NCMB 312 Finals Reviewer PDF

OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Week 13 | Part 1: Communicable Disease...

OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Week 13 | Part 1: Communicable Disease — GI ○ Fomites Tract Take Note: gram positive bacteria are easier to kill but it develop slower Cholera (aka. Eltor) resistance whereas gram negative bacteria an acute bacterial disease / serious illness are harder to kill and develop resistance of the gastrointestinal tract characterized very quickly (this is because sa parang by sudden onset of acute and profuse layer ganern basta layer sabi ni sir) colorless diarrhea, vomiting, severe Pathophysiology: the fluid loss due to dehydration, (massive loss of fluids and diarrhea in cholera is because of the electrolytes that could lead to hypovolemic presence of enterotoxin kasi the shock or metabolic acidosis which can enterotoxin binds with the lining of the cause death if left untreated), cramps, intestine cyanosis, and in severe cases collapse ○ when the vibrio cholerae is Take Note: Eltor ay isang particular strain ingested it will start to multiply sya ng bacterium vibrio cholerae in the intestinal mucosa (predominant cholera pathogen and gram especially in the small intestine negative bacteria sya) and will start to produce Causative Agent: Vibrio Cholerae / choleragen which is an Vibrio Comma enterotoxin and once produced, it ○ comma shaped (if you look at will enter the mucosal cells of the the microscope this gram intestine and will stimulate the negative organism are slightly cause of increased caMP (cyclic curved in shape and it appears adenosine monophosphate — a like moving so naging vibrio or messenger that sends signals to vibrate ganern) parts of the body and the reason ○ survives longer in refrigerated why there is increase in the food (between 24 to 40 degree secretion of chloride) >> celsius) therefore, magkakaroon ng water, ○ when ingested they will grow in potassium and bicarbonate loss the GI tract and produces ○ Inshort — with the toxin acted choleragen enterotoxin (which in the intact epithelium of the is a toxin released by a small intestine, it will result to microorganism that targets the the outpouring of the intestinal intestine and promotes the fluid kaya nag kakaroon ng secretion of fluid and electrolyte severe fluid loss and take note, a in the lumen of the small intestine fluid loss of around 5 to 10% will which causes massive watery result in dehydration which will diarrhea) cause symptoms such as: Incubation Period: Few hours up to 5 excessive thirst days pero usually 1 to 3 days lang restlessness Mode of Transmission: Fecal — Oral washer woman’s hand with 5 F’s as the main sources (wrinkled ganda na ○ Feces parang babad na babad ○ Fingers (soiled hands + utensils sa tubig) can also harbor choleragen) circulatory collapse / ○ Flies shock ○ Food (water, milk or anything na kussmaul's respiration iniingest natin na contaminated (rapid respiration with with choleragen, stool or vomitus intervals of apnea) of a contaminated person) Page 1  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 if treatment is delayed after onset or usually in the first or inadequate there will or second day be Abdominal Medical Management: treatment consist Distention (maybe due of correcting the basic abnormalities to paralytic ileus), without delay (ang goal dito is irehydrate Acute Renal Failure si patient) and possibly ○ restoring the circulating blood Hypokalemia kasi volume syempre nag vovomit ○ restore electrolytes in the normal tapos may diarrhea pa level through rapid intravenous and syempre the more infusion of (alkaline saline stools na nawawala the solution) sodium, potassium, CL, more na lumalabas ang HCO3 potassium ○ ORESOL, hydrites Diagnostic: ○ coconut water which is rich in ○ Rectal Swab potassium ○ Dark Field or Phase Microscopy ○ for Pediatric patients continue (uses a type of microscope that breastfeeding unless oral intake is illuminates the specimen which contraindicated causes microorganism to appear ○ Antibiotics — bright against dark background) Tetracycline (usually ○ Stool Exam prescribed at 500 mg, 1 Clinical Manifestations: tablet every 6 hours for ○ Pathognomonic Sign — Rice adults and for children, Watery Stool (but initially the 125 mg per kg per body stool are brown and contains weight, every 6 hours fecal material then will become for the next 72 hours) pale gray or translucent until it Furazolidone (usually becomes rice water like with an prescribed at 100 mg for inoffensive slightly fishy odor) adults and 125 mg per ○ profuse diarrhea with no kg for children every 6 tenesmus (sensation of defecation hours for 72 hours) even though we have already Chloramphenicol defecated or in other words no (usually prescribed at intestinal cramping) 500 mg tablet for adults causes fluid loss of 1 up and 18 mg per kg for to 30 liters per day children every 6 hours ○ poor tissue turgor for 72 hours) ○ eyes are sunken to the orbit Cotrimoxazole (usually ○ cold skin and wrinkled toes and 8 mg per kg for 72 fingers (aka. washerwoman’s hours) hand) Nursing Management: ○ if the treatment is late irreversible ○ instruct patients and significant problem may occur and the others to protect food and water patient may develop oliguria supplies from fecal which may even lead to anuria contamination, proper storage of and when the patient is in deep food, handwashing before and shock, sudden