FAST-FASTER-FASTEST : COMMUNICABLE DISEASE NURSING

Communicable Disease Nursing
Christian Steve C. Valenzuela, R.N
Lecturer

Will you please help me distinguish the difference of the terms communicable, contagious and infectious?
2

“All contagious diseases are infectious, but not all infectious diseases are necessarily contagious.”
3

4
Major Disciplines of Infection

5
SPORADIC
EPIDEMIC
PANDEMIC
ENDEMIC
Agent
Environment
Host

6
INFESTATION
INFECTION
CARRIER
CASE
SUSPECT
CONTACT
RESERVOIR
HOST
ISOLATION
QUARANTINE
BACTERIOSTATIC
BACTERICIDAL

7
STERILIZATION
DISINFECTION
CLEANING

D’ Chain of Infection
8
Microorganism capable of producing a dse.
Environment/object on which an organism can survive & multiply.
Way in which an organism leaves the reservoir.
Means by which microbes passes from POEx of a reservoir to POEn of a susceptible host.
Permits the organism to gain entrance into the host.
A person at risk for infection.

Rickettsiae
Bacteria
Virus
Parasites
9
Fungi
Protozoa
Infectious agents

10
Contact
Airborne
Vehicle
Vector-borne
What are the modes of transmission?

11
Recovery

12
CONTROL MEASURES
Standard/ Universal
Transmission-based
Precautions
Precautions

13
Categories of Isolation
Precautions:
STRICT
CONTACT
AIRBORNE
DROPLET
ENTERIC
DRAINAGE

14
PREVENTIVE MEASURES
Health Education
Immunization (up-to-date)
Proper food & water handling
Environmental Sanitation

15
Types of
Acquired Immunity:
ACTIVE
PASSIVE
N
A
N
A

16
COMMUNICABLE DISEASES

17
Central Nervous System
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!

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ENCEPHALITIS

19
ENCEPHALITIS
C.A:
I.P:
M.O.T:
Incidence:

20
ENCEPHALITIS
Virus enters neural cells
Signs and symptoms

22
ENCEPHALITIS
Medical Treatment:
Dexamethasone
Osmotic diuretics
Anticonvulsants
Antipyretics
Prevention:

23
ENCEPHALITIS
Nursing Management:
1.SAFETY!
2.SZ Precautions
3.Skin care
4.MIO
5.Close monitoring

24
MENINGITIS

25
MENINGITIS
C.A:
I.P:
M.O.T:
Incidence:

26
Signs and symptoms
MENINGITIS

27
Signs and symptoms
MENINGITIS

29
Medical Treatment:
Osmotic diuretics
Anticonvulsants
Antipyretics
Ceftriaxone
Prevention:
MENINGITIS

30
Nursing Management:
1.SAFETY!
2.Respiratory isolation!
3.SZ precaution
4.MIO
5.Close monitoring
MENINGITIS

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MENINGOCOCCEMIA
- acute infection of the bloodstream and developing vasculitis.
C. A:
I. P:
M.O.T:
Incidence:

32
URTI
Vasculitis
Disseminated Intravascular Coagulation
Signs and symptoms
MENINGOCCEMIA

33
MENINGOCCEMIA
Signs and symptoms

35
Medical Treatment:
Ceftriaxone
Penicillin
Chloramphenicol
MENINGOCCEMIA

36
Nursing Management:
1.Respiratory Isolation
2.SAFETY!
3.Infection control measures
4.Management of shock
MENINGOCCEMIA

37
Prevention and Control:
MENINGOCCEMIA
2.Droplet precaution!
3.Chemoprophylaxis to close contacts.
4.Avoid overcrowded places.

38
- acute infection with systemic neuromuscular effects.
C.A:
M.O.T:
I.P:
tetanus
Source:

39
R
O
T
C
H
I
L
Signs and symptoms
TETANUS

40
Signs and symptoms
TETANUS

41
Diagnostic Tests
Spatula test
Wound culture
Blood exam

42
Medical Treatment:
Passive Immunization!
Antibiotics
Anticonvulsants
Tracheostomy
NGT Feeding
Debridement
TETANUS

43
Nursing Management:
1.Patent AIRWAY!!
2.Quiet, dim environment
3.MIO
4.Nutrition
TETANUS

44
- acute viral disease of the CNS – by saliva of infected animals.
C.A:
M.O.T:
I.P:
RABIES
Source:

