MINISTRYOFHEALTH

SOLWEZICOLLEGEOFNURSINGANDMIDW
IFERY
ASSIGNMENTONE(1)

GROUP NUMBER : FIVE

COURSE : PAEDIATRICS AND CHILD HEALTH NURSING

TASK : ASSIGNMENT I

TUTOR : MADAM MANYIKA

INTAKE : JULY 2022

DUE DATE : 9TH APRIL, 2024

QUESTION:
POLIOMYELITIS
INTRODUCTION
Poliomyelitisisalsocalledinfantilediseaseoracuteflaccidparalysis,itisaninfectiousdiseasecausedbyp
oliovirus.Accordingtotheworldhealthorganization(WHO),1in200polioinfectionswillresultinperma
nentparalysis.Poliowaseradicatedin1953inthefollowingregionandcertifiedpoliofreeinregionslikeA
merica,Europe,WesternpacificamdSouthernAsia.Poliovaccinewasdevelopedin1953andmadeavail
ablein1957,despitehavingotherregionpoliofree,othercountrieslikeNigeriaandDRCarestillhavingpo
liocases.
DEFINITIONOFTERMS

1.Virus-isasmallparticlethatiscapableofinfectingalivingcellandpotentiallycausingdisease(https;/
www.highveld.com/virology)

2.Incubationperiod-isaperiodofbeingexposedtoinfectiontothetimethefirstsymptomsappear.

3.Paralysis-thisislossofmusclefunctioninpartofthebody(Medlineplus)

4.Lymphnodes-
isanovoidorkidneyshapedorganofthelymphaticsystemthatcontainsimmunecellsthathelpfightinfecti
ons

5.Poliomyelitis-
thisisanacuteviraldiseasethatiscausedbyapoliovirusaffectingthecentralnervoussystemcharacterize
dbyfeverandparalysis.
POLIOMYELITIS

Poliomyelitis-
thisisanacuteviraldiseasethatiscausedbyapoliovirusaffectingthecentralnervoussystemcharacterize
dbyfeverandparalysis.

It’sanacuteinfectiousenterovirusdiseasethataffectsthecentralnervoussystemandspinalcord.

CAUSES

Itiscausedbyapoliovirus

MODEOFTRANSMISSION

1. Throughfecaloralroute
2. Foodorwatercontaininghumanfeces
3. Infectedsaliva

PREDISPOSINGFACTORS

1.Poorsanitationduetopoordisposaloffecalmatter

2.Immunecompromisedchildrenduetolowimmunity

3.Nonimmunizedchildrenagainstpolio

4.Tonsillectomy-
thetonsilshelpfightinfectionsthereforewhenthetonsilsareremovedthebodywillbeunabletofightinfec
tions

5.Refugeesduetopoormedicalservices

PATHOPHYSIOLOGY

Theenterovirusinfectsthehumanintestinaltractmainlythroughthefecaloralroute;thevirusbeginstomu
ltiplyfirstintheoropharynxandtheuppergastrointestinaltractmucosaduringthefirst3weeksofincubati
onperiod.Thevirusthendrainsintothecervicalandmesentericlymphnodesandfinallytothebloodstrea
mleadingtoviremia.Thepresenceofthesevirusinthebloodstreamenablesittobewidelydistributedthro
ughoutthebodythencrossesthebloodbrainbarrierandattackstheanteriorhornscellsofthecentralnervou
ssystemprovokingalocalinflammatoryprocessexamplethemeningesincludingthespinalcordleadingt
oflaccidparalysisofthemusclesandaffectstheneurons.Theparalysismayvaryfromweaknessofthemus
clestocompleteparalysisofoneormorelimbs.

TYPESOFPOLIOMYELITIS
 1. Abortivepoliomyelitis:Minorillnessofpoliomyelitis
2. Acuteanteriorpoliomyelitis:Majorillnessofpoliomyelitis
3. Ascendingpoliomyelitis:poliomyelitiswithacephalicprogression
4. Bulbarpoliomyelitis:Asevereformaffectingthemedullaoblongata,whichmayfromdysfuncti
onofswallowingmechanismandcirculatorydistress
5. Cerebralpoliomyelitis:Thisextendsintothebrain.

