain/paresthesia at the site of exposure
 N/V
 Photophobia
 Malaise
 Fatigue
 Excitement Phase
 Delirium


 Aerophobia
 Hydrophobia
 Nuchal rigidity
 Paralytic Phase
 Lethargy
 Paresis or paralysis
 Heart failure
 Respiratory arrest
 Loss of urinary and bowel control
Diagnostic Tests:
1. Brain biopsy of animal
2. Direct Fluorescent Rabies Antibody Test
Management:
FIRST AID Measures:
1. Wash the site with antibacterial soap in running water for at least 3 minutes!
2. Apply antiseptics (povidone iodine or alcohol) and a sterile dressing on the site.
3. If possible, do not immediately stop the bleeding.

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Medical:
1. Administer ARS or HRIg as prescribed.
2. No known medication.
3. Give antibiotics, sedatives as prescribed.
Nursing:
1. Provide a non-stimulating environment.
2. Wear gown, mask and goggles as needed.
3. Restrain the patient prn.
4. Avoid stimulation of any sense of fluids.
5. Monitor cardiac and pulmonary functioning.
6. Avoid being bitten by the rabid patient.
7. Inform the SOs to observe the dog for 14 days for signs of rabies.
Prevention:
1. Dog Immunization at _______________of age and every year thereafter.
2. Keep away from stray animals.
3. Be a responsible pet owner.
 Never allow pets to roam the streets.
 Take care of your pet; bathe, feed them regularly with adequate food, provide clean sleeping quarters.
 Your pet’s action is your responsibility!
National Rabies Prevention and Control Program
Strategies:
a. Manpower Development
 Training of health workers veterinarian and laboratory technicians on management of animal bite cases.
b. Social Mobilization
 Organizational meetings.
 Networking with other sectors.
c. Local Program Implementation
 Establishment/Reactivation of Local Rabies Control Committees
 Enactment/ Enforcement of Ordinance on Dog Control Measures
d. Dog Immunization
V. POLIOMYELITIS
Other terns: Infantile Paralysis
Description: An acute infection of the central nervous system resulting to asymmetrical muscle paresis or paralysis.
MOT:

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Incubation Period:
 Abortive Type

 Pre-paralytic Type


 Paralytic Type
 Muscular weakness or paralysis
 Uncoordinated muscle movements
 (+) __________
 (+) __________
 (+) __________
 (+) __________
Diagnostic Tests:
1. Pandy’s Test
2. Viral Culture
3. EMG
4. Muscle Testing
Complications:
 Hypertension
 Encephalitis
 Respiratory paralysis
 Paralytic ilues
 Post-polio muscle atrophy syndrome
Management:
Medical: NO SPECIFIC TREATMENT
1. Administer analgesics. Avoid opiods!
2. Assist in orthopedic surgery
Nursing:
1. Maintain CBR.
2. Provide respiratory ventilation.
3. ROM exercises.
4. Provide TSB for fever.
5. Check vital signs frequently.
6. Initiate enteric precaution!
7. Provide High Fiber diet.
Prevention:
1. Vaccination.
Oral Polio Vaccine
Inactivated Polio Vaccine
2. Proper waste disposal.
3. Frequent handwashing.
Landry’s Sign in a patient with polio paralytic type

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COMMUNICABLE DISEASES affecting the CIRCULATORY SYSTEM
I. DENGUE FEVER
Other terms: Breakbone Fever/ Hemorrhagic Fever/ Dandy Fever/ Infectious thrombocytopenic purpura
Description: A severe acute febrile disease caused by infection
often characterized by bleeding and hypovolemic shock.
Etiologic Agents: Dengue virus __, __, __, __/ Chikungunya virus/ _______________
MOT:
Vectors: _______________, _______________
Characteristics:
 D
 L
 S
 U
Incubation Period:
Pathognomonic sign:
According to Severity:
According to Sequelae:
A. DENGUE FEVER
B. DENGUE HEMORRHAGIC FEVER
C. DEBGUE SHOCK SYNDROME
DF/DHF/DSS stages:
Febrile Stage:
Toxic Stage:
Convalescent Stage:
Grade I:
Grade II:
Grade III:
Grade IV:

