Urinary Tract Infection .PDF

This is a link for a research of UTIs

Download 

http://www.mediafire.com/view/?4zqpu5cnr9v1fln

Every thing you want to know about Malaria

Malaria

Definition of Malaria :

-acute and chronic parasitic disease transmitted by the bite of infected mosquitoes and it is confined mainly to tropical and subtropical areas.

Etiologic Agent:

 Four species of protozoa:

1.       Plasmodium falciparum

2.       Plasmodium vivax

3.       Plasmodium malariae

4.       Plasmodium ovale

The primary vector of malaria is the female Anopheles mosquito.

> breeds in clear, flowing, and shaded streams usually in the mountains

> bigger in size than the ordinary mosquito

> brown in color

> night-biting mosquito

> usually does not bite a person in motion

> assumes a 36 degree position when it alights on walls, trees, curtains, and the like.

Incubation Period of Malaria

12 days for P. Falciparum

14 days for P. vivax and ovale

30 days for P. malariae

Period of Communicability: untreated or insufficient treated patient may be the source of mosquito infection.

Mode of Transmission of Malaria

Through the bite of an infected female anopheles mosquito.

Parenterally through blood transfusion.

Occasionally, transmitted from shared contaminated needles.

Transplacental transmission for congenital malaria (rare)

Clinical Manifestations of Malaria

1. Paroxysms with shaking chills.

2. Rapidly rising fever with severe headache

3. Profuse sweating

4. Myalgia, with feeling of well-being in between

5. Splenomegaly, hepatomegally

6. Orthostatic hypotension

7. Paroxysms may last for 12 hours, then, maybe repeated daily or after a day or two.

8. In children:

a. fever maybe continuous

b. convulsions and gastrointestinal symptoms are prominent

c. splenomegally

9. In cerebral malaria:

a. changes in sensorium, severe headache, and vomiting

b. Jacksonian or grand mal seizure may occur

Diagnostic Procedure of Malaria

Malarial smear – a film of blood is placed on a slide, stained, and examined microscopically.

 Rapid diagnostic test (RDT) –blood test for malaria that can be conducted outside the laboratory and in the field.

- gives a result within 10-15 minutes.

- detect malarial parasite antigen in the blood.

Pathogenesis of Malaria

·         The parasite enters the mosquito’s stomach through the infected human blood obtained by biting or during blood meal.

·         The parasite undergoes sexual conjugation.

·         After 10 to 14 days, a number of young parasitesare released and invade the salivary gland of the mosquito.

·         The organisms are carried in the saliva into the victim when the mosquito bites again.

·         The parasites invade the RBC where they grow and undergo asexual propagation.

·         RBC ruptures or bursts releasing tiny organisms (merozoites)

·         Merozoites invade new batch of RBC to start another schizonic cycle.

·         Indefinite malaise and slowly rising fever occur for several days.

·         There is shaking chills, rapidly rising temperature, and profuse sweating.

Management of Malaria

·        Medical

a.       Anti-malarial drugs

-          Chloroquine

-          Quinine

-          Sulfadoxine for the resistant P. falciparum

-          Primaquine for relapse of P. vivax & ovale

b.      Erythrocyte exchange transfusion for rapid production of high levels of parasites in the blood.

·         Nursing Management

b. The patient must be closely monitored.

c. Intake and output should be closely monitored to prevent pulmonary edema.

> daily monitoring of patient’s serum bilirubin, BUN creatinine, and parasitic count.

> if the patient exhibits respiratory and renal symptoms, determine the ABG and plasma electrolyte.

c. During the febrile stage, tepid sponges, ice cap on the head will help bring the temperature down.

d. Application of external heat and offering hot drinks during chilling stage is helpful.

e. Provide comfort and psychological support.

f. Encourage the patient to take plenty of fluids. g. As the temperature falls and sweating begins, warm sponge baths maybe given.

h. The bed and clothing should be kept dry.

ii. Watch for neurologic toxicity (from quinine infusion) like muscular twitching, delirium, confusion, convulsion, and coma.

j. Evaluate the degree of anemia.

k. Watch for any signs especially abnormal bleeding.

l. Consider severe malaria as medical emergency that requires close monitoring of vital signs.

Prevention and Control of Malaria

·         Malaria cases should be reported.

·         A thorough screening of all infected persons from mosquitoes is important.

·         Mosquito breeding places must be destroyed.

·         Homes should be sprayed with effective insecticides which have residual actions on the walls.

·         Mosquito nets should be used especially when in infected areas.

·         Insect repellents must be applied to the exposed portion of the body.

·         People living in malaria-infested areas should not donate blood for at least 3 years.

·         Blood donors should be properly screened.

Every thing you want to know about Poliomyelitis

Poliomyelitis (Infantile Paralysis) 

Definition of Poliomyelitis:

- acute infectious disease characterized by changes in the CNS which may result in pathologic reflexes, muscle spasm & paresis or paralysis.

