Communicable Diseases CETRA

Saint Mary’s University
SCHOOL OF HEALTH and NATURAL SCIENCES

Nursing Department
Bayombong, Nueva Vizcaya
Cetra, Bridgette Charise T. September 28, 2022

BSN 3B NCM 113 RLE (5320)
COMMUNICABLE DISEASES
I. DISEASES AFFECTING INTEGUMENTARY SYSTEM
Bacterial
Leprosy
- It is also known as Hansen’s Disease, it is chronic infectious disease that mostly affects the skin,
peripheral nerves, upper respiratory tract mucosa, and the eyes. Leprosy is treatable, and early
treatment can avoid disability.
Causative Agent: Mycobacterium Leprae (closely associated with M. tuberculosis)
Mode of transmission: It is transmitted via droplets, from the nose and mouth, during close and
frequent contact with untreated cases.
Incubation period: It usually takes about 3 to 5 years for symptoms to appear after coming into contact
with the bacteria that causes leprosy. Some people do not develop symptoms until 20 years later.
Clinical manifestations:
✓ Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the
skin around)
✓ Growths (nodules) on the skin
✓ Thick, stiff or dry skin
✓ Painless ulcers on the soles of feet
✓ Painless swelling or lumps on the face or earlobes
✓ Loss of eyebrows or eyelashes
Pathognomonic Sign/s:
 Peripheral Nerve Enlargement
 Loss of sensation
 (+) skin smear test for M. leprae
Medical management/s:
Diagnostic tests: Skin Smear Test, Skin Lesion Biopsy, Lepromin Test, and Wassermann Reaction
Test
Multiple Drug Therapy is done.
- Prevent drug resistance (esp. Dapsone – mainstay drug)
- Hasten recovery
- Lessen period of communicability (1-2 weeks)
Paucibacillary Multibacillary
Rifampicin – once/month Rifampicin – once/month
Dapsone – OD Dapsone – OD
Duration: 6-9 mos. Lamphen – OD (SE: hyperpigmentation of skin)
Duration: 12-18 mos.
Nursing responsibilities:
• Psychological Aspect of Care because of low self-esteem and social stigma
• Clean the wounds with saline or nontoxic substances as indicated.
• Apply a sterile bandage to cover the wounds and maintain an aseptic technique.
• Provide/encourage physical exercise
• Provide information to community people that leprosy is an infectious disease but curable
with treatment.
• Provide information to community people that leprosy is an infectious disease but curable
with treatment.
• Provide drug information
- Encourage the affected people to maintain regular medical care with Multidrug therapy
(MTD).
- Monitor any signs of adverse effects regarding medications and take proper action.
1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269
Nursing Department
Bubonic Plague
- It is also known as Black Death, an illness that is mostly transmitted to people by infected fleas
that travel on rodents. It killed millions of Europeans during the Middle Ages. Prevention does
not entail vaccination, but it does include limiting your exposure to infected mice, rats,
squirrels, and other animals.
Causative Agent: Yersinia pestis
Mode of transmission: It is most often transmitted by the bite of an infected flea. Less common
exposures include handling infected animal tissues (hunters, wildlife personnel), inhalation of infectious
droplets from cats or dogs with plague, and, rarely, contact with a pneumonic plague patient.
Incubation period: It usually takes 1–6 days
✓ rapid onset of fever
✓ body malaise
✓ chills
✓ seizures
✓ muscle cramps
✓ painful, swollen, and tender lymph nodes, usually inguinal, axillary, or cervical
 Swollen lymph nodes or buboes which is very painful and hot-to-the-touch and can range from 1-
10cm in length.
- Antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin are used to
treat plague.
- Oxygen, intravenous fluids, and respiratory support are usually also needed.
• Begin antibiotic medication immediately as ordered
• When plague is detected, the patient should be hospitalized and isolated as soon as possible.
• Maintain standard safety procedures.
• Obtain a contact history so that persons who have had close contact with the patient can be
checked and treated, if necessary.
Erysipelas
- It is a common bacterial skin infection. It affects the upper dermis and the lymphatic veins
within the skin.
Causative Agent: group A streptococcal bacteria, especially Streptococcus pyogenes
Mode of transmission: They may enter through a wound, an insect bite, or lesions caused by another
condition, such as eczema or scabies.
Incubation period: It usually takes 24 to 48 hours.
✓ lesion may feel hot and be painful
✓ high fever
✓ chills
✓ headache
✓ nausea
✓ skin in the affected area may resemble the peel of an orange
✓ Infants: may appear on the abdomen due to infection of the umbilical cord.
 raised, well-defined, tender, and bright red rash
- Penicillin administered orally or intramuscularly is sufficient for most cases of classic
erysipelas and should be given for 5 days, but if the infection has not improved, treatment

Nursing Department
duration should be extended. A first-generation cephalosporin may be used if the patient

