Communicable Diseases Handout

COMMUNICABLE DISEASE NURSING
COMMUNICABLE DISEASES
A. Infectious – needs a break in the skin before it can enter the body
B. Contagious – easily transmitted via airborne or droplet
Chain of Infection
S – usceptible
H - ost
A - gent
R - eservoir
E - xit
M – ode of transmission
E - ntry
1. PERTUSSIS
Aka – WHOOPING COUGH

I.P – 7 – 14 days
C.A. – Bordetella pertussis
MOT – droplet and direct contact
Manifestations:
1. Catarrhal stage
- Stage of increased communicability
- Flu-like symptoms
2. Paroxysmal stage
- Paroxysms of cough (pathog)
3. Convalescent stage
- Recovery and healing
Medical Management
- Oxygen therapy
- Fluid and electrolyte replacement
- Erythromycin and Ampicillin
- Bed rest
- Gammaglobulins
Nursing Management
- Isolation
- Medical asepsis
- Suction machine
- Sunshine and fresh air
- Warm baths
2. DIPHTHERIA
C.A. – Corynebacterium diphtheriae

I.P – 1- 5 days
MOT – direct contact and soiled articles
Types:
1. Nasal – white membranes on nasal septum
2. Nasopharyngeal – bull’s neck
3. Cutaneous diphtheria – yellow spots on the skin
Pathog - PSEUDOMEMBRANE
Medical Management
- Penicillin
- Diphtheria antitoxins
- Ice collar applied to the neck
- Oxygen inhalation
- Bed red
- WOF:Tracheostomy set on the bedside
Nursing Management
- Absolute bed rest for 2 weeks
- Avoid Valsalva
- Soft diet
- Vit. C
Prepared by: Archie D. Alviz RN,RM,MAN| manofsteel_archie@yahoo.com | facebook page: Sir Archie D. Alviz
3. MEASLES
Aka – Rubeola/Morbilli
C.A. – Rubeola virus
MOT – airborne and droplet
Pathog
– Koplik’s spots
- inflammatory lesion in the inner cheek or buccal mucosa
Manifestations:
1. Pre-eruptive – Catarrhal symptoms (rhinitis, conjunctivitis, photophobia, coryza)
2. Eruptive – maculopapular rash, intermittent fever
3. Convalescence - subside
Medical Management
- Anti-viral – Isoprenosine
- Antibiotics (Penicillin) if with complications
- Oxygen
- Iv fluids
Nursing Management
- Isolation
- Quiet room
- Dim light
- TSB
- Bed bath
- Increase OFI
- MMR and anti-measles vaccine
4. GERMAN MEASLES
Aka – Rubella/3-day measles

C.A. – Rubella virus
I.P – 14 -21 days
MOT – airborne, droplet, transplacental
Pathog
– Forscheimer’s spots
- pinkish rash on the soft palate
Manifestations:
1. Prodromal – low grade fever, mild coryza, lymphadenopathy
2. Eruptive – Forscheimer, testicular pain in young adults, polyarthralgia
Medical Management
- symptomatic
Nursing Management
- Isolation
- Dim light
- Mild liquid but nourishing diet
- Good ventilation
- MMR
- Immune serum globulin if (+) exposure
5. CHICKENPOX
Aka – Varicella
C.A. – Herpesvirus varicellae
I.P – 14 -21 days
MOT – direct and fomites
Manifestations:
- Rash (unexposed part - trunk)
- Macule → papule →vesicle → pustule → crust
- Celestial map – scabs/crust
Medical Management
- Zoverax
- Acyclovir
- Antihistamines
- Calamine lotion
- No No to salycilates
- antipyretic
Nursing Management
- Respiratory isolation until all vesicles have crusted
- Disinfect linens under sunlight or through boiling
- Cut fingernails
- Use mitten in children
6. FILARIASIS
Aka – Elephantiasis
C.A. – Wuchereria bancrofti
MOT – mosquito bite
Manifestations:
- Elephantiasis
- Headache
- Chills and fever
- Dolor, tumor, rubor in arms, legs, and scrotum
Diagnostic
- Circulating Filarial Antigen – finger-prick blood droplet
Medical Management
- Hetrazan
- Surgery for scrotal enlargement
- DEC fortified salt
Nursing Management
- Sleep under mosquito net
- Use mosquito repellants between the tie of dusk and dawn
7. SCHISTOSOMIASIS
Aka – Bilharziasis/Snail fever
C.A. – Schistosoma japonicum (Phil)
MOT – ingestion of infected water and through skin pores
Vector – Oncomelania quadrasi
Manifestations:
- Swimmer’s itch
- Bloody mucoid stool
- Icteric
- Jaundice
Diagnostic
- Cercum Ova Precipetin Test - confirmatory
Medical Management
- Praziquantel for 6 months
Nursing Management
- Reduce snail density
a. Expose snails to sunlight
b. Remove weeds
c. Proper irrigation
- Proper waste disposal
- Prevent bathing on snail infested streams
8. PULMONARY TUBERCULOSIS (PTB)

