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White stripes on legs, gray wings. a. Persistence of s/sx of Grade 2 + Circulatory To prevent and control bleeding:
Failure a. Epistaxis
Mosquito (Aedes Aegypti) b. Cold clammy skin b. Gum Bleeding
↓ c. Check for capillary refill c. Hematemesis
Bloodstream d. Hypotension, very rapid weak pulse and rapid d. Melena
↓ respiration.
Creates multiple lesions in the bloodstream Supportive & Symptomatic
---------------------------------------------------- 4. Grade 4 Increase body resistance – proper nutrition
↓ ↓ Persistence of s/sx of Grade 3 + Hypovolemic and adequate rest.
↑ capillary fragility ↑ capillary permeability Shock → Death
(easily bleeds ) (allows shifting of fluid Preventive Measures:
from 1 comp to Diagnostic Exams: CLEAN Program of DOH
another) a. Torniquet Test or Rumpel Leede Test – C- hemically treated mosquito net
↓ ↓ presumptive. L- arva eating fish
Thrombocytopenia edema, ascites, Test for capillary fragility. E- nvironmental Sanitation
and A- nti mosquito soap/off lotion
hemoconcentration 3 Criteria before performing Torniquet test N- atural mosquito repelant trees
1. 6 months or older.
1. Grade 1 2. Fever > 3 days. Immunity: No permanent immunity.
a. Fever – 3-5 days 3. (-) signs of DHF- fever of 3 days.
b. HA; periorbital, abdominal, joint and bone Malaria
pains. Release the cuff, check and count the aka AGUE
c. N/V petechial formation per one square inch (>20 king of tropical diseases manifested by
d. Pathological vascular changes: petechiae and petechial formation = (+) tourniquet test. indefinite period of fever and chills.
Herman sign (generalized flusing/redness of
the skin. b. Platelet Count - ↓ in DHF – definitive test CA: Protozoa – Plasmodium:
e. Diagnosed as Dengue Fever or Dandy Fever c. Hematocrit (Hct) determination - ↑ in DHF 1. Plasmodium Vivax
or Breakbone Fever. due to hemoconcentration . 2. Plasmodium Falciparum – most fatal.
3. Plasmodium Malariae
2. Grade 2 Symptomatic treatment 4. Plasmodium Ovale - Only female mosquitoes
a. Persistence of s/sx of Grade 1 + Bleeding 1. Antipyretic – but never give Acetyl Salicylic or suck blood.
b. Bleeding from: Aspirin (ASA). P. Vivax and P. Falciparum – common causes of
Nose – epistaxis 2. Reye’s Syndrome – a neurologic d/o associated malaria in the Phils.
Gum - gum bleeding with viral infection (<12y/o). MOT: mosquito bite, blood transfusion
Stomach - hematemesis, melena, 3. Vit K (Aquamephyton, Phytomenadion, Night biting from dusk till dawn.
hematochezia Synkavit and Konakion). Breeds in a clear slow flowing water.
4. Vit. C. Rural areas – mountains and forest.
3. Grade 3 5. Blood Transfusion. Lands on surface – 45 degrees angle/slanting.
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b. Sputum Examination – confirmatory, done in 3
If infected by mosquito Tuberculosis series.
↓ aka Kokh’s Infection, Phthisis, PTB, c. Chest X-ray - not definite test, tells only the extent
Blood stream Galloping Consumption. of involvement of the lungs.
----------------------------------
↓ ↓ CA: Acid Fast Bacilli - M. Tuberculosis, M. Bovis, M. 1. According to extent of disease based on
RBC is penetrated Liver Avium/Avis. cavitations within the lungs.
(MO reproduces) (MO stays for 3-5years) a. Minimal
↓ MOT: b. Moderately advanced.
RBC 1. Airborne and droplet c. Advanced – (+) of cavitations within the
2. Ingestion of infected milk of cows lungs.
Cold Stage – shaking of body & chattering of 3. Blood – TB meningitis, TB of bones, TB of 2. According to clinical manifestations.
lips (10-15 mins). the spine. 1. Active PTB
Hot Stage – fever, chills, vomiting, 2. Inactive PTB
abdominal pain (4-6 hours). Incubation Period: 1-2 months (4-8 weeks) 3. According to American Pulmonary Society.
Wet Stage – profuse sweating, feeling of a. TB 0 – (-) exposure (-) infection (-) tuberculin
weakness. S/Sx: testing.
