SIGNS AND SYMPTOMS OF ILLNESSES AND DISEASES

For a clearer understanding of the diseases to be enumerated, it is better to clarify some

terms.
Disease agents pertain to the microorganisms, germs, or many-celled animals which.
cause communicable diseases. Disease-promoting factors mean conditions which
attribute to a person becoming sick and not due to pathogens or germs. Signs of disease
refer to those states which can be seen by other persons such as paleness, bloodshot eyes,
profuse bleeding, and skin rashes. Symptoms of a disease include those conditions which
are felt by the patient such as headache, stomachache, toothache, and Joint pains; nausea,
dizziness, and cramps. The signs and symptoms depend upon the disease.

The following are the signs and symptoms of some diseases:

A. Gastro-intestinal Diseases (mainly diarrhea in nature)

1. Cholera
Disease agent: Cholera vibrio is commonly spread by inadequate/unsanitary toilet
facilities; cooking malpractices; negligence in washing the hands with soap and water
before and after eating and after using the toilet; unsafe drinking water; presence of
vectors such as flies and cockroaches; and failure to submit to the CDT (cholera,
dysentery, typhoid) immunization when necessary.
Signs and symptoms: Excessive vomiting; profuse diarrhea with stool which is coffee-
colored at first, foul smelling, then becomes rice-water-like; cramps in the abdomen;
decreased urine output; and old and sticky perspiration.
Treatment: If conscious rehydrate through coconut water and mixture of 4 glasses of
water with 2 tablespoons of sugar and 1/2 teaspoon of salt. Give as much as the patient
can take. Seek medical supervision.
Prevention and control for cholera, dysentery, and typhoid: Use toilet facilities properly;
wash hands with soap and water before and after eating and after using the toilet; cook
food well; drink clean and boiled water; eliminate contacts with persons sick with the
disease; store food in a clean and dry place; eradicate flies, mosquitoes, and cockroaches
and their breeding places; and submit to CDT immunization when necessary.
2. Bacillary Dysentery or Shigellosis
Disease agent: Shigella bacteria spread the same way as cholera.
Signs and symptoms: Sudden development of abdominal pain and cramp within 48
hours; watery stool with blood and mucus; dehydration; fever; weakness; or change in
consciousness.
Treatment: Therapy for diarrhea and dehydration: soft and easily digested food in little
amount taken frequently; avoidance of milk, fibrous, and fatty foods.
Prevention and control: same as that of cholera

3. Amoebiosis or Amoebic Dysentery

Disease agent: Entamoeba histolytica spreads the same way as bacillary dysentery
through eating' fresh vegetables, the source of which is questionable. One of the causes
is drinking water.
Signs and symptoms: Slow worsening bouts of diarrhea; foul-smelling stools streaked
with fresh blood or mucus; abdominal cramps, sometimes alternating with constipation
over period of five to ten days; pain in defecation.
Treatment: necessary medical supervision
Prevention and control: same as that of cholera and bacillary dysentery

4. Typhoid Fever or Tipus

Disease agent: Typhoid bacilli spread the same way as cholera 'and bacillary
dysentery.
Signs and symptoms: Fever, slow heart rate, rose-colored skin eruptions, spleen
enlargement at the onset, general weakness, headache, nosebleed, fever gradually rises
each day until it reaches 40° C, higher in the evening than in the morning; poor
appetite; coated tongue; teeth and lips covered with a brownish deposit; diarrhea is
common but there might be constipation, instead offensive-smelling which might be
dark, green, or blackish; distended abdomen and tender to the touch; fever often falls
gradually on the third week; convulsion. Headache and delusion may occur.
Treatment: Medical supervision with antibiotics for shortening the course of the
disease; plenty of fluids; prevention of serious complications and good nursing care.
Prevention and control: same as that of cholera and dysentery

B. Respiratory Diseases

1. Pneumonia
Disease agents: Pneumococci, streptococcl, staphylococci, Friedlander's bacilli, and
others spread through airborne microorganisms.
Signs and symptoms: Violent attacks of shivering high fever; stabbing chest. pain; lack
of appetite; headache; cough often with yellow, pink, or rusty sputum; rapid, and
shallow breathing with nostrils dilated with each breath.
Treatment: Proper rest and sleep; normal diet with extra fluid; oxygen administration if
breathing is distressed; medical steam inhalation; hot pack and fomentation; and
medical supervision.
Prevention and control: Keep away from patient; increase body resistance by having
enough rest and sleep and eating nutritious food; avoid exposure to extreme
temperature; consult a physician.

