CHN II Flashcards
Any microorganisms capable of producing a disease
e.g., bacteria, virus, fungi, parasites.
INFECTIOUS AGENT
Environment or object in which organism can survive or multiply
e.g., Human ,animals, fomites, soil, water
RESERVOIR
CHAIN OF INFECTION
Infectious Agent
Reservoir
Portal of Exit/ Mode of escape
Mode of Transmission
Portal of Entry
Susceptible Host
Venue or way which organism leaves the reservoir
Alimentary: Vomiting, diarrhea, biting
Respiratory: Coughing, sneezing, talking
Genitory-Urinary: Sexual - Transmission
Transplacental: Mother to Fetus
Skin:I Skin lesion, cut, blood
PORTAL OF EXIT/ MODE OF ESCAPE
Direct/Indirect Droplet
Particles: >5 mm
Distances: 3 feet
Contact
Respiratory secretions
Fine Particles: <5mm
More than 3ft distance
All droplets can be airborne (PTB)
Airborne
Carrier
e.g., Food, water, medication
Vehicle
Carrier
Insects; Mosquito
Vector
-Ingestion, Inhalation, Penetration
PORTAL OF ENTRY
-At risk -Infant & Children
-Old people -Immunocompromised
SUSCEPTIBLE HOST
-Entry until first s/sx
-Person is unaware of impending illness
INCUBATION PERIOD
-Nonspecific s/sx: Flu-like
-Activates immune response
PRODROMAL PERIOD
-Specific s/sx
-Pathognomonic sign
ACUTE PERIOD
-s/sx starts to disappear
-pt regains health
CONVALESCENT PERIOD
Healthy again.
RESOLUTION AGENT
-Physical & chemical barriers
-Natural flora
-Skin & mucuous membrane
-oils & sweats
-Cilia
-Gag, cough reflex
First line of Defense
-Inflammatory response
-Activate cells: B-E-N
Basophils, Eosinophils, Neutrophils
Second line of Defense
Redness; increase blood flow
Rubor
Swelling; Exudation of fluid
Tumor
Heat; Release of inflammatory Mediators
Calor
Pain; Stretching of pain receptors
dolor
Loss of function; Disruption of tissue structure
Functio Laesa
-Immune response (B-cells & T-cells)
-Specific Protection; Lymphocyres
THIRD LINE OF DEFENSE
-Proteins that destroy familiar antigen
ANTIBODIES
-Foreign bodies (Microorganism)
ANTIGEN
-High resistance; High Antibodies
IMMUNITY
TYPES OF IMMUNITY -Organs, tissues, cells of immune system.
INNATE
TYPES OF IMMUNITY Immunity that develops during lifetime.
ACQUIRED
TYPES OF IMMUNITY In response to an infection or vaccine.
ACTIVE IMMUNITY
TYPES OF IMMUNITY -In response to infection
ACTIVE-NATURAL IMMUNITY
TYPES OF IMMUNITY-In response to vaccine
ACTIVE-ARTIFICIAL IMMUNITY
TYPES OF IMMUNITY -Breastmilk from Mother IgA & Placenta IgG
PASSIVE-NATURAL IMMUNITY
TYPES OF IMMUNITY-After receive antibodies from someone
PASSIVE IMMUNITY
TYPES OF IMMUNITY-From medication/ Immunoglobulin
PASSIVE-ARTIFICIAL IMMUNITY
5 ELEMENTS OF STANDARD PRECAUTIONS
Handwashing first tier
Gloves: clean & sterile
Gown or Apron
Goggles or Mask
Proper Disposal of sharps
-Do not recap
PULMONARY TUBERCULOSIS
Causative Agent
Myobacterium Tuberculosis
Mode of Transmission: PULMONARY TUBERCULOSIS
Airborne-Droplet (coughing, sneezing)
Incubation Period: PULMONARY TUBERCULOSIS
3-8 weeks
Prevention: PULMONARY TUBERCULOSIS
BCG (Given at Birth)
LATENT TB
-Dormant
-Asymptomatic
ACTIVE TB
-Afternoon Low grade fever
-Blood in sputum (Hemoptysis)
-Cough (Chronic) > 2weeks
-Decrease in weight
-Evening sweat/ night sweat
Confirms the diagnosis of PTB
Definitive Test
SPUTUM SMEAR AND CULTURE aka ACID FAST BACILLI (AFB) STAINING
Detects the presence of antibodies
MANTOUX TEST/ TUBERCULIN TEST/ PPD (Purified Protein Derivative)
Result of Mantoux test/ PPD
-Within 48-72 hrs
-(+) induration of 10mm or more
-(+) immunocompromised induration of >5mm
Determines the presence & extent of the disease/ lesion
CHEST X-RAY
-No exposure
-Not infected
CLASS 0
-(-) TB exposure
-(-) s/sx
-(-)test
-(-)x-ray
CLASS I
-TB Infection (preclinical state)
-(-/+) exposure
-(+)tuberculin test
-(-) s/sx
-(-) x-ray
CLASS II
-TB Diseases
-(+)History
-(+)tuberculin test
-(+)s/sx
-(+)sputum
-(+)x-ray
CLASS III
-TB inactive
-(+/-) previous therapy
-(+)x-ray of healed TB
-(+) Tuberculin Test
-(-) S/sx
-(-) Smear
CLASS IV
-Suspected disease
-diagnosis pending
CLASS V
S/E: Orange discoloration of secretion and urine.