1. Low grade fever with night sweats. b. TB I- (+) exposure (-) infection (-) tuberculin
2. Anorexia and weight loss testing.
Nursing Care: 3. Fatigability c. TB II – (+) exposure (+) infection (+) tuberculin
a. Make patient comfortable. 4. Chest pain and dyspnea. testing (-) s/sx.
b. Keep patient warm. 5. Dry cough productive (yellowish/greenish) d. TB III – (+) exposure (+) infection (+) tuberculin
c. Increase fluid intake. blood streak sputum / hemoptysis testing (+) s/sx.
Cerebral Hypoxia – caused by P. falciparum (pathognomonic sign).
causes anemia. 6. Back and epigastric pain. 1. Short Course Chemo therapy – Rifampicin,
7. anemia and amennorhea in female. Isoniazid, Pyrazinamide, Ethambutol (RIPE)
Diagnostic Examinations:
1. Malarial Smear/ Blood Smear – blood is extracted Diagnostic Examinations: a. Rifampicin (R) – causes orange color of tears,
at peak of fever. a. Tuberculin skin testing – screening, ID. urine and stool.
2. Quantitative Buffy Count (QBC) – no need for A presumptive test. b. Isoniazid (INH) – mainstay drug.
the height of fever to set in. Mantoux test – most reliable skin test for TB. 6mons for carrier & inactive adult patient.
0.1 cc Purified Protein Derivative, volar 9mons for children.
Medical Management: aspect. 12mons for immunocompromised patients.
1. Chloroquine (Aralen) – mainstay bleb or wheal formation. Side Effects:
2. Other Drugs: Primaquine, Atabrine, fansidar and a. =<or = to 4mm negative. 1. Peripheral neuropathies/neuritis
Quinine (reserve drug for severe cases). b. = 5-9 mm doubtful (repeat the Foods rich in Vit B6 (pyroxidine).
Used cautiously for pregnant women. test).
Immunity: No permanent immunity. c. = > or = 10mm positive. 2. Hepatotoxicity – (+) jaundice
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Monitor liver enzymes. Instruction to mothers: don’t massage the area, ADS – IM, IV ANST; if (+) give in fractional
Avoid alcohol. (+) fever, (+) abscess formation on the site of dose – desensitization.
injection →scar. IV fluid to dilute toxin.
c. Pyrazinamide (P) – causes hyperurecemia.
d. Ethambutol (E) – causes irreversible optic neuritis Diphtheria Nursing Care:
that brings about blindness. Acute contagious dse char by generalized a. Antibiotic – Penicillin
toxaemia coming from a localized b. Supportive – O2 inhalation, tracheostomy.
2. Standard Regimen (SR) – Streptomycin, Isoniazid inflammatory process known as c. Strict Isolation – highly contagious.
& Ethambutol (SIE). PSEUDOMEMBRANE. d. CBR – to limit the circulation of toxin.
Myocarditis, bronchopneumonia &
a. Streptomycin (S) CA: Corynebacterium diphtheria or Klebs-Loeffler peripheral neuritis – fatal
Side Effects: bacillus. complications.
1. Nephrotoxicity e. Diet: Liquid to soft diet. (-) spices , small
2. Ototoxicity – CN8 (tinnitus/vertigo). MOT: Droplet (direct contact) – affects all ages. frequent feeding, observe strict aspiration
precaution, increase fluid intake.
3. Directly Observed Treatment Short Course S/Sx f. Provide diversional activities for children.
(DOTS) WHO - “tutuk gamutan”. 1. Nasal - dryness, excoriation of upper lip and g. Avoid MOT.
5 Elements: nares (+) of pseudomembrane in the nasal h. Immunization: DPT 0.5cc IM VL, 6, 10,
1. Political will to support the program. turbinate – pathognomonic s/sx. 14 wks of age simultaneous with OPV.
2. Microscopic availability. 2. Grayish-white membrane with leathery Do not massage area to prevent lump
3. Steady supply of medicine. consistency. formation (press).
4. Personnel – RN and midwife. 3. Pharyngeal – (+) bullneck appearance (+) lump hot moist compress.
5. Documentation and recording. (enlargement of the cervical lymphnode). (+) fever – give paracetamol; cooling
4. Laryngeal – (+) respiratory distress - (+) measures.
Nursing Care: hoarseness/aponia. Adverse side effect: CONVULSION
1. D – iet - Small frequent nutritious foods. 5. (+) laryngeal stridor – brassy metallic cough. Nsg. Management: Take temp accurately
2. D – rugs - Adequate drugs and emphasizes to differentiate it from febrile convulsion.
importance of compliance. Diagnostic Examinations:
3. R – est - Conserve energy. a. Nose and Throat Culture Pertusiss
4. Contraindicated Nursing Care: Do not do chest b. Shick’s Test – to determine resistance or
physiotherapy. susceptibility to diphtheria. aka as Whooping cough and Chin cough.