45
RABIES
Signs and symptoms
Prodromal Stage
Excitement Stage
Paralytic Stage

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Diagnostic Tests
Brain biopsy
Direct Fluorescent Rabies Antibody
Observation

47
Medical Treatment:
Local treatment of wound
Active Immunization
Passive Immunization
Antibiotics
RABIES
Prevention:

48
Nursing Management:
1.Provide a non-stimulating environment.
3.Restrain a.d
4.Avoid the sensation of fluids.
5.Monitor CARDIAC and RESPIRATORY status.
6.Avoid becoming the patient!!!
RABIES

49
What to do after you’ve bitten?
1.Wash with soap and water.
2.Go to nearest clinic or hospital.
3.Give antibiotics and anti-tetanus.
4.Observe the dog.
RABIES

50
Acute infection of the CNS 
Muscle spasm, paresis and paralysis
POLIOMYELITIS
C.A:
M.O.T:
I.P:
Source:

51
Signs and symptoms
POLIOMYELITIS
Abortive Type
Pre-paralytic Type
Paralytic Type

52
POLIOMYELITIS

53
Diagnostic Tests
Pandy’s Test
Viral Culture
EMG

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Medical Treatment: Analgesics
POLIOMYELITIS
Prevention: Rehabilitation Orthopaedic Surgery

55
Nursing Considerations:
POLIOMYELITIS
1.Respiratory support!
2.SAFETY!
3.CBR
4.ROM exercises a.d
5.Provide comfort
6.Moist warm pack
7.V/S monitoring
8.Maintain correct body alignment.
9.Enteric Isolation

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CIRCULATORY System
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!

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Dengue
- an acute febrile disease.
C.A:
M.O.T:
I.P:

58
D
L
S
U

59
I:
II:
III:
IV:
Febrile stage:
Toxic stage:
Recovery stage:

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Capillary fragility test
Platelet Count
Polymerase chain rxn

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Medical Treatment:
Paracetamol
Antibiotic
ORESOL
IVF
Blood transfusion

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1. SHOCK position.
2. Comfortable and quiet env’t.
3. Ice packs
4. Protect eyes from bright lights.
5. Bleeding measures!
6. ↑ OFI
7. Measures to relieve fever.
8. Diet: LF, Non-carbonated, non- irritating

63
Prevention:

64
Prevention:
D
E
N
G
U
E

65
malaria
- vector-borne disease with cold, hot and wet stages.
C.A:
M.O.T:
I.P:

66
D’
H
N
R
C

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Cold stage:
Hot stage:
Wet stage:

68
Quantity Buffy Coat
Malarial Smear

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Medical Treatment:
Antimalarial Drugs
Blood transfusion

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1. HOT Stage
2. COLD Stage
3. WET Stage
4. MIO
5. Watch out for neurologic toxicity!
6. Monitor v/s closely.
7. Iron rich foods pls.

71

72
Prevention:
C
L
E
A
N
M
E
U
P
Z
I
A!

73
LEPTOSPIROSIS
- a zoonotic infectious, occupational disease.
C.A:
M.O.T:
I.P:

74
Leptospiremic stage:
Immune/Toxic stage:
F
H
M
N
V
C
C

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Diagnostics
Microscopic Agglutination Test
Culture of organism
Blood and CSF Exam
Urine test

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Medical Treatment:
Penicillin G
Doxycycline
Ampicillin
Erythromycin
Amoxicillin

77

78
Prevention:
1. Health education esp. to high risk groups.
2. Use protective clothing.
3. RAT eradication program
4. Isolation (animals); concurrent disinfection (soiled items)
5. Avoid swimming or wading in contaminated water.

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RESPIRATORY
System
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!

80
DIptheria
- acute viral dse with exotoxin elaboration.
C.A:
M.O.T:
I.P:
Source:

81
Nasal diphtheria
Signs and symptoms
DIPTHERIA
Tonsilopharyngeal diphtheria
Laryngeal diphtheria
Cutaneous diphtheria

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DIPTHERIA

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Diagnostic Tests
Nose & throat culture
Schick’s Test
Moloney’s Test

85
Medical Treatment:
Diphtheria anti-toxin
Erythromycin
Tracheostomy
DIPTHERIA

86
Nursing Management:
1. Patent airway!
2. Isolation
3. TSB
4. Soft and liquid diet
5. Oral hygiene
6. Bedrest
7. DO NOT remove pseudomembrane!
DIPTHERIA

