TETANY

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Risus sardonicus (lock jaw/trismus)

Chvostek sign

Trousseau sign

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 CHICKEN POX (VARICELLA)

An acute and highly contagious disease of viral etiology, characterized by vesicular eruptions on
the skin and mucous membrane with mild constitutional symptoms.

CAUSATIVE AGENT

Human (alpha) herpes virus 3 (varicella zoster virus), a member of the Herpes virus group.

SIGNS AND SYMPTOMS

Pre-eruptive Manifestations:

Mild fever & malaise

Eruptive Stage:

Rash starts from the trunk, then spread to other parts of the body.
Initial lesions are distinctively red papules where contents become milky and a pus-like within 4
days.
In adult and bigger children, the lesions are more widespread and more severe
Vesicular lesions are very pruritic.
Celestial map scabs

Stages of lesions:

Macule lesion that is not elevated above the skin surface.

Papule lesion that is elevated above the skin surface with a diameter of about 3 mm.
Vesicle pop-like eruption filled with fluid.
Pustule vesicle that is infected or filled with pus.
Crust scab or eschar. Secondary lesion caused by the secretion of vesicle drying on the skin.
The scars are superficial, depigmented and take time to fade out.

PATHOGNOMONIC SIGN
 Maculo-papular rash

COMPLICATIONS

Secondary infection of the lesions furuncles, cellulitis, skin abscess, erysipelas

Meningoencephalitis
Pneumonia
Sepsis

MODE OF TRANSMISSION

Direct contact or droplet spread. Indirect through articles freshly soiled by discharges of infected
persons. One of the most readily communicable of disease, especially in the early stage of
eruption.

DIAGNOSTIC PROCEDURES

Virus Culture. A viral culture uses specimens taken from the blister, fluid in the blister, or
sometimes spinal fluid. They are sent to a laboratory, where it takes 1 - 14 days to detect the virus
in the preparation made from the specimen. It is also sometimes used in vaccinated patients to
determine if a varicella-like infection is caused by a natural virus or by the vaccine. This test is
useful, but it is sometimes difficult to recover the virus from the samples.
Immunofluorescence Assay. Immunofluorescence is a diagnostic technique used to identify
antibodies to a specific virus. In the case of herpes zoster, the technique uses ultraviolet rays
applied to a preparation composed of cells taken from the zoster blisters. The specific
characteristics of the light as seen through a microscope will identify the presence of the
antibodies. This test is less expensive than a culture, more accurate, and results are faster.
Polymerase Chain Reaction (PCR). Polymerase chain reaction (PCR) techniques use a piece of the
DNA of the virus, which is then replicated millions of times until the virus is detectable. This
technique is expensive but is useful for unusual cases, such as identifying infection in the central
nervous system.

PREVENTION

Case over 15 years of age are should be investigated to eliminate possibility of smallpox.
Report to local authority. Isolation. Concurrent disinfection of throat and nose discharge.
Exclusion from school for 1 week after eruption first appears and avoid contact with susceptible.

TREATMENT

Zovirax
Oral acyclovir
Oral antihistamine
Calamine lotion
Antipyretic

NURSING MANAGEMENT

Respiratory Isolation is a must until all vesicles have crusted.

Prevent secondary infection of the skin lesion through hygienic care of the patient.
Linens must be disinfected under the sunlight or through boiling.
Cut fingers nails short and wash hands more often.
Provide activities to keep child occupied to lessen pruritus.
 RABIES

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Hydrophobia/photophobia

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 PULMONARY TUBERCULOSIS

Is considered as the worlds deadliest disease and remains as a major public health problem in
the Philippines.
TB is a highly infectious chronic disease caused by the tubercle bacilli.
It is primarily a respiratory disease but can also affect other organs of the body and is common
among malnourished individuals living in crowded areas.
Often occurs in children of underdeveloped and developing countries in the form of primary
complex especially after a bout of a debilitating childhood disease such as measles.

CAUSATIVE AGENT

Mycobacterium tuberculosis and M. Africanum primarily from humans, and M. Bovis primarily
from cattle.