 Etiology
 mycobacterium tuberculosis
MOT
- airborne-droplet
- indirect – FOMITES
Manifestations:
Asymptomatic – INITIALLY
Hemoptysis - PATHOGNOMONIC
Classification:
Class O – no exposure, no infection
Class 1 – exposure, no infection
Class 2 – infection, no disease
- + PPD but no clinical evidence of active TB
Class 3 – disease, clinically active
Class 4 – disease, not clinically active
Class 5 – suspected, diagnosis pending
Diagnostics:
Sputum exam – 3 consecutive (+) results
CXR – nodules, cavities
PPD – tuberculin test/Mantoux test
- exposure only
Management: MULTI-DRUG THERAPY

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
*** take on an EMPTY STOMACH
*** NO LONGER CONTAGIOUS after 2-3 wks of MDT and 2 (-) sputum result
Nursing Responsibilities:
1. Adequate rest
2. Proper nutrition – inc CHON, Vit. C
3. Religious intake of MEDS
4. Semi-fowler
5. Primary prevention
– BCG, public educ about MOT, environmental sanitation
Prevention of spread
- N95 mask worn by the HCP
- Face mask worn by the patient
- Isolation
- Hand washing
- Proper disposal of secretions
9. RABIES
Aka – Lyssa/Hydrophobia
C.A. – Rhabdovirus
Manifestations:
1. Prodromal/Invasion
- salivation, irritability, pain on the bite site
2. Excitement/Neurological
- Excitation and apprehension
- Nuchal rigidity, twitching
- Aerophobia
3. terminal/Paralytic
Medical Management
- TT
- Anti-rabies serum
Nursing Management
- Isolation
- Darken room
- No water on site
- IVF – wrapped securely
- Vaccination of all dogs
- Confine dog for 10-14 days
10. DENGUE AND MALARIA
DENGUE MALARIA
Causative Agent Flavivirus (chikungunya and onyongyong Plasmodium ovale, vivax, malarae, falciparum
virus)
Vector Aedis aegypti Aedis poecilus
D – ay bitting N – ight bitting
L - ow flying F – igh flying
S - tagnant F – lowing
U - rban R - ural
Problem Low platelet count Low RBC count
Manifestations Bleeding tendencies Bleeding tendencies and anemia
Management Symptomatic Symptomatic
Transfusion of platelet Transfusion of RBC
- Fresh frozen plasma - packed RBC
- platelet
11. HEPATITIS
TYPES AKA MODE OF TRANSMISSION