88
DIPTHERIA
Prevention:
1. DPT Immunization
2. Proper disposal of nasopharygeal secretions
3. Pasteurization of milk

89
PERTUSSIS
- repeated attacks of spasmodic coughing.
C.A:
M.O.T:
I.P:
Source:

90
Catarrhal stage:
Paroxysmal stage:
Convalescent stage:

91
PERTUSSIS

92
Diagnostic Tests
Bordet-gengou Agar Test

93
Medical Treatment:
Erythromycin
Antipyretics
PERTUSSIS
Ampicillin
Bronchodilator
Antitussives

94
Nursing Management:
1. PATENT airway!
2. Respiratory isolation
3. Oxygen therapy
4. CBR
5. Supportive measures
PERTUSSIS

95
Prevention:
1. DPT Immunization
2. Proper disposal of nasal and throat secretions
3. Cover mouth when coughing.
PERTUSSIS

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INTEGUMENTARY System
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!

97
measles
- a contagious exanthematous disease with chief symptoms to the URT.
C.A:
M.O.T:
I.P:
Source:
P.C:

98
Pre-eruptive stage:
Eruptive stage:
Convalescent stage:
MEASLES
C
C
C
F
P
H
K

99

100
Diagnostic Tests
Wright’s stain of sputum

101
Medical Treatment:
Measles Ig
Antipyretics
Penicillin
MEASLES
Vitamin A

102
Nursing Management:
1. Isolate the patient.
2. Monitor v/s
3. Dim the lights
4. Saline solution as eye irrigation.
5. Relieve fever
6. Increase OFI
7. Skin care
MEASLES

103
How to prevent measles?
1. IMMUNIZATION is the key!!
2. Intensive IEC Campaign.
3. Contact and droplet precaution.
4. Disinfection of contaminated articles.

104
GERMAN measles
- a communicable exanthematous disease.
C.A:
M.O.T:
I.P:
Source:
P.C:
14-23 days

105
Pre-eruptive stage:
Eruptive stage:
GERMAN MEASLES
F
H
M
C
C
L
F

106

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Diagnostic Tests
Rubella titer

108
Medical Treatment:
Paracetamol
GERMAN MEASLES

109
Nursing Management:
1. Isolate the patient.
2. Bed rest.
3. Dim lights.
4. Saline solution as eye irrigation.
5. Good oral, nasal and skin hygiene.
6. Provide soft diet.
GERMAN MEASLES

110
What are the possible complications of German measles????
Congenital rubella syndrome!

111
How to prevent g. measles?
1. IMMUNIZE your children and a non-pregnant mother.
2. Educate the public.
3. Proper disposal of secretions

112
CHICKENPOX
- a highly contagious dse with vesicular eruptions on the skin and mucous membranes.
C.A:
M.O.T:
I.P:
Source:
P.C:
10 days-3 wks

113
CHICKENPOX

114
Diagnostic Tests
Tzanck test

115
Medical Treatment:
Antiviral agents
Antihistamines
Antipyretics and analgesics
CHICKENPOX

116
Nursing Management:
Strict isolation Prevent secondary infection Eliminate itching Encourage not going to sch. Disinfection of clothes and linen
CHICKENPOX

117
What are the possible complications of chickenpox????
P
I
E
S

118
How to prevent chickenpox?
1. IMMUNIZE your children at 12- 15 months.
2. School exclusion x 7 days.
3. Proper disposal of secretions.

119
HERPES ZOSTER
- an acute viral infection of sensory nerve.
C.A:
M.O.T:
I.P:
Source:
P.C:
13-17 days

120
HERPES ZOSTER

121
Medical Treatment:
Antihistamines
Antipyretics and analgesics
Antiviral agents
Corticosteriods
HERPES ZOSTER

122
Nursing Management:
Strict isolation Prevent secondary infection Eliminate itching Encourage not going to sch. Disinfection of clothes and linen
HERPES ZOSTER

123
What are the possible complications of shingles????
R
E
G

124
SCABIES
- infestation of the skin produced by burrowing action of a parasite mite  skin irritation and vesicle formation with pustules.
C.A:
M.O.T:
I.P:
Source:
Within 24 hours

125
SARCOPTES SCABIEI

126

127
COMMON SCABIES SITES

128
SCABIES
Medical Treatment:
KWELL
Benzyl benzoate
Eurax ointment
Hydrogen peroxide

129
SCABIES
Nursing Management:
1. Apply cream at bedtime.
2. Instruct aeg to avoid bathing.
3. Wash clothes with HOT water.
4. Treat family members.
5. Good handwashing.

