Every thing you want to know about Acquired Immune Deficiency Syndrome (AIDS)

Acquired Immune Deficiency Syndrome (AIDS)

Human Immunodeficiency Virus (HIV) – causes AIDS.

- retrovirus

- belongs to lentevirus, also called “slow virus”.

What are Signs and Symptoms: 

•  AIDS-related Complex (ARC)
•   Memory loss
•   Altered gait
•   Depression
•   Sleep disorders
•   Chronic diarrhea

Minor Symptoms of AIDS:

·         Persistent cough for one

·         month

·         Generalized pruritic

·         dermatitis

·         Recurrent herpes zoster

·         Oropharyngeal candidiasis

·         Chronic disseminated

·         herpes simplex

·         Generalized

·         lymphadenopathy

Major Signs of AIDS:

·         Loss of weight – 10%

·         of body weight

·         Chronic diarrhea for

·         more than one month

·         Prolonged fever for

·         one month

Common Opportunistic Infections  :

Pneumocystis carinii peumonia

Oral candidiasis

·         Toxoplasmosis of the CNS

·         Chronic diarrhea/wasting syndrome

·         Pulmonary/extra-pulmonary tuberculosis

·         Cancers (Kaposi’s sarcoma, cervical

·         dysplasia & cancer, Non-Hodgkin’s lymphoma)

Mode of Transmission of AIDS

·         Sexual intercourse

·         Blood transfusion and sharing of infected syringes and needles among intravenous drug users

·         Vertical or perinatal transmission (from a pregnant woman to the fetus during pregnancy, child delivery, or breastfeeding)

Diagnostic Examinations of AIDS

·         EIA or ELISA – Enzyme link immunosorbent assay

·         Particle Agglutination (PA) test

·         Western Blot analysis – confirmatory diagnostic test

·         Immunofluorescent test

·         Radio immuno-precipitation assay (RIPA)

Treatment Modalitie

“AIDS Drugs” – medicines used to treat but not to cure HIV infection.

- referred to as “anteroviral drugs”.

- inhibits the reproduction of the virus.

Nursing Management in AIDS

1. Health Education

·         know the patient

·         avoid fear tactics

·         avoid judgmental and moralistic messages

·         be consistent and concise

·         use positive statement

·         give practical advice

2. Practice universal/standard precaution

b. 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.

c. Use of Universal barrier or Personal Protective Equipment (PPE).

3. Prevention

b. Avoid accidental pricks from sharp instruments contaminated with potentially infectious materials from AIDS patient.

c. Wear gloves when handling blood specimens and other body secretions

d. Label blood and other specimens with special warning “AIDS Precaution”.

4. Blood spills should be cleaned immediately using common household disinfectants, like “chlorox”.

5. Needles should not be bent after use, but should be disposed into a puncture-resistant container.

6. Personal articles should not be shared with other members of the family.

7. Patients with active AIDS should be isolated.

Every thing you want to know about Hepatitis Hepatitis A (Infectious Hepatitis/Catarrhal jaundice) and Hepatitis B (Serum Hepatitis)

Hepatitis

Hepatitis A (Infectious Hepatitis/Catarrhal jaundice)

- liver disease caused by the hepatitis A virus.

- inflammation of the liver that is not really very severe & runs an acute course.

- starts within 2 – 6 weeks after contact with the virus, lasts no longer than 2 months.

Period of Communicability

The infected patient is capable of transmitting the organism a week before and a week after the appearance of symptoms.

Mode of Transmission

Ingestion of contaminated drinking water or ice, uncooked fruits and vegetables.

Through oral-fecal pathway.

By infected food handlers. Clinical Manifestations Clinical Manifestations

Flu-like illness with chills and high fever

Diarrhea, fatigue, and abdominal pain

Loss of appetite

Nausea, diarrhea, and fever

Jaundice and dark-colored urine

The infection in young children is often mild and asymptomatic

Diagnostic Procedure

1. HAV and HBV – complement fixation rate

2. Liver function test – to determine the presence and extent of liver damage and to check the progress of the liver

3. Bile examination in stool and urine

4. SGOT – serum glutamic oxaloacetic transaminaseSGPT – serum glutamic pyruvic transaminaseALT – serum alanine transaminase

