COMMUNICABLE DISEASE NURSING

DEFINITIONS OF TERMS
1. COMMUNICABLE DISEASE
an illness due to an infectious agent or its toxic products w/c is transmitted directly or indirectly to a well
person or animal or through an agency of an intermediate animal host, vector of the inanimate environment
2. RESERVOIR
natural habitat of the organism that is where it resides and multiplies
3. SOURCE
site from w/c the organism passes immediately to a host
4. MODE OF TRANSMISSION
it indicates the potential of the disease; conveyance of the agent to the host
it can be by common source transmission, contact source, air-borne and vector borne
5. HOST
a person or animal or plant upon w/c a parasite depends for its survival
6. ISOLATION (vs. REVERSE ISOLATION)
the separation of persons suffering from communicable disease or carriers of the infecting organism from
other persons and placing them under such conditions that direct or indirect transmission to susceptible
person is prevented
7. UNIVERSAL PRECAUTIONS
are infectious control measures designed to protect health workers form exposure to diseases
8. INCUBATION PERIOD
the time between exposure to a pathogenic organism and the onset of symptoms of a disease
9. ETIOLOGY
all factors that may be involved in the development of a disease
10. PROPHYLAXIS
prevention of or protection against disease, often involving the use of a biologic chemical or mechanic
agent to destroy o prevent entry of infectious disease
11. PERIOD OF COMMUNICABILITY
refers to a frame of time that a disease is contagious or transmissible by direct or indirect means
12. SEQUELAE
any abnormal conditions that follows and is the result of a disease, treatment or an injury
13. PROGNOSIS
a prediction of the provable outcome of a disease based on the condition of the person and the usual course
of the disease as observed in similar situation
14. PATHOGENICITY
is the ability of a microorganism to produce disease.
15. PATHOGENS
microorganisms that cause diseases in humans are called.
16. VIRULENCE
is the degree of pathogenicity of an infections microorganism.
17. INFECTION
is an invasion and multiplication of microorganisms in body tissue that results in cellular injury.
these microorganisms are called infectious agents.
18. COLONIZATION
is the multiplication of microorganisms on or within a host that does not result in cellular injury.
19. FLORA
are the vegetation of microorganisms on the human body.
Resident flora
microorganisms which are always present on skin
can be reduced through hand washing, but not totally removed
Transient flora
microorganisms that are picked up by the skin from another person or object
attach themselves to the skin and then may be transmitted to a susceptible host

CONTAGIOUS vs. INFECTIOUS

CONTAGIOUS
applied to disease that are easily spread directly
transmitted from person-to-person
INFECTIOUS
are those disease not transmitted by ordinary contact, but require a direct inoculation through a break in the
previously intact skin or mucous membrane
all contagious diseases are infectious
Chain of Infection
Infectious Agent
Agents that produce infections can consist of
bacteria
viruses
fungi
The ability of a microorganism to infect a client is related to:
Pathogenicity
ability to cause disease
Virulence
disease severity
Invasiveness
ability to enter and move through the tissue
Infective Dose
number of organisms needed to initiate infection
Organism Specificity
host preference
Susceptibility of the Host
Source or Reservoir
Required for the microorganism to survive while awaiting a host.
May allow the organism to multiply, making it more dangerous.
The human body is the most common reservoir.
Food, plants, animals, and feces are other common reservoirs.

protozoa
rickettsia
chlamydia

Mode of Transmission
Route of Transmission
Contact Transmission
Vehicle Route
Airborne Transmission
Vectorborne Transmission
Contact Transmission

Direct contact - person to person

Indirect contact - usually an inanimate object

Droplet contact - from coughing, sneezing, or talking by an infected person

Vehicle Route
food

salmonellosis

shegellosis, legionellosis

bacteremia resulting from infusion of a contaminated infusion product

water
drugs
blood
hepatitis B, or non-A non-B hepatitis
Airborne Transmission
Droplet nuclei

 residue of evaporated
Organisms shed into environment from
skin
hair
Dust particles
air containing the infectious agent
Vector Transmission
via contaminated or infected arthropods such as;
flies
mosquitoes
ticks, etc.
Mode of Escape from Reservoir
Respiratory tract
GI tract
GU tract
Open lesion
Mechanical escape
bites from insects
Blood
Mode of Entry into Human Body
1. GI tract
2. GU tract
3. Mucous membrane or skin