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COMMUNICABLE DISEASES affecting the CIRCULATORY SYSTEM con’t…
Diagnostic Tests:
1. SCREENING TEST: Tourniquet test / _______________/ _______________
2. CONFIRMATORY TESTS: decreased Platelet Count and WBC
3. Hemoconcentration – increase of at least 20% of hematocrit
4. Occult Blood
5. Hemorrhagic determination
6. Polymerase Chain Reaction Test
Complication/s: _______________
Management:
Medical:
1. Give Paracetamol/ Acetaminophen for pain and fever! (NO ASPIRIN!)
2. Rapid water replacement:
SEVERE DEHYDRATION : Intravenous fluids
First line : D5LRS or D5 0.9 NaCl
Second line : PNSS or PLRS
MODERATE DEHYDRATION: Oral Rehydration Solution (ORESOL)
Amount :
Duration :
Home-made : __ L water + __ tsp. salt + __ tsp. sugar
: __ glass water + __ pinch salt + __ tsp. sugar
3. Blood Transfusion (for severe bleeding)
4. Oxygen Therapy for patients in shock
Nursing:
1. Supportive/Palliative Care
2. For Hemorrhage:
Nose bleeding : maintain an elevated position of the trunk; put an ice bag over the forehead and at the bridge of the nose.
GI bleeding : put an ice over the abdomen.
3. Promote rest by providing a comfortable and quiet room.
4. Decrease elevated temperature by providing TSB and ↑ OFI.
5. WOF: signs of shock!
6. For Shock – place patient in modified trendelenburg position to promote circulation; provide warmth through lightweight covers
7. Diet: Low Fat, Low Fiber, non-irritating, noncarbonated
Prevention and Control:
D E N G U E
S
S
S
S
 Changing water and scrubbing the sides of flower vases once a week.
 Destroying breeding places of mosquitoes by cleaning surroundings and properly disposing rubber tires, empty bottles, and cans keeping water containers covered

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 Avoid hanging too many clothes inside the house.
 Perform residual spraying of insecticides.
 HEALTH EDUCATION
II. MALARIA
Other terms: Ague/ Marsh Fever
Description: An acute and chronic parasitic disease transmitted by bite of infected mosquitoes endemic in 65 out of 78 provinces in the Philippines.
Etiologic Agents: Incubation Period:
P. ________ ___ days
P. ________ ___ days
P. ________ ___ days
P. ________ ___ days
MOT:
 Bite of a mosquito
 Blood transfusion / shared contaminated needles (rare)
 Transplacental transmission of congenital malaria (rare)
Vector: _______________
Characteristics:
 D
 N
 H
 R
 C
 COLD Stage ( ___ mins. to ___ hours)

 HOT Stage ( ___ hours to ___ hours)

 WET Stage ( ___ hours to ___ hours)

 Hepatosplenomegaly
 Cephalgia
 Epistaxis
 Myalgia
 Arthralgia
Diagnostic Tests:
1. Quantity Buffy Coat Test
2. Malarial Smear
Management:
Medical:
1. DOC: _______________
Route :
Site :
Dose :
Aeg position :
A/E :

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Management:
2. Oral Antimalarial Dugs:
First line :
Second line :
Nursing:
1. COLD Stage:
 Offer blanket and warm drinks.
2. HOT stage:

3. WET Stage:

5. Provide Iron rich foods.
6. MIO
C
L
E
A
N
 Take chemoprophylactic drug (Chloroquine) _____ weeks before and _____ weeks after entering an endemic area.
 Wear clothing that covers the arms and legs in the evening.
 Avoid outdoor activities, particularly during the vector’s peak biting hours from __ PM to
__ AM.
 Use of mosquito repellants.
 Zooprophylaxis
III. LEPTOSPIROSIS
Other terms: Mud Fever/ Trench Fever/ Flood Fever/ Spiroketal Jaundice/ Japanese Seven Days Fever/ Rat Fever
Description: Worlwide zoonotic disease caused by leptospires.
Incubation Period:
MOT:
 Ingestion of contaminated water/ milk
 Skin penetration
 Sexual intercourse (rare)
 Transplacental transmission of congenital leptospirosis (rare)
Vector: _______________

