nurs 102 lect week 6 communicable diseases
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- two examples of helminthes:
-
ascariasis (roundworm)
enterobiasis (pinworm) - example of a spirochete infection:
- Lyme disease
- 8 types of viral infections
-
varicella
rubella (german measles)
rubeola (measles)
Sars
w. nile
avian flu
parotitis
mono - 6 types of bacterial infections
-
pertussis (whooping cough)
tetanus
diptheria
meningitis
salmonella
tb - how is ascariasis (round worm) transmitted?
- ingestion of infected eggs (raw veggies grown in excrement, polluted drinking water.)
- when assessing a client with round worm, what symptoms might you see?
-
protruding abd
swollen face
thin arms and legs
intestinal colic and vomiting
wheezing and coughing
can lead to gi obstruction - how do you diagnose ascariasis?
-
stool for O&P
observe for worms - how is enterobiasis (pinworm) transmitted?
-
-eggs from anus to mouth
-from contaminated food/clothing - pinworm eggs remain infective on skin, bedclothes, and clothing for:
- 29 days
- when assessing a client with pinworm, what symptoms might you see?
-
-intense perianal intching (worse at night
-irritability
-short attn. span
-malnourishment - how do you diagnose pinworm?
- stool for O&P
- where do adult pinworms live?
- small and large intestine
- To prevent pinworm infestations, you should clean toilets/floors with:
- 10% bleach or lysol
- to treat pinworm infestations, all family members
- must be treated at the same time
- to prevent pinworm infestations, avoid:
- swimming in public pools that allow diapered babies
- night clothes and linens should be washed with what to treat pinworm
- hot water and soap
- a tick must be on you for how many hours before you contract lyme disease?
- 36-48hours
- How is lyme disease transmitted?
- bite of infected deer tick
- what two tests are used to diagnose lyme disease?
- elisa, western blot
- stage one of lime disease last for how many days?
- 1-32 after tick bite
- what are some symptoms of lyme disease during stage one? (6)
-
fatigue
malaise
sore throat
fever
back and neck pain
rash (bulls eye config possible) - what is the txmnt for stage one of lyme disease
- 3-4 weeks oral antibiotics
- what are some symptoms of lyme disease during stage two? (7)
-
-severe h/a
-memory lapse
-facial paralysis
-mild cardica problems
-conjunctivitis
-photophobia
-neck stiffness - what is the txmnt for stage two of lyme disease
- 3-4 weeks IV antibiotics
- stage III of lyme disease can happen any time between:
- weeks to years after infection.
- what are the symptoms of stage III lyme disease
-
-arthralgia
-swelling
-reddness
-limitied ROM of lg joints
-encephatlitis
-neuropathies - whats the txment for someone in stage III of lyme disease?
- prolonged course of IV antibiotics
- what are some health promotions/client educations for prevention of lyme disease?
-
-avoid wooded grassy areas may to july
- walk on cleared paths
-use tick repellents with deet or permethrin
-use tick repellents, collars on pets
-tick checks after being in high risk areas
-tick must be attached to body for 36-48 hours to transmit disease - When in the chicken pox (varicella) communicable?
- 1-2 days before vesicles appear until the vesicles dry
- how is varicella (chicken pox) transmitted? (4)
-
direct contact
droplet infection
airborne
contact w/contaminated articles - the chicken pox rash begins on:
- trunk
- what are some symptoms of varicella (chicken pox) ?
-
fever
malaise
anorexia
rash
pruritis - when should children be immunized for the chicken pox?
- one dose between 12-18 mo.
- what if the child hasn't been immunized for varicella, and they are over 13 years old. How do you immunize them?
- 2 doses, 4 weeks apart
- treat chicken pox with:
-
calamine lotion
oatmeal bath
baking soda paste - when is rubella (german measles) communicable?
- 7 days before onset until 5 days after onset
- what four ways can rubella be transmitted?
-
direct contact droplet
indirect contact droplet
airborne
transplacental - What is the immunization for german measles called?
