PULMONARY TUBERCULOSIS

Causative Agent: Mycobacterium TuberculosisHost: Human; CattleMode of Transmission: Airborne-dropletKey Manifestations: a. Night sweatsb. Weight lossc. Late Afternoon feverd. Hemoptysis Common Manifestations:Easy fatigability, cough that progressively

becomes worse

Diagnostic Procedures:a. CXR – may reveal presence of

active or calcified lesions, pleural effusion

b. Direct Sputum Smear Microscopy (DSSM) – presence of acid fast bacilli, Primary diagnostic tool

c. Matoux test/Purified Protein Derivatives (PPD)

Mantoux Test/PPD Testing - Route of administration is

INTRADERMAL - Read after 48-72 hours (2-3

days)- Result – (+ ) Equal or Greater

than 10mm indurations( - ) Less than 10 mm

indurations

Remember:

1. Immunocompromised clients may not have a positive reaction despite of being infected with tubercle bacilli

2. Clients who have received bacilli Calmette-Guerin (BCG) vaccine will have a positive result

ANTI-TB DRUGS (RIPES)MULTIPLE DRUG THERAPY

R-ifampicin – orange discoloration of urine

I-soniazid – peripheral neuritisP-yrazinamide – hyperuricemia E-thambutol – decreased visual

acuityS-treptomycin – effects on VIII

cranial nerve

Remember: ISONIAZID causes VITAMIN B6 DEFICIENCY

Therefore, GIVE Vit.B6 in conjunction with Isoniazid

Prevention and Control

a. BCG immunization at birth

b. Early case finding and prompt referral

Treatment:

a. Domicilliary treatment

b. MDT

c. High-Carbohydrate, High-protein, High Vit.B6

LEPROSY

Causative Agent:

Mycobacterium leprae

Mode of Transmission: Airborne; Prolonged skin-to-skin contact

Clinical Manifestations:

Early and Late Signs

Early Signs:- Loss of sensation on the skin

lesion- Decrease sweating and hair

growth- Pain and redness of the eyes- Ulcers that do not heal - Nasal obstruction or bleeding- Muscle weakness or paralysis of

extremities

Late Signs- Madarosis – loss of eyebrow- Lagophthalmos – inability to

close eyelids- Clawing of fingers and toes- Gynecomastia - Sinking of the nose bridge

Diagnostic Test: Slit Skin Smear

Anti-leprosy Drugs (CD-ROM)

Clofazimine, Dapsone, Rifampicin, Ofloxacin, Minocycline

Prevention and Control

a. Early case finding and prompt referral

Treatment:

a. Domicialliary treatment

b. MDT

SCHISTOSOMIASIS

Causative Agent:Schistosoma japonicumSchistosoma mansoniSchistosoma hematobium

Host: Oncomelania quadrasi (SNAIL)Mode of Transmission: Food-borne,

Direct ContactClinical Manifestation: Spleenomegaly,

inflamed liver, diarrhea, bloody stools, enlarged abdomen

Drug of Choice: Praziquantel (Biltricide)

Control and Prevention

a. Health Education

b. Proper waste disposal

c. Treat snail-breeding sites with molluscicides

d. Use of rubber boots

FILARIASIS

Causative agents: Wuchereria bancrofti

Brugia malayi and Brugia Timori

Host: Aedes poecilus

Mode of Transmission: Mosquito bites

Incubation Period: 8-16 months

Clinical Manifestations:

Hydrocoele – swelling of the scrotum

Lymphedema – temporary swelling of upper and lower extremities

Elephantiasis – enlargement and thickening of the skin

Diagnostic Tests:

a. Nocturnal Blood Examination – blood is taken after 8PM

b. Immunochromatographic Test – antigen test done during daytime

Treatment:

a. Mass treatment

b. Medical treatment

c. Surgical treatment

Medical Treatment:

Diethylcarbamazepine Citrate (DEC)/Hetrazan

Prevention and Control

a. Environmental sanitation

b. Spraying with insecticides

c. Health education

MALARIA

Causative Agent:

Plasmodium falciparum

Plasmodium vivax

Plasmodium ovale

Plasmodium malariae

Mode of Transmission:

Mosquito bites (Anopheles)

