Name of Disease: Etiologic Agent: Clinical Classification: Diagnostic Procedures: Nursing Management:

Tuberculosis
Synonyms:
 Koch’s disease
 Phthisis
 Consumption Disease
Definition:
Tuberculosis is a chronic, sub-acute,
or acute respiratory disease
commonly affecting the lungs.
Characterized by formation of
tubercles in the tissues which tend to
undergo cessation, necrosis, and
calcification.
 Mycobacterium Tuberculosis
 M. Africanum from human
 M. Bovis from cattle
Incubation Period:
2- 10 weeks
Period of Communicability:
The patient is capable of discharging
the organism all throughout life if he
remains untreated. The disease is
highly communicable during the
active phase.
Mode of Transmission:
 Deliberate Inoculation of
microorganism or by droplet.
 Inhalation of organism directly
into the lungs from contaminated
air.
 Direct or indirect contact with
infected persons, usually by
discharges from respiratory tract
by means of coughing, sneezing,
or kissing.
 Contact with contaminated
eating or drinking utensils.
 Rarely through skin lesions.
Source of Infection:
Sputum, Blood from hemoptysis,
nasal discharge, and saliva.
1. Inactive TB
 Symptoms are absent
 Sputum is absent for tubercle
bacilli after repeated
examination.
 No evidence of cavity on chest
X-ray.
2. Active
 Sputum and gastric content
are usually positive for
tubercle bacilli.
3. Activity not determined
When activity has not been
determined from a suitable period of
observation or adequate laboratory
and X-ray studies.
Clinical Manifestations:
 Afternoon rise of temperature
 Night sweating
 Body malaise and weight loss
 Cough, dry and productive
 Dyspnea, hoarseness of voice
 Hemoptysis- considered
pathognomonic to disease
 Occasional Chest pain
 Sputum positive for AFB
 Sputum Analysis for AFB-
confirmatory
 Chest X-ray
 Tuberculin testing
a. Mantoux Test (PPD)- most
accurate and advantageous
b. Tine Test (OT)
c. Heaf Test (LT)
d. Volmet and Pirquet- Skin
scratch/ Patch test
Medical Management:
 Short course chemotherapy may
be given through a six-month
treatment with Isoniazid (INH),
Rifampicin, Pyrazinamide (PZA),
and Ethambutol.
 Patients with frig resistance may
be given with second line drugs
such as Capreomycin,
Streptomycin, Cycloserine,
Amikacin, and Quinolone drugs.
 WHO recommends “Dircet
Observed Theraphy” (DOT) to
prevent non- compliance.
 If the medicine is taken
incorrectly,the patient becomes
resistant to Anti-TB drugs.
 Relapsing patients usually
become resistant to individual
drugs (INH, Rifampicin,
Ethambutol, PZA). They are given
the combination of above
mentioned drugs.
 Maintain respiratory isolation
until patient responds to
treatment or until patient is no
longer contagious.
 Administer medicines as ordered.
 Always check sputum for blood
or purulent expectoration.
 Encourage questions and
conversations so that the patient
can air his feelings.
 Teach or educate the patient all
about TB
 Encourage the patient to stop
smoking.
 Teach the patient to cough or
sneeze into tissue paper and
dispose secretions properly.
 Advise patient to have plenty of
rest and eat balanced meals.
 Be alert for signs of drug
reaction.
 If the patient is taking
Ethambutol, watch for Optic
neuritis. If it develops,
discontinue the drug.
 If the patient receives Rifampicin
(Rifampin), watch for Hepatitis
and Purpura. Also observe the
patient for other complications
like hemoptysis.
 Emphasize the Importance of
regular follow-up examinations
and instruct the patient and his
family about the signs and
symptoms of recurring TB.
Name of Disease:
Schistosomiasis
Synonyms:
 Bilharziasis
 Snail Fever
Definition:
This is a slowly progressive disease
caused by blood flukes of class
trematoda. It is a chronic wasting
disease common among farmers and
their families in certain parts of the
Philippines.
This is not only a public concern but
also a socio-economic problem
because by causing ill-health, it
reduces agricultural productivity.
Etiologic Agent:
Parasitic worm, Schistosoma
Japonicium
Incubation Period:
Atleast two months.
Mode of Transmission:
 Through ingestion of
contaminated water.
 Transmitted through skin pores.  Abdominal discomfort due to
 Transmitted through an
intermediary host, a tiny snail
called, ONCOMELANIA QUADRASI
Source of Infection:
 Feces of Infected Person
 Dogs, Pigs, Carabaos, Cows,
Monekys, and wild rats have
been found to be infected and
therefore, they also serve as
host.
Clinical Manifestations:
The signs and symptoms of the
disease depends on the site of
infection, however, the following can
be observed:
 Pruritic rash develops on the site
of penetration, known as
“swimmer’s itch”.
 Low- grade fever, Myalgia, and
Cough.
hepatomegaly, spleenomegaly,
and lymphadenopathy.
 Bloody- mucoid stool,
“dysentery- like” tha comes on
and offfor weeks.
 Icteric and Jaundice.
 Later, his belly becomes big
because of inflamed liver,
resulting from eggs that
accumulate in that organ.
 After some years of suffering
from this chronic disease, the
patient becomes weak, pale, and
there is marked muscle wasting.
 When parasites reach the brain,
the victim experiences severe
headache, dizziness, and
convulsion.
Diagnostic Procedures: Nursing Management:
 Feaclysis or direct stool exam  Clearing vegetation.
 Kato Katz technique  Proper waste disposal.
 Liver and rectal biopsy  Preventing people, especially
 ELISA children from bathing in infested
 Cercum Ova Precipetin Test streams.
(COPT)- confirmatory diagnostic  Providing health education on
test. the disease process, mode of
transmission, and prevention.
Complications:
 Liver cirrhosis, Portal
hypertension
 Cor Pulmonale, Pulmonary
hypertension
 Heart failure
 Ascites
 Renal failure
Medical Management:
 Praziquantel Tablet for 6 months;
1tab 2x a day for three months,
then 1 tab a day for another
three months.
 Fuadin injection given either IM
or IV. The patient should
consume 360mg for the entire
treatment.
 If the patient continues to live in
the endemic area, he frequently
gets re-infected and has to be
retreated.
Name of Disease: Etiologic Agent: Clinical Manifestations: Diagnostic Procedures: Nursing Management:
Leprosy Mycobacterium Leprae  Clawhand, Footdrop, and ocular  Identification of the signs and  If the patient is admitted to the
manifestations such as corneal symptoms hospital, isolation and medical
Synonyms: Incubation Period: insensitivity, and ulceration,  Tissue biopsy asepsis should be carried out.
 Hansen’s Disease 5 ½ months- 8 years. conjunctivitis, photophobia, and  Tissue smear  Moral support and
 Hansenosis 1- 5 years. blindness develop.  Blood tests show increased RBC encouragement are necessary.
 Loss of eyebrows and Eyelashes and ESR; and decreased Ca,
Definition:  Loss of finction of sweat and albumin, and cholesterol level.
Leprosy is a chronic systemic Mode of Transmission: sebaceous glands
infection characterized by  The disease can be transmitted  Changes in color of the skin Medical Management:
progressive cutaneous lesions. through respiratory droplet.  Loss of sensation  Sulfone Therapy
 Inoculation through skin break  Palntar ulcer that do not respond  Multiple Drug Therapy
and mucous membrane can also to treatment  Rehabilitation, Reacreational, and
be a mode of transmission.  Pain and redness in the eyes Occupational therapy