2. Pulmonary Tuberculosis - PTB, Phthisis, or White Plague

Disease agent: Tubercle bacilli are spread by infected persons through careless
coughing, sneezing, and spitting.
Signs and symptoms: Undue fatigue; progressive loss in weight; loss of appetite;
cough of more than two weeks, especially upon waking up in the morning; afternoon
fever; night sweating; and sputum with blood.
Treatment: Proper rest and sleep; fresh air; well-balanced diet; medication prescribed
by the physician to be taken religiously; surgery in serious cases.
Prevention and control: Isolate the person suffering from tuberculosis. Increase body
resistance; avoid contact with tuberculosis individuals; if someone in the house has
PTB, have all residents undergo sputum examination; submit children to BCG
immunization; advise the patient to use his/her own utensils and cover his/her mouth
anti nose when coughing or sneezing; burn tissue paper wet with nasal and mouth
discharge.

3. Influenza — Flu or Trangkaso

Disease agents: A, B, C, or other types of influenza virus are spread by nasal mouth
discharge of an infected person.
Signs and symptoms: General weakness: fever, sore throat, runny nose, loss of
appetite, inflammation of the nose and pharynx.
Treatment: Medical supervision, warm bed rest, light diet with plenty of fluids, and
proper hygiene.
Prevention and control: Yearly vaccination; good health habits; keep away from the
patient cover your mouth while coughing; and build up body resistance.

4. Bronchitis
Disease agents: Usually viruses and bacteria or due to heavy smoking or air pollution,
common complication of measles, whooping cough, and typhoid fever.
Signs and symptoms: Difficulty in breathing; tightness in the chest; back pain; mild
fever; mild headache; weakness; hoarseness and wheezing dry cough at the ,start and
then with phlegm.
Treatment: Medicine for pain and fever; avoid smoking; bed rest; steam inhalation; hot
fomentation on the chest; plenty of fluids; and medical supervision.
Prevention and control: Build up body resistance: avoid smoking and don't take
alcoholic drinks; and ensure good nursing care to prevent sick person from developing
complications from measles, whooping cough, or typhoid fever,

C. Cardiovascular and Blood Diseases

1. Rheumatic Heart Disease
Disease agent: Streptococcus organisms in the throat cause inflammation, scarring of
the heart, and abnormal flow of the blood.
Signs and symptoms: Sore throat; fever with aching joints; profuse sweating; pains in
the chest; shortness of breath after exercise; palpitations; abdominal pain; and
inflammation of the ankles.
Treatment: Regular medical check-up and urgent frequent sore throats, bed rest, and
good nursing care.
Prevention and control: Consult a physician promptly if sore throat is accompanied by
fever; keep environment clean.

2. Coronary Heart Disease or Ischemia

Disease agent: Hereditary disposition: fat-rich diet leading to the narrowing of the
coronary (heart) arteries.
Signs and symptoms: High blood pressure; difficulty in using a low pillow when
sleeping; dizziness, headache, profuse sweating, light-headedness, may faint.
Treatment: Medical supervision which includes anti-hypertensive drugs to plate the
arteries; diuretics to decrease. the amount of water and salt retained by the body;
weight reduction; avoidance of smoking; regular physical examination; and reporting
of signs and symptoms to the physician and use of herbal therapy.
Prevention and control: Avoid smoking and alcoholic drinks; avoid too much fat and
salt; learn to relax; decrease use of tea and coffee; build up resistance against kidney
diseases; seek medical attention for initial symptoms of the disease.

3. Arteriosclerosis or Hardening of the Arteries

Disease-promoting factors: Old age, hereditary tendencies, too much salt and fat in the
diet, excessive smoking, too much tea or coffee, too much nervous tension and
infections especially syphilis and those of the kidneys.
Signs and symptoms: same as that of coronary heart disease
Prevention and control: same as that of coronary heart disease

4. Hypertension or High Blood Pressure

Disease-promoting factors: Old age; hereditary tendencies that thicken and harden the
arterial walls making them non-elastic that the heart experiences difficulty in pumping
the blood in the arteries which later weakens.
Signs and symptoms: same as that of arteriosclerosis
Treatment: same as that of arteriosclerosis
Prevention and control: Eat a balanced diet; exercise regularly; cut back on oil and
salt; do not smoke; limit alcohol; monitor blood pressure; regular medical supervision.