has an allergy to penicillin.
• Nursing responsibilities:
• Symptomatic treatment of aches and fever
• Hydration (oral intake if possible)
• Cold compresses
• Elevation and rest of the affected limb: Recommended to reduce local swelling,
inflammation, and pain
• Saline wet dressings: Should be applied to ulcerated and necrotic lesions and changed every
2-12 hours, depending on the severity of the infection
Yaws
- It is a common bacterial skin infection. It affects the upper dermis and the lymphatic veins
within the skin.
Causative Agent: group A streptococcal bacteria, especially Streptococcus pyogenes
Mode of transmission: They may enter through a wound, an insect bite, or lesions caused by another
condition, such as eczema or scabies.
Incubation period: It usually takes 24 to 48 hours.
✓ lesion may feel hot and be painful
✓ high fever
✓ chills
✓ headache
✓ nausea
✓ skin in the affected area may resemble the peel of an orange
✓ Infants: may appear on the abdomen due to infection of the umbilical cord.
 raised, well-defined, tender, and bright red rash
- Penicillin administered orally or intramuscularly is sufficient for most cases of classic
erysipelas and should be given for 5 days, but if the infection has not improved, treatment
duration should be extended. A first-generation cephalosporin may be used if the patient
has an allergy to penicillin.
• Symptomatic treatment of aches and fever
• Hydration (oral intake if possible)
• Cold compresses
• Elevation and rest of the affected limb: Recommended to reduce local swelling, inflammation,
and pain
• Saline wet dressings: Should be applied to ulcerated and necrotic lesions and changed every 2-
12 hours, depending on the severity of the infection
Viral
German Measles
- It is also known as 3-day disease or Rubella, a contagious disease that mostly affects
children.
Causative Agent: Rubella virus (RuV) (Pseudo paramyxovirus/Togavirus)
Mode of transmission: It is spread when someone who is infected coughs or sneezes tiny germ-filled
droplets into the air and onto surfaces (Direct-droplet).
Incubation period: The average incubation period of rubella virus is 17 days, with a range of 12 to 23
days.

Nursing Department
✓ pink or red-spotted rash (first sign of infection) that starts on the face and spreads to the rest
of the body.
✓ Pre-eruptive Stage
- Presence or absence of fever (1 to 2 days)
- Mild cough or mild colds
✓ Eruptive Stage
Maculo-papular rashes
- Pinkish, discreet – smaller/finer rashes
- Cephalocaudal – starts at the face
- 24 hrs entire body
Enlargement of lymph nodes – differentiating factor between measles and German measles
✓ Post-eruptive Stage
- Rashes disappears (3rd day of illness)
- Enlarged lymph node gradually subsides
 Forchheimer Spots
- Fine red spots/ Petechial spots
- Soft palate
- Blood tests and a virus culture to confirm
- No specific medicine to treat rubella or make the disease go away faster
- Reverse-transcription polymerase chain reaction (PCR) evaluation
- Chest radiography
- Vitamin A
- Antivirals
- Vaccines
- Immunoglobulins
• Advise the patient or the S/O to drink plenty of fluids.
• Educate that getting plenty of rest will help the body to heal.
• Avoid contact with people who have never had rubella and who have not been immunized.
• Advise the patient to try not to scratch the rash. Put wet and cold cloths on the rash to reduce itching.
• Instruct patient to take an over-the-counter pain medicine, such as acetaminophen (Tylenol),
• ibuprofen (Advil, Motrin), or naproxen (Aleve), to reduce fever and discomfort.
Measles
- It is also known as rubeola, one of the most contagious infectious diseases, with at least a 90%
secondary infection rate in susceptible domestic contacts. It can affect all ages.
• Causative Agent: Morbillivirus
• Mode of transmission: The virus is transmitted by direct contact with infectious droplets or by
airborne spread when an infected person breathes, coughs, or sneezes.
• Incubation period: The incubation period of measles from exposure to prodrome averages 11 to 12
days. The time from exposure to rash onset averages 14 days, with a range of 7 to 21 days. The
prodrome lasts 2 to 4 days, with a range of 1 to 7 days.
• Clinical manifestations:
✓ Pre-eruptive Stage
o High grade fever (3 to 4 days)

Nursing Department
o 3 C’s
- Cough
- Colds/ coryza
- Conjunctivitis
o Eyes are red, excessive lacrimal discharges
o Photosensitivity
✓ Eruptive Stage
o Maculo-papular rashes
o Reddish, blotchy
o Cephalocaudal – 1st appears behind the ears, face, neck, extremities
o Appears 3rd day of illness (2 to 3 days entire body)
o Fine branny
o Desquamation
o If the spots start to peel off – on the road to recovery
• Pathognomonic Sign/s:
 Koplick Spots
- Fine red spots with bluish or grayish white spot at the center
- Within the inner cheek
• Medical management/s:
- Blood tests and a virus culture to confirm
- No specific medicine to treat rubella or make the disease go away faster
- Reverse-transcription polymerase chain reaction (PCR) evaluation
- Chest radiography
- Vitamin A
- Antivirals
- Vaccines
- Immunoglobulins
• Patients will need to be on isolation precautions to decrease transmission within the
community; emphasize the need for immediate isolation when early catarrhal symptoms
appear.
• Measles causes extreme pruritus; nursing interventions include keeping the patient’s nails
short, encourage long pants and sleeves to prevent scratching, keeping skin moist with health
care provider recommended lotions, and avoiding sunlight and heat.
• Treat conjunctivitis with warm saline when removing eye secretions and encourage patient not
to rub eyes; protect the eyes from the glare of strong light.
• Encourage oral hydration; medical literature encourages the use of oral rehydration solution.
• Antipyretics should be administered to the patient as ordered for a temperature greater than
100.4 Fahrenheit unless directed elsewise by a healthcare provider; be sure to remind parents
not to administer aspirin due to the risk of Reye’s syndrome.
Chicken pox
- It is a highly contagious disease that causes an itchy rash with small, fluid-filled blisters.
• Causative Agent: Varicella-zoster virus
• Mode of transmission: The virus can be spread from person to person by direct contact, inhalation
of aerosols from vesicular fluid of skin lesions of acute varicella or zoster, and possibly through
infected respiratory secretions that also may be aerosolized.

