Infectious Disease Process

Infectious agent INTERVENTIONS TO BREAK THE CHAIN

-bacteria OF INFECTION TRANSMISSION
-fungi Prevention of Transmission
-viruses Standard Precaution
-rickettsiae Hand washing
-protozoa Gloves
Reservoir Patient placement
-People •Isolation precaution
-Equipment Limiting movement of patient
-Water Transmission Based Precaution
Portal of exit  Airborne precaution – pt. should be put in
-Respiratory tract a room w/ negative air pressure and wear
-GI tract face mask.
-GU tract Droplet Precaution – Nurse should wear a
-Open lesions facemask.
-from bloodstream Contact Precaution – pt. is placed on a
Mode of transmission private room to facilitate hand hygiene and
 Contact protection of garments from envtl.
Direct – person to person. Indirect – contamination.
usually an inanimate object. Preventing infection in the hospital.
roplet – particles from Nosochomial infection
coughing sneezing or talking by Disinfecting skin
an infected person. •Medical hand washing
Common vehicle route •Use of disinfectants
Food -salmonellosis  Changing infusion sets, caps and sol’n
Water – shigellosis
Drugs – Bacteremia RESPIRATORY SYSTEM
Blood – Hepa B
Airborne 1. Diphtheria
-Droplet nuclei Acute febrile infection of the tonsil, throat,
-Dust particle nose, larynx caused
Vector borne by Corynebacterium diohtheriae which is a
-Flies, mosquito, ticks, rats gram positive rod bacilli.
Portal of entry Incubation period: usually 2 – 5 days.
- Respiratory tract Transmission: Contact with a pt. or carrier
- Gastrointestinal tract with articles soiled with discharges of
- Genitourinary tract infection persons. Milk has served as a
-Direct infection of mucus membrane/ vehicle.
breaks of skin: Period of communicability: variable until
Parenteral: via blood virulent bacilli have disappeared from
Transplacental:motherto fetus secretions and lesions; usually 2 wks. and
Infectious Disease Process seldom more than 4 wks.
Susceptible host Assessment:
 One who lacks effective resistance to  nasal discharge, anorexia, sore throat low
infectious agent. grade fever.
No. of organisms to which host is exposed. Smooth, white or gray membrane
Age,genetics constitution of host, general over tonsillar region w/c leads to hoarseness
physical , mental and emotional health and and potential airway obstruction.
nutritional status of host. Often tachypnea, cyanosis if condition goes
untreated.
 Complication: airway obstruction Convalescent Stage: This is the third
and final stage, where the coughing
Preventions and control: finally subsides. However, another upper
Active immunization respiratory infection may trigger the
Pasteurization of milk symptoms.
Educating of parents Nsg. Intervention:
Reporting of the case to the health officer Focus on prevention and other
for proper medical care. complication.
Nsg. Intervention: Administer antibiotic therapy as ordered.
Maintain strict isolation Provide oxygen and humidification.
Administer antibiotic medications as Avoid environmental precipitants.
prescribed. General care of nose and throat
Have tracheostomy set available discharges.
Provide adequate humidification to allow
for liquefication of secretions. 3. Pneumonia
Preventive: DPT immunization An acute infectious disease of the lungs
usually caused by the pneumoccocus resulting
2. Pertussis(Whooping cough) in the consolidation of one or more lobes of
Acute infection of the respiratory tract. It either one or both lungs.
begins as an ordinary cold caused
Transmission:respiratory droplets.