- MMR
- when should a child get a immunization (MMR)for german measles? (2x)
- 12 months; 4 years
- what are some symptoms of german measles? (rubella)
-
-fever
-h/a
-cough
-lymphadnopothy
-pinkish/red macular pacular arthralgias - Tx for rubella (german measles)
- pallative, analgesics, antipyretics, encourage fluids, keep pregnant women away!
- When is RUBEOLA (measles) communicable?
- 4 days prior to rash until 5 days after onset.
- how is rubeola (measles) transmitted? (3)
-
-direct contact with resp. droplets
-urine
-blood - what are some symptoms for rubeola (measles)?
-
fever
malaise
lethargy
conjunctivitis
cough
coryza
KOPLICK SPOTS - only found in rubeola, small red spots, bluish white centers opposite molars
- koplick spots
- When should someone get immunized for Rubeola?
- 12months and 4 years
- for people with rubeola, give them what for fever?
- antipyretic
- for people with rubeola, do what to help with the conjunctiva?
- clean eyes, dim lights
- Parotitis stands for
- mumps
- when are mumps (parotitis) communicable?
- 6 days before swelling to 9 days after onset
- what two ways can mumps be contracted?
-
droplet from saliva
direct contact from saliva - when should someone get immunized for mumps? (parotitis)
- 12 months and 4 years
- what are some symptoms for mumps?
- fever, h/a, malaise, anorexia, earache from chewing
- By the 3rd day with the mumps, what gland is swollen and painful?
- parotid
- what is a major complication in post puberty boys
- Orchitis
- Orchitis causes severe:
- swelling of the testis
- to treat orchitis, a complication of the mumps, a boy should do what 3 things?
-
-be on soft semi liquid diet
-wear tight undies
-don't consume acidic foods - infective mononucleosis is caused by what kind of virus?
- epstein-barr
- how is mono transmitted? (2)
-
direct contact with saliva
blood transfusion - mono may be contagious for how long?
- years
- what is the most common age group to get mono?
- 15-25 y.o.
- what 3 diagnostic tests are available for mono?
-
-monospot
-differential wbc
-ultrasound of the spleen - cardinal sign for mono is:
- painful exudative tonsillitis (difficulty swallowing.)
- some symptoms of mono: (3)
-
difficulty swallowing
fever
fatigue - what are two things you should teach clients who have mono not to do?
-
no heavy lifting
no contact sports - how is w. nile virus transmitted?
- bite from infected mosquitos
- what age group is at risk for w. nile virus?
- over 50 y.o.
- what are some symptoms of w. nile virus?
-
h/a
stiff neck
high fever
muscle weakness
confusion - w. nile virus can cause fatal:
- encephalitis
- SARS stands for:
- severe acute respiratory syndrome
- how many days should a client be quarantined when they find out they have sars or have been around someone infected with sars?
- 10 days
- how is sars transmitted?
- direct contact with resp. secretions
- What type of precautions is a sars patient on?
- airborne
- what are some symptoms for sars?
-
dry cough
sob
fever >100.4
hypoxemia
pneumonia - what 5 ways is sars treated?
-
interferon
cysteine protease inhibitors
surfaxin
antibiotics
steroids - what is Surfaxin?
- liquid surfactant
- What does a cysteine protease inhibitor do?
- inhibits viral replication
- What keeps virus from entering cell?
- interferon
- water must stand for how long before mosquitos multiply?
- 5-7 days
- the avian flu is also known as:
- A(h5n1)
- the avian flu is transmitted thru:
- water and soil that's been infected by bird feces
- A(H5N1) can survive in soil for how long?
- 3 months
- A(H5N1) can survive in water for how long?
- 30 days
- what must a(h5n1) do to pass easily from human to human?
- mutate
- what two ways can the avian flu mutate?
-
adaptation
gene swap - virus enters a human cell, gradually mutates, mutation makes it easier for virus to attack human cells:
- ADAPTATION
- when 2 viruses enter human cells and replicate
- gene swap
- someone with the avian flu will be on what type of precautions?
- airborne
- what should you inquire about when testing for avian flu?
- recent travels to asian countries incl. turkey and romania.
- what vaccine is available for Diptheria?