diarrhea stops and during preparation of the food may occur as short as 4 hours ○ medical asepsis in handling food item Page 2  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ enteric isolation (nurses will microorganisms during instruct patients and their acute infection until the significant others or family about fecalysis results the proper way to dispose of confirms negative result excreta, tissues etc..) for the organism ○ monitoring vital signs, intake and Take Note: some output (to determine the level of patients remain carrier hydration) for at least a year or two ○ Shigella Flexneri — Group B Bacillary Dysentery (aka. Shigellosis / Bloody (most common in the philippines) Flux) ○ Shigella Boydii — Group C acute bacterial infection of the intestine ○ Shigella Sonnei — Group D characterized by diarrhea, fever, tenesmus Pathophysiology: starts when an and in severe cases bloody and mucoid individual ingest the microorganism and stool after the incubation period the Kiyoshi Shiga (1897) a Japanese Scientist microorganism will invade the mucosal who discovered Shigella bacteria causing lining of the intestine which causes dysentery. inflammation, ulcerations and severe Mode of Transmission: diarrhea that may contain mucus, blood ○ Fecal Oral Route — ingestion and pus of contaminated food and water / Diagnostic: milk (additionally, pwede din ang ○ Fecalysis or microscopic fruits and veggies na nag grow sa examination in order to ground kasi possibly na hugasan determine the presence of blood sya sa polluted water or ma and mucus as well as the bacteria fertilize sya ng soil na ○ isolation of the causative contaminated with human waste) organism from the Rectal Swab ○ Indirect Transmission — or Culture through flies or other object ○ Blood Culture contaminated with fecal material ○ Methylene Blue Staining of the patient (pwede makita ang leukocytes ○ Sex Oro-Anal Contact which will suggest bacterial Causative Agent: infection) ○ Shigella Dysenteriae — Group Clinical Manifestations: A (the most infectious because ○ fever especially in children they live exclusively in the GI ○ tenesmus, nausea, vomiting, tract of humans and just like headache other gram negative bacilli they ○ colicky or cramping abdominal can also develop resistance to pain associated with anorexia and antibiotics and these causative body weakness agent rarely invade the ○ diarrhea (bloody mucoid stool bloodstream) that is watery at first) Incubation Period: 7 ○ dehydration and rapid weight loss hours until 7 days with ○ Complications — rectal the average of 3 to 5 prolapse (particularly in days undernourished children, cough Period and pneumonia, if the infection Communicability: the of the intestine became virulent patient is capable of the intestinal ulceration may lead transmitting the to bowel perforation Page 3  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Medical Management: parasitized tissues and ○ IV solution with normal saline liquid colonic contents with electrolytes in order to Cyst which is passed prevent dehydration or it can be out with stool and managed at home by oral resistant to rehydration therapy environmental ○ low residue or bland diet such as conditions, and this is banana, rice, soda crackers (for also considered as the the mean time avoid any milk infective stage because products because it may trigger they remain viable for or worsen diarrhea) several days in feces, ○ anti diarrheal drugs are water, sewage and soil contraindicated because they in the presence of delay fecal excretion that would moisture and low lead to prolonged fever temperatures ○ Antibiotics — Incubation Period: 1 to 4 weeks or 1 Ciprofloxacin month can be shorter or longer Ofloxacin Mode of Transmission: Fecal Oral Route Levofloxacin / ○ sources of infection is human Azithromycin but excreta ideally no antimicrobial How can humans be infected? — once therapy should be viable cyst is ingested from contaminated administered until ma water, food or hands, (or unhygienic establish na kung ano preparation of food, vectors such as flies, yung specific infection rodents) involve Period of Communicability: duration of ○ ORESOL (1 - 8 - 1) the illness Homemade Salt Sugar Invasive Pathophysiology: good for 24 hours ○ ingestion of cyst that will pass 1 teaspoon of salt through the stomach (unharmed 8 teaspoon of sugar and shows no activity in acidic 1 liter of water environment so basically hindi sya namamatay kahit acidic yung Amoebiasis (aka. Amoebic Dysentery) environment) protozoal infection of human beings that ○ cysts will mature in large initially involves the colon, (but may also intestine and will become involve extraintestinal amoebiasis) and trophozoites spread to soft tissues, most commonly the ○ trophozoites burrow and continue liver and lungs, by contiguity or the lysis of the cells until it gains hematogenous or lymphatic dissemination access in the blood vessels closely related to poor sanitation and slow ○ trophozoites will then travel socioeconomic status and can be acute or going to the hepatic veins chronic invading the liver and then the Causative Agent: Entamoeba Histolytica lungs, then other soft tissues ○ 2 Developmental Stage — Non Invasive Pathophysiology: not all Trophozoites / mature cysts become trophozoites, some Vegetative Form mature cysts will not cause invasion and invades the tissues or colonization and it leaves the large may be found in intestine of the host through the