I.

INTRODUCTION

A. OVERVIEW

Tetanus is a serious bacterial disease that affects your nervous system, leading

to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus

can interfere with your ability to breathe and can threaten your life. Tetanus is

commonly known as "lockjaw."

The incubation period is within three days to three weeks in adults and three to

thirty days in the newborn (tetanus neonatorum)

There's no cure for tetanus. Treatment focuses on managing complications

until the effects of the tetanus toxin resolve.

Symptoms

Signs and symptoms of tetanus appear anytime from a few days to several

weeks after tetanus bacteria enter your body through a wound. The average incubation

period is seven to 10 days.

Common signs and symptoms of tetanus include:

 Spasms and stiffness in your jaw muscles (trismus)

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 Stiffness of your neck muscles

 Difficulty swallowing

 Stiffness of your abdominal muscles

 Painful body spasms lasting for several minutes, typically triggered by minor

occurrences, such as a draft, loud noise, physical touch or light

Possible other signs and symptoms include:

 Fever

 Sweating

 Elevated blood pressure

 Rapid heart rate

Causes

Spores of the bacteria that cause tetanus, Clostridium tetani, are found in soil,

dust and animal feces. When they enter a deep flesh wound, spores grow into bacteria

that can produce a powerful toxin, tetanospasmin, which impairs the nerves that

control your muscles (motor neurons). The toxin can cause muscle stiffness and

spasms — the major signs of tetanus.

B. STATISTICAL DATA

International statistics

This report summarizes the results of that analysis, which found that 233

tetanus cases were reported during 2001--2008; among the 197 cases with known

outcomes, the case-fatality rate was 13.2%. Average annual incidence during that

period was 0.10 per 1 million population overall and 0.23 among persons aged ≥65

years.

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Reference: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6012a1.htm

National Statistic

In the Philippines the incidence rate of tetanus is 12 out of 86,241,627

Scope and Limitation

On June 18, 2018, the student nurses assigned at San Lazaro Hospital Female/Adult

Ward from 1pm to 5pm shift under the supervision of our clinical instructor Sir Eligio

S. Razalan. The student nurses received the patient lying on bed, with IVF of PNSS

inserted at left metacarpal vein. The data is collected via head to toe physical

assessment, interviews with the patient, family members and clinical records,

monitoring of vital signs, recording of present observation, formulating nursing care

plan, implementation of therapeutic management, and health teaching as part of my

duty.

Background of the Study

Patient T is a 71-year-old, female, admitted San Lazaro Hospital last May 31,

2018. She was admitted to the said hospital with chief complaint of weakness.

This case study aims to identify patient’s problems and health needs in order

to promote the general health of the patient by providing proper intervention through

the application of nursing process.

This case was chosen by the student nurses for them to practice their skills in

formulating and implementing a nursing care plan and in conducting a thorough

assessment to help in managing the patient’s case and to have additional information

about the case and to further understand the normal physiology, disease process,

clinical manifestation, nursing intervention, prevention and control.

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As student nurses, we could help our patient by having a deep understanding

of the disease, that we may learn the proper intervention of the Tetanus patients. In

this way, we could render quality care for them. It is our responsibility to render

information and impart health teachings to improve the condition to our patients to the

best of our abilities. One of the characteristics that we, student nurses, should have is

to be informative and only through a keen of disease such as this way for us to gain all

the information that we need to learn.

The student nurses choose this case to practice their skills in formulating

and implementing a nursing care plan, in conducting a thorough assessment to help in

managing the patient's case and to develop my skills. And to execute this case study

with the help of the concepts in Medical-Surgical Nursing Course, Human Anatomy

and Physiology and other science related studies.

General Objectives

This study is designed for the student nurses to become practiced, well-

informed and mannered in delivering holistic care for patients diagnosed with tetanus.

Specific Objectives:

 To demonstrate the vision/mission of the school which is service oriented,

research motivated

 Discuss the anatomy and physiology of the Nervous System

 Define Tetanus. Learn about major etiologic its causes, identify its clinical

manifestation and risk factors.

 Be familiar with the pathophysiology of Tetanus

 Be acquainted with the different drugs, its actions, and perform obligatory

nursing responses for each.

 Plan for a suitable nursing care.

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 Establish a nurse-patient interaction through exchanging of thoughts and

information

 Institution bond between the student nurse and the patient.