SIGNSANDSYMPTOMS

1. Non-ParalyticPoliomyelitis

Signsandsymptomofnon-poliomyelitiscanlastfrom1-10days.

1.Fever-duetoinfectionsinthebloodstream

2.Headache-duetopresencetoxinsinthebloodstream

3.Vomiting-duetoincreasedintracranialpressure

4.Fatigue-duetotheinfectionsinthebloodstream

5.Meningitis-invasionofthevirusinthebrainmeninges

2.ParalyticPoliomyelitis

Initialsymptomsaresimilartonon-
paralyticpoliobutafteraweektheybecomemoresevereandtheseinclude

1.Lossofreflexes-duetoinfectionsinthespinalcord

2.Musclepain-leadingtospasms

3.Looseandfloppylimbssometimessymmetrical

4.Deformityofthelimbsespeciallythehips,anklesandfeet–duetoimpairedbloodcirculation

5.Droolingofsaliva-duetoinvasionofthevirustothetrigeminalneurons
CLASSIFICATIONS

 Spinalpolio(79%)thisoneaffectsthespinalcord.
 Bulbopolio(2%)affectsthebrainstem
 Bulbospinalpolio(19%)affectsboththespinalcordandthebrainstem.

INVESTIGATIONS
1. Physicalexaminationtonoteforanyparalysis
2. Stoolforvirologytoisolatethepoliovirus
3. Lumberpuncturetoruleoutmeningitis
4. Bloodslidetoruleoutmalaria
5. Fullbloodcountwillshowsleukocytosis

NURSINGCAREPLAN

PROBLEM NURSINGDI OBJECTVE INTREVENTION/RATIONAL EVALUATION

AGNOSIS
Alteredbody Alteredbodyte Tomaintainnor Opennearbywindowstoreducetem Feverreducedby1
o
temperature mperaturerelate malbodytempe peraturebyconvection. cdegreesCelsius
of39oc dtopresenceofp raturewithin1h Tepidspongingwithwarmwatertor evidencebytemp
oliovirusinthebl ourofhospitaliz educetemperaturebyevaporation. eratureof38oc
oodsteamevide ation Giveantipyreticssuchasparacetam
ncedbytempera olsyrup120mgevery8hours.
tureof39ocdegre
esCelsius
Impairedph Impairedphysic Toimmobilizet Strictbedresttopreventpain. Affectedlimbmo
ysicalmobili almobilityrelate heaffectedlimb Positiontheaffectedlimbusingsan bilizedevidenced
ty dtoparalysisevi dbagstomaintainbodyalignment. bychildbeingcal
dencedbyloose Footboardswillbeusedtopreventfo m.
andfloppylimbs odrop.
orlossofmuscle Nursethechildonabedwithahardbo
control ardtomaintainbodyalignment.
Railedbedtopreventfalling.
Pain Torelivepainwi Hot,moistcompressappliedtothem Painrelievedevid
thin30minuteso usclestorelievepainandmusclespa encedbychildrest
fhospitalization sms. ingandnotcrying
Minimalhandlingofaffectedpartto
relievepain.
Analgesiasuchasparacetamolsyru
p120mgevery8hourstobegivenora
llytorelievepain.

Ineffectiveai Ineffectiveairw Tomaintainpat Positionthechildinalateralposition Airwayclearance

rwayclearan ayclearancerela entairwaythrou withheadtiltedtothesidetoallowdr doneevidenceby
ce tedtomusclepar ghouthospitali ainageofsecretions. normalsaturation
alysis. zation. Suctioningtobedonewhennecessa of<85%
rytoclearairway.
Oxygenadministrationifneedarise
stopromotetissueperfusion.
Imbalanced Imbalancednutr Topromotegoo Oralcaretobedonetopromoteappet Nutritionmaintai
nutrition itionlessthanbo dnutritionandh ite. nedevidencedbyc
dyrequirementr ydrationstatust Smallfrequentfeedstobegiventopr hildnotlosingweg
elatedtoanorexi hroughouthosp omotenutritionandfluidintake. ht.
a,nauseaandvo italization. Breastfeedingtomaintaingoodnutr
miting. itionstatus.
Naso-
gastricfeedingevery2hourstoprom
otegoodnutritionandhydration.