Three distinct forms of Leprosy: Cardinal Signs

1. Lepromatous Leprosy L-oss of sensation on skin patches
 Most serious type and considered E- nlargement of Peripheral nerves
to be most infectious. P-resence of Leprosy Bacilli in the
 It causes damage to respiratory skin smear.
tract, eyes, and testes as weel.
 Lepromin Test is negative but
skin lesions conatin large amount
of Hansen’s bacillus.
2. Tuberculoid Leprosy
 Affects peripheral nerves and
sometimes surrounding skin.
 Lepromin Test is positive, but the
organism is rarely isolated from
the lesions.
 Anesthesia is present.
3. Borederline Leprosy
Ha sthe characteristics of both
lepromatous and tuberculoid
leprosy. Skin lesions of this type are
diffused and poorly defined.
Name of Disease:
Filariasis
Synonyms:
Elephantiasis
Definition:
Filariasis is a parasitic disease caused
by African eye worm, a microscopic
thread-like worm. The adult worm
can live in human lymphatic system.
This is an extremely debilitating and
stigmatizing disease caused by
parasitic worms affecting men,
women, and children. It affects the
poor in both rural and urban areas.
The disease is rarely fatal, however,
it causes disability, gross
disfigurement, and untold suffering
of millions of men, women, and
children.
Etiologic Agent:
Wucheria Bancrofti
Mode of Transmission:
Transferred from person to person
by mosquito bite.
Clinical Manifestations:
 Symptoms vary depending on
the type of the parasitic worm
that caused the infection, but all
infections usually begin with
chills, headache, and fever
between three months and one
year after the insect bite.
 There may also be swelling,
redness, and pain in the arms,
legs, or scrotum.
 Areas of abscess may appear as a
result of dying worms or a
secondary bacterial infection.
 Lymphadenitis
 Lymphangitis
 Hydrocele
 Lymphedema
 Elephantiasis
 Red, painful and tender scrotum
Diagnostic Procedures: Nursing Management:
 Circulating Filarial Antigen (CFA)  Elephantiasis of the legs can also
test is performed on a finger- be eased up by elevating the legs
prick blood droplet taken any and providing support with
time of the day and gives result in elastic bandages.
a few minutes.
 The larvae and can also be found
in the blood, but mosquitoes
which spread the disease are
active at night, the larvae are
usually found between 10:00pm
to 2:00am.
 Patient’s history must be taken
and pattern of inflammation and
signs of lymphatic obstruction
must be observed.
Medical Management:
 Ivermectin, Albendazole, or
Diethylcarbamazine (DEC)
 Hetrazan: 6mg/KBW taken as
single dose/year
 Antibiotics/Antifungals for
superimposed infection