- DTP
- what are some symptoms for diptheria?
-
low grade fever
fatigue
h/a
sore and edematous throat (bull throat) - what type of precautions is a person with diptheria on?
- droplet
- what should you keep at the bedside of a diptheria client?
- tracheostomy tray
- characterized by a pseudomembrane covering the posterior pharynx. Rubbery membrane forms and covers inflammed tissue of the oropharynx, nasopharynx, and laryngopharnx in what communicable disease?
- diptheria
- what are the 3 stages of pertussis? (whooping cough)
-
catarrhal
paroxysmal
convalescense - the catarrhal stage of pertussis lasts how long?
- 1-2 weeks
- the paroxysmal stage of pertussis lasts how long?
- 4-6 weeks
- During the catarrhal stage (I) of pertussis, what are some common symptoms?
-
coryza
conjunctivitis
cough
fever - Pertussis is highly contagious in the: stage
- catarrhal
- during the paroxysmal stage of pertussis (II), what happens?
- coughing ends in a loud whoop. During coughing spasms, eyes buldge, tongue pertrudes, red cheeks, thick mucus plug dislodges, vomit
- What are 3 txments for pertussis?
-
-antibiotics
-increase fluids
-sm. freq. meals - what immunization is available for pertussis?
- DPT
- when does someone receive the DPT immunization?
- 2,4,6,15 months and 4 years
- how does tetanus get transmitted?
- from soil to open wounds
- what are some symptoms of tetanus?
-
irritability
h/a
fever
painful spasms of muscles - with tetanus, any wounds to the head and face are
- fatal
- tetanus likes to live in
- dead tissue
- if a client has bacterial meningitis, they are put on what type of precautions?
- droplet
- how is meningitis diagnosed?
- lumbar puncture/spinal tap
- what immunization is available for meningitis?
- hib
- what three things should be monitiored on someone with meningitis?
-
hydration
electrolytes
increased intracranial pressure - inflammation of cns, spreads to cerebral spinal fluid to subarachnoid space with:
- bacterial meningitis
- what are some symptoms of meningitis?
-
fever
vomiting
h/a
stiff neck
seizures
irritability - how is salmonellosis transmitted?
- food contamination
- how is salmonella diagnosed?
- stool culture
- symptoms of salmonella:
-
abd pain
fever
foul diarrhea - what type of precautions is a client with tb put on?
- airborne
- symptoms for tb:
-
cough for more then 3 wks
fever
chills
night sweats
fatigue
anorexia
wt. loss - with tb, a cough may last for:
- more then 3 weeks
- clients are more at risk for tb if they:
- have another chronic disease
- what are some diagnostic tests for tb? (4)
-
ppd
cxr
sputum smear
culture for afb - three major principles of nursing care for the client with communicable disease
-
1. prevent the spread of infection by using aseptic practice
2. disease managment
3. health promotion - hiv stands for:
- human immunodeficiency virus
- Hiv is a disease along a continuum. It ranges from:
- asymptomatic infection to full blown aids
- hiv was discovered by a french scientist in
- 1983
- where and from what did hiv originate?
-
w. africa
chimps - what type of virus is hiv?
- retrovirus
- what 4 types of cells are affected by hiv?
-
CD4
t lymphocytes
monocytes
macrophages - what cells decrease while replicating more hiv?
- cd4
- hiv process is in a slowed state of activity until the CD4 cells are activated by :
- an invasion of pathogens
- the stimulation of the immune system causes an increased replication of HIV cells rather than an increase in:
- cd4 cells
- HIV is a bloodborne infection that is transmitted in three ways:
-
sexually
infected blood
mother to infant - most common mode of transmission of HIV
- sexual contact with hiv infected partner
- whats the percentage for contracting hiv with one act of receptive anal intercourse?
- 0.5-3% chance
- whats the percentage for contracting hiv with one act of vaginal intercourse?
- 0.1% chance
- whats the percentage for contracting hiv with one time of sharing a needle with an hiv infected person?
- 1%
- what percentage of neonates born to hiv infected mothers will have the virus?
- 20-25%
- can hiv be transmitted thru breast milk?