COMPLICATIONS
1. Meningitisduetoinfectionsinthecentralnervoussystem
2. Osceolosisonelegwillbeshorterthantheother
3. Osteoporosisduetoinfectionsinthebone
4. ParalysisduetopresenceofvirusintheCNS
5. Encephalitisduetopresenceofinfectionsinthebrainstem
6. Neuropathy
7. Skeletaldeformities
8. Respiratorydistressduetoparalysisofthediaphragmandintercostal.

PREVENTION
1.Vaccination:Theprimaryandmostcrucialpreventivemeasureagainstpolioisvaccination.Th
eoralpoliovaccine(OPV)andtheinactivatedpoliovaccine(IPV)arewidelyusedforimmunizati
on.Thesevaccinesprovidelong-termprotectionagainstpolioandhelptopreventtransmission.
2. Routineimmunization:Itisrecommendedthatchildrenreceiveaseriesofpoliovaccinationsstart
ingfrominfancy.Thestandardimmunizationscheduleincludesseveraldosesofthepoliovaccin
eatspecificintervals.Completingthefullcourseofrecommendedvaccinationsisessentialforad
equateprotection.
3. 3.Routinevaccinationcampaigns:Nationalimmunizationcampaignsareconductedinmanyco
untriestoensuremaximumcoverage.Thesecampaignsaimtoreacheverychildbelowacertainag
ewithinaspecifictimeframe,regardlessoftheirpreviousimmunizationstatus.
4. Surveillanceandmonitoring:Activesurveillancesystemsarecrucialfordetectinganypoliocase
sandmonitoringthecirculationofthevirus.Thishelpsinidentifyingandrespondingtooutbreaks
promptly.
5. Improvedsanitationandhygiene:Sincepoliovirusspreadsthroughthefecal-
oralroute,maintainingpropersanitationandhygienepracticesisimportant.Thisincludesaccess
tocleanwater,properwastedisposal,andpromotinghandwashing.
6. Travelrecommendations:Peopletravelingtoareaswherepolioisstillendemicorwhereoutbreak
shaveoccurredshouldreceiveapoliovaccineboosterdosebeforetraveling.Thishelpstopreventt
heimportationofthevirusintonon-endemicareas.
7. Publiceducationandawareness:Educatingthepublicaboutpolio,itstransmission,andtheimpor
tanceofvaccinationplayasignificantroleinprevention.Publichealthcampaignscanhelpdispel
myths,addressvaccinehesitancy,andencouragevaccineuptake.

conclusion

Inconclusion,wehavedefinedpoliomyelitis,causes,types,predisposingfactorsandtype.wefur
therdiscusesedmanagementofpoliomyelitisusinganursingcareplanandfinallythecomplicati
ons.however,vaccinationremainscrucialinpreventingthespreadofpolioandprotectingchildre
nfromthisdebilitatingdisease.Ifyouorsomeoneyouknowexhibitssymptomsofpolio,seekmed
icalattentionpromptly.
REFERENCES

1.Essentialpediatrics3rdedition
2.Wong’snursingcareofinfantsandchildren10thedition
3.Poliocasecountworldhealthorganization27thDecember2017
4.Poliomyelitis,epidemiologyandpreventionofvaccine-
preventablediseases(thepinkbook)publichealthfoundationchapter18,30thDecember2016

5.Pediatricnursingcareplans.Assumabeevijaypee2012firstedition.