by Bordatella pertussis.Itbegins as an ordinary
Predisposing factors:
cold, which is attended by paroxysms of cough
ending in a characteristic whoop as the breath Fatigue
is drawn in. Over exposure to inclement weather
Incubation period: 5 – 21 days, average is 10 Exposure to polluted air
days. Malnutrition
Transmission: Air droplets Incubation period: 2 – 3 days
Communicability: greatest during the catarrhal Sign & Symptoms
stage before the onset of paroxysms of Common cold
coughing. Chest indrawing
Rusty sputum
Assessment: Productive cough
Catarrhal Stage: This first stage is Fast respiration
defined by a hacking cough usually at High fever
night. Symptoms are similar to a cold Vomiting at times
with a runny nose, congestion and Flushed face
sneezing. This is usually the most Dilated pupils
contagious period and lasts about a Severe chill in children
couple weeks. Pain over affected lung
Paroxysmal Stage: After a couple of Highly colored urine
weeks, the coughing can get worse, Etiology:
meaning more irritating and repetitive. Viral – H. Influenza
Sometimes the cough is so bad that the Bacterial:
person can vomit from it. The typical Streptococcus pneumonia
whooping cough is present during this (greenish - yellow colored sputum)
periods, although young infant may not Staphylococcus pneumonia
develop the characteristic sound. (yellow or blood- streaked sputum)
Antibiotics tend to be much less Diagnostic:
effective during this stage. Culture of organism from sputum
Chest xray New TB patients whose sputum is positive.
Treatment: Extra pulmonary tuberculosis.
Antibiotic according to organism identified Intensive phase:
Respiratory isolation Rifampicin,Isoniazid,Pyrazinamide,
Hospitalization Ethambutol
Inhalation therapy -given daily for 2 mos.(months
1&2).After
Nsg. Intervention: month 2,Maintenance phase will
Bedrest start only if
Adequate food intake the sputum is negative.
TSB Maintenance Phase(cat. I)
Frequent turning to side Isoniazid, Rifampicin
-given daily for the next 4 months
Antibiotic as ordered
Cool humidity Category II
Prescribed to previously treated who are:
4. Tuberculosis Relapses
Bacterial infection of the lungs. It is primarily a Failures
respiratory disease common among Intensive phase
malnourished individuals living in crowded Rifampicin,Isoniazid,Pyrazinamide,
areas. Ethambutol,
Infection agent: Streptomycin
Mycobacterial tuberculosis and M.africanum(h -given daily for 2 months(months
uman) and M. bovis(cattle). 1&2)
Transmission: Airborne method through Rifampicin,Pyrazinamide,Ethambuto
coughing, singing or sneezing. l,Streptomycin
Communicability: as long as viable tubercle -given on the
bacilli are being discharged. 3rd month.Maintenance phase will
Susceptibility: First 6 – 12 months; highest in start only if the sputum is negative.
children under 3.
Assessment: Maintenance phase(cat. II)
Predisposing factor: Isoniazid, Rifampicin,Ethambutol
Frequent close contact with infected -given daily for 5 months(months
individual. 4,5,6,7,8)
Debilitating conditions and disease. (add PZA if pt. Is weighing more than
Poor nutrition 50 kgs.)
Crowded living condition. Category III
Clinical Manifestation:  New pulmonary TB patients whose
Fatigue, malaise sputum is smear(-) for 3 times and a
Anorexia, weight loss chest xray result of PTB minimal.
Chronic cough Extra pulmonary(not serious)
Low grade fever Intensive Phase:
Night sweats Rifampicin,Isoniazid,Pyrazinamide
hemoptysis -given daily for 2 months
Diagnostic: Maintenance phase:
Tuberculin skin test(PPD) Rifampicin, Isoniazid
Chest Xray -given daily for the next 2 months
Sputum test (add PZA and INH for pt. weighing
Treatment more than 50kgs.)
Category I
 5. Severe acute respiratory syndrome –
Influenza A
CA. Novel Corona Virus--- first reported in
China November 2002
--Cases 8300
---812 deaths July 2003.
MT: direct mucous membrane
Respiratory droplets or exposure
to fomites
Incubation period: of 2-10 days
How long will the virus exist on the surface
1.Vius stable in urine and feces
at roon temperature for at least one or two
2.It survives on paper, on plastered wall,
plastic surfaces and stainless steel after 72
hours and on a glass slide after 96 hours
3.Hospital environmental samples from a
number of sites, including walls and the
ventilation system tested for positive of SARS
4.Virus loses infectivity after exposure to
different disinfectants and fixatives. Heat
at556 degree rapidly kill the virus.
Early systemic symptoms followed within
2-7 days by dry cough and/or shortness of
breath, often without upper respiratory
tract symptoms
Development of radio graphically
confirmed pneumonia by day 7-10 of
illness
Lymphopenia in most cases
S/S: sudden onset of high grade fever usually
greater than 38 degree
Headache and overall feeling of
discomfort and body aches.