4.
5.

wounds or
perineal area

Placenta
Respiratory tract

Susceptible Host
A person with a reduced immune response has increased susceptibility.
The immune response is the bodys natural defense against infection.
Factors Influencing Production of an Infectious Disease:
1. Age
4. Surgery
2. Heredity
5. Nutrition
3. Stress
6. Health Status
Factors Influencing Production of an Infectious Disease
Age
The elderly and children under two years of age are at greatest risk.
Heredity
Conditions or diseases resulting in the absence of or inability to form immune defenses.
Stress
Increase in metabolic rate which results in using up stored energy
Elevation of blood cortisol, decreasing anti-inflammatory responses
Continued stress produces exhaustion, further depleting ability to ward off infection.
Surgery
Eliminates primary barrier of infection.
Predisposes clients to surgical site infections.
Localized infection at wound site can progress to a systemic infection.
Additional risks include catheters and tubes.
Nutrition
Insufficient protein consumption reduces antibody production and inhibits the bodys ability to ward off
infection.
Health Status
Clients w/ disease of their immune system are at greater risk.
Chronic diseases can predispose the client to infection.
Four Stages of Infection

1.
2.
3.
4.

Incubation - the time between exposure to a pathogenic organism and the onset of symptoms of a disease
Prodromal earliest phase of the developing disease condition
Illness
Convalescence - period of recovery after an illness

DEFENSE MECHANISM
OF THE BODY
*******Normal Defense Mechanisms******
Nonspecific immune defenses
Specific immune defenses
Work in harmony to defend the host from pathogens.
Nonspecific Defense Mechanisms
Protect the host from all microorganisms
Not dependent on prior exposure to the antigen
1. Skin and Normal Flora
2. Mucous Membranes
3. Sneeze, Cough Reflexes
4. Tearing Reflexes

5.
6.
7.

Elimination
Acidic Environment
Inflammatory Response

Nonspecific Immune Defenses

Mucous Membranes
Mucus entraps infectious agents and contains substances that inhibit bacterial growth.
Cilia trap and propel mucus and microorganisms away from the lungs.
Skin
Intact skin is the bodys first line of defense against infection.
Sebum is produced by the skin and contains fatty acids that kill some bacteria.
Normal Flora
Normal flora residing on the skin compete with pathogenic flora for food and inhibit their multiplication.
Inappropriate antibiotic use may disrupt the balance of normal flora.
Sneeze and Cough Reflexes
Physically expel mucus and microorganisms from the respiratory tract and oral cavity with force
Elimination Patterns and Acidic Environment
Resident flora of the large intestines
Flushing action of urination
Mechanical process of defecation
Acidic environment of urine and vagina
Inflammatory Response
Tissue injury caused by bacteria, trauma, chemicals, heat, or any other phenomenon
Release of substances that produce secondary changes in the tissue
Tearing Reflex
Protects the eyes by continually flushing away microorganisms
Inflammatory Response
Tissue injury caused by bacteria, trauma, chemicals, heat, or any other phenomenon
Release of substances that produce secondary changes in the tissue
Specific Immune Defense
(The Immune Responses)
Immunity is a specific defense mechanism that creates an immune response to a specific invading antigen.
Immune Responses
Active immunity results from the development within the body of antibodies that neutralize the infective agent.
Passive immunity is acquired by the introduction of preformed antibodies.
Acquired immunity results either from exposure to an antigen or from the passive injection of immunoglobulins.
Natural immunity refers to the genetically determined response of protection within a specific species.
Artificial immunity is produced following a vaccine.