SIGNS AND SYMPTOMS

Cough of two weeks or more

Fever
Chest or back pains nor preferable to any musculo-skeletal disorders
Hemoptysis or recurrent blood-streaked sputum
Significant weight loss
Other signs and symptoms such as sweating, fatigue, body malaise and shortness of breath

PATHOGNOMONIC SIGN

Hemoptysis

COMPLICATIONS

Hemoptysis
Pleurisy
Pleural effusion
 Empyema
Pneumothorax
Aspergilloma
Endobronchitis
Brochiectasis
Laryngitis
Cor pulmonale
Ca bronchus
Enteritus
Miliary Tuberculosis
HIV related opportunistic infections

MODE OF TRANSMISSION

Airborne droplet method through coughing, singing or sneezing.

Direct invasion through mucous membranes or breaks in the skin may occur, but is extremely
rare.
Bovine tuberculosis results from exposure to tuberculosis cattle, usually by ingestion of
unpasteurized milk or dairy products.

DIAGNOSTIC PROCEDURES

Chest x-ray
Tuberculin Test/ Mantoux Test
Sputum AFB

PREVENTION

Prompt diagnosis and treatment of infectious cases

BCG vaccination of newborn, infants and grade 1 school entrants
Educate the public in mode of spread and methods of control and the importance of early
diagnosis.
Improve social conditions, which increase the risk of becoming infected, such as overcrowding.
Make available medical laboratory and x-ray facilities for examination of patients, contacts and
suspects, and facilities for early treatment of cases and persons at high risk of infection and beds
for those needing hospitalization.
Provide public health nursing and outreach services for home supervision of patients to supervise
therapy directly and to arrange for examination and prevent treatment of contacts.

TREATMENT

Persons with TB can be cured through regular and complete intake of the prescribed anti TB
medications. Because patients frequently stop taking their medications before completing
treatment, the Directly Observed Treatment, Short-course (DOTS) strategy is recommended.
Drug of choice: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol and Streptomycin Sulfate

NURSING MANAGEMENT

Maintain respiratory isolation until patient responds to treatment or until the patient is no longer
contagious.
Administer medicines as ordered.
Always check sputum for blood or purulent expectoration.
Encourage questions and conversions so that the patient can air his or her feelings.
 Teach or educate the patient all about PTB.
Encourage the patient to stop smoking.
Teach the patient to cough or sneeze into tissue paper and dispose secretions properly.
Advise patient to have plenty of rest and eat balanced meals.
Be alert for signs of drug reaction.
If the patient is receiving ethambutol, watch for optic neuritis. If it develops, discontinue the drug.
If the patient receives rifampicin (Rifampin), watch for hepatitis and purpura. Also observe the
patient for complications like hemoptysis.
Emphasize the importance of regular follow-up examinations and instruct the patient and his
family about the signs and symptoms of recurring TB.
 ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
Human Immunodeficiency Virus (HIV) Infection

A clinical syndrome resulting from damage to the immune system caused by infection with HIV.
First occurred in Africa and spread in Caribbean Island.

CAUSATIVE AGENT

Retrovirus- Human t-cell lymphotrophic virus 3 (HTLV - 3)

Belongs to lentevirus, also called slowvirus

SIGNS AND SYMPTOMS

Physical
Macula-papular rashes
Loss of appetite
Weight loss
Fever of unknown origin
Malaise
Persistent diarrhea
Tuberculosis (localized and disseminated)
Esophageal candidiasis
Kaposis sarcoma (skin cancer)
Pneumocystis carinii pneumonia
Gaunt-looking, apprehensive

Mental

(Early stage)

Forgetfulness
Loss of concentration
Loss of libido
Apathy
 Psychomotor-retardation
Withdrawal

(Later stage)

Confusion
Disoriented
Seizures
Mutism
Loss of memory
Coma

PATHOGNOMONIC SIGN

T4 below 200/dl

COMPLICATIONS

Tuberculosis (TB). In resource-poor nations, TB is the most common opportunistic infection