5. Congenital Heart Disease

Disease-promoting factors: Poor development of the heart valves or the primary blood
vessels due to German measles among pregnant women during the first 3 months of
pregnancy.
Signs and symptoms: Frequent chest cold; shortness of breath; pains over the heart;
clubbing of the fingers and toes; bluish skin; and retarded growth of the infant/child.
Treatment: Medical supervision by a cardiologist is needed to determine the part of the
heart with damage and heart surgery.
Prevention and control: Advice pregnant women (in their first three months of
pregnancy) to build up their resistance against German measles.

5. Malaria
Disease agent: one or more of the four types of plasmodial malaria introduced in the
blood by the Anopheles mosquito that has previously bitten a person with malaria
Signs and symptoms: attacks of chill and fever for a few hours followed by drenching
sweats every 2-3 days depending on the type of parasite; general weakness; anemia
and enlarged spleen.
Treatment: Early detection of the disease especially those rending in a malarial region
to practice professional help for diagnosis and treatment.
Prevention and control: Destroy breeding places of mosquitoes and their larva; protect
self from mosquito bites; work for early detection of the disease; cooperate with
malaria control workers; screening of doors and windows; use of suitable clothes; and
when malaria is suspected, submit to blood test or take genuine tablets for prophylaxis.

Other Diseases

1. Chicken Pox or Varicella

Disease agent: Virus
Signs and symptoms: Mild fever, backache, vomiting, lesions - first, red spots, like
pimples followed by small blisters and finally, crusts/scabs. The older the patients, the
more serious the symptoms are.
Treatment: Take prescribed antihistamine to relieve Itching.
Prevention and control: Keep away from patient; practice hygiene; and keep
environment clear.

2. Measles or Rubeola
Disease agent: Virus
Signs and symptoms: Sneezing; runny nose; watery eyes which become sensitive to
bright light; hoarse and dry cough; pain and soreness in the chest skin rash - pink spots
first seen behind the ears, on neck, roots of the hair, and on the forehead, and then on
the limbs or trunk: then spots grow darker and purplish before disappearing, forming
irregular blotches. In serious cases, high fever, delirium, cracked tongue, rapid pulse,
and even unconsciousness are observed.
Treatment: Bed rest; intake of sufficient fluids; nutritious food; and medical assistance
to avoid complications such as broncho pneumonia, encephalitis, and middle ear
infection, and exacerbation of latent TB.
Prevention and control: Keep patient away from others; have babies vaccinated against
measles and build up body resistance.

3. German Measles or Rubella

Disease agent: Virus
Signs and symptoms: Not as severe as Rubeola; may last for 3 to 4 days; mild skin
rashes; enlarged lymph nodes at the back of the head and neck.
Treatment: same as that of Rubeola
Prevention and control: Pregnant women in their first 3 months of pregnancy should
avoid getting sick of this disease and have Infants vaccinated against German measles.

4. Dengue Fever or Dengue Hemorrhagic Fever (DHF)

Disease agent: Two forms of dengue
a. Dengue Fever — a severe flu-like illness that affects older children and adults but
rarely causes death.
Signs and symptoms: Abrupt onset of high fever, pain behind the eyes which worsens
with eye movement, muscle and joint pains, loss of sense of taste and appetite,
measles-like rash • over chest and . upper limbs, nausea, and vomiting.
b. Dengue Hemorrhagic Fever (DHF) — a more severe form in which bleeding and
occasional shock occur leading to death; is more serious in children.
Signs and symptoms: Similar to dengue fever with severe and continuous stomach
pain; pale, cold or clammy skin; bleeding from the nose, mouth, and gums, and skin
bruising; frequent vomiting with or without blood; sleepiness and restlessness;
constant crying; excessive thirst (dry mouth); rapid, weak pulse, difficulty in breathing
and fainting.
Treatment: No drug to cure dengue or vaccine to prevent it. Medical prevention
needed: bed rest, plenty of fluids, hot fomentation on painful areas and ice bag for
headache.
Prevention and control: Eliminate mosquito breeding places by covering water
containers tightly and removing garbage articles around the house that collect water.
Protect yourself from mosquito bites through mosquito coils, electric vapor mats,
mosquito nets, skin repellants, and screen on doors and windows: Use insecticides
through spraying and fogging. Isolate patients suffering from dengue fever for at least
15 days. Report any suspected case of dengue fever in the neighborhood to the nearest
health center.