5. Avoid MOT. c. Moloney’s Test – to determine Affects below 6 y/o.
6. Proper disposal of nasopharyngeal secretions. hypersensitivity to diphtheria.
7. Covering of mouth when sneezing. *Removal of the pseudomembrane is not CA: Coccobacillus -
8. Immunization : Gives temporary immunity. encouraged facilitate bleeding and fast a. Bordetella pertussis
Immunization with BCG immediately after birth regrowth. b. Hemophilus pertussis
0.5cc ID ® deltoid area. d. Neutralize toxin.
Incubation Period: 7-10 days
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a. Rose spots in the the abdomen –pathognomonic
MOT: Droplet Medical sign.
1. Immunization: Pertussis Immune b. Ladder like fever.
S/Sx Globulin. a. splenomegaly
2. Antibiotics: Erythromycin b. Typhoid psychosis – due to release of toxins.
1. Catarrhal stage – highly contagious, child stays at 3. Fluid and Electrolyte Replacement Coma vigil look.
home. 4. Mild form of sedation: Codeine Difficulty in protruding the tongue.
s/sx: Carphologia – involuntary picking up of
a. (+) of colds Nursing Care: linen.
b. Nocturnal coughing 1. CBR Sabsultus tendinum – involuntary
c. Fever 2. Maintain F&E balances. twitching of tendon.
d. Tiredness and listlessness 3. Provide adequate nutrition. 3. Defervescence Stage – (+) ulcer formation
4. Proper positioning when feeding. intestinal perforation bleeding spillage in
2. Spasmodic or Paroxysmal stage 5. Provide abdominal binder to prevent hernia. peritoneal cavity.
s/sx:
a. 5-10 successive forceful coughing which Preventive Measures: same as Diptheria. S/Sx of Peritonitis:
ends in a prolonged inspiratory phase or 1. Sudden and severe abdominal pain.
whoop. Immunity: No permanent immunity. 2. Persistence of fever.
b. (+) production of mucus (tenacious) plug 3. board-like rigid abdominal.
on airway passage.
c. Other manifestations: Typhoid Fever 4. Convalescent /Lysis Stage – s/sx starts to subside.
a. Congested face, tongue. Still have to observe for relapse.
b. Teary eyes with protrusion of eyeball. CA: Salmonella typhosa →Payer’s patches
c. Distended face and neck veins. Diagnostic Examinations:
d. Involuntary mict. and defecation. MOT: Fecal-oral
e. Abdominal/inguinal hernia.
f. Deafness due to hemorrhage of Sources of infection: feces, fingers, food, flies and 1. Blood Culture
vestibular apparatus of ear. fomites. a. Widal Test
Antigen O (AG O) or Somatic Antigen =
2. Convalescent stage – s/sx starts to disappear. 3 Stages of Typhoid Fever presently infected.
Patient no longer communicable and on Antigen H (Ag H) or Flagellar Antigen =
road to recovery. 1. Prodromal Stage – (+) MO in the blood stream. previously exposed to TF or has had an
Fever, dull HA, N/V, abd pain, diarrhea or immunization.
Diagnostic Examinations: constipation. b. Thypi dot – uses blood specimen where it
a. Nasal Swab 2. Fastigial/Pyrexial - MO invades the payer’s identifies antibodies.
b. Bordet-Gengou Test patches.