Mild respiratory symptom at the start and
other two days pt. Develops dry cough
and have respiratory difficulty.
Infection Control:
Healthcare facilities should ensure the
availability of materials for adhering to
respiratory hygiene/cough etiquette in waiting
areas for patients and visitors:
Provide tissues and no-touch receptacles for
used tissue disposal.
Provide conveniently located dispensers for
alcohol-based hand rug.
Provide soap and disposable towels for hand
washing where sinks are available
6. Influenza
Orthomyxoviridae (orthos, Greek for
"straight"; myxa, Greek for "mucus")[1] are a
family of RNA viruses that includes five genera:
Influenzavirus A - humans,
other mammals and birds
Influenzavirus B - infect humans and seals
 Influenzavirus C - infect humans and pigs
Isavirus – atlantic salmon
Thogotovirus – tick, mosquito, mammals
• Influenza A (H1N1)
 What is 2009 H1N1 (swine flu)?
2009 H1N1 (referred to as “swine flu” )
 new virus was first detected in people
in the United States in April 2009.
 On June 11, 2009, the World Health
Organization(WHO) signaled that a
pandemic of 2009 H1N1 flu was underway
can survive on environmental surfaces and
can infect a person for 2 to 8 hours after
being deposited on the surface.
 What kills influenza virus?
Influenza virus is destroyed by heat (167-
212°F [75-100°C]).
 chemical germicides:
 chlorine, hydrogen
peroxide, detergents (soap),iodophors (i
odine-based antiseptics), and alcohols
Mode of Transmission
 Person to person
 infected droplets
S/S:
flu-like, including fever, cough,
headache, muscle and joint pain, sore
throat and runny nose
 sometimes vomiting and diarrhea.
 certain people are at “high risk” of
serious complications.
people 65 years and older,
children younger than five years old,
pregnant women
 people of any age with certain chronic
medical conditions.
 This includes pregnancy, diabetes,
heart disease, asthma and kidney
disease.
Diagnostic Procedure
 Viral and Rickettsial Disease Laboratory
(VRDL)
  The VRDL testing capabilities include
viral culture,
 polymerase chain reaction (PCR),
serologic testing,
 sub-typing,
 strain characterization
 antiviral resistance testing.
CDC Guidelines
 Cover your nose and mouth with a
tissue when you cough or sneeze.
Throw the tissue in the trash after you
use it.
 Wash your hands often with soap and
water, especially after you cough or
sneeze. Alcohol-based hand
cleaners*are also effective.
 Avoid touching your eyes, nose or
mouth.
 try to avoid close contact with sick
people.
 If you are sick with flu-like illness, CDC
recommends that you stay home for at least
24 hours after your fever is gone except to
get medical care or for other necessities.
 (Your fever should be gone without the
use of a fever-reducing medicine.)
 Keep away from others as much as
possible to keep from making others sick.
 In children, emergency warning signs
that need urgent medical attention include
 Fast breathing or trouble breathing
 Bluish or gray skin color
 Not drinking enough fluids
 Severe or persistent vomiting
 Not waking up or not interacting
 Being so irritable that the child does not
want to be held
 Flu-like symptoms improve but then
return with fever and worse cough
 In adults, emergency warning signs that
need urgent medical attention include:
 Difficulty breathing or shortness of
breath
 Pain or pressure in the chest or
abdomen
 Sudden dizziness
 Confusion
 Severe or persistent vomiting
 Flu-like symptoms improve but then
return with fever and worse cough
Treatment
 oseltamivir or zanamivir for the
treatment and/or prevention of infection with
2009 H1N1 flu virus.
 Antiviral drugs - prevent serious flu
complications.
Bird’s Flu
 Avian Influenza A1 – identified in Italy in
1900.