The Humoral Immune Response

B lymphocytes recognize the antigen as an enemy.
Immunoglobulins are plasma protein cells that produce five different classes of antibodies (IgG, IgA, IgM, IgE, and
IgD).GAMED
Immunoglobulins circulate throughout the bloodstream for the purpose of destroying antigens.
Cell-Mediated Immunity
Fights pathogens that survive inside cells.
Antigen stimulates the release of activated T cells.
T-helper cells
T-suppressor cells
T-cytotoxic cells
Nosocomial Infections
Infections acquired in a health care setting that were not present or incubating at the time of the clients admission
Common Sites of Nosocomial Infections
Urinary tract
Surgical sites
Respiratory tract
Localized Versus Systemic Infections
Infection results from tissue invasion and damage by an infectious agent.
Localized infections are limited to a defined area or single organ.
Systemic infections affect the entire body and involve multiple organs.
Nosocomial Infections
Procedures identified as possible sources of infection are:
Inadequate hand washing
Catheterization technique
Improper suctioning technique
Improper dressing-change technique
Contamination of closed drain system
ASEPSIS
Asepsis is the absence of microorganisms.
Aseptic technique is the infection control practice used to prevent the transmission of pathogens.
Medical Asepsis
(Clean Technique)
Practices to reduce the number, growth, and spread of microorganisms
The most common cause of nosocomial infections is contaminated hands of health care providers.
Wash hands before and after every client contact.
Surgical Asepsis
(Sterile Technique)
Practices that eliminate all microorganisms and spores from an object or area
Surgical scrub
Sterile fields
Surgical attire
Sterile instruments and equipment
Role of Health Care Personnel and Health Agencies in Infection Control
Reinforce adherence to isolation.
Client and family instruction
Post signs indicating type of isolation.
Alert to psychological discomfort
Provide necessary supplies.
Place clients in a private room with adequate
ventilation.
Use disposable supplies and equipment.
Labeling of all articles leaving the room
Use of impermeable bags or double bagging

DISEASE

CAUSATIVE
AGENT

DIAGNOSPATHOGNO-MONIC SIGN
TIC TEST
A. RESPIRATORY
Chest x-ray, HEMOPTYSIS
AFB,
Afternoon fever, night sweats, body
Mantoux
malaise, weight loss, cough (dry to
test, sputum productive), dyspnea, hoarseness of
GS
voice, chest pain

1. PULMONARY
TUBERCULOSIS
(Kocks, Phthisis,
Consumption)

Mycobacterium
Tuberculosis

2. PNEUMONIA

Streptococcus
pneumoniae,
staphyslococcus
aureus,
diplococcus
pneumoniae

Chest x-ray,
sputum GS,
increase
WBC

3. PERTUSSIS
(Whooping Cough)

Bordetella
Pertussis

Nasopharyn
geal swab,
sputum
culture,
CBC

NURSING CARE

Maintain respiratory isolation until

patient responds to treatment,
Administer meds, O2 as ordered
Check for purulent, or bloody
expectoration
Semi-fowlers position
Give health teaching about PTB,
Stop smoking
RUSTY SPUTUM
Maintain patent airway and
Sudden onset of chills with rising
adequate oxygenation, rest &
fever, stabbing chest pain aggravated nutrition
by coughing, choking cough, body
Control spread of infection, TSB,
malaise, labored respiration, rapid
CPT
and pounding pulse,
Monitor danger signs like marked
dyspnea, delirium, cold moist skin,
cyanosis and exhaustion
WHOOPING COUGH
Isolation and medical asepsis
CATARRHAL STAGE
During paroxysm pt should not be
Coryza, sneezing, lacrimation, & dry left alone and suctioning
bronchial cough becoming irritating, equipment should be ready at all
hacking and nocturnal
times to avoid obstruction of
PAROXYSMAL STAGE
airway
Spasmodic, recurrent with excessive Sunshine and fresh air is important
explosive outburst of cough in a
but should be protected from draft
series of 5-10 coughs in one
Should be kept quiet as possible

4. DIPTHERIA
(Strangling angels
disease, Klebbs
Loeffler Disease)
YPES
A. NASAL
B. TONSILAR
C. NASO
PHARYNGEAL
D. WOUND/
CUTANEOUS
4. INFLUENZA
(La grippe, Flu)