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 LEPTOSPIREMIC Stage
 Fever – sudden in onset
 H
 M
 N/V
 Cough
 Chest pain
 H
 H
 H
 H
 J
 TOXIC Stage
 Liver failure
 Meningitis
 Kidney failure
 Myocarditis
 Shock
Diagnostic Tests:
1. CONFIRMATORY: __________________________ (MAT)
2. Blood and CSF Culture
3. Urine analysis
Management:
Medical:
1. DOC: _______________
S/E:
2. Antibiotics as prescribed: Penicillin, Ampicillin, Amoxicillin
3. Erythromycin if allergic to penicillin.
Nursing:
1. Provide TSB and increase OFI.
2. Administer medications as prescribed.
3. Provide small frequent feedings.
 HEALTH EDUCATION among at risk people.
 Use of protective boots and gloves.
 Stringent community-wide rat eradication program.
 Isolate patients and concurrent disinfection of soiled articles.
 Avoid contact with contaminated water.

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COMMUNICABLE DISEASES affecting the RESPIRATORY SYSTEM
I. DIPTHERIA
Description: Acute febrile infection of the tonsil, throat, nose, larynx or a wound marked by a patch or patches of grayish membrane.
Incubation Period:
MOT:
 Respiratory secretions of a carrier/case
 Direct contact with contaminated articles
 Milk has served as a vehicle (unpasteurized)
Source: saliva, respiratory secretions, unpasteurized milk
Pathognomonic signs: Pseudomembrane, _______________
Diagnostic Tests:
1. Schick’s Test
Indication: _______________
2. Moloney’s Test
Indication: _______________
3. Nose and throat culture
Complication/s:
 BPn
 Peripheral neuritis
 Myocarditis
Management:
Medical:
1. DOC: _______________
2. Administer diphtheria antitoxin I.V
3. Supportive management
NASAL diphtheria:
TONSILOPHARYNGEAL diphtheria:
LARYNGEAL diphtheria:
CUTANEOUS diphtheria:
A patient with bullneck of diphtheria

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COMMUNICABLE DISEASES affecting the RESPIRATORY SYSTEM con’t…
Management:
Nursing:
1. Maintain airway patency!
2. Respiratory isolation for ___ days/ until ___ cultures are negative after antibiotic therapy is completed.
3. Bed rest for ___ weeks.
4. Measures to relieve fever.
5. ALERT!! The patient suffers DOB (difficulty of breathing). To promote airway patency, as a nurse it is crucial to remember that: DO/ DO NOT remove pseudomembrane!
 DPT Immunization!
 Proper disposal of nasopharyngeal secretions.
 Pasteurization of milk.
II. PERTUSSIS
Other term: Whooping cough
Description: Acute infection of the respiratory tract. It begins with cold increasing in severity, then followed by paroxysms of cough ending in whoop as breath is drawn in.
Etiologic Agents: Hemophilus Pertussis/ _______________/ _______________
Incubation Period:
MOT:
 Ingestion of contaminated water/ milk
 Skin penetration
 Sexual intercourse (rare)
 Transplacental transmission of congenital leptospirosis (rare)
Source:
 Nasopharyngeal secretions
Pathognomonic sign: _______________
 INVASIVE/ _______________ Stage
 __ week to __ week
 most communicable stage
 low-grade fever, rhinitis, mild cough, lacrimation
 SPASMODIC/ _______________ Stage
 AURA:
 Severe, violent coughing attacks, vomiting, cyanosis,
exhaustion
 RECOVERY/ _______________ Stage
 Coughing attacks decreases
Diagnostic Tests:
1. Bordet-gengou Agar Test
A patient with pertussis in spasmodic stage

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COMMUNICABLE DISEASES affecting the RESPIRATORY SYSTEM con’t…
Complication/s:
 C
 O
 B
 H
Management:
Medical:
1. DOC: _______________
2. Ampicillin or clarithromycin
Nursing:
1. Maintain airway patency!
2. Oxygen therapy as directed.
3. Respiratory Isolation.
4. Provide a quiet and non-stimulating room to reduce coughing.
5. Bed Rest.
6. Keep patient warm and out of drafts of wind.
7. Frequent oral hygiene.
8. Apply abdominal binder.
 DPT Immunization!
 Proper disposal of nose and throat secretions.
 Cover mouth when coughing.
 Erythromycin should be given to close and household contacts for __ days.
COMMUNICABLE DISEASES affecting the INTEGUMANTARY SYSTEM
I. MEASLES
Other term: Rubeola/Red/7-day measles
Description: An acute highly communicable infection characterized by fever, rashes, and symptoms referable to URT.
Etiologic Agents: Measles virus/ RNA-containing paramyxovirus
Incubation Period:
MOT:
 Direct contact with droplets from infected persons
 Respiratory route
Source:
 Nose and throat secretions
Period of communicability:

