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DRUG OF CHOICE
DIAGNOSTIC TESTS
CAUSATIVE AGENTS
CD PHARMACOLOGY
Malaria: CHLOROQUINE
Schistosomiasis: PRAZIQUANTEL
Scabies: EURAX/ CROTAMITON
Chicken pox: ACYCLOVIR/ZOVIRAX
Tuberculosis: R.I.P.E.S.
Pneumonia: COTRIMOXAZOLE; Procaine Penicillin
Helminths: MEBENDAZOLE; PYRANTEL PAMOATE
What is Infection?
INFECTION - "the state or condition in which the body or part of the body is invaded by a pathogenic
agent ( bacteria, virus, parasites etc.) which under favorable conditions multiplies and produces effects
which are injurious…"
Infectious Agent
A. RESIDENT ORGANISMS
deeply seated in the epidermis, not easily removed by simple handwashing,
Ex: Staphylococci
B. TRANSIENT ORGANISM
represent recent contamination,
survive for a limited period of time, acquired during contact with the infected colonized patient or
environment,
easily removed by good handwashing
Ex: ( Klebsiella & Pseudomonas)
Infectious Agent
Bacteria – heama organism, systemic
Virus – nuero organism, systemic
Fungi – skin organism, local
Protozoa – GI organism, local
Infectious Agent
2. AIRBORNE
- droplet, dust, organisms in env.
3. VECTOR - insects or animals
4. VEHICLE
- food (salmonella), water (shigellosis), blood (Hepa B), medication ( contaminated infusion)
PREVENTION OF
COMMUNICABLE DISEASE
Prevention is worth a pound than cure
PREVENTION OF
COMMUNICABLE DISEASE
Health Education – primary role of the nurse
Specific Protection- handwashing, use of protective devices
Environmental Sanitation – clean and conducive for health
Definition of Prevention
“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability. The
concept of prevention is best defined in the context of levels, traditionally called primary, secondary,
and tertiary prevention”
Note: We make use of the epidemiology in CHN in order to come up a community diagnosis and also to
determine the effectiveness of a particular treatment
Types of Epidemiologic Data
Demographic data
Demography is the study of population groups
Ex. Population size and distribution
Vital Statistics
Environmental data
Health services data
Ex. Ratio between nurse and the population being served
Ex. Degree of utilization of health facility/ service
Epidemiologic Investigation
TERMS
Disinfection – pathogens but not spores are destroyed
Disinfectant – substance use on inanimate objects
Concurrent disinfection – ongoing practices in the care of the patient to limit or control the spread of
microorganisms.
Terminal disinfection – practices to remove pathogens from the patient’s environment after his illness is
no longer communicable
EPI
BCG - TB
DPT – Diptheria, Pertussis, Tetanu
OPV - Poliomyletis
Hepatitis B
Measles
Immunization
Contraindications
-conditions that require hospitalization
For DPT 2 and 3 – history of seizures/ convulsions within 3 days after the first immunization with DPT
Nursing responsibility: ask how the child reacts to the first dose
For infant BCG – clinical AIDS
The following conditions are NOT contraindications:
Fever up to 38.5 ºC
Simple or mild acute respiratory infection
Simple diarrhea without dehydration
Malnutrition (it is indication for immunization)
Schedule of immunization
Infant BCG
0 to 11 months or 0 to 1 year
at birth
0.05 ml (dose) – ID, right arm
School entrance BCG
When the child enters Grade 1 with or without scar on the right arm then still go on with the vaccination
except if he is repeating Grade 1
Schedule of immunization
DPT
3 doses, 4 weeks or 1 month interval
Target age: 1 ½ to 11 months but child is eligible up to 6 years
If 7 years old and above DT only not P
0.5 ml, IM, vastus lateralis
Schedule of immunization
OPV
3 doses, 4 weeks/1 month
Target population: same as above, eligibility until Grade 6
2-3 drops, oral route
*Feb 8-March 8: Oplan Polio Revival Drive
No side effect, but advise the mother to avoid feeding the child for 30 minutes after the vaccine, if
vomits within the 30 minute period, repeat the vaccination
Schedule of immunization
Hepa B
3 doses, 4 weeks
Can be given at birth
Target age 1 ½ to 11 months
0.5 ml, IM, vastus lateralis
Patient may experience local tenderness
Schedule of immunization
Measles
9 to 11 months
Most babies have protection because of maternal antibodies thus this vaccine is given at 9 months
because the time where the maternal antibodies wear off, other virus if it still active it will kill the
vaccine
0.5 ml, subcutaneous, any arm
Measles
Fever and measles rash lasting for 1 to 3 days within 2 weeks after immunization (modified measles)
Immunization
Fully Immunized Child
when he received all the antigens that should be given in the first year of life (1 dose BCG, MV; 3 doses
DPT, OPV, HB)
Completely Immunized Child
All vaccines given but went beyond 0ne year of age
1. The clinic nurse notes that the physician has documented a diagnosis of herpes zoster
(shingles) in the client’s chart. Based on an understanding of the cause of this disorder, the nurse
would determine that this definitive diagnosis was made following which diagnostic test?