 Negative stranded & segmented
 1997 – 6 died in Hongkong
 Jan 2004 – H5N1 outbreak in Vietnam &
Thailand’s poultry industry
 Spread to Indonesia, S. Korea, Japan
 Feb 2004 – seen in pigs
 British Columbia – 2 human cases were
confirmed
M/T:
 Airborne
ManureContaminated feeds, H2O,
equipment, clothing
 Cats – vectors
 NOTE: No human-human transmission
 Not seen in well cooked meat
Incubation – 3-5 days
S/S:
 Fever, sore throat, cough –
severe pnuemonia --- death.
Prevention/Treatment:
VACCINE
GASTROINTESTINAL SYSTEM
1. Cholera
Vibrio cholerae,
1. Gram negative, motile, curved rod.
2. Survive well in an ordinary
temperature 22-40 degrees
3. Survive longer in refrigerated foods
4. An enterotoxin, choleragen– grow in
the intestinal tract
M/T:
contaminated water/food –
10000 organisms are sufficient to cause
disease,
depends on stomach pH.
S/S:
Profuse diarrhea and vomiting 35-60
 hours after infection Antitoxin antibodies
Rapid dehydration, electrolyte imbalance To Ease Symptoms
and acidosis. Oral Rehydration
Transmission: Intraveneous RehydrationImmunization
Fecal - oral route Active Immunity induced by:
Bacterium transmitted via contaminated attenuated V. cholerae Toxoid
water, food Preventing contamination of food and water
Carriers: houseflies and other insects Education
Person to person transmission Personal and domestic hygiene
Period of communicability
Improvement of sewage systems
During stool positive stage few days
after delivery
Incubation period: 1 – 3 days 2. Typhoid fever
Pathogenesis: A systemic infection characterized by
V. Eltor continued fever, malaise, anorexia, slow
Enterotoxin pulse, diarrhea.
Stimulates adenylate cyclase A usual fatality of 10% is reduced to 2 or 3
Conversion of ATP % by antibiotic therapy.
(adenosine triphosphate– adesinemonoph Infectious
osphate agent: Salmonella typosa,typhoid bacillus
(CAMP) Transmission:
Stimulate mucosal cell –increase direct or indirect contact with patient or
secretion of chloride carrier.
(Water and bicarbonate loss) Vehicle: food and water
Toxin acts upon intact epithelium on
Vector: flies
vasculature of stomach
Incubation period: average 2wks.
Outpouring of intestinal fluid
(5-10 % of body wt) Pathogenesis
Dehydration and metabolic acidosis Contaminated food and water with
Hypokalemia Salmonella typhi
Acute renal failure Intestinal tract
Multiplies in the blood stream
Symptoms: pathognomonic sign is is RICE Localized in
WATERY Stool intestine Bacteremia
Acute , profuse diarrhea diarrhea and gallbladder
Sudden severe diarrhea fever, headache, chills
Inflammation of distal ileum
Mucus and intestinal tissue visible in feces
loss of appetite
Muscle cramps
Rose spots
Vomiting Watery greenish stool
Loss of skin turgor If not treated:
Weak pulse Perforation of the
skin is fold, fingers and toes are wrinkled intestine Cns involvement
assuming “washer woman’s hand. S/s
Treatment: Headache, chilly sensation, aching all
Chemotherapeutic over the body.
 Antibiotics (tetracycline) Diarrhea
Immunological 4th & 5th day
Local mucosal immune response High fever in the morning and afternoon
to V.cholerae Communicability:
Serological antivibrio antibodies As long as typhoid bacilli appear in excreta.
Prevention and control: Administer IgG w/ in 2 wks of exposure.
Same w/ cholera Enteric precaution
Nsg. Intervention: Abstinence when affected
Demonstrate to the family how to give
bedside care. Hepa B
Any bleeding, abdominal Identification of infected indvl.
pain,restlessness,hypothermia should be Abstinence when affected
reported. Administration of hepa B vaccineat high risk
Take TPR & teach family member to take Administration oh HBIG to pt. w/ one time
record. exposure.
Enteric precaution & needle precaution.
3. Hepatitis Nsg. Intervention
Widespread inflammation of the liver tissue Bed rest w/ BRP
caused by viruses, bacterial infection or Nutritional intake
continuous exposure to alcohol, drugs. Avoid alcohol
Types of Hepa Regular check up
Assessment Do not donate blood
Hepatitis A
Young children & young adult. 4. Dysentery
Crowded living An acute bacterial infection of the intestine
Food handlers characterized by diarrhea, fever, and in severe
Contaminated water cases bloody and mucoidstools.