A Infectious hepa
B Serum hepa
C Post-transfusion hepa
D Delta agent hepa
E Enteric hepa
F HYPOTHETICAL VIRUS
G DO NOT CAUSE ILLNESS IN HUMAN
Onset:
Acute – Hepa A and E
Chronic – Hepa B, C
STAGES:
1. Pre-icteric stage
- fatigue, nausea, vomiting, anorexia
2. Icteric stage
- jaundice, dark urine, acholic stool
3. Post-icteric stage
SEXUALLY TRANSMITTED DISEASES
12. SYPHILIS
C.A. – Treponema Pallidum
MOT – intimate contact
Sources of infection
– discharges, semen, surface lesions
Manifestations:
1. Primary syphilis
– chancres - painless raised lesions
2. Secondary syphilis
– condylomata lata – pink or grayish white lesions
3. Latent syphilis
- Asymptomatic
4. Late syphilis
- Gumma – deep, single, painless assymetrical lesion
Medical Management
- Penicillin
- Tetracycline
Nursing Management
- Stress importance of continuing treatment
- Partners should be tested
- Universal precaution
- Keep lesion dry
13. GENITAL HERPES

C.A. – Herpes simplex virus
Manifestations:
- Genital sores
- Painful sores
- Fever
- Muscular pain
- Burning sensation on urination
Medical Management
- acyclovir
Nursing Management
- Personal hygiene
14. GONORRHEA
C.A. – Neisseria gonorrheae
Manifestations:
Female
- Bursning and frequent urination
- Yellow vaginal discharge
Males
- Dysuria with pus
- Rectal infection for homosexuals
- prostatitis
Medical Management
– Ceftriaxone
- Penicillin
- Infants born to mother with gonorrhea – give 1% silver nitrate
Nursing Management
- All info about patient is confidential
- Isolation
- Sex education
- Contact tracing
15. CHLAMYDIA
C.A. – Chlamydia trichomatis
MOT – vaginal and rectal intercourse
Manifestations:
- Cervicitis
- Dyspareunia
- Dysuria
- Pyuria
- Scrotal swelling
- Tenesmus
Medical Management
- Doxyclycline x 7 days
- Azithromycin x 1 dose
Nursing Management
- Suggest that both partnes should submit to HIV testing
16. TRICHOMONIASIS
C.A. – Trichomonas vaginalis
MOT – STD
Manifestations:
- Cervicitis
- Vaginitis
- Urethratis
- Dyspareunia
- Dysuria
Medical Management
- Metronidazole
Nursing Management
- Practicing safe sex
PARASITISM
17. PARAGONIMIASIS
C.A. – Lung fluke – Paragonimus westermani
Reservoir - seafoods
MOT – fecal-oral
Eggs may circulate to following sites:
Liver, Spleen, Kidney, Brain, Peritoneum, Testis/ovary, Spinal cord
Manifestations:
- diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities
Medical Management
- Praziquantel
Nursing Management
- avoid eating raw or undercooked freshwater crabs and crayfish from endemic waters
18. TAENIA SAGINATA

C.A. – Beef tapeworm
Reservoir – cattle
MOT – fecal-oral
Manifestations:
- Asymptomatic
- weight loss, dizziness, abdominal pain
- Diarrhea
- Chronic indigestion
Medical Management
- Praziquantel
- Niclosamide
Nursing Management
- avoid eating raw or undercooked cattle
19. HOOKWORM
Reservoir – mammales (dogs, cats)
MOT – fecal-oral
Manifestations:
- Ground itch
- Epigastric pains
- Indigestion
- nausea
- Vomiting
- constipation
- diarrhea
Medical Management
- Albendazole
- Iron, folic acid, Vit B12 – for anemia
Nursing Management
- sanitation

Communicable Diseases Handout

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COMMUNICABLE DISEASE NURSING

Aka – WHOOPING COUGH

C.A. – Corynebacterium diphtheriae

Aka – Rubella/3-day measles

8. PULMONARY TUBERCULOSIS (PTB)

Management: MULTI-DRUG THERAPY

- Confine dog for 10-14 days

10. DENGUE AND MALARIA

TYPES AKA MODE OF TRANSMISSION

SEXUALLY TRANSMITTED DISEASES

13. GENITAL HERPES

18. TAENIA SAGINATA

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