A. Skin biopsy
B. Wood’s light examination
C. Culture of the lesion
D. Patch test
ANSWER: C
Viral culture is the confirmatory test for Herpes. Patch test is an allergy test.
2. Nurse Jezel is preparing to care for a child with rubella (German measles) and anticipates
contact with infectious material during care. She enters the supply closet where the masks,
gloves, gowns, and goggles are kept. Which item(s) does the nurse obtain to care for this child?
ANSWER: B
No need of goggles because causative agent cannot cause infection when it enters the mucous
membrane of the eyes.
3. Eunice, six year old, is scheduled to receive a measles, mumps, rubella (MMR) vaccine. The
nurse preparing to administer the vaccine reviews the child’s record and questions the order if
which of the following is documented in the child’s record?
ANSWER: B
MMR vaccine contains aminoglycosides antibiotic. Allergic reaction to neomycin
aminoglycosides warrant further check by the doctor.
4. Ms. Flores clinic nurse prepares to administer a measles, mumps, rubella (MMR) vaccine to a
5-year-old child. The nurse administers this vaccine:
ANSWER: C
MMR vaccine is given via this route. Before administration always check for allergy to eggs.
5. Mrs. Analesa Plaga mother brings her six years old child to the clinic because the child has
developed a rash on the trunk and on the scalp. Mrs. Analesa reports that the child has had a low
grade fever, has not felt like eating and generally has been tired. The child is diagnosed with
chickenpox. Mrs. Plaga inquires about the communicable period associated with chickenpox. A
nurse plans to base the response on which of the following?
6. A nurse provides instructions to the mother of a child with mumps regarding respiratory
precautions. The mother asks the nurse about the length of time required for the respiratory
precautions. The nurse most appropriately responds:
A. Respiratory precautions are not necessary once the swelling appears.
B. Respiratory precautions are not necessary before the swelling begins.
C. Respiratory precautions are indicated during the period of communicability.
D. Respiratory precautions are indicated for 18 days following the onset of parotid swelling.
ANSWER: C
The patient is placed on isolation during the period of communicability.
ANSWER: D
Chlorine is used in disinfecting objects because it rapidly kills viruses causing AIDS and
Hepatitis B. It does not kill all microorganisms but is effective in killing most microorganisms.
The presence of pathogenic microbes would mean contamination.
8. In Communicable Diseases cases, which of the following should be done to the CHN bag?
ANSWER: A
In communicable diseases cases in the community in relation to CHN bag; the main goal is to
prevent the spread of infection. Therefore the bag should be thoroughly cleanse and disinfected.
Option B would be appropriate if the question is asking for neatness and organization of the
nurse. Option C and D are not related to the topic in communicable disease.
ANSWER: C
During home visit, the nurse performs handwashing first after placing the bag in a convinient
place, As a preparation for handwashing activity, the nurse first takes the towel out, soap dish as
well as the apron. The nurse then performs handwashing.
10. After completion of the nursing care or treatment, the nurse must protect himself and prevent
the spread of infection. What is used to clean item used?
A. Alcohol
B. Isopropyl
C. Zephiran
D. Wet ones
ANSWER: A
After completing nursing care or treatment, clean and alcoholize the things used.