RIFAMPICIN
When to take: RIFAMPICIN
1st: Empty stomach (best) but can cause gastric irritation
2nd : with food
3rd: at bedtime
NRSG ALERT: RIFAMPICIN
Protect drug from light
A/E: RIFAMPICIN
Hepatoxicity
S/E: Hepatic enzymes elevation
Peripheral neuropathy (competes w/ vit.6 B6 absorption)
ISONIAZID
When to take: ISONIAZID
Before meals
Prophylaxis: ISONIAZID
10-50 mg
Treatment: ISONIAZID
5-100 mg
A/E: ISONIAZID
Hepatoxicity
HPN Crises
-Rapidly bacteriostatic
-slowly bacteriocidal
-may lead to hyperurecemia
-Arthralgia (Shoulder)
PYRAZINAMIDE
When to take:PYRAZINAMIDE
with or without food
2 TB DRUGS PHOTOSENSITIVE?
Rifampicin & Pyrazinamide
A/E:Pyrazinamide
Hepatoxicity
Ototoxicity
Nephrotoxicity
GI Upset
Leads to optic neuritis (Red-green discrimination)
-Skin rash
ETHAMBUTOL
WHY DO NOT GIVE ETHAMBUTOL TO CHILDREN 6 YRS OR YOUNGER
R: because they cannot reliably monitor Vision.
-Renal impairment
-Tinnitus (ringing of the ears)
-Auditory impairment
STREPTOMYCIN
Causative agent:TETANUS
clostridium tetani
Excretes toxins:
-Destruction
-Weak toxin
-Lysis of blood
TETANOLYSIN
Excretes toxins:
-Type of neurotoxins
-Cause muscle spasm
TETANOSPASMIN
Mode of transmission: TETANUS
Enters skin via non-intact skin
Incubation period:TETANUS
3 days to 1 month
Prevention: TETANUS
-TT Vaccination
-Health education
Pathognomonic sign: TETANUS
Risus-Sardonicus/Sardonic smile/ grin
-Facial nerve affected
S/SX: SPASM
Involuntary muscle contraction
Dangerous: Laryngeal Muscle
S/SX: TRISMUS
Trigemiinal nerve (lock jaw)
Opisthotonus (arching of the back)
Risus-Sardonicus/Sardonic smile/ grin
Nursing Responsibility: Lock jaw
NGT/ TPN
Nursing Responsibility:-Opisthotonus (arching of the
-Side lying
DOC: TETANUS
PENICILLIN
METRONIDAZOLE
A/E: Disulfiram-like reaction: TETANUS DOC
METRONIDAZOLE
DISULFIRAM -LIKE REACTION:
-Anxiety
-Blurred Vision
-Choking/ chest pain
-DOB
-Flushing of face
-Headache
-Sweating
-Vomiting
NURSING MANAGEMENT: TETANUS
1.Non-stimulating environment
Quiet and Dim
2.Tracheostomy -spasm
3.Cardiac Monitor
Causative agent: POLIOMYELITIS
Legio Debilitans
I.Brunhilde
II.Lansing
III.Leon
OTHER NAME OF POLIOMYELITIS
(Heins-Medin Disease)
Mode of transmission: POLIOMYELITIS
FECAL-ORAL
Prevention: POLIOMYELITIS
-OPV- Sabin V (NPO to promote absorption)
-IPV- Salk V sanitation
-SANITATION
ABORTIVE POLIO
-localized
-Sore throat
-Tonsilitis
-Enlarged cervical lymph nodes
NON-PARALYTIC POLIO
-Systemic
-Flu-like symptoms
PARALYTIC POLIO
-Reaches Spinal cord
-Painful muscle spasm usually one sided.
