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

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