5. BIRDSS FLU
(Avian Infuenza)

expiration & ends in a loud crowing

inspiratory whoop & chocking on
mucuc that causes vomiting
CONVALESCENT
Gradual dec in paroxysm of
coughing both in frequency &
severity, vomiting ceases
Coryne-bacterium Nose and
PSEUDOMEMBRANE
Diphteriae,
throat swab DOB, Husky voice, Increase HR
Klebbs Loeffler
Virulence
Stridor
Bacillus
test
Nasal drainage/secretion
Schicks test Swelling of the palate
Molony test Low-grade fever
Loefler slant Insidious feeling with fatigue,
malaise, slight sore throat and inc
temp, cervical adenitis
Swollen neck- BULLS NECK
SKIN- with yellow spots or sores
COMPLICATION- myocarditis,
polyneuritis, airway obstruction
RNA containing
Oropharyng Sudden, chilly sensation,
myxoviruses type eal washing hyperpyrexia, malaise, sore throat,
A,B,C
or swabbing coryza, rhinorrhea, myalgia,
for virus
headache, severe back ache with
culture
sweating, vomiting
Viral
serology
WBC
Avian Influenza
Viral
Fever, sore throat, cough
Virus (AI 1)
Culture
Severe case- pneumonia
(H5N1)

since activity and excitement

precipitate paroxysm
Provide warm baths, keep the bed
dry and free from soiled linens
Intake and output should be
closely monitored
Absolute bed rest x 2 wks
Soft diet, small frequent feedings
Fruit juices rich in Vit.C
Ice collar applied to the neck
Care of the nose and throat
SUPPORTIVE CARE
-adequate nutrition, fluid and
electrolyte balance
-O2 inhalation
-tracheostomy if required
-give Anti-Diptheria Serum
-Penicillin may be give as ordered
Stay at home
Drink plenty of fluids
TSB
Isolate
Limit strenuous activity
Give Paracetamol, Aspirin,
Ibuprofen as prescribed
Same as Flu

B. GASTRO
BLOODY MUCOID STOOL
Colicky abdominal pain
Watery foul smelling stools

1. AMEBIASIS
(Amebic Dysentery)

Entameba
Hystolitica

Fecalysis,
rectal swab

2. CHOLERA
(Eltor)

Vibrio Cholerae
- cholerae
(classica
l
- Eltor
Vibrio Comma
- Ogawa
- Inaba
- Hirojim
a
Shigella bacilli
Group
A S.
Dysenterae
B.- S. Flexneri
C. S. Boydii
D. S. Sonnei

Fecalysis,
rectal swab

Profuse painless RICE WATERY

STOOL without blood or mucus
Occasional vomiting
Rapid dehydration
Acidosis and hypokalemia
Oliguria to anuria

Fecalysis,
rectal swab
CBC- Rise in
agglutination
titers after the
first week

Persistent DIARRHEA WITH

BLOOD, MUCUS & PUS
(WATERY) WITH TENESMUS
Cramping and abdominal pain
Profound prostration
Nausea and vomiting

3. SHIGELLOSIS
(Bacillary Dysentery)

1. HEPATITIS
*A- Infectious
hepatitis, Epidemic
Hepatitis, Epidemic

Hepatitis A
(HAV)

C. HEPATO-ENTERIC
PRODROMAL
SGOT inc.
Fever, malaise, anorexia, abdominal
Inc. phosphate discomfort, nausea, headache
Leucopenia
ACUTE ICTERIC PERIOD

Enteric isolation
Bed rest
BRAT
Adequate nutrition and hydration
Monitor I & O
Rehydrate parenterally/orally
Perianal care
Deodorize room
Prompt fluid therapy with volumes
to correct fluid and electrolytes
Place in watten bed
Keep linen dry and clean
Keep place quiet and well
ventilated
Give oresol
Give tetracycline as prescribed
Enteric isolation
Maintain fluid and electrolyte
imbalance to prevent dehydration

Maintain bedrest until enzyme

level begin to normalize
Give O2 as needed
Provide adequate nutrition

Jaundice, Catarrhal
Jaundice, Type A
hepatitis, HA
*B- Type B hepatitis,
serum hepatitis,
homologous serum
jaundice, Australian
Antigen hepatitis, HB
*C- Parenterally Non
A- Non B hepatitis,
Post-transfusion Non
A non B, HC
*D- Delta agent
hepatitis, viral
hepatitis D, Delta
associated hepatitis,
hepatitis delta virus
*E- Enterically
transmitted non A non
B hepatitis
2. TYPHOID FEVER
(Enteric Fever, Typhus
Abdominalis)

(pre-icteric)
Leukocytosis
(later)
Hepatitis B
(HBV)

Hepatitis C,
a flavivirus
HDV- unable to
replicate a cell by
itself, requires coinfection with HBV
to undergo
replication cycle