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COMMUNICABLE DISEASES affecting the INTEGUMENTARY SYSTEM con’t…
 PRE-ERUPTIVE/ ENANTHEM Stage

 Koplik’s spots
 ERUPTIVE/ _______________ Stage
 Maculopapular rashes/ _______________
 High grade fever
 Diarrhea
 RECOVERY/ CONVALESCENT Stage
 Rashes begins to clear
Diagnostic Test:
1. Wright Stain of sputum or nasal scrapings
Complication/s:
 P
 O
 S
 E
Management:
1. Administer antipyretics a.p.
2. Antibiotics
3. Passive Immunization
Nursing:
1. Isolate the patient at least __ to __ days after onset of rash.
3. Bed rest in humid, comfortably warm room.
4. Remove excess clothing and covers.
5. Cool with tepid bath. NO ALCOHOL USE!
6. Dim the lights for photophobia.
7. Keep fingernails trimmed.
8. Encourage increase OFI.
 Measles Immunization!
 Avoid exposing children to any person with fever or with acute catarrhal symptoms.
 Disinfection of all articles soiled with secretion.
II. GERMAL MEASLES
Other term: Rubella/3-day measles
Description: A highly communicable exanthematous disease.
Etiologic Agents: _______________/ _______________
Incubation Period:
Morbilli Rash in patient with measles at eruptive stage

54
MOT:
 Respiratory/ Oral droplet
Source:
Diagnostic Test:
1. Rubella Titer
Complication/s:
 Congenital Rubella Syndrome
 Arthralgia, arthritis
 Encephalitis
Management:
1. Administer antipyretics a.p.
2. Supportive management
Nursing:
1. Isolate the patient at least __ week after onset of rash.
2. Bed rest
3. Dim lights for photophobia.
4. Good oral and nasal hygiene.
5. NOTE: Advice mothers after receiving MMR vaccine, or nonimmune women with plans to be pregnant to avoid exposure to patients with rubella infection.
6. Provide soft liquid diet.
 MMR Immunization!
PRE-ERUPTIVE Stage:
ERUPTIVE Stage:

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III. CHICKEN POX
Description: An acute infectious disease of sudden onset with slight fever, mild constitutional symptoms and eruptions.
Incubation Period:
MOT:
 Indirect contact through contaminated articles
Source:
 Malaise
 Centrifugal Rash – macules to papules and
vesicles to crusts
 Fever
 Pruritus
Diagnostic Test:
1. _______________
Complication/s:
 P
 I
 Encephalitis
 S
Management:
Medical:
1. Administer antivirals a.p.
DOC: _______________
2. Give oral antihistamines, antipyretics and analgesics as directed.
3. NO ASPIRIN!
Nursing:
2. Shorten fingernails to prevent scratching.
3. Treatment of itching: Baking soda or oatmeal baths, calamine lotions to lesions.
4. Provide quiet, well ventilated environment.
 Chicken pox vaccination at __ to __ months of age.
 School exclusion for 7 days after eruption first appears and avoid contact with susceptible.
Vesiculo-papular Rash in patient with Chicken pox

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IV. HERPES ZOSTER
Other terms: Shingles/ Cold sores
Description: An acute viral infection of sensory nerve.
Incubation Period:
MOT:
 Indirect contact through contaminated articles
Source:
 Nasopharyngeal secretions
 Painful vesiculo-pustular rash
 Low-grade fever
 Headache
Complication/s:
 R
 Encephalitis
 G
Management: The same with chicken pox.
Medical:
1. Administer antivirals as prescribed.
DOC: _______________
2. Give oral antihistamines, antipyretics and analgesics as directed.
3. Administer prescribed corticosteroids. NO ASPIRIN!
Nursing:
2. Shorten fingernails to prevent scratching.
3. Treatment of itching: Baking soda or oatmeal baths, calamine lotions to lesions.
4. Provide quiet, well ventilated environment.
Prevention and Control: The same with chicken pox.
 Vaccination at __ to __ months of age.
 School exclusion for 7 days after eruption first appears and avoid contact with susceptible.
Vesiculo-pustular Rash in patient with Shingles
Common sites of Shingles

