communicable diseases

Question 1

Measles

Answer 1

D/S Highly contagious communicable maculopapular lesions cover body
E/T Rubeola virus; 10- to 20-day incubation period
S/S Gradual onset; rhinitis, drowsiness, anorexia, high fever, Koplik’s spots on oral mucosa, photophobia, cough
D/X Clinical picture; leukopenia
T/X Symptomatic; BR, darkened room; antipyretics, liquids, isolation
P/P Benign, runs 5 days; complications of croup, conjunctivitis, hepatitis/If exposed, gamma globulin; active immunization

Question 2

Rubella German measles

Answer 2

D/S Acute infectious fever, rash much like measles but shorter course
E/T Rubella virus with 14- to 21-day incubation period
S/S Malaise, headache, slight fever, sore throat, pale red rash, slightly elevated discrete papules, highly diffuse
D/X Isolate virus or detect its antibody
T/X Nonspecific, symptomatic; BR, topical antipruritics, warm water baths
P/P Usually good; dangerous in pregnant women/Immunization; if exposed, gamma globulin

Question 3

Mumps

Answer 3

D/S Acute contagious, fever, inflammation of parotid salivary glands
E/T Mumps virus, 18-day incubation period; transmitted by droplets of saliva
S/S Unilateral or bilateral swollen parotid glands, headache, malaise, fever, earache
D/X Clinical picture, history of exposure
T/X Analgesics, antipyretics, adequate fluid intake, isolation
P/P Good; complications include epididymo-orchitis, pancreatitis/Mumps vaccine, avoiding exposure

Question 4

VZV

Answer 4

D/S Highly contagious; distinctive rash of macules, papules, vesicles, crusts
E/T Varicella-zoster virus (VZV); 2- to 3-week incubation period via respiratory route
S/S Pruritic rash, erythematous macules, papules, vesicles, scabs, anorexia, malaise
D/X Clinical picture, history of exposure
T/X Isolation; reducing itching with calamine lotion or cool bicarbonate soda
P/P Good; complications secondary to bacterial skin infection/Varcella- zoster immune globulin

Question 5

Diphtheria

Answer 5

D/S Acute, life-threatening, membrane-like coating that forms over mucous membrane surfaces of respiratory tract; toxic reaction primarily affecting heart, peripheral nerves
E/T Corynebacterium diphtheriae, 1- 2-day incubation; false membrane enlarges to impair respiratory function
S/S Slight headache, malaise, mild fever; appearance of false membrane to tonsils, pharynx; steady, blood-tinged nasal discharge
D/X Characteristic membrane; culture and sensitivity testing of bacteria
T/X Diphtheria antitoxin, isolation, BR, soft or liquid diet
P/P Varies according to severity of disease; death may result/Immunization

Question 6

Pertussis

Answer 6

D/S Acute, highly infectious; repetitious, paroxysmal cough; prolonged, harsh, shrill sound during inspiration (the “whoop”)
E/T Bordetella pertussis; 7-to-10-day incubation period; organism multiplies along airway, affecting bronchi, bronchioles; mucus accumulates and obstructs airflow
S/S
Catarrhal stage: Gradual onset; coldlike symptoms, fever, running nose
Paroxysmal stage: Classic cough in periodic attacks, weight loss, dehydration
Decline stage: Gradual diminishing of coughing
D/X History of exposure, classic cough, very high white blood cell count, identification of bacteria
T/X Antibiotics during catarrhal stage; adequate nutrition, fluid intake, clear mucus
P/P Varies; uncomplicated lasts 12 weeks; death can result/Immunization series

Question 7

Tetanus

Answer 7

D/S Acute, life-threatening, persistent, painful contractions of skeletal muscles
E/T Clostridium tetani, commonly found in soil; spores enter body by puncture wound, producing powerful toxin
S/S Either gradual or abrupt; jaw stiffness, involvement of esophageal muscles, some neck muscles; jaws become rigidly fixed, altered voice, contortion of facial muscles with contractions
D/X Classic symptoms

T/X Clean, débride site of wound; human tetanus immune globulin, muscle relaxants, trachial tube
P/P Frequently fatal, especially in unimmunized clients/Immunization with boosters