Prepared by: Maedine Joan S.

Urbano
Rabies (hydrophobia/Lyssa) is a specific, acute, viral infection communicated to man by saliva of an infected animal

Two kinds of rabies: urban or canine rabies- transmitted by dog sylvatic rabies- a disease of wild animals and bats that sometimes spread to dogs and cats and livestock.

Etiologic Agent rhabdovirus- it is a bullet-shaped filterable virus with strong affinity to the CNS.

ncubation period! " week to # and half months in dog $en days to "% years in human

&eriod of communicability &atient is communicable from three to five days before onset of symptoms until the entire course of illness. 'ogs and cats for (-% days before on set of clinical sign

)ode of transmission nfected animal carries the rabies virus in its saliva and transmits it to man by biting. *irus spread when the saliva comes in contact with the persons mucus membrane.

&athogenesis +rom the site of the bite the organism proceed to CNS ,nce the virus infect the individual the spreads is called centripheral and centrifugal

Susceptibility and resistance! All warm-blooded mammals are susceptible.

Clinical manifestations -( phases. ". &rodromal/ invasion phase a. +ever, anore0ia, malaise, sore throat, copious salivation, lacrimation, perspiration, irritability apprehensiveness. b. &ain in at the original bite site. c. &ain become sensitive to light, sound and temperature. d. &ain and aches in different part of the body. e. Numbness, tingling sensation f. )ild difficulty of swallowing. 1. E0citement or neurological phase a. 'elirium associated by involuntary twitching. b. )ay e0hibit eyes are fi0ed and glossy and skin is cold and clammy. c. Severe and muscle spasm of the muscle of the mouth, pharyn0 , laryn0, on attempt to swallow. d. &rofuse drooling of saliva e. 'eath may occur during the episode of spasm or from cardiac/respiratory failure. (. $erminal / paralytic phase a. &atient become 2uiet and unconscious. b. Spasm ceases with progressive paralysis. c. $here is tachycardia or irregular respiration. d. 'eath occus due to respiratory paralysis. 'iagnostic procedure a. *irus isolation from the patient3s saliva b. +luorescent rabies anti-body -+4A.

c. &resecence of negri bodies in the dog3s brain. )odalities and treatment ". 5ash the wound from the bite and scrathes of dog with soap and running water for ( minutes. 1. 6ive tetanus to0oid. (. 6ive tetanus antiserum infiltrated around the wound or given ) 7. 6ive anti rabies vaccine both passive and active. )anagement ". solate the pt.

1. 6ive emotional and spiritual support. (. 'arken room and provide a 2uiet environment &revention and control ". *accination of all dogs 1. Confinement of any dog that has biten a person for "8 9 7 days. (. &rovide public education.

$uberculosis ntroduction 5orld deadliest disease )a:or health problem of the &hilippines ;ighly infectious chronic disease Common among malnourished individual

Etiologic agent! 4od shape organism )ycobacterium tuberculosis, m. africanum from human and ). bovis for cattle

ncubation period 1-"8 weeks

)ode of transmission! Airborne droplet- coughing , or snee<ing. 'irect invasion- mucous membranes or break in the skin =ovine tuberculosis-e0posure to cattle-ingestion of unpasteuri<ed milk or dairy products.

Source of infection Sputum , hemoptysis, nasal discharge and saliva.

Clinical classification of tuberculosis. ". )inimal- slight lesion w/o demonstate e0cavation. 1. )oderately advanced a. ,ne or both lungs b. *olume affected should not e0tend to one lobe (. +ar advanced classifications )ore e0tensive that moderate

Clinical manifestation ". nactive $= s/s0 of tuberculosis are absent absence of cavity on chest 0-ray

1. active a. tuberculin test positive b. 0-ray of the chest generally progressive. c. Sputum gastric content are positive for tubercle bacilli. (. Activity not determined. Clinical manifestation ". afternoon rise of temperature 1. night sweating (. body malaise and weight lose 7. cough, dry and productive %. hoarseness of voice >. hemoptysis #. sputum positive for A+=. 'iagnostic procedure! ". sputum analysis for A+= 1. chest 0ray (. tuberculin testing a. mantou0 test -&&'. b. tine test -,t. c. heaf test -?$. modalities of treatment.

". Short course chemotherapy may be given to si0 month sonia<id , rifampicin, pyra<inamide, ethambutol &t. with drug resiatnce may be given with second lne drugs such as capreomycin, streptomycin, cycloserine, amikacin and 2uinolone drugs. ',$S-to prevent non compliance. )edicine is taken incorrectly the patient becomes resistant to anti-$= drugs. 4elapsing pt. usually become resistant to ant-$= drugs

Nursing management ". )aintain respiratory isolation until pt. respond tp treatment 1. Administer medicines as ordered. (. Always check sputum for blood or purulent e0pectoration 7. Encourage pt. to stp smoking %. $each pt. to cough or snee<e in tissue >. Advice plenty of rest and eat balanced meals.