5. Iron Anemia Disease-promoting factors: Lack of Iron in the diet, intestinal

parasitism (hookworm), repeated pregnancies or abortion resulting in the deficiency of
oxygen-carrying material of the blood, and frequent profuse menstrual flow
Signs and symptoms: Paleness of the conjunctiva and gums; weakness and dizziness;
lack of appetite; shortness of breath; palpitations; headache; irritability and
restlessness, numbness, tingling in the extremities, fissures or sores at the corners of
the mouth.
Treatment: Eat foods containing iron and seek medical attention.
Prevention and control: eat food rich in iron such as deal is liver papaya bitter gourd
and other green vegetables. Avoid over fatigue. Consult a physician if there is profuse
menstruation (among women).

6. Cancer -Uncontrolled growth and multiplication of abnormal body cells which often
form a mass or tumor
Disease-promoting factors: Exposure to radiation; exposure to coal tars (tobacco),
arsenics, nitrates, and other chemicals; air pollution; familial tendencies; chronic
alcoholism; trauma or injury; ultraviolet rays from the sun; and other viruses.
Seven Danger Signs of Cancer: Change in the bowel or bladder habits; a sore that does
not heal; unusual bleeding or discharge; thickening or lumps in the breast or
elsewhere; indigestion or difficulty in swallowing; obvious change in the wart or mole;
and nagging cough or hoarseness.
Treatment: Medical help with early detection and treatment; chemotherapy; irradiation
therapy; surgery; and Chichirica therapy.
Prevention and control: At the first suspicion of cancer, seek medical help. Avoid too
much sunbathing, smoking, and drinking liquors, eating pork and beef, taking
hormonal preparations, excessive use of food coloring and seasoning.

7. Allergy — Sensitivity of a person to an offending agent called allergen without

producing similar effects to an average individual to first or successive exposures.
Disease-promoting factors: Inhalation of allergens such as pollens, dust, vapors, odors;
eating of certain foods such as chocolates, eggs, chicken, shrimps, and other
crustaceans; taking some drugs and injectable; more contact with the skin or mucous
membrane of certain dyes and physical agents like light, heat, and cold.
Signs and symptoms: Sneezing; Rhinitis (runny nose); congestion and swelling of the
bronchial lining with too much mucus that the person experiences difficulty in
expelling air than taking it in (asthma); eczema (weeping lesions); itchiness; breathing
difficulty.
Treatment: Upon identification of the allergen, avoid the offending agent, stay indoors
if sensitive to blooming plants in season; avoid drugs you are sensitive to; desensitize
through building of the body tolerance to some drugs by grad,, administration In
increasing amount of the allergen and taking antihistamine, prescribed by the doctor.
Prevention and control: Consult a physician immediately especially when symptoms
are serious. Subject patient to a series of sensitivity tests for allergy. Remove
offending allergens.

8. Diabetes Mellitus Disease-promoting factors: Disease in the secretion of insulin by

the Islets of Langerhans resulting in the increase of blood sugar; due to hereditary or
familial tendency or diet with too much sugar, salt, and fats in the diet.
Signs and symptoms: Tiredness or weakness; frequent urination; excessive thirst;
extreme hunger; blurred vision; itching; tingling or numbness in hands and feet
wounds that do not heal; vaginal infection; tuberculosis; and recurrent infections.
Treatment: Medical supervision, low salt, low fat, and less sugar in the diet: insulin
therapy when necessary; immediate attention to wound healing.
Prevention and control: Eat more fruits and vegetables; avoid soft drinks, concentrated
fruit juices, and junk foods; reduce intake of sweet, fatty, and salty food; have regular
exercise; stop smoking and avoid drinking alcohol; keep within the ideal body weight
and discourage marriages between families with diabetes.

CLASSIFICATIONS OF DISEASES
Morbidity is due to common and uncommon diseases, communicable and non-
communicable diseases which are part and parcel of our living. A meaningful
understanding of such types of diseases is essential in being able to lead purposive,
productive, and healthy lives.