130
Prevention:
1. Rinse all clothing, towels and bed linens in hot water.
2. Keep fingernails short.
3. Vit. A & C.
4. Environmental sanitation
5. Good personal handwashing.

131
SCABIES
Can you get scabies from a dog or cat?

132
PEDICULOSIS
- infestation of hairy parts of the body with the eggs, larvae or adults of lice.
C.A:
M.O.T:
I.P:
Source:

133
PEDICULUS HUMANUS

134
PEDICULOSIS
Medical & Nursing Mngt.:
KWELL shampoo
ivermectin
Avoid sharing of brushes, towels, combs, and clothing. Proper hygiene.

135
GASTROINTESTINALSystem
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!
Alert!

136
Typhoid fever
- an infection affecting the small intestines .
C.A:
M.O.T:
I.P:
Source:
1-3 weeks

137
TYPHOID FEVER
Ladder-like FEVER
Diarrhoea
Headache
Abd’l tenderness
S
S
C
C

138

139
Diagnostic Tests
Typhi Dot test
Widal’s test

140
Medical Treatment:
Chloramphenicol
Ampicillin
Cotrimoxazole
TYPHOID FEVER

141
Nursing Management:
TYPHOID FEVER
1.Maintain and restore the fluid & electrolyte balance.
2.Enteric Isolation.
3.Supportive mngt.

142
TYPHOID FEVER
1. Handwashing
2. Sanitary disposal of excreta.
3. Provision of safe drinking water.
4. Good personal hygiene.
5. Milk pasteurization.
Prevention:

143
SHIGELLOSIS
- an acute infection of the lining of the small intestines.
C.A:
M.O.T:
I.P:
Source:
1 - 4 days

144
SHIGELLOSIS
BLOODY Mucoid-stool
Fever
Tenesmus
Abdominal pain
N/V

145
Medical Treatment:
Cotrimoxazole
Tetracycline
Chloramphenicol
SHIGELLOSIS
IVF

146
Nursing Management:
1. Maintain and restore the fluid & electrolyte balance.
2. Enteric Isolation.
4. Low-fiber diet
SHIGELLOSIS

147
1. Handwashing
2. Sanitary disposal of excreta.
3. Provision of safe drinking water.
5. Milk pasteurization.
6. Avoid eating uncooked foods.
Prevention:
SHIGELLOSIS

148
CHOLERA
- acute bacterial disease of the GIT characterized by profuse secretory diarrhea.
C.A:
M.O.T:
I.P:
Source:

149
CHOLERA
R
A
V
I
S

150
CHOLERA
What is the possible complication of cholera?

151
Medical Treatment:
Tetracycline
Cotrimoxazole
Chloramphenicol
CHOLERA
PLRS or ORESOL

152
Nursing Management:
1. Maintain and restore the fluid & electrolyte balance.
2. Enteric Isolation.
4. Low-fiber diet
CHOLERA

153
RED-TIDE POISONING
C.A:
M.O.T:
I.P:
Source:
- syndrome of characteristic neurologic symptoms after ingestion of poisonous shellfish.

154
PARALYTIC SHELLFISH POISONING
Numbness Headache Abd’l cramps Paraesthesia Paralysis

155
Nursing Management & Prevention:
1. No definite medications!
2. Induce vomiting.
3. Drink pure coconut milk.
4. NaHCO3 solution.
5. Respiratory support.
6. Avoid using vinegar in cooking shellfish.
PARALYTIC SHELLFISH POISONING

156
MUMPS
C.A:
M.O.T:
I.P:
Source:
- acute contagious disease, with swelling of one or both of the parotid glands.
P.C:
12-26 days

157
MUMPS
F
H
M
F
S
E

158
MUMPS

159
Medical Treatment:
Aspirin
Sedatives
Cortisone
MUMPS
IVF

160
MUMPS
My child got mumps, is there any complications that my son might develop?
Orchitis
Oophoritis
Encephalitis
Deafness
Conjuctivitis

161
Nursing Management & Prevention:
1. Support scrotum
2. Diet:
3. Measures to relieve pain.
4. Encourage use of dark glasses
5. TSB
6. Concurrent disinfection
7. Terminal disinfection
8. Avoid secondary infxn
9. Respiratory isolation
10. MMR vaccine!
MUMPS

