SAS 3

Universal Precaution – assumes that all patients are infected with blood-borne diseases.
Standard Precaution – is assumed only for specific diseases.

Infectious bodily fluids

1. Blood
2. Semen
3. Vaginal secretion
4. Synovial fluid
5. Amniotic fluid

Yellow bin – infectious waste.

Immunization – introduction of antibodies in susceptible person or animal.
- Types of Immunity
1. Naturally acquired – passive – placental; active – recovery from disease.
2. Artificially acquired – passive – indirect-antitoxins; active – vaccines and toxoids.

Immunized – state of being protected against any disease.

Sub-clinical – immunity acquired through constant exposure from disease.
Antigen – marker – any substance that causes immune system to produce antibodies.
Antibodies – protector

- Types of Antigens
1. Inactivated – killed organism that cannot cause disease (e.g., rabies vaccine)
2. Attenuated – weakened or has reduced virulence but still alive (e.g., MMR, OPD, BCG)

First In, First Out principle on vaccines as they have a shelf life or an expiry date.
Cold Dogs – where vaccines are put – ice in box to maintain temperatures.
Cold Chain System – how to the temperature of vaccine is maintained.

What damages vaccines: Heat and sunlight, freezing, chemical agents to clean vaccine storage
areas. They should BE KEPT AT 0 TO 8 DEGREES CELSIUS.

Environmental Sanitation: PD 856

I. Water Supply Sanitation Program

Level 1 (Point of Source) Protected well or developed spring, no distribution system.
Level 2 (Communal Faucet System) Source reservoir, piped distribution network.
Level 3 Water works system, individual house connection.

II. Policies on Proper Excreta and Sewage Disposal

Level 1 Non water carriage toilet facility
Level 2 Water sealed and flush type.
 Level 3 Water carriage toilet connected to septic tank or sewerage system.

III. Policies on Food Sanitation Program

IV. Policies on Hospital Waste Management

Deep well is built under specific distance.

Control System (NURSING MANAGEMENT)

- Isolation and quarantine
- Disinfection (C or T)
- Disinfection of killing undesirable small animals.
- Fumigation – gaseous agent.

Curative aspect
- Medical management
- Nursing management

Rehabilitative aspect
- Activity
- Nutrition

Means of Controlling Spread of Communicable Disease

1. Elimination of source of infection
2. Interruption of transmission
3. Protection of susceptible host.

Isolation – separation of patients with communicable diseases.

Purpose: to confine the infectious agent and prevent escape of infection.

7 Categories

1. Strict – highly contagious

2. Contact – by close or direct contact
3. Respiratory – infectious dz over short distances through air.
4. TB – positive smear / cx-ray that suggests active TB.
5. Enteric – direct contact with feces.
6. Drainage/secretion – direct or indirect contact with purulent materials or drainage from
infected site.
7. Universal Precaution – applied when handing blood and body fluids.
SAS 4

AIDS – immune deficiency that is acquired. Combination of signs and symptoms that form a
distinct clinical picture of disorder.

- Caused by HIV – retrovirus, lentivirus, or slow virus. Time between infection and
symptoms may take longer which allows microorganisms to be transmitted. Infection
and appearance of AIDS may take 7-12 years.

“Window Effect” – where HIV infection takes place, but HIV antibodies have not appeared yet,
causing HIV to become undetectable.
- They become detectable 4-6 weeks after infection.
- CD4 – protein molecules that is found in the T-cells.

Transmission
1. Sexual contact
2. Injection of infection blood
3. Perinatal

- Blood Transfusion
- Organ Donation
- Accidental exposure in hospitals or clinics.

Diagnostic Tests

1. EIA/ELISA – enzyme link immunosorbent assay

2. PA – particle agglutination test
3. Western Blot Analysis – confirmatory diagnostic test
4. Immunofluorescent test
5. RIPA – radio immune-precipitation assay
6. HIV Antibody Test

S/S
- CD4 count – criterion that determines if the client is HIV positive or has AIDS.

Neurological Symptoms (Aids-related complex, ARC)

- Memory loss
- Altered gait.
- Depression
- Sleep d/o
- Chronic diarrhea
 Top 10 Symptoms

1. Depression
2. Diarrhea
3. Thrush
4. Weight loss
5. Lipodystrophy
6. Sinus infection
7. Fatigue
8. N/V
9. Lactic acidosis
10. Peripheral neuropathy

Bacterial Opportunistic Infections

MAC – mycobacterium avium complex – when cd4 count is <50.

Tuberculosis
Salmonellosis

Viral

1. Herpes
2. Hepatitis
3. Genital warts
4. Cytomegalovirus CMV – can cause retinitis.
5. Malluscum contagiosum – dome shaped papules.

Fungal

1. Candidiasis
2. Cryptococcal Meningitis
3. Histoplasmosis – small lesions that appear on the skin. CD4 count <200.

Pneumonias

1. Bacterial
2. Pneumocystis Carinii Pneumonia (Pneumocystis Jeroviccii)

Cancers

1. Kaposi’s Sarcoma – cancerous lesions caused by overgrowth of blood vessels.

2. Cervical Dysplasia and cancer – common in women – associated with HPV.
3. Non-Hodgkin’s lymphoma - cancerous tumor of the lymph nodes.
Parasitic
1. Toxoplasmosis
2. Cryptosporidiosis – caused by crypto. CD4 count >200.

- AIDS drugs are not cure for HIV infections.

- They are called “antiretroviral drugs”.
- Inhibit the reproduction of virus.

NDX
- Knowledge deficit
- Social isolation
- Risk for infection
- Anxiety
- Self-esteem disturbance
- Altered role performance.

4 C’s of Management
1. Compliance
2. Counseling
3. Contact tracing.
4. Condoms

SAS 5

Amoebiasis – protozoal infection involving colon, but can spread to soft tissues, like liver or
lungs through lymphatic dissemination.

Infectious Agent – Entamoeba Histolytica

2 Developmental Stages
1. Vegetative
2. Cyst

Source of infection – human excreta

Period of communicability – entire duration of illness.
Incubation – Severe: 3 days; Sub-acute – several months; Average – 3-4 wks.