- yes
- infection with hiv is a gradual destruction of the:
- body's immune system
- transmission of hiv is possible during what stages?
- all 5
- what is the first stage of hiv called?
- acute retroviral syndrome (window phase)
- the acute retroviral syndrome (window phase) of hiv lasts for how long?
- 1-3 weeks
- In this stage of hiv, the antigen in the system, but body hasn't developed antibodies yet, no symptoms yet, hard to detect
- acute retroviral syndrome (window phase)
- it takes this long for the hiv antibody test to become positive:
- 3wks to 3months
- from 3 wks- 3 months, a person with hiv will experience the following symptoms:
-
flu like symptoms
low grade fever
chills
malaise
skin rash
lymphadenopathy - the third phase of hiv infection is called the:
- early chronic infection
- the early chronic infection (stage III) will start when?
- 1-20 years after infection
- what is encouraged with ppl who have hiv virus?
- exercise
- the fourth stage of hiv is known as:
- intermediate chronic infection.
- the intermediate chronic infection of hiv will last
- 1-3 years
- during the intermediate chronic infection of hiv, what are some symptoms?
- they vary. Immune system starts to fail., persistant low grade fever, diarrhea, lesions, night sweats, weight loss, cognitive slowing,peripheral neuropathy
- the fifth stage of hiv is known as:
- late chronic infection
- During the late chronic infection, hiv turns to:
- aids
- during the late chronic infection (AIDS), what symptoms occur?
- respiratory pneumonia, wasting gi problem
- what two tests are used to diagnose hiv?
- elisa, western blot
- blood is tested for hiv with the elisa test 2x because
- the elisa test provides a large number of false positives
- after the elisa test comes up positive for hiv, we do what test?
- western blot
- what types of lubes should we tell people to use when worried about hiv?
- water based
- If you have an needle using drug addict, what could you teach them about limited chance of getting hiv?
-
clean equip with bleach
use needle exchange program
dont share
rehab - treat hiv pregnant female with what during pregnancy and delivery?
- azt
- newborns to hiv infected mothers are treated with
- azt
- elected C sections decrease chance of passing hiv to fetus to what percentage? (must be before membranes are ruptured)
- 10%
- what is the normal level for CD4 of a normal/noninfected person?
- 600-1200mm3
- what is the level of CD4 in a person with generalized hiv symptoms?
- 200-500mm3
- what is the level of CD4 in a person with infections and malignancies associated with aids?
- 200 and under
- branched dna is also know as
- viral load
- what measures the amount of hiv virus circulating in peripheral blood?
- branched DNA or viral load
- a desirable viral load is:
- 10,000 or less
- a retrovirus uses several different enzymes to replicate and assemble more HIV within the cell. Pharmacological txmnts target:
- these enzymes and block their actions
- What are three types of meds that help with hiv?
- protease inhibitors, fusion inhibitors, and reverse transciptase inhibitors
- blocks viral HIV RNA from transforming into cell dna. It also blocks viral hiv from incorporating into new cells as they divide
- reverse transcriptase inhibitors
- What block viral replication in the cells
- protease inhibitors
- what prevents binding of hiv to healthy cells, thus blocking entry
- fusion inhibitors
- fusion inhibitors are given how? how often?
- SC injection, bid
- is herpes curable?
- no
- type I hsv affects areas:
- above waist
- type II hsv affects areas:
- below the waist
- 2 risk factors for HSV?
-
prior hsv infections
impaired immune system - what part of the nerve does hsv affect?
- ganglion
- initial infection of hsv can appear like:
- flu like symptoms
- Purulent vaginal drainage, painful urination, single or multiple leasion that heal without scarring are all symptoms of:
- hsv
- what causes an outbreak to occur once infected?
- stress, fever, emotional upset, over exposure to sun
- can herpes be transmitted during delivery?
- yes
- what 4 tests are availble to diagnose hsv?
- visual, pap smear, viral culture of fluid inside vesicle, tissue culture
- is herpes reported to health dept?
- no
- what three things can help people with hsv?
-
antiviral meds
viscous lidocain
burrows solution - how may different types of gential warts are there?