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V. SCABIES
Description: An inflammatory parasitic disease of the skin
Incubation Period:
MOT:
 Close personal contact
Source:
 Contaminated bed linens, clothing, towels,
 Itching, more intense at night
 Small erythematous papules
 Short, wavy burrows in the skin surface
Diagnostic Test:
 Scraping from its burrow with a hypodermic needle/ curette then examined under microscope.
Management:
Medical:
1. Administer antiparasitic as prescribed:
 benzyl Benzoate (Burroughs, Welcome)
 crotamiton (Eurax)
 permethrin (Nix, Kwell)
2. Topical or systemic steroids may be needed.
Nursing:
1. Teach proper use of medication:
 Apply thin layer from neck downward; every inch of the skin must be treated. Apply to dry skin.
 Leave medication on for 8-12 hours. Wash thoroughly.
2. Advise patient to avoid close contact for 24 hours after treatment to prevent transmission.
3. Treat the whole family.
Prevention and Control: The same as in chicken pox.
 Handwashing!
 Good personal hygiene.
 Regular changing of clean clothing, beddings, and towels. Rinse with hot water after use.
 Keep fingernails short.
 Eat foods rich in vitamin A and C.
Common scabies sites

58
VI. PEDICULOSIS
Other term: Pthiriasis
Description: Infestation of hairy parts of the body with the eggs, larvae, or adults of lice.
Etiologic Agent: Pediculus humanus
Head lice: _______________ Body lice: _______________
Pubic lice: _______________ Eyelids & Eyelashes: _______________
Incubation Period:
P. Capitis: ___ days
P. Corporis: ___ days
P. Pubis: ___ days
MOT:
 Direct personal contact
 Indirect contact with contaminated articles
Source:
 Contaminated bed linens, clothing, towels, combs
 Itching
 Small erythematous macules at puncture sites
Management:
Medical:
1. Administer antiparasitic as prescribed:
 lindane (Kwell) shampoo – P. capitis
 permethrin (Nix) or topical Kwell – P. corporis and pubis
 pilocarpine drops – P. palpebrarum
2. Give ivermectin if resistant to the drugs described above.
Nursing:
1. Teach proper use of medication:
 Apply lotion or cream after bathing to affected hairy and adjacent areas; wash off after 8-12 hours.
 Alternatively, apply shampoo to affected hairy areas and lather for 4-5 minutes, rinse, let hair dry.
2. Wash all clothing, towels, linens, combs, and hair items in hot water for 10 minutes.
3. Proper hygiene.
Pediculus Capitis

59
COMMUNICABLE DISEASES affecting the GASTROINTESTINAL SYSTEM
I. TYPHOID FEVER
Description: A systemic infection and ulceration of the Peyer’s patches of the small intestine.
Incubation Period:
MOT:
 Fecal-oral route
 5 Fs
Source:
 Feces
 Urine
Pathognomonic Sign: _______________
 Fever – insidious in onset
 Headache
 Malaise
 Anorexia
 Splenomegaly
Diagnostic Test:
1. _______________ test
2. _______________ test
Complication/s:
 Perforation of intestine
 Intestinal hemorrhage
Management:
Medical:
1. Intravenous fluids and electrolytes.
2. Antibiotic therapy as prescribed.
DOC: _______________
Ampicillin, amoxicillin, cotrimoxazole, cefotaxime
3. Avoid antispasmodics, and laxatives.
Nursing:
1. Maintain and restore fluid and electrolyte imbalance.
2. Enteric precaution.
3. Encourage good personal and food hygiene.
 HANDWASHING
 Sanitary disposal of human feces.
 Sanitary food processing, preparation, and serving.
 Avoid eating raw foods.
 Adequate provision of safe washing facilities.
 Fly control and screening.
 Protection of purified water supplies and construction of safe privy.
 Control of infected individual contacts and environment.
Rose spots distribution in the abdomen