In this connection, there is a need to distinguish common and uncommon diseases

based on frequency of occurrences. Children's diseases generally differ from adult
diseases what may be common among children may not be necessarily common
among adults.
Let us focus on children's common and uncommon diseases. Common diseases are
those affecting many children during the childhood years irrespective of sex, economic
status of the parents, and the place where they live. These include colds, measles,
chicken pox, and dengue fever based on the latest Department of Health data.
Uncommon diseases are rare or unusual. Their victims are composed of very rare
percentage of number of people in the Philippines. Not many children and adults get
sick because of them.
Diseases may also be categorized as communicable and non-communicable.
Communicable diseases are caused by microorganisms or macroorganisms and are
transferred from one person to another through direct and indirect con tact. These
diseases are caused by germs or pathogens (disease-producing organisms) or
biological disease agents. These pathogens vary In size from the smallest virus which
can be seen through an electron microscope to the multi-cellular which can be seen by
the naked eye. These viruses cause measles, mumps, chicken pox, and colds. Some
bacteria cause tuberculosis, typhoid, pneumonia, and syphilis. Amoebiasis and malaria
are due to one-celled animals while scabies, Intestinal parasites, and head lice can be
traced to many-celled animals. Since communicable diseases can be transmitted
through direct and indirect means, measures can be planned to prevent and control
them.

Non-communicable or non-infectious diseases are not brought about by

microorganisms or pathogens. They are due to several factors.
Some non-infectious diseases are the following:
1. Organic - caused by malfunctioning of a body part (e.g., enlarged heart and
nephritis)
2. Functional - due to emotional trauma or experiences of the individual (e.g., nervous
breakdown due to the death of a relative, kleptomania, or being paranoid)
3. Congenital - brought about by conditions during fetal life and the baby is born with
it (e.g., abnormal mitral valve of the heart)
4. Degenerative - brought about by old age or other factors wherein body cells
deteriorate and lose their resiliency (e.g., arteriosclerosis and arthritis)
5. Nutritional - triggered by lack of intake of nutrients (e.g., malnutrition - iron
anemia, goiter, and kwashiorkor; over nutrition - hypertension, kidney stones, and
tooth decay)
6. Endocrine-due to improper functioning of the endocrine glands (e.g., gigantism,
dwarfism, and diabetes mellitus)
7. Cardiovascular - resulting from the improper functioning of the heart and blood
vessels (e.g., coronary heart disease and arteriosclerosis)
8. Radiological - due to exposure to radioactive materials (e.g., leukemia and cancers
due to exposure to radioactive elements)
9. Physical - those due to injuries suffered by a body part (e.g., fractures and
dislocations due to accidents)
10. Allergenic - due to a person's sensitivity to exposure to offending and resulting in
exaggerated reactions such as itching, skin rashes, sneezing, respiratory difficulty,
shock, or even death (e.g., sensitivity to pollen grain, animal fur, and flowers or allergy
from eating eggs, shrimps, or chicken)
POLICIES AND PROCEDURES IN GIVING MEDICAL ASSISTANCE
For most persons, regardless of age, medical care is necessary when one gets sick.
Emphasis is placed on the person's disease rather than on the fact that he/she is a
particular person with certain capabilities and needs but happened to be ill. It is
important that the family receives sufficient knowledge of the person's illness so that
they readily understand the need for hospitalization if ever. It is also necessary for the
family to have some understanding of the tests and treatments to be given and the risk
and discomfort from the physician's recommendations.

In helping the patient, the following should be provided:

