Air and Droplet Borne Dses

LEARNING OBJECTIVES• At the end of the session, the students will be:

a. Knowledgeable about different types of air and droplet borne diseases.

b. Able to understand the mode of transmission of bacteria and viruses for different types of air and droplet borne diseases.

c. Able to identify the clinical manifestation and sign and symptoms of each diseases.

d. Knowledgeable about the complications and treatments.

e. Able to understand the nursing intervention on each diseases.

1. CHICKEN POX

Known as: VARICELLA

Caused by: Varicella-zoster virus

MODE OF TRANSMISSION

Direct contact, droplet (airborne) spread, and contaminated objects.

INCUBATION PERIOD: 14-16 days

COMMUNICABLE PERIOD: 1 to 2 days before the onset of the rash to 6 days after the first crop of vesicles, when crusts have formed.

SOURCE: respiratory tract secretions of infected person; skin lesion.

CLINICAL MANIFESTATION

COMPLICATIONS

MEDICAL MANAGEMENT

• Acyclovir (Zovirax): Anti viral agent

• Acetaminophen, ibuprofen: for fever

• Calamine lotion

• Diphenhydramine (Benadryl)

To relieve

itchiness

NURSING MANAGEMENT

• Encourage to drink a lot of fluids • Continue food intake as tolerated• Continue activity as tolerated• Isolation until all the lesions have crusted

at least 5 days after the rash appear. • Rash tends to be extremely itchy

What to do to calm itching:

a. cool compress

b. Cool water bath

c. Keep the fingernails short

NURSING INTERVENTION HOSPTIAL SETTING

• Ensure strict isolation (contact and airborne precautions).

• HOME SETTING: Isolate infected child until the vesicles have dried; isolate high-risk children from the infected child.

– Vaccine: Varivax vaccination

2. MEASLES (RUBEOLA)

Agent: Virus

Incubation period: 10-20 days.

COMMUNICABLE PERIOD: From 4 days before to 5 days after the rash appears; mainly during prodromal (catarrhal stage).

SOURCE

• Respiratory tract secretions, blood, or

urine of infected person

TRANSMISSION: Airborne or direct contact

with infectious droplets

ASSESSMENTa. Fever

b. Malaise

c. Coryza and cough

CORYZA: It describes the inflammation of the mucous membranes lining the nasal cavity which usually gives rise to the symptoms of nasal congestion and loss of smell, among other symptoms.

d. Rash appears as red, discrete maculopapules that blanch easily with pressure and gradually turn a brownish color (lasts 6 to 7 days)

e. Rash begins behind the ears and spreads downward to the feet.

KOPLIK’S SPOT : small, red spots with a bluish white center and a red base; located on the mucosa and last 3 days.

The MMR vaccine is an immunization shot against measles

INTERVENTIONS

1. Use respiratory precautions if the child is hospitalized

2. Restrict child to quiet activities and bed rest

3. Use a cool mist vaporizer for cough and coryza.

4. Dim lights if photophobia is present

5. Administer antipyretics for fever.

3. GERMAN MEASLES (RUBELLA)

Agent: rubella virus

Incubation period: 14 to 2 days

Communicable period: 7 days before to about 5 days after the rash appears

SOURCE

• Nasopharyngeal secretions; virus is also present in blood, stool and urine

TRANSMISSION:

a. Airborne or direct contact with infectious droplets

b. Indirectly via articles freshly contaminated with nasopharyngeal secretions, feces, or urine

c. transplacental

ASSESSMENT

a. Low-grade fever

b. Malaise

c. Pinkish red maculopapular rash that begins on the face and spreads to the entire body

d. Petechial spots may occur on the soft palate

INTERVENTIONS

a. Provide supportive treatment.

b. Isolate the infected child from pregnant women.

4. PERTUSSIS (WHOOPING COUGH)

Agent: Bordetella pertusis

Incubation period: 5 to 21 days (usually 10 days)

Communicable period: Greatest during the catarrhal stage

SOURCE

Discharge from the respiratory tract of the infected person.

TRANSMISSION:• Direct contact or droplet spread from

infected person;• Indirect contact with freshly contaminated

articles.

ASSESSMENT

• Low-grade fever, malaise, sore throat• Foul-smelling, mucopurulent nasal

discharge• Gray membrane on the tonsils and

phyrnx• Lymphadenitis (Neck edema)

INTERVENTIONS

1. Ensure strict isolation of the hospitalized child

2. Administer antitoxin as prescribed (preceded by a skin or conjuctival test to rule out sensitivity to horse serum).

3. Provide bed rest

4. Administer antibiotics as prescribed (azithromycin or erythromycin).

5. The MMR vaccine is an immunization shot against measles, mumps and rubella (also called German measles).

5. POLIOMYELITIS

Agent: enteroviruses

Incubation period: 7 to 14 days.