Nursing Department
• Incubation period: The average incubation period for varicella is 14 to 16 days after exposure to a
varicella or a herpes zoster rash, with a range of 10 to 21 days
✓ Pre-eruptive Stage – 24 to 48 hours
- Presence of absence of low-grade fever
- Headache
- body malaise
- muscle pain
✓ Eruptive Stage
- Vesiculo-papular/ pustular rashes
- Macule → Papule → Vesicle →Vesiculopapular
- Itchy – Pock Marks
- Rashes start to dry
- Crusts (dry), falls off (peels off)
 Rash that turns into itchy, fluid-filled blisters that eventually turn into scabs
- Use Acetaminophen (Tylenol) for Pain and Fever
- Antiviral therapy
- Varicella zoster immune globulin
- Antibiotic therapy.
• Educate parents about the importance and safety of the Varicella Zoster vaccine.
• Manage pruritus in patients with varicella with cool compresses and regular bathing; warm
soaks and oatmeal or cornstarch baths may reduce itching and provide comfort.
• Trimming the child’s fingernails and having the child wear mittens while sleeping may reduce
scratching.
• Advise parents to provide a full and unrestricted diet to the child
Herpes Zoster
- It is also known as shingles, is caused by the reactivation of the varicella-zoster virus (VZV), the
same virus that causes varicella (chickenpox).
• Causative Agent: Varicella-zoster virus
• Mode of transmission: The virus is spread through direct contact with the rash or through
• breathing in virus particles that get mixed in the air.
• Incubation period: The average incubation period for varicella is 14 to 16 days after exposure or a
herpes zoster rash with a range of 10 to 21 days.
✓ Enlarged lymph nodes
✓ Fever, chills, and headache
✓ Itching
✓ Raised dots on your skin and redness in that area
✓ Stabbing or shooting pain
✓ Tingling or burning feeling in or under your skin
✓ Upset stomach
 rash and sometimes even before the rash appears patients have typical pain in a dermatomal
distribution.

Nursing Department
- Symptomatic treatment
- Antivirals (acyclovir, famciclovir, valacyclovir), especially for immunocompromised patients
• Assess the client’s description of pain or discomfort: severity, location, quality, duration,
precipitating or relieving factors.
• Assess for nonverbal signs of pain or discomfort.
• Educate the client about the following measures:
• Wear loose, nonrestrictive clothing made of cotton.
• Apply cool, moist dressings to pruritic lesions with or without Burrow’s solution several times a
day. Discontinue once the lesions have dried.
• Avoid temperature extremes, in both the air and bathwater.
• Avoid rubbing or scratching the skin or lesion.
• Use topical steroids (anti-inflammatory effect), anti-histamines (anti-itching effect, particularly
useful at bedtime), and analgesics.
• Use topical steroids (anti-inflammatory effect), anti-histamines (anti-itching effect, particularly
useful at bedtime), and analgesics.
II. DISEASES AFFECTING THE GASTROINTESTINAL TRACT

Bacterial
Bacillary dysentery
- It is also known as shigellosis, a gastrointestinal disease caused by bacterial infection.
Causative Agent: Shigella
Mode of transmission: The virus is spread through direct contact with the rash or through breathing
in virus particles that get mixed in the air.
Incubation period: The incubation period is usually 1 - 3 days, but can be up to 7 days.
✓ Diarrhea containing blood or mucus.
✓ High fever.
✓ Painful stomach cramps.
✓ Nausea and vomiting
 Stool may contain blood and mucus.
- Stool Examination
- Rectal Swab
- Antibiotic (Ciprofloxacin)
- Oral rehydration Therapy
- Rehydrate patient with oral or IV fluid and antibiotics
- Monitor signs and symptoms of dehydration and teach the patient to finish medication
- Warn patient to avoid antimotility medications which delay excretion of microorganisms
- Assess for vital signs, sudden increase in pulse rate, extreme pallor, and prostration may
indicate impending shock or intestinal perforation.
- Educate patient and/or S/O about the 5 keys to food safety in handling food: Choose (Choose
safe raw materials); Clean (Keep hands and utensils clean); Separate (Separate raw and
cooked food); Cook (Cook thoroughly); and Safe Temperature (Keep food at safe
temperature) to prevent foodborne diseases

Nursing Department
Cholera
Causative Agent: Vibrio Cholerae
Mode of transmission: A person can get cholera by drinking water or eating food contaminated with
cholera bacteria. In an epidemic, the source of the contamination is usually the feces of an infected
person that contaminates water or food. The disease can spread rapidly in areas with inadequate
treatment of sewage and drinking water.
Incubation period: The incubation period of cholera is between 2 hours and 5 days.
✓ profuse watery diarrhea
✓ vomiting
✓ thirst
✓ leg cramps
✓ restlessness or irritability
 Rice-watery stools
- Stool Examination
- Rectal Swab
- Antibiotic (Tetracycline)
- IV Therapy
- Assess the status of dehydration (skin color, temperature, skin turgor, mucous membranes, eyes,
crown, body temperature, pulse, respiration, behavior, weight loss).
- Observe for a sudden attack of diarrhea, fever, anorexia, vomiting, nausea, abdominal cramps,
increased bowel sounds, and bowel movements more than 3 times a day, with liquid stool
consistency, with or without mucus or blood.
- Assess for the knowledge of diarrhea at home, dietary knowledge, and knowledge about the
prevention of recurrent diarrhea.
- Drink plenty of fluids to avoid dehydration. Oral Rehydration Salt (ORS) is used to prevent
dehydration.
- Daily weight is an indicator of overall fluid and nutritional status.
- Maintain hydration. Replace ongoing fluid losses until diarrhea stops.
- Administer medications as indicated. Give an oral antibiotic to the patient with severe
dehydration as prescribed.
Food poisoning (has types: protein & carbohydrates)

- It is also known as food-borne illness which is the result of eating contaminated, spoiled, or toxic
food.
 Protein poisoning is when the body takes in too much protein with not enough fat and
carbohydrate for a long period of time. It is also known as “rabbit starvation” or “mal de
caribou.” These terms came about to describe only consuming very lean proteins, such as
rabbit, without consuming other nutrients.
 Carbohydrates poisoning is an excessive intake of different types of carbohydrates ranging
from digestible polysaccharides to refined sugars that collectively mediate noxious effects on
human health, a phenomenon that we refer to as ''carbotoxicity.
Causative Agent: Norovirus, Salmonella, Clostridium perfringens, Campylobacter, Staphylococcus
aureus (Staph, listeria
Campylobacter Meat and poultry. Contamination occurs during processing if animal
feces contact meat surfaces. Other sources include unpasteurized milk
and contaminated water.