- over 70
- what is gential warts caused by?
- hpv
- what is wart growth facilitated by?
- warm moist conditions
- warts are usually what 2 colors?
- gray or white
- when will warts enlarge?
- during pregnancy
- warts can settle where in an infant?
- larynx
- what 3 ways can warts be diagnosed?
-
biopsy
pap smear
visual exam - what is the mode of transmission for gential warts?
- sexual contact
- who is eligable for hpv vaccine?
- 12-14 y.o. girls who are not sexually active
- what percentage of women with gential warts get cervical cancer?
- 70
- what therapy can eradicate hpv (warts)
- none
- is gonorrhea reported to the health dept?
- yes
- how is gonorrhea transmitted?
- sexual contact
- s/s of gonorrhea
- can be asymptomatic; purulent, yellow green drainage, dysuria, urinary freq, pelvic or abd pain, vaginal burning
- can gonorrhea be treated and cured?
- yes
- what are some symptoms in men with gonorrhea?
- redness, swelling, pain, drainage
- what diagnostic test is available for gonorrhea?
- smear/culture
- what should newborns receive if mother has gonorrhea?
- prophylactic eye ointment (erythromycin)
- if newborns born to mothers with gonorrhea are untreated they can become:
- blind
- what two big problems are associated with untreated gonorrhea?
- ectopic pregnancies, sterility
- is syphillis reported to the local health dept?
- yes
- what are the four stages of syphillis?
- primary, secondary, latent, tertiary
- during the primary stage of syphillis, what is a main symptom?
- painless open sore or chancre
- syphillis is HIGHLY contagious during what stage?
- I
- without txment of syphillis, chancre usually disappears when?
- in 6wks
- during the secondary stage of syphillis, what symptoms are present?
- rash, alopecia, malaise
- during the latent stage of syphillis, what symptoms are present?
- none
- the secondary stage of syphillis occurs how long after chancre appears?
- 6wks to 6months
- what disease is known for skin lesions on hands and feet?
- syphillis
- in what stage is syphillis no infectious except to fetus of pregnant woman
- latent
- when does the tertiary stage of syphillis occur?
- 3-20 years after initial infection
- how do you diagnose a person with syphillis if theyve had it for more than a year?
- lumbar puncture
- if a client has syphillis for less then a year, treat them with:
- PCN IM in one large dose
- when does syphillis become uncurable?
- tertiary phase
- follow up care is important for all stages of:
- syphillis
- what is the most common sti in the us?
- chlamydia
- is chlamydia reported to health depts?
- yes
- 45% of clients seeking treatment for gonorrhea also have:
- chlamydia
- 40% of women with PID have PID as a result of:
- chlamydia
- 50% of all people in world have
- chlamydia
- in females with chlamydia, what are some symptoms?
- painful urination, abnormal vaginal discharge, pelvic pain.
- chlamydia may cause: (3)
- pid, ectopic pregnancy, infertility
- neonates are at risk for what if mother has chlamydia?
- opthalmia neonatorum
- what two tests can diagnose chlamydia?
- cell culture, 4hr quick lab test
- what groups are at risk for bacterial vaginosis, or gardnerella vaginallis?
- sexually active women. reoccurence if sex partners untreated
- a change in vaginal flora, causing an alkaline vaginal pH causes:
- gardnerella vaginalis.
- if the vaginal ph is below 4.5:
- gardnerlla vaginalis
- paste liek vaginal discharge, fishy odor without inflammation
- gardnerella vaginalis
- what are people treated with who have gardnerella vaginalis?
- flagyl
- causes urethritis, epididymitis, inflammation, and rectal discharge in men:
- yeast infection (fungal vaginits or monilial)
- causes white curdlike discharge, itching, edema, redness in women
- yeast infection (fungal vaginits or monilial)
- asymptomatic to prurits, green/yellow vaginal discharge
- trichomoniasis
- how is trichomoniasis treated
- flagyl
- a complex infectious process in which organisms from the lower genital tract migrates from the cervix to the uterine cavity and fallopian tubes
- PID pelvic inflammatory disease