Communicable period: not exactly known; the virus is present in the throat and feces shortly after infection and persists for about 1 week in the thorat and 4 to 6 weeks in the feces.

SOURCE

• Oropharyngeal secretions and feces of the infected person

TRANSMISSION: Direct contact with infected person; fecal-oral and oropharyngeal routes.

ASSESSMENT

1. Fever

2. Malaise

3. Anorexia

4. Nausea

5. Headache

6. Sore throat

7. Abdominal pain followed by soreness and stiffness of the trunk, neck and limbs that progresses to flaccid paralysis.

INTERVENTION

1. Enteric precaution

2. Supportive treatment

3. Bed rest

4. Monitoring for respiratory paralysis

5. Physical therapy

6. MUMPS

•Known as PAROTITIS •Viral disease of the human species.

• Painful swelling of the salivary glands (classically the parotid gland)

• Painful testicular swelling (orchitis) and rash may also occur.

• The symptoms are generally not severe in children.

• In teenage males and men, complications such as infertility or sub fertility are more common.

SIGN AND SYMPTOMS

a. Parotid inflammation (or parotitis)

b. Fever

c. Headache

d. Orchitis, referring to painful inflammation of the testicle.[7] Males past puberty who develop mumps have a 30 percent risk of orchitis.[8]

• a contagious disease that is spread from person-to-person through contact with respiratory secretions such as saliva from an infected person.

• When an infected person coughs or sneezes, the droplets aerosolize and can enter the eyes, nose, or mouth of another person.

• Mumps can also be spread by sharing food, sharing drinks, and kissing.

• Contagious from approximately 6 days before the onset of symptoms until about 9 days after symptoms start.

• The incubation period (time until symptoms begin) can be from 14–25 days but is more typically 16–18 days.

EXAMINATION

• Confirmation of swollen glands• Test of saliva or blood

VACCINE

The MMR vaccine is an immunization shot against measles, mumps and rubella (also called German measles).

TREATMENT

• There is no specific treatment for mumps.

• Symptoms may be relieved by the application of intermittent ice or heat to the affected neck/testicular area and by acetaminophen/paracetamol (Tylenol) for pain relief.

• Warm salt water gargles, soft foods, and extra fluids may also help relieve symptoms.

• Patients are advised to avoid fruit juice or any acidic foods, since these stimulate the salivary glands, which can be painful.

7. TUBERCULOSIS

Infectious disease cause by bacillus Mycobacteriurm tuberculosis.

It is transmitted AIRBORNE

• The infection may spread through

lymphatic or blood stream to the lymph

nodes other sites such as BONE

MARROW, KIDNEYS and MENINGES.

PATHOPHYSIOLOGY

CLINICAL MANIFESTATION

• Fatigue • Weight loss• Fever• Loss of appetite• Productive cough (sputum containing

mucus, pus or blood)• Auscultation of lung: rales or crackles• Pleural effusion

DIAGNOSTIC INVESTIGATION

• Tuberculin skin test (PPD)• Sputum smear and culture• Chest X-ray

MEDICATION MANAGEMENT

• FIVE DRUGS MOST COMMONLY USE:

1. Isoniazid (INH, Laniazid, Nydrazid)

2. Rifampin (Rifadin, Rimactane)

3. Pyrazinamide (Tebrazid)

4. Streptomycin

5. Ethambutol

• Follow up involves monitoring of side effects and monthly sputum tests.

• Drug must be taken for 6-12 months

HOSPITAL CARE

• Teaching: hand washing, cover nose and mouth when sneezing, coughing.

• Wear special particulate respirator mask when in the lcint’s room

• Isolation room ventilated to outside (negative pressure room); discontinued when client no longer considered infectious.

• Psychological support: reinforcement of the need to take medication. Many clients choose to stop drug therapy.

NURSING INTERVENTION

Administer antituberculosis drugs. Monitor side effect of the drugs. Nutritional diet Good ventilation Isolation (airborne precaution)

PREVENTIVE MEASURES

• Avoidance of overcrowded and unsanitary conditions

• Vaccination

a. BCG (Bacillus Calmette-Guerin): Made to weakened mycobacterium

b. Prophylactic use of isoniazid: Given daily over a period of 6 to 12 months to people in high-risk categories.

POINTS TO REMEMBER

• Obtain sputum specimens before drug

therapy is initiated

• Multiple drug therapy is necessary to

prevent the development of resistant

organisms.

• Give drugs in a single daily dose.

• Drug therapy must be continued for 6-12

months even though the x-ray sputum

specimen and manifestation are within

normal limits

• Client is generally considered non infectious

after 1-2 weeks of continuous drug therapy

• Avoid use of alcohol during drug therapy to

reduce risk of hepatotoxicity.