Coefficient of
183 S
Coefficient of
157 S for HAV
Salmonella
Typhosa/Typhi

Tenesmus, jaundice, scleral icterus,

lassitude, enlarged liver
DEFERVESCENT
-jaundice emerges
HbsAgN/V
hepatistis B
Vague abdominal discomfort
surface
Arthralgic
antigen
Rash often progressing to jaundice
ELISA
N/V
SGPT <800IU Vague abdominal discomfort
Anorexia
Progressing to jaundice less
frequently to HB
Serologic test Inflammation of the liver maybe
for HDV
severe and always co-exist with
(anti-D-IgG), HBV
anti- D-IgM)

Diet- high in calories, CHO,

limited fats
Monitor S/S of dehydration
Maintain intact mucus membrane
Health teachings to px about
disease transmission, isolation and
avoidance of blood donation
Treat sexual partner, all preganant
woman should undergo HbsAg

Same as HA

Typhi-dot
ELISA
Widals test
Rectal swab

SMALL ROSE SPOTS on chest and

abdomen
Ladder-like fever
Chills, Sweating, Headache,
malaise, anorexia, bradycardia, nonproductive cough, constipation,
mental dullness, slight deafness,
parotitis

Enteric precaution
TSB, watch for bladder distention
and intestinal bleeding
Give high calorie, low residue diet
during febrile stage
Maintain, restore fluid and
electrolytes
Maintain good personal hygiene

3.
SCHISTOSOMIASIS
(Blood Fluke Disease,
Snail Fever,
Bilharziasis)

Schistosoma
Japonicum,
Schistosoma
Mansoni,
Schistosoma
Haematobium

1. RABIES
(lyssa, Hydrophobia)

Rhabdo virus,
Rabies Virus

Fecalysis,
BIG BELLY- due to hepatomegally,
Kato-katz
splenomegally, lymphadenopathy
technique
Bloody mucoid-stool
ELIZA
SWIMMERS ITCH- pruritic rash at
COPTthe site of penetration
Cercum Ova
Headache, dizziness, and convulsion
Precipetin
when parasite reaches the brain
Test
Becomes icteric, jaundice
D. CENTRAL NERVOUS SYSTEM
FRAPRODROMAL/INVASIVE
Flourescent
-fever, anorexia, malaise, sore throat,
Rabies
copious salivation, lacrimation,
Antibody
perspiration, irritability, excitability,
Presence of
apprehensiveness, depression,
negri body in melancholia & insomnia
dogs brain
EXCITEMENT/NEUROLOGICAL
Isolation from Marked excitation, apprehension,
pts saliva and even terror, delirium with nuchal
throat
rigidity, involuntary twitching,
maniacal behavior, eyes fixed and
glossy, skin is cold and clammy,
severe painful spasm of muscles of
the mouth, larynx and pharynx,
AEROPHOBIA, HYDROPHOBIA,
PHOTOPHOBIA, profuse drooling
of saliva, tonic or clonic contraction
of muscles
TERMINAL/PARALYTIC
Pt becomes quiet, unconscious, loss
of bowel and urinary control,
progressive paralysis, DEATH

DRUG OF CHOICE
PRAZIQUANTEL
Proper disposal of excreta
Use of rubber boots
Treat small breeding places
Eradicate snail
Improve irrigation system
Report endemic case
Isolate patient
Emotional and spiritual support
Provide optimum comfort
Darken the room, provide quiet
and safe environment
IVF should be wrapped and needle
should be securely anchored
Patient should not be bathed and
there should be no running water
in the room or within hearing
distance of the patient
Proper counseling of relative
Post-exposure treatment of relative
Post-mortem care
Concurrent and terminal
disinfection

