Micro Lab P3 Revieweer PDF

Pertussis/Whooping cough is an infectious disease characterized by repeated attacks of spasmodic coughing w/c consists of a series of explosive expirations, typically ending in a ling-drawn forced inspiration which produces a crowing sound, the "whoop", and is usually followed by vomiting. Causativ...

Pertussis/Whooping cough is an infectious disease characterized by repeated attacks of spasmodic coughing w/c consists of a series of explosive expirations, typically ending in a ling-drawn forced inspiration which produces a crowing sound, the "whoop", and is usually followed by vomiting. Causative Agent: Bordetella Pertussis Incubation Period: 7 to 14 days Period of Communicability: 7 days after exposure to three weeks after typical paroxysms Mode of Transmission: Direct contact Indirect contact Soiled linens and other articles contaminated by respiratory secretions Clinical manifestations: Catarrhal Stage - Characterized by non-specific symptomatology where there is mucoid rhinorrhea, sneezing, lacrimation, and dry Bronchial cough - Cough becomes irritating, hacking, nocturnal and more severe. Most communicable stage. Paroxysmal Stage Occurs on the 7^th^ to the 14^th^ day. Cough becomes spasmodic and recurrent with excessive, explosive outbursts in a rapid series of 5 to 10 rapid coughs one expiration. In Each cough ends with a loud, crowing inspiratory whoop, and choking on mucus that causes vomiting. Face becomes cyanotic, veins on the face and neck become distended, the eyes appear to bulge ar pop out of the Eyeballs, and tongue protrudes. Involuntary urination, lethargy, and exhaustion. Convalescent Stage Marked by gradual decrease in the paroxysms of coughing, both in frequency and severity At this stage, vomiting ceases Complications: Pneumonia Atelectasis Convulsions due to lack of oxygen Umbilical hernia Otitis media Bronchopneumonia is the most dangerous complication Mainutrition and starvation due to persistent vomiting, inability to sleep and rest. Diagnostic test: Nasopharyngeal swab Sputum culture CBC indicates leukocytosis Treatment: Supportive therapy: ✔F&E replacement ✔ Adequate nutrition ✔ Oxygen therapy Antibiotic erythromycin and ampicillin Hyperimmune convalescent serum or gamma globulin Nursing management: Isolation and medical asepsis Suctioning equipment should be readily available Keep the child still as quiet as possible Provide warm baths and keep the bed dry Prevention: Isolation of 4 to 6 weeks from the onset of illness DPT immunization Tetanus/Lockjaw Tetanus is fatal in up 60% of unimmunized persons, death occurs within 10 days of onsst. Prognosis is poor if symptoms develop within three days Causative Agent: Clostridium Tetani Produces a potent exotoxin with prominent systemic neuromuscular effects such as generalized spasmodic Contractions of the skeletal musculature ✔Tetanospasmin is responsible for muscle spasms Tetanolysin is responsible for the destruction of RBCs Source of Infection: Animal and human feces Soil and dust Rusty materials, unsterile sutures, pins, and scissors Mode of Transmission: Punctured wounds contaminated by dust, soil, or animal excreta containing C. Tetani Rugged, traumatic wounds and bums. Babies delivered to mothers without tetanus toxoid immunizations Umbilical stump of newbom. Unrecognized wounds (cleansing the ears with sharp materials) Dental extraction, circumcision, and ear piercings Clinical Manifestations Neonate Feeding and sucking difficulties Short, mild and voiceless but excessive cry Tonic or rigid muscular contractions, spasms or convulsions Fever and dehydration Cyanosis and pallor Flaccidity, exhaustion, and death Older children and adult Localized ✔spasms and increased muscle tone near the wound Systemic: Sys Hyperactive deep tendon reflexes, tachycardia, painful involuntary muscle contractions ✔Neck and facial muscle rigidity (trismus) Grinning expression (nsus sardonicus) Board-like abdomen/abdominal ngidity Bpisthotonos is spasm of the muscles causing backward arching of the head, neck, and spine