associated with HIV and a leading cause of death among people with AIDS.
Cytomegalovirus. This common herpes virus is transmitted in body fluids such as saliva, blood,
urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains
dormant in your body. If your immune system weakens, the virus resurfaces causing damage
to your eyes, digestive tract, lungs or other organs.
Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick,
white coating on the mucous membranes of your mouth, tongue, esophagus or vagina.
Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding
your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous
system infection associated with HIV, caused by a fungus found in soil.
Toxoplasmosis. This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread
primarily by cats. Infected cats pass the parasites in their stools, and the parasites may then
spread to other animals and humans.
Cryptosporidiosis. This infection is caused by an intestinal parasite that's commonly found in
animals. You contract cryptosporidiosis when you ingest contaminated food or water. The
parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with
AIDS.
Kaposi's sarcoma. A tumor of the blood vessel walls, this cancer is rare in people not infected with
HIV, but common in HIV-positive people.
Lymphomas. This type of cancer originates in your white blood cells and usually first appears in
your lymph nodes. The most common early sign is painless swelling of the lymph nodes in your
neck, armpit or groin.
Wasting syndrome. Aggressive treatment regimens have reduced the number of cases of wasting
syndrome, but it still affects many people with AIDS. It's defined as a loss of at least 10 percent of
body weight, often accompanied by diarrhea, chronic weakness and fever.
Neurological complications. Although AIDS doesn't appear to infect the nerve cells, it can cause
neurological symptoms such as confusion, forgetfulness, depression, anxiety and difficulty
walking. One of the most common neurological complications is AIDS dementia complex, which
leads to behavioral changes and diminished mental functioning.
Kidney disease. HIV-associated nephropathy (HIVAN) is an inflammation of the tiny filters in your
kidneys that remove excess fluid and wastes from your bloodstream and pass them to your urine.
Because of a genetic predisposition, the risk of developing HIVAN is much higher in blacks.

MODE OF TRANSMISSION
 Sexual contact
Blood transfusion
Contaminated syringes, needles, nipper, razor blades
Direct contact of open wound/mucous membrane with contaminated blood, body fluids, semen
and vaginal discharges.

DIAGNOSTIC PROCEDURES

IA or ELISA - Enzyme link immunosorbent assay

Particle Agglutination (PA) test
Western Blot analysis confirmatory diagnostic test
Immunofluorescent test
Radio immuno-precipitation assay (RIPA)

PREVENTION

Maintain monogamous relationship

Avoid promiscuous sexual contact
Sterilize needles, syringes and instruments used for cutting operations
Proper screening of blood donors
Rigid examination of blood and other products for transfusion
Avoid oral, anal contact and swallowing of semen
Use of condoms and other protective device.

TREATMENT

AIDS Drugs - medicines used to treat but not to cure HIV infection, referred to as
antiretroviral drugs which inhibits the reproduction of the virus.

NURSING MANAGEMENT

Health Education - know the patient, avoid fear tactics, avoid judgmental and moralistic
messages, be consistent and concise, use positive statement and give practical advice.
Practice universal/standard precaution thorough medical hand washing after every contact with
patient and after removing the gown and gloves, and before leaving the room of an AIDS
suspect or known AIDS patient.
Use of Universal barrier or Personal Protective Equipment (PPE).
Avoid accidental pricks from sharp instruments contaminated with potentially infectious
materials from AIDS patient.
Wear gloves when handling blood specimens and other body secretions
Label blood and other specimens with special warning AIDS Precaution
Blood spills should be cleaned immediately using common household disinfectants, like
chlorox
Needles should not be bent after use, but should be disposed into a puncture-resistant
container
Personal articles should not be shared with other members of the family
Patients with active AIDS should be isolated
 MENINGITIS

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

brudzinski's sign

kernig's sign

nuchal rigidity

opistothonus

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 SCHISTOSOMIASIS

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 DENGUE

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Herman,s sign: petechial spots

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 MALARIA

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Stepladder fever; black water fever

Cycle of hot stage (high fever) followed bydiaphoretic stage (sweating) and then cold
stage(chilling)

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 PNEUMONIA

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Greenish rusty sputum

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 HEPATITIS A

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 HEPATITIS B

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

Icteric sclera

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 HEPATITIS C

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 MENINGOCOCCEMIA

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT
 SEVERE ACUTE RESPIRATORY SYNDROME

DEFINITION

CAUSATIVE AGENT

SIGNS AND SYMPTOMS

PATHOGNOMONIC SIGN

COMPLICATIONS

LABORATORY EXAMINATIONS

DIAGNOSTIC PROCEDURES

TREATMENT

NURSING MANAGEMENT