Objectives At the end of this presentation the students will be able to:
Define Tetanus Toxiod.
Explain pathophysiology and Causes.
Describe Sign and symptoms.
Explain types and Diagnostic finding.
Describe medical, and nursing management of tetanus
toxiod. Tetanus Tetanus, also called lockjaw, is a serious infection caused by Clostridium tetani. This bacterium produces a toxin that affects the brain and nervous system, leading to stiffness in the muscles. If Clostridium tetani spores are deposited in a wound, the neurotoxin interferes with nerves that control muscle movement. Causative agent Clostridium tetani Tetanus is caused by an infection with the bacterium Clostridium tetani, which is commonly found in soil, saliva, and dust. The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object. Pathophysiology . Sign and Symptoms Common signs and symptoms of tetanus include: Spasms and stiffness in jaw muscles (also called lock jaw) Stiffness of neck muscles Difficulty swallowing Stiffness of abdominal muscles Fever Sweating Painful body spasms lasting for several minutes, typically triggered by minor occurrences, such as loud noise, physical touch or light Types of tetanus UNCOMMON TYPES:
LOCAL TETANUS:
Persistent muscle contractions in the same anatomic area
as the injury, which will however subside after many weeks; very rarely fatal.
CEPHALIC TETANUS:
Occurs with ear infections or following injuries of the
head; facial muscles contractions. Common types: GENERALIZED TETANUS - descending pattern: lockjaw stiffness of neck difficulty swallowing rigidity of abdominal and back muscles. - Spasms continue for 3-4 weeks, and recovery can last for months - Death occurs when spasms interfere with respiration. NEONATAL TETANUS: - Form of generalized tetanus that occurs in newborn infants born without protective passive immunity because the mother is not immune. - Usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with an unsterile instrument. Methods of diagnosis Based on the patient’s account and physical findings that are characteristic of the disease.
Diagnostic studies generally are of little value, as cultures
of the wound site are negative for C. tetani two-thirds of the time. When the culture is positive, it confirms the diagnosis of tetanus
Tests that may be performed include the following:
Culture of the wound site (may be negative even if tetanus is present) Tetanus antibody test Other tests may be used to rule out meningitis, rabies, or other diseases with similar symptoms. Clinical treatment Tetanus is typically treated with a variety of therapies and medications, such as: antibiotics such as penicillin to kill the bacteria in your system tetanus immune globulin (TIG) to neutralize the toxins that the bacteria have created in your body muscle relaxers to control muscle spasms a tetanus vaccine given along with the treatment cleaning the wound to get rid of the source of the bacteria In some cases, a surgical procedure called debridement is used to remove dead or infected tissue. If you have difficulty swallowing and breathing, you may need a breathing tube or ventilator (a machine that moves air in and out of the lungs). Nursing management Provide complete bed rest to the patient. Keep the patient in dim lighted, quite and well ventilated room as spasm can be stimulated by bright light, noise or even touch. Fluid and electrolytes balance should be maintained. Due to spasm and increased muscle activity patient need extra high calorie and protein diet. Change patient position every 2 hourly to prevent bed sore. care of wound such as removal of necrosed tissue, cleaning with hydrogen peroxide and treatment with antibiotic ointment is done. References
Breslow, Lester. (2002). “Tetanus.” Encyclopedia of Public
Health. New York : Macmillan Reference USA/Gale Group Thomson Learning. Lederberg, J. (2003) Clostridia. Encyclopedia of Microbiology. New York, NY: Academic Press. 1, 834-839. Olendorf, D., et al. (1999).“Tetanus.” The Gale encyclopedia of medicine. Detroit : Gale Research. http://nfid.org/powerof10/section2/factsheet-tetanus.html http://www.who.int/vaccines/en/neotetanus.shtml http://www.who.int/vaccines- surveillance/StatsAndGraphs.htm
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