Nursing Department
Clostridium perfringens Meats, stews and gravies. Commonly spread when serving dishes don't
keep food hot enough or food is chilled too slowly.
Noroviruses Raw, ready-to-eat produce and shellfish from contaminated water. Can
be spread by an infected food handler.
Staphylococcus aureus Meats and prepared salads, cream sauces, and cream-filled pastries. Can
be spread by hand contact, coughing and sneezing.
Salmonella Raw or contaminated meat, poultry, milk, or egg yolks. Survives
inadequate cooking. Can be spread by knives, cutting surfaces or an
infected food handler.
Listeria Queso fresco and other soft cheeses, raw sprouts, melons, hot dogs,
pâtés, deli meats, smoked seafood, and raw (unpasteurized) milk
Mode of transmission: It is usually caused by the consumption of contaminated food or water

containing bacteria, viruses, parasites, biotoxins or chemicals. Places where such agents are commonly
found: Widely distributed in domestic and wild animals.
Incubation period: It usually begins 6 to 24 hours after exposure
✓ Upset stomach
✓ Stomach cramps
✓ Nausea
✓ Vomiting
✓ Diarrhea
✓ Fever
 puffy cheeks and swollen jaw
- Replacement of lost fluids. Fluids and electrolytes — minerals such as sodium, potassium and
calcium that maintain the balance of fluids in your body — lost to persistent diarrhea need to be
replaced
- Hydration formulas such as Pedialyte™ can be helpful
- Doctor may prescribe antibiotics if you have a certain kind of bacterial food poisoning and your
symptoms are severe. Food poisoning caused by listeria needs to be treated with intravenous
antibiotics during hospitalization
- Assess the condition of patient.
- Assess the type of poisoning
- Oral rehydration is achieved by administering clear liquids and sodium-containing and glucose-
containing solutions. A simple ORS may be composed of 1 level teaspoon of salt and 4 heaping
teaspoons of sugar added to 1 liter of water.
Viral
Mumps
- It is a viral infection that primarily affects saliva-producing (salivary) glands that are located near
your ears.
Causative Agent: Paramyxovirus, a member of the Rubulavirus family.
Mode of transmission: It is transmitted person to person through direct contact with saliva or
respiratory droplets of a person infected with mumps.
Incubation period: The average incubation period for mumps is 16 to 18 days, with a range of 12 to 25
days

Nursing Department
✓ Fever
✓ Headache
✓ Muscle aches
✓ Tiredness
✓ Loss of appetite
 puffy cheeks and tender, swollen jaw
- Antipyretics (acetaminophen) to reduce fever.
- Analgesics – NSAID
- Antiviral regimens
- Educate patient about mumps
- Encourage hydration and rest
- Educate about hand washing
- Tell patient to keep away from school or work until symptoms subside
- Educate caregiver on vaccination
- Take acetaminophen for pain
- Evaluate patient for other complications like pancreatitis, orchitis, aseptic meningitis,
weakness, etc.
Parasite
Protozoa
- A type of gastroenteritis brought on by a parasite
Causative Agent: Giardia and Cryptosporidium
Mode of transmission: It is transmitted by consumption of contaminated water and food. Exposure to
an infected person through his/her blood.
Incubation period: It usually takes 10-15 days
✓ Diarrhea
✓ Stomach cramps
✓ Fatigue
✓ Loss of appetite
✓ Low blood pressure
✓ Low grade fever
- Anthelminthics
- Encourage the patient to drink plenty of fluids
- Monitor patient for signs of dehydration.
- Remind patient to wash hands after using the bathroom and before eating or handling food.
Flukes
- Liver flukes are parasites that can infect humans and infect the liver, gallbladder, and bile duct in
humans.
Causative Agent: Opisthorchiidae (Clonorchis and Opisthorchis) and Fasciolidae (Fasciola)
Mode of transmission: Humans can get by eating raw or undercooked fish, crabs, or crayfish from
areas where the parasite is found.

Nursing Department
Incubation period: The infection is patent about 10-12 weeks after the metacercariae are ingested.
The whole cycle takes 18-20 weeks. The hatching of fluke eggs and the multiplication of snails depend
on adequate moisture and temperatures greater than 10ºC.
✓ fever
✓ chills
✓ abdominal pain
✓ liver enlargement
✓ nausea
✓ vomiting
✓ hives
- Triclabendazole
- Praziquantel
- Increase the electrolyte and fluid balance.
- Monitor fluid intake and output and look out for dehydration symptoms
- Reduce pain and discomfort.
• Determine the kind and severity of the pain
• Determine the kind and severity of the pain
• Provide a warm compress to the abdomen
• Teach a distraction technique to lessen discomfort
• Choose a comfortable position that helps lessen pain.
- Improve nutrition. Give a balanced diet, daily body weight measurements, emphasize the need of
proper nutrition and practice excellent oral hygiene.
III. DISEASES AFFECTING THE RESPIRATORY SYSTEM

Bacterial
Diphtheria
- It is a serious bacterial infection that usually affects the mucous membranes of the nose and
throat.
Causative Agent: Corynabacterium diphtheriae (Klebs – loeffler bacilli)
Mode of transmission: It is spread from person to person, usually through respiratory droplets, like
from coughing or sneezing. People can also get sick from touching infected open sores or ulcers.
Incubation period: It usually takes 2-6 days
✓ a thick grey-white coating that may cover the back of your throat, nose and tongue.
✓ a high temperature (fever)
✓ sore throat.
✓ swollen glands in your neck.
✓ difficulty breathing and swallowing.
 swollen glands (enlarged lymph nodes) in the neck
- Nose and throat culture
- Schick’s test – intradermal injection of toxin, will show (+) without immunity, 1-3 cm
- Moloney test – intradermal injection of toxoid, if positive there is erythema within 24 hrs
(hypersensitivity to Diphtheria toxoid)
- Penicillin G Sodium
- Supportive: Oxygen inhalation