c. Agar Plate – use nasopharyngeal secretions Features: 2. Stool and Urine Exams
d. Cough Plate
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Medical: orange skin, orange eyes pathognomonic Jaundice, Hepa
Antibiotic – Chloramphenicol. sign. Epidemic
Hepa
Nursing Care: Diagnostic Examination: Source of Feces Blood, semen, Blood
1. Fluid and Electrolyte Management. 1. Blood culture: Leptospira Infection cervical
2. Provide adequate nutrition – (+) vomiting - small agglutination test (LAT) secretions
frequent meals ; (+)diarrhea - (x) fatty food. Leptospira antigen-antibody test Causative HAV or RNA HBV of DNA HCV
3. Provide comfort measures. (LAAT). agent containing containing
Microscopic agglutination test (MAT). virus
virus
MOT Fecal - oral Person-person, Percutaneous
Leptospirosis Medical Management: parenteral/
aka Mud fever, Swamp fever, Canicola 1. Antibiotics – Tetracyline drug of choice. percutaneous,
fever, Pre-tibial fever, Weil dse, Not given to a. child <8y/o staining of teeth. placental
Swineherd dse and Ictero-Hemorrhagica Pregnant women – teratogenic effect bone Incubation 2-7 wks 6wks-6mons 5wks-7-8
dse. defect. Period wks/12wks
Never give tetracycline with calcium rich food, Risk Crowding, Multiple sex Blood
Source of infection: Excreta of rats particularly urine. antacid and iron prep & milk. homosexual partners, recipients
2. Give Penicillin to patient allergic to tetracycline. members of
s, food
CA: Give 1hr before meals or 2hrs after meals or medical team,
1. Leptospira (spirochete) – bacteria empty stomach. handlers,
blood, drug
2. Leptospira canicola poor addicts
3. Leptospira hemorrhagica Nursing Care: Symptomatic sanitation,
4. Leptospira enterogans – common in Phils. 1. Provide eye care. unsafe
2. Warm compress for muscle pain. water
MOT: Skin penetration 3. I/O, consistency, frequency & amount. supply,
children
Incubation Period: 2 days to 4 weeks Preventive Measures:
1. Environmental sanitation by eradication Carrier No No Yes
People at risk: sewage workers, farmers, miners, of rats. state
people living in Manila areas. 2. Avoid walking through floods. Prognosis 0.5% 1-10% 1-2%
mortality mortality mortality
Incidence: rainy seasons Hepatitis Prevention Proper Screen blood Screen blood
Inflammation of the liver. handwashing donors donors
S/sx: Hepa A Hepa B Hepa C , sanitation,
1. Fever, HA, vomiting. Synonym Infectious Serum Hepa, Post – screen food
2. Myalgia and myositescalf muscles. Hepa, Homologous transfusion handlers,
3. Jaundice with hemorrhages on skin & mucous Catarrhal Hepa, Viral Hepa enteric
membrane icter-hemorrhagic yellow and red precautions
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Hep. B Protein Independent Antigen
1. Pre-Icteric Stage (HBeAa)= (+)chronic hep B. a. Male - Urethritis
S/Sx: 3. Routine Test b. Female – Cervicitis
Fever, RUQ, pain, fatigability, weight loss, body a. Bilirubin Testing
malaise, N/V, anorexia, signs of anemia. b. Prothrombin Time Testing (PTT) For Male:
c. Ultrasound or CT Scan of Liver 1. Dysuria
d. Urinalysis 2. Redness & edema of urinary meatus acidic
urine passes through burning sensation (+)
2. Icteric Stage pain.
S/Sx: Medical Management: 3. Purulent urethral discharges abundant in the
(+) jaundice – inability of liver to eliminate (N) 1. Hepatic Protectors or Liver Aides contain vitamins, morning – morning drop.
amount of bilirubin , (+) pruritus, urine is tea minerals and phospholipids: 4. Abscess forms on the prostate gland prostitis
colored or brown, passing out of alcoholic or a. Essentiale for adults. epidydimitis formation of scar on epidydimis
clay colored or no color stool, persistence of sx b. Jetepar or Silymarine for pedia. obstruction flow of the sperm cellsterility.
of pre-ecteric stage but to a lesser degree. 2. New trends in treating Hepatitis
a. Antiviral : Lamivudine For Female:
3. Post – Icteric Stage b. Immuno-modulating drug: Interferon 1. Dysuria and urinary frequency.
S/Sx: 2. Itchy, red and edematous meatus, if cervix is
Jaundice and other s/sx starts to disappear. Nursing Care: affected.
Energy starts to increase and patient is on the 1. Provide rest to promote liver regeneration. 3. Burning pain and purulent discharges, if urethra
road to recovery. 2. Low fat diet, High CHON intake to spare protein is affected.
It takes 3-4 months for the liver to recover metabolism. 4. Abscess forms on the bartholin’s and skene’s
(avoid alcohol for 1year and ASA & Immunization: Hep B vaccine is given at gland endocervitis & endometritis.
acetaminophen). 6 wks after birth, 3 doses at one month interval, 5. (+) narrowing of fallopian tube sterility.
Dose: 0.5cc IM, VL.