2. ENCEPHALITIS
(Brain Fever)

Bacteria, virus,
fungi, rikettsia,
toxins, chemical
substances, or
trauma

CSF Analysis,
ELISA (IgM)
Polymerase
chain reaction

3. MENINGITIS
(CSF Fever)

Bacteria, virus,
fungi

Lumbar
Puncture test,
urine culture,
blood smear
and culture,
gram stain

4. MENINGOCOCCEMIA

Neisseria
Meningitidis

Lumbar
Puncture test

Chills, sore throat, arthralgia,

myalgia, abdominal pain
Nuchal rigidity, ataxia, tremors,
mental confusion, speech difficulty,
ocular palsy, PTOSIS, DOB,
DYSPHAGIA
MOTOR DISTURBANCES
Persistent convulsions, Parkinsonian
syndrome or paralysis agitans,
epilepsy
MENTAL DISTURBANCES
Mental dullness, mental
deterioration, lethargy, mental
depression, sleep disturbance
ENDOCRINE DISTURBANCES
Patient may grow fat or thin, lost of
sexual interest or activity
Headache, hyperpyrexia, convulsion
fever, nausea and vomiting, nuchalspinal rigidity, meningeal irritation
+ BRUDZINSKI SIGN, +
KERNIGS SIGN, +
OPISTHOTONUS, exaggerated and
symmetrical DTR,
signs of increase ICP: bulging
fontanel for infants, projectile
vomiting, severe frontal headache,
blurring of vision, alteration in
sensorium
Nasopharyngitis, high grade fever
with chills, N/V, malaise, headache,

Control of convulsions, promote

safe environment
Sanitary disposal of nose and
throat secretions
TSB, unless the px is comatose,
fluid should be encouraged
Oral care should be strictly done
Record I &O, provide mouth gag

Check NVS
Monitor fluid balance
Ensure patients comfort
Position the patient carefully to
prevent joint stiffness and neck
pain
Follow strict aseptic technique
Provide reassurance and support to
px and family
Administer mannitol, antibiotics,
anticonvulsant with precaution
Same as meningitis
Prophylactic drug- Rifampicin

5. TETANUS
(Lock jaw)

Clostridium
Tetani

1. MUMPS
(Infectious Parotitis)

Myxovirus
parotidis

1. DENGUE FEVER
(Breakbone fever,
Dandy Fever,
Infectious

Flaviviruses
(dengue virus
1,2,3,&4)
Arboviruses,

Serologic test
EIA

petechial, purpuric, or echymotic

hemorrhages scattered over the
entire body and mucous membrane
WATERHOUSE FRIEDRICHSEN
SYNDROME- Adrenal medullary
hemorrhage
RISUS SARDONICUS/
SARDONIC GRIN/SARDONIC
SMILE, opisthotonus, lock jaw,
board-like abdomen, intermittent
tonic convulsions, neck facial
muscle rigidity (trismus),
Tetanolysin destruction of RBC
Tetanospasmin- muscle contraction

E. PAROTID GLAND
Virus
SWELLING OF SALIVARY
isolation in
GLANDS leading to dysphagia and
saliva, urine
earache, enlargement and reddening
of Whartons duct and Stensens
duct. Fever 1 day prior to grandular
swelling, anorexia, headache
COMPLICATION
Epididymo-orchitis, oophoritis,
encephalitis, meningoencephalitis,
mastitis, neuritis, thyroiditis
F. BLOOD VECTOR BORNE
Platelet count GRADE I FEBRILE STAGE
<100cubic
Fever, headache, +tourniquet test,
mm
anorexia, N/V, petechial rash,
+HERMANS SIGN, generalized

Give Tetanus toxoid, ATS, TIG

O2 inhalation
Feed thru NGT
Tracheostomy
Adequate fluid and electrolytes
maintain adequate airway
Avoid contractures and pressure
sores, avoid stimulation: limit
visitors, darkened and quiet room
Respiratory isolation x 9 days from
onset of swelling
Bedrest until swelling subsides
Give fluids and soft bland food
Provide warm or cold pack for
relief of discomfort, light support
to scrotum
Hot or cold compresses to swollen
neck area
Kept in mosquito free environment
Bedrest
Monitor V/S
Apply ice pack for nose bleeding,

Thrombocytopenic
Purpura, Hemorrhagic
Fever)

Chikungunya
viruses
VECTOR:
Aedes Egypti

2. MALARIA
(Ague, Paludism,
Marsh Fever, Periodic
Fever)

Plasmodium
Ovale
Plasmodium
Vivax
Plasmodium
Falciparum
Plasmodium
Malariae
VECTOR:
Anopheles
Leptospira

3. LEPTOSPIROSIS
(Weils Disease,
Canicola Fever,
VECTOR:
Hemorrhagic Jaundice, Rats/rodents
Mud Fever, Swineherds Disease)

Malarial
smear, rapid
diagnostic test
(RDT)