1. Safety. The environment must continually be evaluated to prevent accidents.
Equipment to be used should be in good working order and used properly. Avoid the
possibility of tipping forward or sliding down when using a wheelchair.
2. Observation. Provision for observation is crucial to the welfare of the patient.
Observation of the patient should be made especially in the light of his/her diagnosis.
It is important for the physician to observe and ecord the patient's appearance, activity,
and treatment.
3. Diagnostic tests. The diagnostic procedures ordered must be understood so that
adequate preparation, execution, and follow-up may be provided.
4. Supportive procedures. Various types of supportive sr-- procedures and techniques
are used to maintain or improve the physical and emotional resources of the patient.
These may include the maintenance of fluid balance and proper nutrition, relieving
pain, or improving body function. They also include the interest and love expressed by
the family and friends.
5. Medications. If you are looking after a patient in the home, you may be called upon
to give him/her medicines. Medicines may contain one or more drugs. As long as you
exercise due care, give only what the doctor ordered. There are four basic rules (errors
should not occur):
a. Check the medicine to make sure it is the right one.
b. Give the exact amount ordered by the doctor.
c. Give to the patient for whom it was prescribed.
d. Give it at the time ordered by the doctor.
6. Rehabilitation. As the patient progresses, provisions for rehabilitation may be
needed to recover the skills lost during illness. The skills needed for daily tasks are the
priority. All convalescent patients whether young or old should be encouraged to rest
at least an hour every afternoon, preferably on the bed where they can relax. Plenty of
fluids and an Interesting and appetizing diet will promote recovery. The patient needs
to exercise, too, and the doctor will guide you about the amount of exercise needed.
7. Recording of events. Observation and care, treatments, medications, and patient's
reactions form part of the record. The caregiver should give an accurate description of
the condition of the patient. Keeping a written record of the patient's conditions and
observing both his/her physical health and emotional health can help the physician
evaluate the patient. Putting into record details of medicines administered is important
for assessment and future references by the doctor, the caregiver, and the family and
patient.
PROCEDURE IN COMMUNICATING WITH CLIENT'S RELATIVES
ACCORDING TO STANDARDS
It is also important that family and friends share in attending to the patient, so that they
will feel that they are included in caring for the patient and ought to actively
participate in his/her recuperation. The attitude of those around the patient has a
decided effect on his/ her recovery. A cheerful attitude encourages and supports the
patient, and promotes his/ her cooperation in his/her own recuperation. Some of the
procedures are:
1. The main problem in preparing a patient for medical assistance lies in the
preparation of his/her family. The family should be the first to know the medical
condition of the patient
2. The family can be requested, to give a brief background of the health history, habits,
and skills to help medical staff in individualizing his/her care.
3. To have access to necessary professional services appropriate to his/her needs and to
be informed if services are available
4. To be informed of the rights and responsibilities of the patient In advance
concerning the care and treatment he/she will receive
5. It is important for the family and relatives to have an understanding of the tests and
treatments to be given, the risks, and discomfort.
6. Inform the family whatever diagnosis may result concerning the patient.
7. Whatever recommendations the physician may give, the family must be well
informed.
8. Whatever progress in the patient's condition, the family should be informed.
9. Truthful assurance of the condition of the patient is the best guide, so that the patient
will have confidence in his/her family and physician. .

PROCEDURE IN COMFORTING AND CONSOLING CLIENT

A good caregiver has a fairly good knowledge of the behavior of a client It is
important that the caregiver should be very understanding and tolerant of the client's
behavior. He/ She should adapt and adjust to the client's behavior. The caregiver
should accept and understand the fact that the patient has the same needs as those who
are well and healthy.

It should be remembered that in caring for a client after an illness or injury, one has to
address not only his/her physical needs but also his/her psychological needs. There are
situations when the client feels depressed and frustrated because of the limitations and
dependence imposed by an Illness or injury. Home care can encourage a client's sense
of competence and independence by allowing him/her to make decisions for
himself/herself even with minor ones.
Some of the procedures are:
1. Remain calm and balanced while approaching the client In gentle manner to prevent
agitation or aggression.
2. Be patient and do your best; talk and carry on a conversation with thp client wit,
providing care.
3. Focus yourself on the condition of the client.
4. Be courteous. If the client is difficult to please, don't take it personally. Ask her why
he/she feels bad, and offer your help to make him/her feel better.
5. Use a gentle touch to calm him/her. Assure him/her that things are under corn
6. Give him/her some positive statements that he/she can repeat. Distract his/her
attention so he/she can focus on something else to stop the thoughts that anxiety.
7. Encourage the client to participate in conversation and to verbalize his concerns.
Listen to him/her attentively.
8. Encourage independence by teaching the client how to meet his/her own and allow
him/her to participate in activities and procedures as he/she is able.

Reference:
• Patino, M.J. and Basbas, L.D. (2017). Caregiving Volume II First Edition.
Rex Publishing. Quezon City, Philippines
• Yahoo Images
http://drshikinzainal.blogspot.com
/2014/08/universal-
precautions.html