Diagnostic Examination: Immunity: Don’t give a permanent immunity. If pregnant, it will cause: ectopic pregnancy or
1. Liver Enzyme Test – determine extent of liver opthalmia neonatorum.
damage. Gonorrhea
ALT, AST, GGT, ALP, LDH. aka Jack, Gleet, Clap, Strain, GC and Morning Diagnostic Examination:
2. Serum Antigen- Antibody (Ag-Ab) Test Drop. 1. C&S by mucosal scrapping
a. Hepatitis A 2. Pap Smear or Vaginal Smear
Hepatitis A Surface Antigen = (+) 2 wks CA: Neisseria Gonorrhea
after exposure to Hep. A. Medical Management:
Anti- HAV. MOT: Sexual Contact, transferred to baby during birth. 1. Antibiotic
b. Hepatitis B a. Ceftriaxone (Rocephin)
Hep. B Surface Antigen (HBsAG): (+) acute Incubation Period: 3-21 days b. Doxycycline (Tetracycline)
hepatitis B. 2. Psychological aspect of care – low self-esteem.
Manifestation:
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3. Health education: safe sex, monogamous Diagnostic Examination: Temporary memory loss.
relationship, masturbation, use of condom, 1. C&S by mucosal scrapping Altered gait.
behaviour modification. 2. Dark Field Microscope
3. Serologic Test
4. Flourescent Treponema Antibody Adults: 2 Major sxs and 1 Minor sx.
Absorption Test – confirmatory test. Children: 2 Major sxs and 2 Minor sxs.
Syphilis
aka Pox, Lues, SY, and Bad Blood Disease. Medical Management: 3 Major Sx:
Antibiotic: Benzathine Penicillin G 1. Fever – 1 month & above.
CA: Treponema Pallidum – a spirochete that passes to (Penadur). 2. Diarrhea – 1 month & above.
the placental barrier during the 16th week of pregnancy 3. 10% weight loss/ stunted growth for pedia.
(2nd & 3rd trimester). Nursing Care & Preventive Management:
same as GONORRHEA. 6 Minor Sx:
MOT: Sexual contact, vertical transmission. 1. Persistent cough – 1 month & above.
HIV infection means one is infected with AIDS 2. Persistent generalized
Incubation period: 10-90 days Virus lymphadenopathy.
AIDS = infected by virus + incompetent immuno- 3. Generalized pruritic dermatitis.
1. Primary Stage response. 4. oropharyngeal candidiasis.
a. Chancre, a painless popular lesion on face, lips, 5. Recurrent herpes zoster.
tongue, under the breast, fingers and genitals. CA: Human Immuno-Deficiency Virus (HIV) 6. Progressive dessiminated herpes zoster.
b. Regional lymphadenopathy. retrovirus.
Opportunistic Infection:
2. Secondary Stage: highly infectious & contagious. MOT: BT, sexual contact, exposure to infected blood, a. TB is the most common of the Avium Type (from
a. Fever & malaise products or tissues vertical (mother-child) or Perinatal birds)
b. Skin rashes & dermatitis: dry, hard, wart like (pregnancy, delivery & breastfeeding), sharing needles. b. PCP
lesions Condyloma lata. c. CMV
a. Oral mucous patches. Incubation Period: 6 mons – 7 years d. CNS lungs eyes
b. Alopecia – patchy, polka dot or moth eaten e. Cancer : Kaposi Sarcoma malignancy of
appearance of hair and thinning of pubic hair. MO detected by macrophagealert T Cells blood vessel (skin) – appearing as pink/purple
↓ painless sots on the skin called Leopard Look
3. Tertiary Stage – HIV ← Antibodies ← stimulate B cells f. Enzyme Link Immunoassorbent Assay
a. Gumma – infiltrating lesion found on deeper Fever with night sweats without a cause. (ELISA) Test – screening test
tissues & body organs such as skin, bone and Enlargement of the lymph nodes without a g. Western Blot – confirmatory
liver. cause. h. CD4 and T cell count
b. Aortitis & aneurysm. Fatigability. If more than or equal to 200 HIV infected.
c. Paresthesia, abnormal reflexes, dementia and weight loss. If less than 200 AIDS.
psychosis. Altered sleeping patterns.
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1. Nucleus Analogs prevent the virus to multiply 2. Education
during the initial phase of cell division. 3. Counselling
4. Behavior Modification
a. Nucleoside Reverse Transcriptase Inhibitor
(NRTI)
a. Delavirdine
b. Nevirapine
Nursing Care:
1. Promote knowledge and understanding.
2. Promote quality of life.
3. Provide self care and comfort.
Preventive Measures: