handouts

2. Health
State of complete physical ,
mental, intellectual, spiritual
and social well-being and
not merely the absence of
disease or infirmity.

4. Disease Vs. Illness
Disease
It is a pathological condition that
disrupt the normal functioning of the
body. It is objective, characterized by
an abnormality in the structure or
function of body organs.

5. Objective- information or
analysis is fact-based,
measurable and observable.

6. Illness
It is the human response to
disease. It is subjective because
it is based on the experience of
the patient.

7. Four Stages of Illness
• Experiencing signs and symptoms
• Assuming the sick role or
validating the sickness
• Seeking medical care
• Assuming dependent role while
recovering

8. Subjective -information is
based on personal opinions,
interpretations, points of
view, emotions and
judgment.

9. Communicable Disease
Vs.
Non-Communicable
Disease

10. Communicable Disease
– disease which can be
transmitted from one person
to another

11. Non-Communicable
Disease
- Also known as chronic
disease. It is not passed
from one to anothet

12. Sign
Vs.
Symptoms

13. Sign
- is an objective physical
manifestation of illness, injury or
disease. Examples: rapid pulse,
High temperature, low blood
pressure, muscle weakness.

14. Symptoms
-it is what the patience
experience about the illness,
injury or disease.
Examples: chills, numbness,
fatigue.

15. Endemic
Vs.
Sporadic

16. Endemic
-infectious disease that
occurs frequently and in
cycles in a specific
geographical area. Influenza
is an example.

17. Sporadic
-disease that occurs
singly, occasionally or in
irregular intervals.

18. Epedemic
Vs.
Pandemic

19. Epidemic
- refers to a contagious, or viral
illness that spreads to many
people in one geographic region
that occurs in excess of number of
cases that usually be expected.

20. Pandemic
- contagious or viral illness
that spreads in many areas
across large region or across
the globe.

21. Fomite
Vs.
Vector

22. Vector
- is an infected insect/animal
or insect/animal that carries
and transfers infectious
agent.

23. Fomite
- is an inanimate (meaning it
can not move itself) object
which can possibly harbor
infectious agent.

24. The Causes of
Disease

25. Supernatural Belief
-Ancient times belief explained
that disease is caused by a
supernatural being ( a God or a
dead ancestor), or a person
with special powers ( a witch
or a sorcerer).

26. Poisonous Gas Belief
- Major beliefs during the 1800s.
explained that disease (such as
malaria) is caused by rotting
plants or bad vapour that came
from swamps.
Malaria- came from mala aria
meaning bad air.

27. Germ Belief
-Holds that microscopic
organisms are responsible
for infectious diseases.

28. Agent-Host-Environment Belief
(Classic Agent)
- This belief explains disease as a
product of the complex interaction
among three factors ( agent, host and
environment)

29. Agent-Host-Environment Triangle

31. Host
- is an organism usually a person or an
animal affected by the disease.
Environment
-is the condition outside the host that
allows disease to be transmitted.
Agent
- is the organism that cause disease.

32. Factors in the
Development of
Disease

33. Personal Factor
-referring to a practices and etiquettes in
managing disease.
Economic Factor
- Relating to poverty that leads to a lack of
accurate education and information about
nutrition, hygiene and disease
management.

34. Cultural Factor
-referring to beliefs that provide false sense of
security and delaying healthcare and
appropriate treatment.
Some superstitious beliefs.
• Taking a bath on Friday will make one sick.
• Washing the eyes with the first urine early
in the morning an effective cure for sore
eyes

35. • An amulet or anting-anting protects
the wearer from diseases and helps
counteract witchery.
• Relapsed or binat is caused by eating
certain kinds of food or by cutting the
hair soon after illness.

36. Environmental Factor
-Referring to unsanitary conditions, presence of toxic chemicals,
hazardous pollutants, extreme weather condition that makes people
weaken and vulnerable to a lots of infection.
Political Factor
-Referring to political issues, such as corruption that affect the provision
of health care services and resources to the people. In many cases
people’s health is not given utmost priority.
Educational Factor
- Disease transmission can also be due to misinformation or lack of
information thus education is crucial in disease prevention and control.

37. CHAIN OF INFECTION

39. INFECTIOUS AGENT/ CAUSATIVE AGENT/
PATHOGENS
-disease-causing organisms.The greater the
organism's virulence (ability to grow and
multiply), invasiveness (ability to enter
tissue) and pathogenicity (ability to cause
disease), the greater the possibility that
the organism will cause an infection.
Infectious agents are bacteria, virus, fungi,
and parasites.

40. Microorganisms

41. Virus
• Small infectious agent that replicates only
inside the living cells of other organisms.
• Infects all types of life forms. Requires
intracellular parasite (can’t survive outside
the host’s cell)
• On the borderline between living and non-
living matter

42. • Can have varied shapes:
helical – like a coiled spring
icosahedrons – with 20 triangular sides or a very
complex shape.
• Attacks all kinds of biological agents, even bacteria
• Consist of a bit of nucleic acid ( RNA or DNA, but
never both within a protein coat)

43. Specific Disease Caused by a Virus
• AIDS- Acquired Immune Deficiency Syndrome
• Chickenpox
• Common cold
• Dengue fever
• Influenza
• Measles
• Poliomyelitis
• Rabies
• Warts

44. Influenza Virus

45. HIV Virus

46. Bacteria
• Single-celled
• No true nucleus
• Can be aerobic (needs oxygen) and
anaerobic (does not need oxygen)
• Can be spherical (coccus), rod-shaped
(bacillus), or spiral (spirillum)
• Can be in pairs (diplo-), in clusters
(staphylo-), or in chains (strepto-)

47. • Majority comprise the normal flora (live in the
human body)
• Majority are good/friendly (probiotic) Can be
opportunistic (friendly bacteria turn harmful
when the immune system weakens)
• Causes disease by directly attacking tissues or
releasing toxins
• Some can live in a dormant state as spores

48. Specific Disease Caused by Bacteria
• anthrax
• cholera
• diptheria
• gonorrhea
• leprosy
• Tetanus
• tuberculosis

49. Bacillus Bacteria

50. Staphylococcus Bacteria

51. Streptococcus Bacteria

52. Protozoa
• Parasitic or free living (can survive
outside the host)
• Has a variety of shapes and sizes
Various types; amoeba, ciliates,
flagellates or sporozoans found most
often in stagnant water or moist soil.

53. Specific Disease Caused by
Protozoa
• Malaria
• Amoebic dysentery

55. Fungus
• Thrive on dead or decaying matter
• Multicellular (like molds), or unicellular
(like yeasts) Spore-forming (this is the
reason why it’s sometimes difficult to treat)
• Cause diseases of the skin, mucous
membranes and lungs

56. Specific Disease Caused by Fungus
• Tinea or ringworm (jock itch,
athlete’s foot)

58. Parasitic Worm
• Largest among the pathogens
• Can either be flatworms or
roundworms
• Examples of flatworms are
tapeworms (can be transmitted by
eating raw fish/pork/beef) and
flukes (example is schistosoma
japonicum/mansoni that causes
schistosomiasis

59. Tape Worm

60. Fluke

61. • Examples of
roundworms are
pinworms and
hookworms.

63. Hook Worm

64. Specific Disease Caused by
Parasitic Worm
• Ascariasis
• Elephantiasis
• Enterobiasis
• Schistosomiasis
• Taeniasis

65. RESERVOIR
This is the place wherein the
infectious agent lives and
multiplies. This can be living
(animal, human, plant) or non-
living(air, water, food,
utensils/equipment).

66. Sick
Person

67. PORTAL OF EXIT
A route or a place of exit providing a
way for a microorganism to leave the
reservoir. The common most mode of exits
are break in the skin, nose, mouth or anus
and special body openings such as vagina,
penis, urethra, ears and eyes.
It may be through the bite of
mosquito or needle prick.

68. Coughing or Sneezing

69. MODE OF TRANSMISSION
Method of transfer by which the
organism moves or is carried from
reservoir to a new host.
Direct Transmission
- Through close contact or direct
person to person contact

70. Shaking of Hands

71. Indirect Transmission
- Through an intermediate item or carrier .
Examples:
• Vector-borne transmission -bite of
mosquito
• Vehicle-borne transmission
-contaminated items (utensils),
contaminated water, air, and 3F’s ( food, flies
and fingers)

72. Mosquito Bite

73. PORTAL OF ENTRY
An opening allowing the
microorganism to enter the host.
Examples: mouth, nose skin and
urogenital organs.
The mode of entry is same as the
mode of exit.

74. Eating With Bare Hand

75. SUSCEPTIBLE HOST
This is a person who is vulnerable to
disease due to weak immunity or a
prior infection. Children and elderly
are more prone to a lot of
infections. Immunization is one way
to strengthen one’s immunity to
disease.

76. Weak
Person

77. The Spread of
Infection

78. Patient Situation: 1
An elderly patient, hospitalized with a
gastrointestinal disorder, was on bed rest and
required assistance for activities of daily living. The
patient had frequent uncontrolled diarrhea stools
and the nurse provided excellent care to maintain
cleanliness and comfort. Following one episode of
cleaning the patient and changing the bed linen,
the nurse immediately went to a second patient to
provide care. The nurse's hands were not washed
before assisting the second patient.

79. Infectious agent: Escherichia coli
Reservoir: Large intestine
E. coli, bacteria in the large intestine of humans forms the greater part of the
normal intestinal flora.
Portal of Exit : E. coli exited the body in feces.
Mode of Transmission: The nurse removed the contaminated linen from the bed.
The E. coli organism contaminated the hands of the nurse who then provided
morning care to another patient.
Portal of Entry: The second patient receiving care had a Foley catheter. The nurse
manipulated the tubing attached to the catheter. The E. coli organism on the
nurse's hands contaminated the catheter tubing and ascended to the patient's
meatus and then into the urinary bladder.
Susceptible Host: The second patient with a Foley catheter. This patient was
elderly and had a chronic illness necessitating complete bed rest. The Foley
catheter contaminated by the E. coli organism provided a direct route into the
urinary bladder.

80. Breaking of the
Chain

81. Patient Situation: 2
A patient assigned for morning care has an open wound on her left lower leg. The
wound is draining and when last cultured, the microorganism MRSA was
identified.
In preparation for bedmaking, hands of the nurse were washed. Clean linen and a
bag for soiled linen were gathered from the linen room and placed on the
patient's clean bedside stand.
To remove the soiled linen from the bed, the following procedure was followed:
Hands washed
Gloves worn
Each side of the soiled linen ends folded towards the middle of the bed
Soiled linen held away from the nurse's clean uniform
Soiled linen placed in the linen bag for later discard
Protective gloves removed
Hands washed

82. Infectious Agent: MRSA (Methicillin-resistant organism)
Reservoir: Patient's infected wound
Portal of Exit: Draining from the open wound
BREAK IN THE CHAIN = Nurse used proper hand
washing techniques, wore protective gloves and
properly handled the linen.
Mode of Transmission: MRSA commonly transferred on hands of the nurse by
indirect contact
BREAK IN THE CHAIN =Proper hand washing, gloving and handling of linen
Portla of Entry: The nurse manipulated the tubing attached to the catheter.
BREAK IN THE CHAIN=Organisms isolated with use of medical asepsis and
body substance isolation
Susceptible Host: PROTECTED

83. Incubation Stage
- This is the time from the entry of
germ to the appearance of the first
sign of symptom.This can last from
several hours to several months or
even years.
STAGES OF INFECTION

84. Early Symptom Stage
- This is when the general signs and
symptoms of the disease appear such
as fever, nasal discharge, and rashes. It
is the early stage of the battle between
the germs and the body.During this
time , the disease is higly contagious
and diagnosis is difficult at this stage.

85. Clinical Stage
- This is the height of the disease
when the infection is very severe.
During this period one is obviously
sick as characteristic signs and
symptoms of the disease appear.

86. Recovery Stage
- During this stage, there is a
gradual return to health as signs
and symptoms begin to
disappear.The body is now on its
way to recovery. However when the
body is unable to recover, disability
or death may result.

87. There are times when a person
experienced a relapsed or binat. It
happens when a sick person partially
recovers but goes back to clinical
stage.Recovery takes much longer after
a relapse because the body defenses
are still weak from a previous infection.

88. PREVENTION AND
CONTROL OF INFECTION

89. Medical Asepsis
-helps to contain infectious organisms and to
maintain an environment free from
contamination. Include hand washing, gowning
and wearing facial masks when appropriate, as
well as separating clean from contaminated or
potentially contaminated materials and
providing information to patients about basic
hygienic practices.

90. Standard Precautions
-combine the major features of universal
precautions and body substance isolation.
These standard precautions alert the health
care worker to patient situations that require
special barrier techniques. These barrier
techniques are used when working with any
patient where potential or actualized contact
with blood or body fluid exists.

91. Universal Precautions
-help control contamination from bloodborne
viruses such as human immunodeficiency virus
(HIV) and hepatitis viruses. When in contact
with a patient's blood or any body secretion
that may be contaminated with blood,
protective measures such as wearing gloves,
gown, facial mask, and/or goggles must be.

92. Body Substance Isolation
-protects against bacterial organisms that may exist in
body substances. Body substance isolation applies in
all patient encounters regardless of the diagnosis. The
application of gloves for contact with moist body
surfaces and areas of nonintact skin, gowns when in
contact with body secretions, and facial mask when in
danger of contact with respiratory droplet secretions,
prevents the contamination of both health care
worker and patient.