Nursing Department
- Tracheostomy
- Suction secretions
- Strict Isolation
- Complete bed rest
- Concurrent disinfection
- Proper disposal of nasopharyngeal secretions
- Complete bed rest
- Liquid to soft diet
- Small frequent feedings
- Increase fluid intake
Pertussis
- It is also known as whooping cough which is a highly contagious respiratory disease
Causative Agent: Bordetella pertussis
Mode of transmission: It is spread easily from person to person through the air. When a person who
has whooping cough sneezes or coughs, they can release small particles with the bacteria in them.
Other people then breathe in the bacteria.
Incubation period: It usually takes 7-10 days, while disease takes 6 weeks
✓ Catarrhal Stage
- nasal catarrhal, frequent sneezing, teary-eyed
- cough
✓ Paroxysmal Stage
- cough worsens: becomes rapid, successive, paroxysmal, ends in inspiratory whoop,
followed by vomiting
- force of coughing may cause involuntary micturition/defecation, bulging of eyes,
intracerebral hemorrhage, abdominal hernia
- vomiting signals end attack
✓ Convalescent Stage
- Episodes of coughing become less frequent and not as severe
- Slow recovery begins during this phase of the disease.
- Occasionally episodes of coughing may recur for months.
 Violent coughing followed by a whooping sound made as a person gasp for air
- Borde-Gengou Culture nasopharyngeal swab
- Penicillin
- Bed rest
- Proper positioning during attacks
- Nutritious diet
- Abdominal binders
- Adequate ventilation
- Close nursing observation during attacks
- Concurrent disinfection
- Avoid precipitating attacks

Nursing Department
Viral
Influenza
- It is also known as flu which is viral infection that attacks your respiratory system — your
nose, throat and lungs.
Causative Agent: Influenza virus
Mode of transmission: It is spread mainly by droplets made when people with flu cough, sneeze, or
talk. These droplets can land in the mouths or noses of people who are nearby (usually within about 6
feet away) or possibly be inhaled into the lungs.
Incubation period: It is usually two days but can range from one to four days.
✓ fever* or feeling feverish/chills.
✓ cough.
✓ sore throat.
✓ runny or stuffy nose.
✓ muscle or body aches.
✓ headaches.
✓ fatigue (tiredness)
✓ some people may have vomiting and diarrhea, though this is more common in children than
adults.
- Oseltamivir (Tamiflu)
- Zanamivir (Relenza)
- Peramivir (Rapivab)
- Baloxavir (Xofluza)
- Rapid diagnostic tests
- Polymerase chain reaction testing
- Direct immunofluorescent tests
- Serologic testing
- Testing for Avian infuenza
- Chest radiography
- Assess respiratory status for rate, depth, ease, use of accessory muscles, and work of breathing
- Auscultate the lung fields for the presence of wheezes, crackles (rales), rhonchi, or decreased
breath sounds.
- Administer oxygen as ordered. Monitor oxygen saturation by pulse oximetry, and notify the
physician of readings <90% or as prescribed by the physician.
- Assess patient for pallor or cyanosis, especially to nail beds and around the mouth.
- Monitor patient for cough and production of sputum, noting amount, color, character, and
patient’s ability to expectorate secretions, and the ability to cough
- Position patient in high Fowler’s or semi-Fowler’s position, if possible.
- Turn the patient every 2 hours and as needed
- Administer bronchodilators as ordered
- Perform postural drainage and percussion, as ordered.
- Encourage fluids, up to 3-4 L/day unless contraindicated.
- Encourage deep breathing exercises and coughing exercises every 2 hours
- Instruct patient to avoid excessively hot or cold fluids or environmental temperature extremes
- Teach the patient or significant others regarding splinting abdomen with a pillow during cough
efforts.
- Instruct patient/family to avoid crowds and persons with upper respiratory infections when
possible.

Nursing Department
Coryza
- It describes symptoms of cold which is 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.
Causative Agent: Haemophilus paragallinarum
Mode of transmission: Airborne infection by dust or respiratorydischarge droplets, and contamination
of feed and water.
Incubation period: The incubation period is 1–3 days with a typical disease duration of 2–3 weeks.
✓ Nasal discharge
✓ Nasal obstruction
✓ Sneezing
✓ Sore throat
✓ General malaise
✓ Cough
✓ Hoarseness
✓ Loss of taste and smell
✓ Mild burning of the eyes
✓ Feeling of pressure in the ears or sinuses, due to obstruction
✓ Mucosal swelling
✓ Fever
- Erythromycin
- Oxytetracycline
- Sulfonamides
- Fluoroquinolones
- Macrolides
- Vitamin C
- Give warm salt-water gargles to relieve sore throat pain.
- Encourage the patient to have adequate rest and have plenty of fluids.
- Administer analgesics, decongestants, and expectorants as indicated.
IV. DISEASE AFFECTING THE CIRCULATORY SYSTEM

Malaria
- It is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain
type of mosquito which feeds on humans
Causative Agent: Plasmodium
- Vivax –most common
o Falciparum – most common/most fatal
- Ovale
- Malariae
Mode of transmission: Usually, people get malaria by being bitten by an infective female Anopheles
mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through
a previous blood meal taken from an infected person.
Incubation period: The incubation period in most cases varies from 7 to 30 days. The shorter periods
are observed most frequently with P. falciparum and the longer ones with P. malariae.
✓ Cold Stage (15mins.)
- Chilling sensation (shaking of the body)