Isolation of
Leptospires
* 1-7 days
(blood)
* 4-10 days
(CSF)
* after 10
days (urine)

abdominal pain, arthralgia, myalgia

GRADE II- HEMORRHAGIC
All signs & symptoms of grade I +
spontaneous bleeding
GRADE III- CIRCULATORY
Weak pulse, narrow pulse pressure,
hypotension, cold clammy skin and
restlessness
GRADE IV- SHOCK
Undetectable pulse pressure and
pulse
SHIVERING CHILLS
Rapid rising of fever with severe
headache, profuse sweating,
myalgia, splenomegally,
hepatomegally, orthostatic
hypotension,
CEREBRAL MALARIA
Changes in sensorium, severe
headache and vomiting, Jacksonian
or grand mal seizure

Restore blood volume place on

trendelenburg or transfuse blood as
ordered.
TSB, give Paracetamol, avoid
giving Aspirin
Use soft bristled toothbrush
Avoid dark-color foods
Increase fluid intake
Give analgesic as prescribed

SEPTIC STAGE
Remittent fever, chills, headache,
anorexia, abdominal pain, severe
prostration, respiratory distress
IMMUNE OR TOXIC STAGE
Headache, meningeal manifestation
like convulsion, oliguria and anuria
with progressive renal failure, shock,
coma, CHF

Isolate patient proper disposal of

urine
Keep under close surveillance
Eradicate rats, rodents
Bed rest, adequate diet
Administer fluid, electrolytes and
blood as indicated, Tetracycline,
Pen G Na, Peritoneal Dialysis as
ordered

Strict monitoring of I&O, VS

TSB
Hot application or offering hot
drinks during chilling
Encourage comfort and
psychological support
Watch for S/S of bleeding,
evaluate degree of anemia, watch
out for neuro toxicity

4. FILARIASIS
(Elephantiasis)

1. MEASLES
(7-day fever, red
measles, Rubeola)

2. GERMAN
MEASLES
(Rubella, 3-day fever)

Wuchereria
Bancrofti
Bruglia Malayi

Circulating
Filarial
Antigen
(CFA)

CONVALESCENCE
Relapse may occur during 4th 5th
week
ELEPHANTIASIS
Lymphedema, lymphangitis,
lymphadenopathy in arms, breast,
scrotum, legs

G. INTEGUMENTARY (ERUPTIVE FEVER DISEASE)

Rubeola Virus,
WBC,
PRODROMAL PERIOD
paramyxoWrights stain Low grade fever, headache, malaise,
viruses,
of sputum or
3 Cs coryza, conjunctivitis, cough
Morbilli
nasal scraping Presence of enanthem (KOPLIK
SPOT, STIMSONS LINE0
ERUPTIVE PERIOD
Rashes(erythematous,
maculopapular eruption behind ears,
face then neck, arms, trunk, legs)
high grade fever, anorexia,
irritability, abdominal tympanism,
pruritus, lethargy
CONVALESCENCE PERIOD
Rashes fades away, fever subsides,
symptoms subside & appetite returns
Rubella Virus
Virus
PRODROMAL PERIOD
Family:
isolation from Low grade fever, headache, malaise,
Togaviridae
nasal and
mild coryza, conjunctivitis, POST-

Sleep under mosquito nets

Give DEC as prescribed
Surgery may be used to remove
surplus tissue and provide a way to
drain fluid around the lymphatic
vessels.
Elevate legs and apply elastic
bandages
DEC fortified salts
Isolation (quiet, well ventilated,
subdued light)
TSB
Skin care
Oral and nasal hygiene
Care of eyes (sensitive to light)
and ears (check for mastoid
infection).
Change position every 3-4 hours

