8.4 Emerging Infectious Disease Concepts and Nursing Care Flashcards
Emerging Boundaries
- Threat of increase incidence in infection in the future
Due to
- Changes/Evolution of existing organisms
- Known infections spreading to new geographic areas
- Previously unrecognized infections appearing in areas undergoing ecological transformation
- Old infections re-emerging due to antimicrobial resistance
MDR-TB
- Multidrug resistant
- Resistant to isoniazid and rifampin (the most potent drugs against TB)
XDR
- Extensively resistant TB
- Resistant to isoniazid and rifampin as well as fluoroquinolone and at least one of the three injectable second-line drugs (amikacin, kanamycin, capreomycin)
- Treatment is much less effective
- Patients with HIV who develop XDR-TB are much more likely to develop the disease (from latent stage) and have higher risk of death
TB
- 20% of cases are resistant to at least 1 of the first/second line drugs
- 5% are resistant to both isoniazid and rifampicin
- 10% are either XDR or total drug resistant
Risk Factors of Developing TB
- Do not take TB medication regularly
- Do not finish full course of antibiotics
- Re-develop TB after taking TB medications in the past
- Spending time with someone who has drug-resistant TB
- Comes from an area in the world with drug-resistant TB
Collaborative Problems
- Ineffective gas exchange and airway clearance
- N95 masks must be worn (airborne precautions)
Education
- Patients may have unwanted side-effects from their antibiotics such as nausea, hearing loss, and fatigue. They must finish their course of antibiotics even though it may impair the patients ability to work or continue with ADLS
Lyme’s Disease
- Caused by Borrelia Burgdorferi
- Transmitted through infected black-legged ticks
Diagnosis
- Based on symptoms, physical findings, exposure to ticks, and lab tests
- If untreated can spread to joints, heart and nervous system
Lyme’s Disease Early S/S
- Fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes
Erythema Migrans (EM) Rash
- Begins at site of tick bite in about 7 days but could range between 3-30
- Expands gradually overtime up to 12 inches
- Clears as it enlarges making it look like a bulls-eye
Lyme’s Disease Late S/S
- Occurs days to months later
- Severe headache and neck stiffness
- Arthritis (severe joint pain and swelling, particularly knees and other large joints)
- Facial Palsy (loss of muscle tone or drooping of one/both sides of the face)
- Intermittent pain in tendons, joints, bones
- Heart palpitations, irregular HB (Lyme’s Carditis)
- Dizziness/SOB
- Inflammation of brain/spinal cord
- Nerve pain
- Shooting pain or numbness or tingling of hands/feet
- Short-term memory
Lyme’s Disease Medication
- Doxycycline
- Cefuroxime
- Amoxicillin
Post Treatment Lyme Disease Syndrome (PTLDS)
- Chronic Lyme’s Disease
- Fatigue/muscle aches lasting longer than 6 months
- Can disable a person
IV Treatment
- Ceftriaxone and Penicillin
Chronic Wasting Disease
- Transmissible spongiform encephalopathy
- Affects deer, elk, and moose
- Caused by proteins that malfunction (prions)
- Fatal to animals but has not been transmitted to people
- Venison from hunters should be tested if it is harvested in an area where it has been found
- No treatment
Influenza
- Respiratory virus
- Flu season is October-March (peaks in December and February)
Type A
- Highly contagious and causes moderate-severe illness in all ages. Easily mutates
Type B
- Stable virus that causes mild symptoms. Primarily affects children, college campuses, and long-term care settings
Type C
- EXTREMELY BENIGN, patients may not even feel symptoms.
Pandemic
- Worldwide spread of new disease
- Viruses that have caused past pandemics typically originate from animal influenza viruses
Ebola
- Natural reservoir is unknown however most likely bats
- Africa is high risk because 4/5 virus strains occur from animals native to there
Transmission
- Direct Contact (broken skin or mucous membranes)
- Blood/bodily fluids (semen)
- Objects such as needles/syringes that have been contaminated with blood
- Infected bats, apes, monkeys
S/S
- These do not show up right away
- DOES NOT SPREAD UNTIL HOST HAS DEVELOPED SYMPTOMS
Prevention of Spread
- PPE
- Obtain blood specimens
- Medication administration
- Cleaning vomit/diarrhea
- Communication with team members
- Showering after doffing PPE
- N95 respirator, 2 gloves, face shield