Nursing Department
- Keep patient warm (provide with blanket

- warm drinks
- expose to droplight
- hot water bag as ordered on soles of feet
✓ Hot Stage (2-6 hours)
- High grade fever
- Vomiting
- Abdominal pain
✓ Wet Stage
- Profuse sweating
- Feeling of weakness
- Blood smears
- Rapid diagnostic tests.
- Atovaquone-proguanil (Malarone)
- Quinine sulfate (Qualaquin) with doxycycline (Oracea, Vibramycin, others)
- Primaquine phosphate
- Chloroquine phosphate
- Artemisinin-based combination therapies (ACTs)
- Improve body temperature. Warm water compress on forehead and both axilla (not more than
15 minutes each time)
- Maintain warm environment by using warm blankets, adequate clothing)
- Improve tissue perfusion. Patient may need supplemental oxygen if condition is severe;
maintain a well-ventilated room, head of the bed at 30º
- Lessen activities that require moderate to high exertion.
- Improve fluid volume. Encourage increase in oral fluid intake and administer parenteral fluids
as ordered.
- Educate the patient and family.
V. DISEASES AFFECTING THE GENITO-URINARY SYSTEM

Bacterial
Gonorrhea
- It is also known as Clap, drip, or ‘tulo’ which is an infection caused by a sexually transmitted
bacterium that infects both males and females. Gonorrhea most often affects the urethra,
rectum or throat. In females, gonorrhea can also infect the cervix.
Causative Agent: Neisseria gonorrhoeae bacterium
Mode of transmission: It is transmitted through sexual contact with the penis, vagina, mouth, or anus
of an infected partner. It can also be spread perinatally from mother to baby during childbirth.
Incubation period: It usually takes 3 to 21 days.
✓ Male – obvious signs because same opening for reproduction and urination
- Urethritis, dysuria
- Redness and edema of urinary meatus
- Purulent urethral discharge
- Frequent gonorrhea - scar in the epididymis – obstruct flow of sperm cell -sterility
✓ Female – shows symptoms if they have Pelvic Inflammatory Disease; urethra is not usually
affected
- Urethral discharge

Nursing Department
- Frequent gonorrhea - Narrowing of the fallopian tube – ectopic pregnancy/ sterility

✓ Gonococcal septicemia
- Tender papillary skin lesion (pustular, hemorrhagic or necrotic)
- Migratory polyarthralgia
- Polyarthritis
- tenosynovitis
 Pus draining from the genitalia in the morning
- Culture and sensitivity
▪ Urethral discharge
▪ Swab/scrape directly on the anterior urethra
- Cervical smear/ Pap smear
- Penicillin – Benzathine Penicillin G
- Cephalosporin – Ceftriaxone, Cefuroxime
- Tetracycline – Doxycycline
- Use standard precautions when obtaining specimens for laboratory examination and when
caring for the patient.
- Isolate the patient with an eye infection.
- If the patient has gonococcal arthritis, apply moist heat to ease the pain in the affected joints.
- Before treatment, determine if the patient has any drug sensitivities.
- Monitor the patient for complications.
- Tell the patient that until cultures prove negative, he’s still infectious and should avoid
unprotected sexual contact.
- Urge the patient to inform his sexual partners of his infection so that they can seek treatment.
- Advise the partner of an infected person to receive treatment even if she doesn’t have positive
cultures.
- Counsel the patient and his sexual partners to be tested for human immunodeficiency virus
and hepatitis B infection.
- Instruct the patient to be careful when coming in contact with his bodily discharges so that he
doesn’t contaminate his eyes.
- Tell the patient to take anti-infective drugs for the length of time prescribed.
- Promoting screening to asymptomatic patients who may be at risk of STIs
- Referring all people with suspected or confirmed gonorrhea to a GUM clinic or other local
specialist sexual health service
- Managing people in primary care when referral is not possible or acceptable
- To prevent reinfection, tell the patient to avoid sexual contact with anyone suspected of being
infected, to use condoms during intercourse, to wash genitalia with soap and water before
and after intercourse.
Syphilis
- It is also known as Pox, Lues, Bad Blood Disease which is a bacterial infection usually spread by
sexual contact
Causative Agent: Treponema Pallidum
Mode of transmission: It can be spread from person-to-person by direct contact with a syphilitic sore,
known as a chancre. Chancres can occur in, on, or around the penis, vagina, anus, rectum, and lips or
mouth. Syphilis can spread during vaginal, anal, or oral sex.

Nursing Department
Incubation period: The average time between acquisition of syphilis and the start of the first symptom
is 21 days. However, this can range from 10 to 90 days.
✓ Primary
▪ Chancre
- Painless moist ulcer that heals spontaneously with or without treatment
- Genitals or extragenital (face, fingers, tongue, anal, lips)
▪ Regional lymphadenopathy
✓ Secondary/ Infectious
▪ Highly communicable
▪ Flu-like symptoms
▪ Fever, headache, body malaise, sore throat
▪ Skin rashes, condyloma lata/ condylomata lata
- Lesions fused together found under the breast or genitalia
▪ Oral mucous patches
▪ Patchy alopecia
▪ Thinning of pubic hair
▪ Generalized lymphadenopathy
✓ Latent Phase
▪ Asymptomatic (1 to 2 yrs)
▪ May still spread infection
✓ Tertiary/ Late Stage
▪ Gumma – infiltrating tumor (skin, bone, liver)
▪ Not communicable
▪ CV changes – aortitis, aneurysms
▪ CNS degeneration – paresthesia, abnormal reflexes, shooting pains, dementia, psychosis
 Maculopapular rash (seen in 50–70% of patients) that may affect the palms and soles
 Chancre
- Darkfield microscope
- Serologic test
▪ FTA-ABS (Flourescent Treponema Antibody Absorption Test) – DEFINITIVE
▪ VDRL (Venereal Disease Research Laboratory)
o RPR (Rapid Plasma Reagin)
- Primary, secondary or early latent syphilis
o single dose of intramuscular (IM) penicillin G benzathine 2.4 million units.
o Alternative therapies: doxycycline 100 mg orally (PO) twice daily for 14 days or
ceftriaxone 1 to 2 gm IM or intravenously (IV) daily for 10 to 14 days or tetracycline
100 mg PO 4 times daily for 14 days.
- Late latent syphilis
o IM penicillin G benzathine 2.4 million units once weekly for 3 weeks.
o Alternative therapies: doxycycline 100 mg PO twice daily for 28 days or tetracycline
100 mg PO four times daily for 28 days.
- Tertiary syphilis
o IM penicillin G benzathine 2.4 million units once weekly for 3 weeks.
- Neurosyphilis
o treated IV penicillin G aqueous 18-24 million units daily for 10 to 14 days.
- Educate patient on safe sex practice