Isolation
Bedrest until fever subsides
Darken room to avoid photophobia

Genus:
Rubivirus

throat
washing,
urine

3. VARICELLA
(Chicken Pox)

VZ-Virus

Virus
isolation from
vesicle fluid,
pustule

4. HERPES ZOSTER
(Shingles)

VZ- Virus

Tissue culture
technique,
smear of
vesicle fluid

AURICULAR, SUBOCCIPITAL,
CERVICAL
LYMPHADENOPATHY which
occur on the 3rd to 5th day after onset
ERUPTIVE PERIOD
FORCHEIMERS SPOT
Eruption appears after the onset of
adenopathy, + testicular pain in
young adults, polyarthralgia and
polyarthritis
PRE-ERUPTIVE PERIOD
Mild, fever, malaise
ERUPTIVE PERIOD
Centrifugal growth of rashes
MACULE- lesion that is not
elevated above the skin surface
PAPULE- lesion that is elevated
above the skin 3mm diameter
VESICLE- a pop-like eruption filled
with fluid
PUSTULE- vesicle that is infected
or filled with pus
CRUST- scab or eschar
PRODROMAL PERIOD
Malaise, fever
ERUPTIVE PERIOD
Pustule to vesicles to scab
Lesion is unilateral and appears in
cluster following a peripheral nerve
route
Eruption has neural distribution and

Mild liquid diet but nourishing

Irrigate eyes with warm saline to
relieve irritation
Care of the ears
Good ventilation
Prevent spread of infection

Respiratory isolation until all

vesicles have crusted
Hygienic measure to prevent
complication
Proper disposal of nasopharyngeal
secretion
Disinfection of linen by sunlight or
boiling
Cut fingernails and wash hands
For child- apply mittens
Provide diversional activities to
avoid scratching of vesicles.
Strict isolation precaution
Apply cool, wet dressings with
NSS to pruritic lesions
Avoid cross-infection

1. AIDS
(Acquired Immune
Deficiency Syndrome)

2. SYPHILIS

is painful
H. SEXUALLY TRANSMITTED DISEASE
HIV- Human
ELISA (Initial MINOR SIGNS
Immunotest x 3)
Persistent cough x 1 month
deficiency Virus WESTERN
Generalized pruritic dermatitis
BLOT
Recurrent herpes zoster
(Confirmatory Oropharyngeal candidiasis
Chronic disseminated herpes
simplex
Generalized lymphadenopathy
MAJOR SIGNS
Weight loss- 10 % BW
Chronic diarrhea x > 1 month
Prolonged fever x 1 month
COMPLICATIONS
Pneumocystic Carinii Pneumoniae
Oral Candidiasis, Toxoplasmosis of
CNS, Wasting syndrome (chronic
diarrhea), PTB, EPTB, Cancers
(Kaposis Sarcoma, Cervical
Dysplasia and Cancer, NonHodgkins Lymphoma
Treponema
Pallidum

Dark-Field
Examination
of Chancre
Fluid

chancre or primary sore (painless)

Influenza-like Syndrome
5 common lesion
-dermatitis
-mucous patches
-alopecia
-Iritis

FOUR CS
COMPLIANCE- gives
information and counsels the client
resulting in client following
treatment, prevention, and
reccmmendation successfully
COUNSELLING/EDUCATION
About treatment, disease, guidance
on how to avoid STD again
Facts about HIV and AIDS
CONTACT TRACING- Tracing
out and providing treatment on
partners
CONDOMS- Promoting condom
use, instructing about their use and
providing them.

Case finding
Health teaching &
guidance along preventive
measure
Proper direction on how to
use community resources
and services

3. Gonorrhea

1. ASCARIASIS
(Roundworm
infection)

Neisseria
Gonorrheae

Ascaris
Lumbricoides

Identification
of the
organism
-Gramstrained
Smear
-Culture
-Direct
Fluorescent
Antibody Test

purulent urethral
discharge
dysuria
prostatitis
pelvic pain and fever
severe scrotal pain
urethral sticture
spread of infection to
posterior urethra, prostate,
seminal vesicles and
epididymitis
inflamed cervix w/ purulent
discharge
infection spreading to anus
and urethra and up to the
endometrium
vaginal discharge
urinary frequency and pain
I. PARASITISM
Stool for Ova Malnutrition due to damage to the
Kato
intestinal mucosa imparing
techniques,
absorption of nutrients
abdominal
Biliary Tract, Intestinal obstruction
xray, CBC
Hepatic abscess

Isolation of patient
Neonatal prevention
silver nitrate
aqueous penicillin
given IV or IM for
positve gonorrhea
mothers
Control Measures
active
immunization
passive
immunization
public health
control
Health Education

Importance of personal hygiene

Availability of toilet facility
Deworming with Mebendazole
15cc as single dose as ordered
Improve nutrition