Primary route: Infection agent: Shigella(dysentery bacillus)
 Fecal - oral Transmission:
Hepatitis B Eating contaminated food
Contact with serum Drinking contaminated water
Blood transfusion Hand to mouth transfer.
Saliva & semen Flies; object soiled by feces of a carrier
All ages Incubation period: 1 day, usually less than 4
days.
Clinical Manifestation(phases) Communicability: During acute infection and
Diagnosis: until microorganism is absent from feces. A few
 ATP individuals become carriers for a year or two
Normal or protein and rarely longer.
Prolonged PT Susceptibility: Common and more severe in
Presence of HBsAg in serum of hepa B children.
client Prevention & control
Sanitary disposal of feces
Treatment: Sanitary preparation of food.
No specific meds Adequate safe washing
Diet modification: Fly control
calories, CHON, CHO as tolerated, fat Control of infected individual contacts
 activity Reporting to local health officer
Isolation of patient
Nsg. Intervention Rigid personal precaution by personnel
Hepa A Nsg. Intervention:
Hygiene Hospitalization if facilities are available
Health education Health education
Identification of infected indvl. Obtain stool specimen from any person found
w/ undiagnosed diarrhea Shower or wash off substance
Diet: low fiber plenty of fluids, easy digestible Antidotes- drug overdose
food Ingested- emesis, adsorbents
Eliminate substance from the body
5. Amoebiasis Induce emesis- administer syrup of ipecac
Most infections are asymptomatic. Intestinal Emesis is contraindicated if pt. Is
disease varies from acute dysentery with fever, comatose, severe shock, ingested strong
chills and bloody diarrhea to mild abdominal corrosive substance
discomfort with diarrhea containing blood or Support client physically & psychologically
mucous alternating with periods of constipation If suicide attempt, refer for psychiatric
or remission evaluation
Infection agent:Entamoeba histolytica is a If accidental poisoning w/ a child, parents
protozoan parasite often demonstrate guilt, and elf approach in
Transmission: fecal-oral regard to their parenting role
Incubation: 2 – 4 weeks
Communicability: The disease is
communicable for as long as the infected 7. Salicylate poisoning
person excretes E. histolytica cysts, which may Toxic amounts affect the respiratory center
continue for years. with direct stimulation of the medulla resulting
Preventive Measures: in hyperventilation, loss of carbon dioxide and
 Health Education precipitating respiratory alkalosis.
 To prevent future exposures, Clinical manifestation:
recommend that individuals: Hyperventilation
 Always wash their hands thoroughly Nausea, vomiting
with soap and water before eating or  temperature
preparing food, after using the toilet, and Tinnitus
after changing diapers. Excitability
 After changing diapers, wash the child’s seizure
hands as well as their own. Diagnostic:
 Dispose of feces in a sanitary manner. Serum salicylate level
 When caring for others with diarrhea, Electrolytes
scrub hands with plenty of soap and water Signs of toxicity
after helping the persons use the toilet, or Ringing in the ear
changing diapers, soiled clothes or soiled Dizziness
sheets. especially before handling food, Hearing & visual problem
before eating and after toilet use. Delirium & sweating
 Avoid sexual practices that may permit Treatment:
fecal-oral transmission.
Induce vomiting w/ syrup of ipecac or
gastric lavage ff. by activated charcoal.
6. GI Poisoning Vit. K to reduce bleeding tendencies
General principle(SIRES) IV fluids & NaHCO3 to treat acidosis and
Stabilize increase the excretion of hydrogen ion.
Initiate the ABC’s of CPR Severe cases: peritonial or hemodialysis
Terminate exposure to the substance Nsg. Intervention:
Identify Focus on ABC
Obtain accurate history and retrieve available Induce vomiting
substance. VS, LOC
Notify local poison center Health education
Reverse the substance effect
 8. Acetaminophen poisoning - fever/chills occur q72hrs on the 4th day
Primary toxic effect are on the liver after onset.