Nursing Department
- Encourage the use of condoms

- Encourage treatment of a partner
- Administer benzathine penicillin
- Educate patient on avoiding sex with an infected partner
- Listen to the heart for the murmur of aortic regurgitation
- Check the chest x-ray report (syphilis can cause aortic aneurysms)
- Assess neurologic and mental status (rule out tertiary syphilis)
- Assess genitals to ensure healing has occurred
Chancroid
- It is also known as soft chancre which is a sexually transmitted disease (STD) that results in
sores on your genitals
Causative Agent: Haemophilus ducreyi
Mode of transmission: It is spread by sexual contact with an infected individual. The bacteria are more
likely to invade the sexual organs at the point of a pre-existing injury, such as a small cut or scratch.
The likelihood of transmission is greater if a person is very active sexually and does not practice
personal hygiene.
Incubation period: The incubation period for chancroid is about three to seven days
✓ Raised and painful bumps on the skin of your genitals.
✓ Ulcers with ragged soft edges that develop from these bumps.
✓ Reddened and shiny skin on the sores.
✓ Leakage of pus and infectious fluid.
✓ Spreading and connecting of these sores into larger areas.
 Painful ulcer
- azithromycin
- ceftriaxone
- ciprofoxacin
- erythromycin
- Use standard precautions whenever you may come into contact with genital secretions – for
instance, when collecting specimens and performing a physical examination.
- Administer anti-ineffective medications and, possibly, analgesics as ordered.
- Provide topical care by washing the affected area with soap and water, followed by a bacterial
agent. Don’t allow the area to remain moist; this can enhance the growth of the organism.
- Report all cases of chancroid to the local board of health if required in your state.
- Examine the patient’s sexual contacts and refer them for treatment, even if they’re
asymptomatic.
- Monitor the effectiveness of analgesic administration by asking the patient to rate his pain before
and after receiving the drug.
- Inspect the ulcers for signs of healing as well as signs of localized infection.
- Instruct the patient to take his anti-infective medication for the period prescribed.
- Teach the patient not to apply creams, lotions, or oils on or near his genitalia or on other lesion
sites.
- Advice the patient to abstain from sexual contact until follow-up evaluation shows that healing is
complete usually about 2 weeks after treatment begins.
- Inform patient that condoms may provide protection from future infection.

Nursing Department
Granuloma Inguinale
- It is also known as donovanosis which is a sexually transmitted disease (STD) that is rarely seen in
the United States. The disease is commonly found in tropical and subtropical areas such as
southeast India, Guyana, and New Guinea. There are about 100 cases reported per year in the
United States. Most of these cases occur in people who have traveled to or are from places where
the disease is common.
Causative Agent: Klebsiella granulomatis
Mode of transmission: The mode of transmission of granuloma inguinale primarily occurs through
sexual contact; however, it is hypothesized to have low infectious capabilities because repeated
exposure is necessary for clinical infection to occur.
Incubation period: Symptoms of granuloma inguinale usually begin 1 to 12 weeks after infection.
✓ Sores in the anal area
✓ Small, beefy-red bumps on the genitals or around the anus
✓ skin gradually wears away
 painless bumps turn into raised, beefy-red, velvety nodules (granulation tissue)
- Culture of tissue sample (hard to do and not routinely available)
- Scrapings or biopsy of lesion
- Trimethoprim-sulfamethoxazole
- doxycycline
- erythromycin
- ciprofloxacin
- azithromycin
- Educate the patient about the regular and correct use of condoms
- Encourage people on the avoidance of unsafe sex practices, such as frequently changing sex
- partners or having sexual intercourse with prostitutes or with partners who have other sex
- partners
- Prompt diagnosis and treatment of the infection (to prevent spread to other people)
- Identification of the sexual contacts of infected people, followed by counseling or treatment of
- these contacts
Viral
Lymphogranuloma Venerium
- It is an ulcerative disease of the genital area
Causative Agent: Chlamydia trachomatis serovars L1, L2, and L3
Mode of transmission: It is spread through unprotected anal, oral or vaginal sexual contact, especially
if there is trauma to the skin or mucous membranes. It can also be spread via sharing of sex toys
between partners
Incubation period: The incubation period for LGV ranges from three to 30 days after infection for a
primary lesion and from 10 days up to several months if a bubo is the first manifestation
✓ Primary stage
- small, painless papule that can ulcerate to form a herpetiform lesion or chancre
- Mucopurulent discharge of the rectum, urethra, or cervix
✓ Secondary stage/Inguinal Stage
- painful inguinofemoral lymphadenopathy, "buboes".
- proctitis and infection of the perirectal and pelvic lymph nodes