-Disease of the lower motor neurons.

 Etiologic Agent: polio virus (Legio debilitans)

Incubation Period of Poliomyelitis:

7 to 21 days for paralytic cases with a repeated range of 3 to 35 days.

Period of Communicability:

·         first 3 days to 3 months of illness

·         Most contagious during the first few days of active disease, & possibly from 3 to 4 days before that.

Mode of Transmission of Poliomyelitis:

·         Direct contact with infected oropharyngeal secretions & feces

·         Person to person transmission through healthy carriers

·         Indirect through contaminated articles & flies, contaminated water, food & utensils.

Diagnostic Procedures of Poliomyelitis:

·         Throat swab

·         Stool culture throughout the disease

·         Culture from the CSFModalities of Treatment Modalities of Treatment

·         Analgesics to ease headache, back pain & leg spasm

·         Moist heat application to reduce muscle spasm & pain

·         Bed rest is necessary

·         Paralytic polio requires rehabilitationNursing Management Nursing Management

·         Carry out enteric isolation.

·         Observe patient carefully for signs of paralysis & other neurologic damage

·         Perform a neurologic assessment at least once a day

·         Check blood pressure regularly

·         Watch for signs of fecal impaction due to dehydration & immobility.

·         Prevent the occurrence of bed sores.

·         Wash hands after every contact with patient.

·         Apply hot packs to affected limb to relieve pain and muscle shortening.

·         Dispose excreta & vomitus properly.

·         Provide emotional support both to patient & family.

·         Maintain good personal hygiene, oral & skin care.

Every thing you want to know about Pertussis

Pertussis

Definition of Pertussis:

Whooping cough – infectious disease characterized by repeated attacks of spasmodic coughing which consists of aseries of explosive expirations, typically ending in a long-drawn forced inspiration which produces a crowing sound, the “whoop” & usually followed by vomiting.

Causative Agent  –  Bordetella pertussis

Incubation Period: 7 to 14 days

Period of Communicability: 7 days after exposure to 3 weeks after typical paroxysms.

Mode of Transmission of Pertussis:

·         Direct contact & droplet

·         Indirect through soiled linens & other articles contaminated by respiratory secretions.

Sources of infection: secretions from the nose & throat of infected persons- extremely contagious

Diagnostic Procedures of Pertussis:

·         Nasopharyngeal swabs

·         Sputum culture

·         CBC (Leukocytosis)

Modalities of Treatment of Pertussis:

1. Supportive therapy

a.       Fluid & electrolyte replacement

b.      adequate nutrition

c.       oxygen therapy

2. Antibiotics (erythromycin & ampicillin)

3. DPT vaccine

Nursing Management of Pertussis:

·         Isolation and asepsis should be carried out.

·         Should not leave the patient alone. Suctioning equipment should be ready at all times for emergency use to avoid airway obstruction.

·         Sunshine & fresh air are important.

·         Provide warm baths, keep the bed dry & free from soiled linens.

·         Intake & output should be closely monitored.

Every thing you want to know about Pediculosis

Pediculosis

Definition of Pediculosis:

-flattened, wingless insects commonly attack man.

Etiologic Agent:

4. Pediculus humanos var. capitis (head lice)

5. Pediculus humanos var. corporis (body lice)

6. Pdiculus pubis or pubic lice (crab lice)

a.       Feed on human blood & lay their eggs in body hair & clothing fibers.

b.      After the nits hatch, the lice must feed within 24 hours otherwise it will die.

c.       They mature in about 2 – 3 weeks.

d.      It injects toxin into the skin that produces mild irritation & a purpuric spot.

Clinical Manifestations of Pediculosis:

1. The head louce

a.       more common in female than in male. Infects more children than adults.

b.      b.Itching is the first & predominant symptom.

c.       irritation, excoriation & crusting & foul smelling mass consisting of matted hair, nits, ova, pus, crusts, & pediculi results (plica polonica)

2. Body louse

a.       initial lesions are minute red spots

b.      spot swells & secondary crust & excoriation is formed on the surrounding skin as a result of scratching.

3. Crab lice

a.       unusual, persistent itching in the pubic region

b.      Maculae caeruleae – grayish pigmented spots – found in the surface of the inner thighs or the abdomen, pea-size to a small coin.

Treatment of Pediculosis:

1. Head lice

a.       dusting the scalp with 1% malathion powder is a reliable & convenient method

b.      massage with gamma benzene hexachloride shampoo in the scalp for 4 minutes, then rinse.

2. Body louse

a.       laundry (dry clean) or boil the clothing & beddings

b.      good body hygiene must be observed always.

3. Crab lice

a.       apply Kwell or Gamene (Lindane) cream or lotion

b.      Rub crotaminon (Eurax, Geigy) into the affected area.

c.       repeat the application of crotaminon after 1 week.

d.      simultaneously treat the person who had sexual contact with the patient

e.      remove remaining nits mechanically.