Clinical Manifestations:

Anemia, Hepatomegaly, Spleenomegaly

Profuse sweating, fever, malaise, recurrent chills

Diagnostic Test:

Blood Smear

Prevention and Control:

a. Chemoprophylaxis

b. Zooprophylaxis

c. Insecticide

d. House spraying

e. On stream clearing

f. On stream seeding

Antimalarial Medications:

Chloroquine – Oral preparation

Quinine – IM injection

For prevention, instruct the people to avoid outdoor night activities (9PM-3AM)

Dengue

Hemorrhagic Fever

Causative Agent:

Dengue virus 1, 2,3,4

Chikungunya Virus

Incubation Period: 6 – 11 days

Mode of Transmission:

Mosquito Bite (Aedes Aegypti)

Clinical Manifestations:

a. First 4 days – Febrile/Invasive stage

high fever, abdominal pain and headache, vomiting,

conjunctival infection, epistaxis

b. 4th-7th days – Toxic or Hemorrhagic Stage

Lowering of temperature, severe abdominal pain,

hematemesis or melena (signs of bleeding),

hypovolemic shock

c. 7th – 10th day – Convalescent/Recovery Stage

Stabilization of vital signs and other sign and symptoms

Diagnostic Test:

Torniquet Test (Rumpel Leads Test)

Prevention and Control:

1. Environmental Sanitation

Nursing Management:

Supportive and Symptomatic treatment

a. Analgesic

b. Rapid Fluid Replacement

c. Blood transfusion

Remember: DO NOT GIVE ASPIRIN

MEASLES

Causative Agent: Filterable virus of measles

Mode of Transmission: Droplet spread by nose and throat secretions

Incubation Period: 10-14 days

Clinical Manifestation: a. Koplik spotsb. Erupted area of the cheeksc. Branny desquamation

CHICKEN POX

Causative Agent: VaricellaMode of Transmission: direct contact

or droplet spread

Incubation Period: 13-17 days

Period of Communicability: 1 day before and 6 days after the appearance of first crop of vesicles

Clinical Manifestations:

Slight Fever, Vesicular Rash, granular scabs

Remember: Exclusion from schools for 1 week after first eruption appears

MUMPS (EPIDEMIC PAROTITIS)

Causative Agent: Paramyxovirus

Incubation: 13-26 days

Period of Communicability:

As long as glandular swelling remains

Clinical Manifestations:

Painful swelling in front of ear, angle of jaws and down the neck

Orchitis – painful swelling of one or both testicles

Treatments:

a. Active Immunization (MMR)

b. Active Treatment

c. Diet – Soft Diet

d. Passive immunization

PNEUMONIA

Causative Agent: Diploccocus pneumoniae, Virus

Mode of Transmission: Airborne

Incubation Period: 2-3 days

Clinical Manifestations:

Chest indrawing

Fast breathing

Nursing Managements:

a. Bed rest

b. Nutrition

c. Increased fluid intake

d. Frequent turning from side to side

CHOLERA

(EL TOR)

Causative Agent: Vibrio El Tor

Incubation Period: Few hours – 5 days

Mode of Transmission: Foodborne and Waterborne

Clinical Manifestations:

Rice Watery Stool

Severe Dehydration

Muscular Cramps

Nursing Management:

a. Fluid Replacement

b. Electrolyte replacement

c. Proper Nutrition – “am”, soup, Low residue diet

RABIES

(Lyssa)

Causative Agent:

Rhabdovirus, Lyssavirus

Incubation Period: 2 to 8 weeks

Mode of Transmission: Dog bites

Clinical Manifestation:

Hydrophobia

Sense of Apprehension

Delirium and Convulsions

Paralysis

Nursing Management

a. Wound care

b. Post-Exposure Treatments

- active and passive immunization

c. Health education to the public

BACILLARY

DYSENTERY

Causative Agent: Shigella

Mode of Transmission: Food-Borne, Direct contact, Vector-borne

Incubation Period: Less than 4 days

Clinical Manifestation:

Tenesmus – painful spasm of the anal sphincter

Bloody and Mucoid stool

Nursing Managements:

a. Personal Hygiene

b. Proper Diet and Nutrition

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