Nursing Department
- pelvic, lower abdominal, or low back pain

- nodes appear fleshy and show diffuse reticulosis.
- suppurative granulomatous lymphadenitis and peri lymphadenitis occur with matting of
the nodes.
- nodes coalesce to form stellate abscesses.
✓ Tertiary stage
- anogenitorectal syndrome
- resultant rectal stricture
- elephantiasis of the genitalia.
- Proctocolitis
- perirectal abscesses
- ischiorectal abscesses
- rectovaginal fistulas
- anal fistulas
- rectal stricture
 Painful inguinofemoral lymphadenopathy, "buboes"
- Doxycycline
- erythromycin base
- azithromycin
- Encourage patient to practice safe sex
- Encourage the use of condoms
- Encourage patient to remain compliant with medications
- Check labs for culture results
- Administer antibiotics as ordered
- Check labs to ensure female is not pregnant as doxycycline cannot be given in pregnancy
- Encourage the patient to notify the partner to come in for a screening test
- Encourage patient to follow up in the STD clinic
Herpes simplex
- It is most commonly known as herpes which is characterized into two types: HSV1 and HSV2.
Many people live with asymptomatic HSV, which means they have the virus without ever
having an outbreak or active episode of herpes
Causative Agent: Herpes Simplex Virus (HSV)
Mode of transmission:
▪ HSV-1 is mainly transmitted by oral-to-oral contact which is transmitted through oral secretions
or sores on the skin, can be spread through kissing or sharing objects such as toothbrushes or
eating utensils
▪ HSV-2 is a transmitted through sexual contact with someone who has genital HSV-2 infection.
Incubation period: The average incubation period for an initial herpes infection is 4 days (range, 2 to
12) after exposure. The vesicles break and leave painful ulcers that may take two to four weeks to
heal after the initial herpes infection.
✓ Skin may tingle, itch, or burn for a day or so.
✓ One or more painful, fluid-filled blisters may appear
✓ HSV 1
o blisters appear on the lips or around the mouth

Nursing Department
o sores can appear anywhere on the skin.

✓ HSV 2
o sores typically occur on the penis, vagina, buttocks, or anus. Women can have sores
inside the vagina
o sores can appear anywhere on the skin.
✓ Fever
✓ Muscle aches
✓ Swollen lymph nodes (glands) in the neck (oral herpes) or groin (genital herpes) are possible.
✓ Have trouble urinating or have a burning feeling while urinating.
✓ Eye infection (herpes keratitis)
 small blisters that break open, leaving painful sores
- Acyclovir
- Famciclovir
- Valacyclovir
Oral herpes (herpes simplex type 1)
- If patient has sores on face, Remind him/her to:
o Do not kiss anyone
o Do not have oral sex
o Do not share items such as silverware, cups, towels, and lip balms
- Health teaching to prevent spreading the sores to other parts of the body by:
o Washing your hands after touching a cold sore.
o Using a cotton-tip swab to apply herpes medicine to a cold sore also help
Genital herpes (herpes simplex type 2)
- Educate the patient about the condition
- Tell patient to abstain from sexual activity
- Educate about the use of condoms
- Inform past, current and future partners about potential infection
- Instruct patient to gently clean the infected area with mild soap and water
- Advise the patient to wash hands before and after cleaning the infected area
- Advise the patient to use cotton undergarment
- Provide information and counseling and support groups in their area
Infectious mononucleosis
- It is also known as kissing disease which is a contagious infecton
Causative Agent: Epstein-Barr Virus
Mode of transmission: This virus spreads most commonly through bodily fluids, especially saliva.
However, these viruses can also spread through blood and semen during sexual contact, blood
transfusions, and organ transplantations.
Incubation period: Symptoms can take between 4 to 6 weeks to appear and usually do not last
beyond 4 months.
✓ extreme fatigue
✓ fever
✓ sore throat
✓ head and body aches
✓ swollen lymph nodes in the neck and armpits
✓ swollen liver or spleen or both

Nursing Department
✓ rash
 Swollen tonsils that appear red and with white lesions that may be oozing pus
- Monospot blood test
- Medications that reduce fever, pain, and sore throat
- Acetaminophen is the most commonly advised pain reliever
- Nonsteroidal Anti-Inflammatory Medications (NSAIDs) such as ibuprofen, naproxen, or aspirin
can also be used
- Corticosteroid injection, usually dexamethasone, rapidly reduces the swelling blocking the
throat
- Obtain a history of exposure
- Check vitals and document presence of fever
- Encourage not sharing food or personal care items
- Encourage patient not to kiss
- Educate patient on avoiding sports for at least 6 weeks
- Encourage hydration
- Tell the patient not to take penicillin-like antibiotics as it may result in a rash
- Take acetaminophen for pain and headache
- Inform patients to miss school until symptoms subside


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Saint Mary’s University

SCHOOL OF HEALTH and NATURAL SCIENCES

Cetra, Bridgette Charise T. September 28, 2022

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

duration should be extended. A first-generation cephalosporin may be used if the patient

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

II. DISEASES AFFECTING THE GASTROINTESTINAL TRACT

1st Floor, Constant Jurgens (UB) Building

Food poisoning (has types: protein & carbohydrates)

1st Floor, Constant Jurgens (UB) Building

Mode of transmission: It is usually caused by the consumption of contaminated food or water

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

III. DISEASES AFFECTING THE RESPIRATORY SYSTEM

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

IV. DISEASE AFFECTING THE CIRCULATORY SYSTEM

1st Floor, Constant Jurgens (UB) Building

- Keep patient warm (provide with blanket

V. DISEASES AFFECTING THE GENITO-URINARY SYSTEM

1st Floor, Constant Jurgens (UB) Building

- Frequent gonorrhea - Narrowing of the fallopian tube – ectopic pregnancy/ sterility

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

- Encourage the use of condoms

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

- pelvic, lower abdominal, or low back pain

1st Floor, Constant Jurgens (UB) Building

o sores can appear anywhere on the skin.

1st Floor, Constant Jurgens (UB) Building

1st Floor, Constant Jurgens (UB) Building

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