No known antidote 4. Plasmodium Ovale – very rare
Assessment: Primary vector – Female Anopheles mosquito
Assymptomatic Characteristics:
Anorexia a.Breeds in clear, flowing, shaded streams.
Nausea & vomiting b.Bigger in size than ordinary mosquitoes.
RUQ pain c.Brown in color
d.Night-biting mosquitoes
Jaundice
e.Does not bite a person in motion
Treatment:
f.Assumes 36 degree position.
Emesis w/ ipecac
Incubation Period
Nsg. Intervention:
12 days for P. Falcifarum
same w/ salicylate
14 days for P. Vivax & Ovale
30 days for P. Malariae
9. Lead poisoning
An acquired condition in which blood levels of Period of Communicability:
lead are above normal causing damage first in 3 yrs & more – untreated/insufficiently
the hematologic system, renal system and the (P. malariae)
central nervous system. 1-2 yrs – P. Vivax
Less than 1yr. - P. Falcifarum
Assessment
Mode of Transmission
Lead poisoning Through bite of infected A. mosquito
Treatment: Blood transfusion
Chelating agent to prevent absorption and Shared contaminated needles – rare
aid in excretion of kidneys Transplacental - rare
Nsg. Intervention: Clinical Manifestations
Assist in screening and diagnosis 1.Paroxysms with shaking chills x12hrs daily or
after a day or 2. (Continuous in children)
Administer chelating agent
2.Rapidly rising fever, severe headache
Health education
3.Profuse sweating.
Assist to identify measures to prevent 4.Myalgia & well-being.
occurrence . 5.Splenomegaly, hepatomegaly
6.Orthostatic hypotension
7.In cerebral malaria – changes in sensorium,
BLOOD severe headache, vomiting
1. Malaria: 8.Jacksonian/Grand mal seizure
- an acute & chronic parasitic disease Diagnostic Procedure
transmitted by the bite of infected 1. Malarial Smear
mosquitoes. 2. Rapid Diagnostic Test (RDT)
Etiologic Agent: Pathogenesis:
PROTOZOA OF GENUS PLASMODIA 1. Ano.mosquito bites infected individual –
4 Species: parasite multiply in mosq.- invades
1.Plasmodium Falcifarum (malignant salivary gland – bites another individual,
Tertian) tends to form microemboli) injects parasites – invades RBC-multiply –
2. Plasmodium vivax (Benign Tertian) RBC ruptures releasing merozoites –
- nonlife threatening invades new RBC – fever, chills, profuse
- manifested by chills q48hrs on the sweating
3rd day onward esp. if untreated.
Coagulation defect Anemia
3. Plasmodium Malaria (Quartan)
Liver/renal pulmonary/ Shock
- nonlife threatening
Failure cerebral edema
 Coma
death
Management
Medical:
1.Anti-malarial drugs – chloroquine, quinine
(Plamodium malariae)
1.Sulfadoxine – P. Falcifarum
2.Primaquine – P. Vivax, Ovale
3.Erythrocyte exchange transfusion
2.Nursing Management:
a. TSB, V/S, OFI, I&O, external heat &
warm drinks during chilling stage
b. Psychological support
c. Watch for neurologic Quinine
toxicity: muscular
twitching, delirium, confusion, convulsio
n, coma.
d. Monitor serum billirubin,
BUN, creatinine, parasitic count, ABG,
electrolytes, Hgb.
e. Watch for signs of bleeding
Prevention/Control
Cases shd be reported.
Thorough screening og infected persons
Mosq. breeding places must be destroyed.
Mosquito nets shd be used in infected areas.
Insect repellents to exposed portion of the
body.
Blood donors shd. be properly screened.
2. Schistosomiasis
Is a slowly progressive disease caused by
blood flukes of class trematoda.
Etiologic Agent:
Schistosoma Japonicum
3 Types:
1. S. Japonica
(Oriental Schistosomiasis) –infects
intestinal tract (Katayama Disease).
2. S. Mansoni – infects int.
tract; common in Africa
3. S. Hematobium – affects urinary
tract; found in Middle East
Incubation Period – 2 months
Sources of Infection:
Feces of infected person
Dogs, pigs, cows, carabaos, monkeys, wild
rats, tiny snails (Oncomelania Quadrasi)
Mode of Transmission:
 Ingestion of contaminated water.