60
COMMUNICABLE DISEASES affecting the GASTROINTESTINAL SYSTEM con’t…
II. SHIGELLOSIS
Other term: Bacillary Dysentery
Description: An acute bacterial infection of the intestine.
Etiologic Agent: Shigella group:
S. _______________
S. _______________
S. _______________
S. _______________
Incubation Period:
MOT:
 Eating contaminated foods, drinking contaminated water/milk
 5 Fs
Source:
 Feces
 Diarrhea
 Fever
 Tenesmus
Diagnostic Test:
1. Stool analysis
Complication/s:
 Fluid and electrolyte imbalance
Management:
Medical:
2. Administer antibiotics as directed.
DOC: _______________
3. Avoid: _______________
Nursing:
4. Avoid: _______________
 HANDWASHING

61
III. CHOLERA
Other term: Asiatic Cholera/ Epidemic cholera/ El Tor
Description: An acute serious illness characterized by sudden onset of acute and profuse diarrhea, vomiting and other GI symptoms.
Incubation Period:
MOT:
 5 Fs
Source:
 Feces
 Vomitus
 Vomiting
 Muscular cramps
 DHN
 Cyanosis
 Collapse
Diagnostic Test:
1. Stool analysis
Complication/s:
 Fluid and electrolyte imbalance
 W
Management:
Medical:
1. Give antibiotics as prescribed.
DOC: _______________
Nursing:
4. Avoid: _______________
 HANDWASHING

62
IV. RED-TIDE POISONING
Other term: Paralytic Shellfish Poisoning
Description: A syndrome of characteristic symptoms predominantly neurologic which may occur within minutes or several hours after ingestion of poisonous shellfish.
Incubation Period:
MOT:
 Ingestion of raw or inadequately cooked seafoods
Source:
 Facial numbness
 Vomiting
 Dizziness
 Headache
 Tachycardia
 Paralysis
Management: NO SPECIFIC MEDICATION INDICATED!
1. Induce vomiting.
2. Drinking pure coconut milk and NaHCO3 (25 gms. + ½ water).
3. Never cook shellfish affected by red tide with vinegar.
4. NOTE: Red tide toxin is not totally destroyed upon cooking. Avoid bi-valve mollusks when red tide warning has been issued by the proper authorities.
V. PARAGONIMIASIS
Description: A chronic parasitic infection, which greatly reduces human productivity and quality of life.
MOT:
 Ingestion of raw and insufficiently cooked crabs.
Source:
 Chronic cough
 Chest/back pain
 S/Sxs of PTB
Diagnostic Test:
1. Sputum Exam
2. CSF analysis

63
Complication/s:
 Cerebral paragonimiasis
Management:
Medical:
1. TOC: _______________
2. Alternative drug: bithionol (Bitin)
 Treatment of Infected Person
 Sanitary disposal of human feces
 Anti-mollusk campaigns
 Avoid eating infected foods
 Avoid bathing in infected water
VI. MUMPS
Other term: Epidemic parotitis
Description: An acute contagious disease characterized by swelling of one or both parotid glands.
Incubation Period:
MOT:
 Direct contact
 Airborne droplet
Source:
 Secretions from mouth and nose
 Headache
 Anorexia
 Malaise
 Fever
 Anorexia
 Parotitis
Diagnostic Test:
1. Serologic testing
2. Clinical signs and symptoms
Complication/s:
 Orchitis – most common complication in male adults
 Oophoritis
 E
 D
 C
Parotitis in patient with mumps

64
Management:
Medical:
1. Administer _______________ for fever.
2. If orchitis develops, give sedatives to relieve pain.
3. Cortisone 300 – 400 mg. then 100 mg q6h.
Nursing:
1. Support scrotum using suspensory, pillow or a sling between the thighs.
2. Measures to relieve pain and fever.
3. Provide a _______________ diet.
4. Encourage frequent antiseptic mouth washes.
5. Symptomatic management.
 MMR Immunization!
 Terminal disinfection
 Respiratory Isolation
VII. HEPATITIS A
Other term: Infectious hepatitis, Epidemic hepatitis, Catarrhal jaundice
Description: A form of acute hepatitis occurring either sporadically or epidemics and caused by viruses introduced by fecally contaminated water or food.
Incubation Period:
MOT:
 5 Fs
Source:
 Flu-like s/sx
 Malaise
 Anorexia
 Abdominal pain
 N/V
 Fever
 Lymphadenopathy
 Jaundice
 Pruritus
Diagnostic Test:
1. Elevated liver enzymes