tMumpsisacontagiousviralinfectionthatprimarilyaffectsthesalivaryglands,causingswelling,
pain,andfever.Thebestwaytoprotectyourselfandothersfrommumpsisthroughpreventivemea
sures,whichmainlyinvolvevaccinationandgoodhygienepractices.
1.**Vaccination**:Themosteffectivewaytopreventmumpsisthroughvaccination.TheMMR
(measles,mumps,andrubella)vaccineistypicallygivenintwodoses,withthefirstdoseadminist
eredaround12-15monthsofageandtheseconddosearound4-
6yearsofage.EnsuringthatyouandyourfamilymembersareuptodateonyourMMRvaccination
scangreatlyreducetheriskofcontractingmumps.
2.**Practicegoodhygiene**:Mumpsisspreadthroughrespiratorydropletsorsalivafromaninf
ectedperson,sopracticinggoodhygienecanhelppreventitsspread.Encouragefrequenthandwa
shingwithsoapandwater,especiallyaftercoughingorsneezing,beforepreparingfood,andafter
usingthebathroom.Avoidsharingutensils,cups,orotherpersonalitemswithsomeonewhomay
beinfected.
3.**Avoidclosecontactwithinfectedindividuals**:Ifsomeoneinyourhouseholdorcommunit
yisdiagnosedwithmumps,trytoavoidclosecontactwiththemuntiltheyarenolongercontagious.
Thisincludesstayinghomefromworkorschoolifyoususpectyoumayhavebeenexposedtothevi
rustopreventfurthertransmission.
4.**Coveryourmouthandnosewhencoughingorsneezing**:Useatissueoryourelbowtocover
yourmouthandnosewhencoughingorsneezingtopreventthespreadofrespiratorydropletsthat
maycontainthemumpsvirus.Disposeofusedtissuesproperlyandwashyourhandsafterward.
5.**Stayhomewhensick**:Ifyoudevelopsymptomsofmumps,suchasswellingofthesalivary
glands,fever,headache,ormuscleaches,itisessentialtostayhometopreventspreadingthevirust
oothers.Contactyourhealthcareproviderforguidanceonmanagingyoursymptomsandwheniti
ssafetoreturntoworkorschool.
6.**Maintainahealthylifestyle**:Astrongimmunesystemcanhelpyourbodyfightoffinfectio
nsmoreeffectively.Makesuretoeatabalanceddiet,getregularexercise,stayhydrated,andgeten
oughresttosupportyouroverallhealthandwell-being.
Byfollowingthesepreventivemeasures,youcanreducetheriskofcontractingmumpsandprotec
tyourselfandothersfromthiscontagiousviralinfection.Ifyouhaveconcernsaboutmumpsornee
dmoreinformationonvaccination,consultwithyourhealthcareproviderforpersonalizedguida
nce.

state5complicationsofmu...
1.Meningitis:Mumpscansometimesleadtoinflammationofthemembranessurroundingthebra
inandspinalcord,resultinginmeningitis.Thiscancausesymptomssuchassevereheadaches,fev
er,andneckstiffness.
2.Encephalitis:Inrarecases,themumpsviruscaninfectthebrainandcauseinflammation,known
asencephalitis.Thiscanleadtosymptomssuchasconfusion,seizures,andevenpermanentbrain
damageinseverecases.
3.Orchitis:Mumpscanalsocauseinflammationofthetesticlesinmales,knownasorchitis.Thisc
onditioncanresultinpain,swelling,anddiscomfortinthescrotum,andinrarecasesmayleadtode
creasedfertility.
4.Oophoritis:Infemales,mumpscancauseinflammationoftheovaries,knownasoophoritis.Thi
scanleadtolowerabdominalpain,irregularmenstrualcycles,andpotentialimpactsonfutureferti
lity.
5.Pancreatitis:Mumpsmaycauseinflammationofthepancreas,knownaspancreatitis,whichca
nmanifestassevereabdominalpain,nausea,vomiting,andpotentiallyleadtocomplicationssuch
asdiabetesorevenpancreatic