 Through skin pores.
 Through an intermediary host
Characteristic of Oncomelania Q.
The snail thrives in river banks, fresh water,
streams, creeks, canals, swamps.
Can be found clinging to water hyacinths,
grasses, decaying leaves, pieces of rotting
woods, bamboos, coconut husks.
Loves to stay in sandy loam soil
The adult snail is greenish-brown and is just
as big as the smallest grain of palay.
Pathogenesis
Sexually Transmitted disease
A disease acquired through sexual contact
with an infected person, including oral and
rectal activities.
One person can have one or more STD at a
time.
All sexual partners must be evaluated.
3. Gonorrhea
Most common venereal diseasel; an infection
of the genital urinary tract, however may affect
the rectum, pharynx and the eyes.
Infection agent: Neisseria gonorrheae
Incubation period: 2 – 7 days
Transmission: Sexual contact,perinatal
Communicability: Contagious as long as
organism is present.
Assessment
Men
Urethritis, dysuria
Profuse purulent discharge
Epididymitis
Neonate
Opthalmia neonatorum
Women
Vaginal discharge, dysuria
If untreated; may result in PID
Diagnostics
Positive gram stain smear of discharge
Positive culture(Thayer Martin medium)
Medical Mgt.:
Ceftriaxone
Cefixime
Ciprofloxacin or Orfloxacin
Nsg. Intervention:
Prophylactic treatment for gonorrhea, eye
infection in the neonate.
 Encourage follow up cultures 7 – 14 days infection.
after treatment and at 6 months. Chancre(male)
Teach importance of abstinence from Chancre (female)
sexual intercourse and consumption of Secondary stage: Chancres leads to general
alcohol until cultures are negative. infection.
Urge client to inform sexual mate so that Rash occurs 2 to 8 wks after the chancre.
he/she may be treated. Involves the trunk, extremities, palms of
hand and sole of feet
4. Trichomoniasis Transmission occurs through contact with
lesion.
Itching, burning, frothy , yellow, copious,
malodorous vaginal discharge. Tertiary stage: final stage
Sexual partner needs to be treated also  slowly progressive inflammatory disease
because of cross infection.  potential to affect multiple organs.
Men are usually asymptomatic. Signs of infection:
Lymphadenopathy
Infection agent: Trichomoniasis vaginalis Arthritis
Predisposing factors Meningitis
Excessive douching Hair loss
Oral conraceptive Fever
Antibiotics Malaise
Steroids Weight loss
Stressful situation Diagnostic & Management
Improper cleaning after voiding and Serologic test:
defecating I.Non treponemal
Assess for recurrent chronic infection as II.Treponemal test
this may indicate a prediabetic state and Medical Mgt.
should be evaluated. I.Antibiotics- Pen G is the drug of choice for
Nsg. Intervention: early syphilis of less than 1 yr.
Appropriate cleansing - Doxycycline is used in case of
Infection is worse around the menstrual hypersensitivity to Penicillin.
period. Nsg. Intervention:
Do not douch periodically. Administer antibiotic as ordered.
Discourage the use of feminine hygiene Health education
sprays. Use of gloves
If hronic, it is necessary to have sexual Proper handwashing
partner tested. abstinence

5. Syphilis 6. Candidiasis
An acute and chronic infection caused by the Internal itching, beefy red irritation,
spirocheteTreponema pallidum. inflammation of vaginal epithelium.
Incubation period: 10 –90 days White, cheese like discharge which clings to
Transmission: Direct cntact the vaginal mucosa.
Communicability: highly infectious in primary Infectious agent: Candida albicans
and secondary stage. Nsg. Intervention:
Stages of Syphilis Proper hygiene
Primary stage : Sitz bath
 occurs 2 to 3 wks after inoculation of Avoid tight clothings
organism. Wear cotton lined undergarments
Chancre – painless lesion at the site of Change tampons regularly
Hand washing
Use of Vaginal suppositories, ointment and
creams
Do not use feminine spray