65
Management:
1. Complete bed rest.
2. Administer _______________
3. Small frequent feedings.
4. Diet:
5. I.V Fluid and electrolyte replacement as indicated.
6. Relieve pruritus.
7. Avoid hepatotoxic drugs and alcohol.
 Ensure safe water for drinking.
 Sanitary method in preparing handling and serving food.
 Proper excreta and urine disposal.
 Separate and proper cleaning of articles used by patient.
 PROPER HANDWASHING!

66
SEXUALLY TRANSMITTED DISEASES
DISEASE CA MOT IP S/SX DX/MGT PREVENTION
Syphilis
Sexual Contact
Direct contact with infective sore
Transplacental
BT
Indirect contact with contaminated articles
10 days-3 months
Primary Stage (4-6 weeks)
__________________
Secondary Stage (1 week-6 months)
generalized rashes, generalized tender discrete lymphadenopathy, mucus patches, flu-like symptoms, patchy alopecia
Late stage (1-50 years):
No symptoms; non-infectious
Diagnostic test:
- Dark field illumination test
DOC: __________________
A –
B –
C –
D –
E –
Gonorrhea
Sexual contact
2-10 days
Thick purulent yellowish discharge Burning sensation upon urination / dysuria
Culture of urethral and cervical smear
Gram staining
DOC: ____________________
Trichominiasis
Sexual Contact
Indirectly through wet objects
4-20 days, average of 7 days
Females: Asymptomatic
White/greenish-yellow odorous discharge vaginal itching and soreness painful urination
Males: Slight itching of penis Painful urination Clear discharge from penis
Culture
DOC: _____________________

67
Chlamydia
Sexual Contact
NSVD
2-3 weeks for males, usually NO s/sx for females
Females:
Dyspareunia
Slight Fishy vaginal discharge
Males:
Penile discharges
Burning sensation during urination
Urethritis
Culture
DOC: ______________
Candidiasis
Direct contact
White, cheese-like vaginal discharges
Curd-like secretions
Culture
DOC:
________________for oral thrush
________________for mucous membrane and vaginal infection
________________for systemic infection
Hepatitis B
Right-sided abdominal pain
Jaundice
Yellow-colored sclera
Anorexia
Nausea and vomiting
Joint and muscle pain
Steatorrhea
Dark-colored urine
Low-grade fever
Hepatitis B Surface Agglutination (HBSAg)Test
Hepatitis B Immunoglobulin
Diet: ____________________

68
OTHER COMMUNICABLE DISEASES
SARS
Droplet
2-10 days
 Fever (>38°C)
 Chill
 Malaise
 Myalgia
 Headache
No specific treatment
1. Establishment of triage 2.Identification of patient 3.Isolation of suspected probable cases 4.Tracing and monitoring of close contact 5.Barrier nursing technique for suspected and probable case
1. Utilize personal protective equipment (N95 mask)
2. Handwashing
3. Universal Precaution
4. Patient wears mask
5. Isolation
Bird Flu or Avian Flu
Direct
Contact with infected birds
2-4 days
 Fever
 Body weakness
 Cough
 Sore throat
 Dyspnea
 Sore eye
Isolation Technique
Control in birds:
1. Rapid destruction, proper disposal of carcasses and quarantining and rigorous disinfection of farms
2. Restriction of movement of live poultry.
1. Vaccination
2. Proper cooking of poultry
Influenza A
(H1N1)
Droplet
7-10 days
 Flu-like S/Sx
 Vomiting or nausea
 Diarrhea
1. Nasopharyngeal (throat) swab
2. Immunofluorescent antibody testing
DOC: ____________________________
1. Cover nose & mouth when coughing and sneezing
2. Proper handwashing
3. adequate nutrition
4. Proper lifestyle
ALL THE BEST!

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