162
PARAGONIMIASIS
C.A:
M.O.T:
Source:
- a chronic parasitic lung infection.

163
PARAGONIMIASIS
Chronic cough
Hemoptysis
Chest/back pain
TB s/sx

164
Diagnostic Tests
Sputum exam
CSF analysis

165
Medical Treatment:
Praziquantel
PARAGONIMIASIS
Bithionol

166
Prevention:
1. Sanitary excreta disposal.
2. Avoid eating infected foods.
3. Avoid bathing in infected water.
4. Educate the public about the disease.
PARAGONIMIASIS

167
HEPATITIS

168
HEPATITIS A
C.A:
M.O.T:
I.P:
Source:
- infection of the liver caused by HAV.
15-50 days
POC:

169
HEPATITIS A

170
Diagnostic Tests
AST and ALT
↑ IgM

171
HEPATITIS A
Medical and Nursing Mngt.:
1. NO specific treatment. 2. Adm. HAIg a.d then Hepatitis A vaccine. 3. Complete bed rest. 4. Diet: 5. Relieve pruritus. 6. Avoid hepatotoxic drugs. 7. Avoid drinking alcohol beverages.

172
OTHER EMERGING DISEASES

173

174
C.A:
M.O.T:
I.P:
P.C:
4-6 days

175
HFMD
Fever
Mouth sores
Anorexia
Malaise
Sore throat
Skin Rash

176
HFMD
Prevention:
1. HANDWASHING.
2. Disinfect dirty surface and soiled items.
3. Avoid close contact with persons with the disease.

177
HFMD
Can we acquire hand, foot and mouth disease from pets or animals?
Is H-F-M Disease the same with Foot and Mouth disease?
What is the usual month when HFMD becomes prevalent?

178

179
Avian FLU
C.A:
I.P:
- flu infection in birds that affects humans.
2-4 days

180
Can I acquire bird flu through inhalation of feces and discharge of infected birds?
Mode of Transmission
How about having direct contact with the INFECTED poultry?
What if I happen to have a direct contact with the cages?

181
AVAIN FLU
Medical Treatment:
Oseltamivir
Zanamavir
Amantadine

182
AVAIN FLU
Prevention:
1. H5N1 vaccination!
2. Banning of importation of birds.
3. Cook chicken thoroughly.
4. Culling

183

184
Swine flu
C.A:
M.O.T:
I.P:
- flu infection in swine that affects humans.
7-10 days

185
Flu-like signs and symptoms
Sore throat
Diarrhea

186
SWINE FLU
Medical Treatment:
Oseltamivir
Zanamavir

187
AVAIN FLU
Prevention:
1. H1N1 vaccination!
2. Cover nose and mouth when coughing or sneezing.
3. HANDWASHING!
4. Proper disposal of carcasses.
5. Adequate nutrition.
6. Rapid disinfection

188

189
Severe acute respiratory infection
C.A:
M.O.T:
I.P:
- a new type of atypical pneumonia that infects the lungs.
2 -10 days

190
SEVERE ACUTE RESPIRATORY INFECTION
Body weakness
Cough
DOB
Episodes of sore throat
Fever

191
Medical Treatment:
Antivirals
Corticosteroids
NO definitive Tx

192
P R E V E N T

193

194
DRILL 1
The following management decreases tendency of increased intra-cranial pressure, except: a. Avoid valsalva maneuver b. Administer anti-diuretics c. Lessen environmental stimuli d. Elevate head part

195
DRILL 2
The following are the diagnostic procedures for encephalitis, except: a. EEG b. Blood culture c. Lumbar tap d. Nose and throat swab

196
DRILL 3
The only mosquito-borne encephalitis that has vaccine is the: a. Australian X encephalitis b. Japanese encephalitis c. Equine encephalitis d. St. Louis encephalitis

197
DRILL 4
Meningitis is characterized by flexion of the hip and knee while in supine position when neck is flexed. This is known as: a. Kernig’s sign b. Brudzinski’s sign c. Hoyne’s sign d. Homan’s sign

198
DRILL 5
Which among the following causative agents of meningitis that is common among children? a. Hemophilus influenza b. Streptoccocus pneumoniae c. E. Coli d. Meningoccocus

199
DRILL 6
Which of the following facts about meningitis is not true? a. Humans may be asymptomatic b. Caused by gram (-) bacteria c. Can be caused by a virus d. Non-infectious after 1 week of Tx

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