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MEDSURG -FINALS (SIR ERICH > TETANUS > Flashcards

TETANUS Flashcards

1
Q

is an infectious disease caused by Clostridium tetani which produces potent exotoxin with prominent systemic neuromuscular efforts manifested by generalized spasmodic contractions of the skeletal musculator.

A

Tetanus

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2
Q

INFECTIOUS AGENT

A

Clostridium tetani

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3
Q

Tetanus is fatal up to 60% of unimmunized persons, usually within________ of onset.

A

10 days,

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4
Q

When symptoms develop within_________, the prognosis is poor. (Longworth, 2000)

A

3 days

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5
Q

INCUBATION PERIOD

A
  • 3 days to 3 weeks in adult
  • 3 to 30 days in Tetanus Neonatorum.
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6
Q

Anaerobic, gram (+) with round terminal spore with slender body giving a drumstick appearance.

A

Clostridium tetani

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7
Q

The organism comes in two form, spore forming and the vegetative form.

A

C. Tetani

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8
Q

The organism releases two types of toxin

A
  1. Tetanospasmin
  2. Tetanolysin
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9
Q

responsible for muscle spasm;

A

Tetanospasmin

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10
Q

responsible for destruction of RBC.

A

Tetanolysin

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11
Q

Source of infection

A
  • Animal and human feces.
  • The organism are found in the intestinal wall of herbivorous animals, including man.
  • Soil and dust.
  • Unsterile sutures, pins, rusty materials, scissors
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12
Q

MOT

A

Normally, the mode of transmission is through punctured wound that is contaminated by dust, soil, or animal excreta containing Cl. Tetanus.

  • Rugged traumatic wounds and burns.
  • Umbilical stump in newborn especially for babies delivered at home with faulty cord dressing; babies delivered to mothers without Tetanus toxoid immunization.
  • Unrecognized wounds (cleaning of the ear with sharp materials)
  • Dental extaction, circumcision, ear piercing.
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13
Q

Clinical Manifestation
Neonate

A

A. Newborn infants have feeding and sucking difficulty.

b. The infant may cry excessively, most of the time voiceless crying.

c. An attempt to suck results in spasm and cyanosis.

d. There is fever due to infection and dehydration.

e. The jaw becomes so stiff that the baby cannot suck or swallow.

f. Tonic and rigid muscular contraction, spasm or convulsion provoked by stimuli.

g. Mild, short, voiceless cry.

h. Cyanosis and pallor

i. May end with flaccidity, exhaustion, and finally, death.

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14
Q

MANIFESTATIONS OF OLDER. CHILDREN AND ADULT

A

If tetanus remains localized, signs of onset are spasm and increased muscle tone near the wound.

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15
Q

MANIFESTATIONS OF OLDER. CHILDREN AND ADULT

If it becomes systemic or genaralized, indications include:

A
  • Hypertonicity, hyperactive tendon reflexes, tachycardia, profuse sweating, low grade fever, and painful involuntary muscle contraction.
  • Neck and facial muscle rigidity. (trismus)
  • Grinning expression (risus sardonicus) – considered as pathognomonic to the disease
  • Board-likeadbomen/abdominalrigidity
  • Opisthotonos
  • Intermittent tonic convulsion lasting for several minutes which may result in cyanosis and sudden death due to asphyxiation.
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16
Q

– considered as pathognomonic to the disease

A

Grinning expression (risus sardonicus)

17
Q

Neck and facial muscle rigidity

A

Trismus

18
Q

type of abnormal posture where the back becomes extremely arched due to muscle spasms

A

Opisthotonos

19
Q

In severe cases,_______ followed by the accumulation of secretions in the lower airway resulting to _______due too involvement of respiratory muscles.

A

laryngospasm, respiratory distress

20
Q

may occur during severe spasm, yielding to coma and death.

A

Fracture of the vertebra

21
Q

In mild cases, after a period of weeks, spasm gradually diminishes in frequency and severity with__________ being the last symptom to disappear.

A

trismus

22
Q

In fatal cases, death is usually occurs during the first ________ of the disease.

A

10 days

23
Q

Complications

A
  • Uncontrolled/involuntary tightening of the vocal cords (laryngospasm)
  • Broken bones (fractures)
  • Septicemia
  • Infections gotten by a patient during a hospital visit (hospital-acquired infections)
  • Breathing difficulty, possibly leading to death (1 to 2 in 10 cases are fatal)
24
Q

Modalities of Treatment:

Specific Within_______ after a punctured wound, the patient should receive ATS, TAT, or TIG especially if the patient does not have any previous immunization.

A

72 hours

25
Q

Modalities of Treatment:

Specific Within 72 hours after a punctured wound, the patient should receive_____, ______, _____ especially if the patient does not have any previous immunization.

A

ATS, TAT, or TIG

26
Q

Treatment: Tetanus toxoid

A

.5cc IM give in standard schedule

27
Q

Treatment: to control infection

A

Pen G Na

28
Q

Treatment: to decrease muslce rigidity and spasm

A

Muscle relaxant

29
Q

Nonspecific Treatments:

A

a. Oxygen inhalation
b. Feed thru NGT
c. Tracheostomy
d. Adequate fluid, electrolyte, and caloric intake e.

30
Q

Good nursing care

A

• Maintainadeqauteairway
• Providecardiacmonitoring
• Maintain an IV line for medication and emergency care if necessary
• Carry out efficient wound care
• Avoid stimulation; warn visitors not to upset or overly
stimulate the patient
• Avoid contractures and pressure sores
• Watch out for urinary retention

31
Q

Prognosis

A

Highest fatality occur at the extreme of life.

• Local tetanus usually offers favorable prognosis, except in dysphagic form of cephalic tetanus.

• Absence of convulsion favors the prognosis especially in patients 20 years old and below.

• Apnea occurs after prolonged spasm and is a critical factor in sudden death.

• Acute respiratory obstruction and over sedation may lead to early death. Response to anticonvulsant therapy is relevant to prognosis.

32
Q

Highest fatality occur at the

A

Extreme of life

33
Q

usually offers favorable prognosis, except in
dysphagic form of cephalic tetanus

A

Local tetanus

34
Q

favors the prognosis especially in patients 20 years old and below.

A

Absence of convulsion

35
Q

occurs after prolonged spasm and is a critical factor in sudden death

A

Apnea

36
Q

________ and _________
occurs after prolonged spasm and is a critical factor in sudden death

A

Acute respiratory obstruction and over sedation

37
Q

Prevention and Control

A
  1. Active immunization of Tetanus Toxoid for Adults 2. DPT for babies and children.

MEDSURG -FINALS (SIR ERICH (13 decks)

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