-damaged neurons (Asymmetrical paralysis)
BULBAR POLIO
-reaches the brain
-Brainstem (Pons, medulla oblongata)
-Respiratory paralysis
-HPN (silent killer)
MANAGEMENT: POLIO
-Analgesic
-penicillin
-no to opiods
-Aggrevate Respiratory (Demerol Paralysis)
NRSG MANAGEMENT: POLIO
-Sanitation
Causative agent: CHICKEN POX
Varicella-Zoster Virus, Herpes Virus
Other name of chicken pox
(VARICELLA)
reactivation of the varicella-zoster virus
Herpes Zoster
Herpes Zoster
-Stress
-Same manifestation w/ severe pain & tenderness along posterior nerve.
Mode of Transmission: Chicken Pox
Direct Contact
Incubation period: Chicken Pox
2-3 weeks
Prevention: Chicken Pox
Active immunization with live attenuated varicella vaccine
S/sx: Chicken pox
-Trunkal–> rashes–>macule–>papule–> vesicle–>scabs–>full off–>Shallow pink depression
-(+) fever peaking on 2-4 days
Management: Chicken Pox
Aziclovir 800 mg 3x/ day
Supportive management: Chicken Pox
Antipyretic
Short fingernails
Isolation & Airborne precautions
Causative agent: MUMPS
Mumps Virus (Rubivirus)
Mode of transmission: MUMPS
direct contact by airbornee, droplet or fomites contaminated by saliva.
Incubation period: MUMPS
12-26 days life long immunity after recovery.
Prevention: MUMPS
MMR (12-15 month; Booster dose: 4-6 years)
S/sx: MMR
Asymptomatic in 30-40% cases
-Fever -anorexic
-malaise -swollen, painful, &
tender parotid glands
-Affecting submaxillary &
sublingual glands
Complications: mumps
-Epididymorchitis
-Meningoecephalitis
-Oophoritis
-Pancreatitis
Supportive management:
Comfort Measure, isolation & droplet precaution.
Causative Agent: MEASLES
Filterable virus
genus: Morbillivirus Family Paramyxoviridae
Mode of transmission: MEASLES
Direct contact with infectious airborne droplet.
Incubation period: MEASLES
8-12 DAYS
Prevention: MEASLES
MMR
S/Sx:MEASLES
initially an upper respiratory condition characterized by escalating fever (Peak 3-5 days)
Pathognomonic sign: MEASLES
Koplik’’s Sign: Graying peck in the buccal mucosa- 2nd day
MANAGEMENT: MEASLES
Supportive measures
Anti-pyretic with fluids
Vitamin A supplement
Causative Agent: DIPTHERIA
Corynebacterium Diptheria (Klebs-Loeffer Bacillus)
HIGH PREVALANCE OF DIPTHERIA DURING:
Cooler months (December-February)
KNOWN AS EPIDEMIC PAROTITIS
MUMPS
Mode of transmission: DIPTHERIA
-Direct or Intimate contact with carrier
-indirect contact with articles, food, & environment contaminated with discharge from nose, skin, eyes, or lesion on body parts of infected person.
Incubation period: DIPTHERIA
2-5 days
s/sx: DIPTHERIA
Low grade fever
Pseudomembrane
Nasal
Facial & Pharyngeal
Laryngeal
Management: DIPTHERIA
Isolaton: until (-) nose or throat culture
Antibiotic
Bed rest 2-3 weeks
Nutrition & hydration
Gas exchange
Diagnosis: DIPTHERIA
Specimen Culture
Causative agent: FLU
Influenza Virus (A,B,C)
Mode of transmission: FLU
Direct contact by mouth & nose
Droplet secretions (Upper airway)
Incubation period: FLU
3-5 days
Prevention: FLU
HIB, Influenza Vaccine
S/sx: FLU
-Bodyache -chills
-dry cough -fever
-headache -Pharyngitis
Supportive measures: flue
Anti-pyretic
Analgesics
Fluids
Rest
Vit. A Supplement
Causative agent: pertussis/ whooping cough
Hemophilus Pertussis
Bordetella Pertussis
Bordet Gengou Bacillus
Mode of transmission: pertussis
Respiratory secretions
Droplet-airborne
Fomites
***Highly contagious except: PERTUSSIS
3rd Phase
ncubation period: PERTUSSIS
6-20 Days