Presented by:

A2 Pediatric Ward
 is a mild, but highly contagious viral
infection common in young children.
 common in infants and children younger
than 5 years old
A. ETIOLOGY
o HFMD is cause by Enterovirus family of
viruses.
o Coxsackie virus A16 and Enterovirus 71

B. RISK FACTORS
 Summer and fall seasons
 Toddler age range
 High risk exposure location
 Ineffective hygiene
 Compromised immune system
1. Meningitis
2. Encephalitis
3. Dehydration
4. The skin vesicles may develop a
secondary bacterial infection
The diagnosis of hand foot and mouth
disease is typically based on clinical
grounds.
MAY ADD BY THE DOCTOR:

1.Throat swab
2.Blood sample(culture and immuno
assay)
3.Stool sample
 The treatment of hand foot and mouth
disease is supportive.
 No anti-viral agent specific for the
etiologic agents.
BACKGROUND OF THE CASE
A.)PATIENT DEMOGRAPHIC AND DIAGNOSIS

O Patient Name : Patient X

O File Number: 7293629
O Age: 3 years and 6 months
O Sex: Male
O Chief complaints: fever for 3 days
O Diagnosis: Upper Respiratory Tract Infection. Hand, foot and mouth
disease
O Name of Consultant: Dr. Chorva
O Date of admission: 11-7-16 @ 1930H
O Date of discharge: 14-7-16 @1400H
O Admission source: OPD
 HISTORY
O A case of 3 years old male Indian
presented to OPD complaining of fever
for 3 days, rash appear on hand , foot
and mouth with poor feeding for 3 days.
 EXAMINATION
O Conscious level GCS 15/15
O Skin –dry, poor skin turgor
O Head and neck-congested throat, there is white
ulcers on mouth and tonsils
O Chest and lungs-good airway entry
O Heart-sounds normal
O Abdomen/urogenital- soft and lax
O Neurological-normal
O Extremities- rashes on foot, hands and mouth
O Psychiatric-normal
1. CBC
Report Date: 29/12/16
2.CRP
Report Date: 29/12/16
3. UREA AND ELECTROLYTES AND LIVER
FUNCTION TEST
Report Date: 11/07/16
 NURSING
MANAGEMENT

Monitor and assess of fluid balance of the
patient
Avoid touching or playing with other
patients
Strict compliance of infection control
measures
Encourage to increase oral intake
Provide tepid sponge bath or full if there is
fever
 Provide health teaching to the parents like:
 *Practicing a good hygiene is the best defense against
HFMD. Children should also be taught not to put their hands
in or near their mouth.
 *It’s also important to disinfect any common areas in your
home or regular basis. You should also disinfect toys, pacifier
and other objects that may be contaminated with the virus.
 *If your child experience symptoms such as fever or sore
throat, stay at home from school. You should continue
avoiding contact with others once the telltale blisters and
rashes develop. This can help you avoid spreading the disease
to others.
 * Do not let children attend nurseries or school until afebrile
and all vesicles have dried up
 *Keep children at home while symptomatic and do not let them
attend activities that mix with other children
 NURSING GOALS INTERVENTIONS EVALUATION
DIAGNOSIS
Hyperthermia After 2 hours *Assess condition and Goal met:
monitored vital signs.
related to of nursing After 2 hours
*Perform Tepid
inflammatory intervention of nursing
Sponge bath.
process as patient will intervention
*Maintain bed rest
evidenced by be able to and adequate rest temperature
Skin warm to maintain a period. decreased to
touch and temperature *Provide cooling normal body
measures.
Body within normal temperature-
Temperature - range. *Remove extra 36.9 C.
clothing or blanket
38.5 C.
*Administer
Antipyretics as
ordered.
NURSING DIAGNOSIS GOALS INTERVENTIONS EVALUATION

Acute pain After 4 hours of *Assess pain, noting Goal met: After
location
related to acute nursing 4 hours of
characteristics and
inflammation of intervention intensity. nursing
hand, foot and patient will intervention,
*Note urine flow and
mouth as verbalize relief characteristics.
patient was
evidenced by of pain. able to
* Encourage to
facial grimace verbalized relief
verbalize concerns.
and abdominal Instruct also the of pain with
pain with pain mother to report any pain score of-0
score of 2. unusualities.
*Provide comfort
measures like back
rub or deep
breathing exercises.
*Administer
analgesics as
indicated.
 NURSING GOALS INTERVENTIONS EVALUATION
DIAGNOSIS
Fluid volume After 24 hours * Assess skin turgor Goal met after
deficit related of nursing *monitor vital sign 24 hours of
to poor intake intervention *Monitor intake and nursing
and mouth patient’s body Output intervention,
sores in the fluid balance *Encourage to normal body
mouth as will maintain increase oral fluid fluid balance
evidenced by intake was
poor skin *Weigh daily maintained.
turgor and dry *Administer IV fluid
lips as ordered
 NURSING GOALS INTERVENTIONS EVALUATION
DIAGNOSIS

Deficient After 15 *Assess Mother’s Goal met after

ability/ readiness
knowledge minutes of 15 minutes of
and barriers to
related to lack nursing learning nursing
of information intervention intervention,
*State objectives
about the patient will be clearly in learner’s Mother was
disease able to term
process and understand able to
*Provide
method of about the verbalized
information relevant
prevention. disease only to the situation understanding
process and *Determines about the
method of patient’s mother disease process
prevention method of
and method of
accessing
information (visual, prevention.
auditory and etc)