5.  IgM level

Treatment Modalities

1. There is no specific treatment, although bed rest is essential.

2. Diet must be high in carbohydrate, low in fat, and low in protein.

3. Patient must take vitamin B complex.

4. Isoprinosine (methisoprenol) – enhance the cell-mediated immunity of the T-lymphocytes.

Nursing Management

1. The patient must be isolated (enteric isolation).

2. Patient should be encouraged to rest during acute or symptomatic phase.

3. Improve nutritional status.

4. Utilize appropriate measures to minimize spread of the disease.

5. Observe the patient for melena and check stool for the presence of blood.

6. Provide optimum skin and oral care.

7. Increase in ability to carry out activities:

a. encourage the patient to limit activity when fatigued

b. assist the client in planning periods of rest and activity

c. encourage gradual resumption of activities and mild exercise during recovery

Prevention and Control

1. Hands should be washed thoroughly every after use of toilet.

2. Travelers should avoid water and ice if unsure of their purity.

3. Food handlers should carefully be screened.

4. Safe preparation and serving of food must be practiced.

5. The public should be educated on the mode of transmission.

Hepatitis B (Serum Hepatitis)

-inflammation of the liver caused by hepatitis B virus.

- More serious than Hepatitis A due to the possibility of severe complications such as massive damage and hepatocarcinoma of the liver.

Incubation Period Incubation Period-50 to 189 days or 2 to 5 months

Period of Communicability:

The patient is capable of transmitting the virus during the latter part of the incubation period and during the acute phase.

The virus may persist in the blood for many years.

Mode of Transmission

Direct contact via infected body fluids.

Through contaminated needles and syringes.

Through infected blood or body fluids introduced at birth

Through sexual contact

HBV transmission does not occur:

By fecal-oral route

By food-borne or water-borne transmission

By arthropod (mosquito) transmission

Clinical Manifestations

·         Prodromal Period

a.       Fever, malaise, and anorexia

b.      Nausea, vomiting, abdominal discomfort, fever, and chills

c.       Jaundice, dark urine, and pale stools

d.      Recovery is indicated by a decline of fever and improved appetite

*Fulminant Hepatitis – fatal & manifested by ascitis and bleeding

Diagnostic Procedures

1. Compliment Fixation test

2. Radio-immunoassay-hemaglutinin test

3. Liver function test

4. Bile examination in blood and urine

5. Blood count

6. Serum transaminase – SGOT, SGPT, ALT

7. HbsAg

Prevention

·         Blood donors must be screened to exclude carriers.

·         Caution must be observed in giving care to patients with known HBV.

·         Hands and other skin areas must be washed immediately and thoroughly after contact with body fluids.

·         Avoid injury with sharp objects or instruments.

·         Use disposable needles and syringes only once and discard properly.

·         Avoid sharing of toothbrush, razor, and other instruments that may be contaminated with blood.

·         Observe “safe sex”.

·         Have adequate rest, sleep, and exercise, and eat nutritious food.

·         Hep B vaccine is recommended for pre-exposure.

·         Hepatitis Immune Globulin (HBIg) should be administered within 72 hours to those exposed directly to hep B virus either by ingestion, by prick or by inoculation.

Every thing you want to know about German Measles (Rubella/Three-day Measles)

German Measles (Rubella/Three-day Measles)

- mild viral illness caused by rubella virus.

- Causes mild feverish illness associated with rashes and aches in joints.

-Has a teratogenic effect on the fetus.

Incubation Period: 14-21 days

Period of Communicability

-communicable approximately 1 week before and 4 days after the onset of rashes.

- At its worst when the rash is at its peak.

Mode of Transmission:

5. Direct contact

6. Air droplets

7. Transplacental transmission

Clinical Manifestation

1. Prodromal Period

a.       low grade fever

b.      headache

c.       malaise

d.      mild coryza

e.      conjunctivitis

2. Eruptive Period

a.       Pinkish rash on the soft palate (Forchheimer’s spot), en exanthematous rash that appears first on the face, spreading to the neck, the arms, trunk, and legs

b.      Eruption appears after the onset of adenopathy

c.       Children usually present less or no constitutional symptoms.

d.      The rash may last for one to five days and leaves no pigmentation nor desquamation.

e.      Testicular pain in young adults.

f.        Transient polyarthralgia and polyarthritis may occur in adults and occasionally in children.

Nursing Management

1. The patient should be isolated.

2. The patient should be advised to rest in bed until fever subsides.

3. The patient’s room must be darkened to avoid photophobia.

4. The patient must take mild liquid but nourishing diet.

5. The patient’s eyes should be irrigated with warm normal saline to relieve irritation.

Prevention 

·         Administration of live attenuated vaccine (MMR).

·         Pregnant women should avoid exposure to patients infected with Rubella virus.

·         Administration of Immune Serum Globulin one week after exposure to Rubella.