colon with feces and excreted already to infect a Page 4  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 susceptible host again (tapos yung cyst RUQ pain that radiates will remain viable and infective in a moist to the shoulder and cold environment for at least 12 days jaundice is rare and will survive in water for about 30 intermittent pain days) abscess may break in the ○ can be killed by — lungs = anchovy sauce putrefaction the sputum (decomposition that Medical Management: takes place in the body) ○ Metronidazole (Brand Name = desiccation (removal of Flagyl) — antibiotic and moisture ot drying out antiprotozoal medication that is an organism), and commonly prescribed if temperature of below 5 amebiasis has been confirmed by degree celsius and about parasitological stool examination 40 degrees celsius 800 mg tablet TID for 5 Diagnostic: days ○ Stool (common method possibly administered through IV presence of cyst and pus or color if patient is hospitalized white or yellow with plenty of ○ Ampicillin ameba) & Blood Exam (for ○ Tetracycline leukocytosis) ○ Streptomycin ○ Proctoscopy & Sigmoidoscopy ○ Replacement Fluid & (biopsy sample) Electrolytes Clinical Manifestations: Nursing Management: ○ Acute Amoebic Dysentery ○ observe isolation and enteric slight attack of diarrhea precaution (watery, foul smelling ○ Health Teaching — stool often containing drinking purified water blood streaked mucus) cover leftover food alternating with periods hand washing after of constipation and often defecation or before accompanied by eating tenesmus avoid eating ground nausea, flatulence, vegetables abdominal distention , avoid washing foods tenderness in the right from open drum or pail iliac region ○ Proper Collection of Stool ○ Chronic Amoebic Dysentery Specimens attack of dysentery instruct to avoid mixing which last for several urine with feces days and usually select large portions followed by constipation containing blood and there may be tenesmus, mucus as possible anorexia, weight loss label the specimen and weakness properly and sent it enlargement of the liver immediately in the poor skin turgor over the laboratory (deliver agad abdomen not more than 30 mins) ○ Extraintestinal Forms Typhoid Fever Page 5  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 a bacterial infection transmitted by Incubation Period: 5 until 14 days contaminated water, milk, shellfish, and (varies, usually 1 – 3 weeks, average of 2 other foods weeks) an infection of the GIT affecting lymphoid Period of Communicability: varies as tissues of the small intestines — Peyer's long as the patient is excreting Patches microorganisms capable pa din sila to From Course Unit: Typhoid fever, also infect other people known as enteric fever, is a potentially Pathophysiology: fatal multisystemic illness caused ○ ingestion of S. Typhi (in normal primarily by Salmonella enterica serotype circumstances, person that is typhi and, to a lesser extent, S enterica healthy the bacteria will be killed serotypes paratyphi A, B, and C. The by the gastric juices of the terms typhoid and enteric fever are stomach pero for the individual commonly used to describe both major na susceptible or mga hindi nag serotypes. Karl Joseph Eberth was the first prorpdouce ng enough gastric to describe the bacillus that was suspected juices, the bacteria will to cause typhoid in 1880. Four years later, propagate) Georg Gaffky was a pathologist that ○ once nag propaget, MO travel to confirmed this link, naming the bacillus the small intestines and Eberthella typhi, which is known today as maapektuhan ang Peyer’s Salmonella enterica. British bacteriologist Patches Almroth Edward Wright first developed ○ inflammation of the small an effective typhoid vaccine at the Army intestinal linings will cause Medical School in Netley, Hampshire. It ulcerations and create a hole was introduced in 1896 and used ○ leak of bowel contents into the successfully by the British during the Boer abdomen War in South Africa ○ MO is absorbed into Causative Agent: Salmonella Typhosa / circulation Typhi (gram negative is a motile organism ○ reaches different organs of the that is pathogenic only to humans and can body such as the pancreas, brain, survive for weeks in water and dry GI etc.. sewage) Diagnostic: Mode of Transmission: Fecal Oral Route ○ Typhidot — the confirmatory — 5Fs test that uses blood or stool, it ○ Feces (primary source) detects the presence of IgM and ○ Finger IgG (for more efficient ○ Flies determination of the bacteria, the ○ Food (water and milk) blood should be collected prior ○ Fomites the administration of antibiotics) Other Source of Infection: ○ ELISA — to determine presence ○ those who recovered from the of antibodies disease ○ Rectal Swab — to determine the ○ those who took care of infected presence of salmonella typhi person ○ Widal Test ○ person who ingested shellfish or Agglutination oyster which harvested in water (clumping of blood cells that is contaminated with sewage when antibodies and disposal of stool and vomitus of antigens interact an infected individuals together) for O (somatic body or polysaccharide Page 6  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 form) and H (flagellar ○ terminal (applied when the or protein form) Ag patient is no longer the source of V Ag — carbohydrate infection and carried out when envelop the patient is discharged or died) Clinical Manifestations: Onset State and concurrent (after the ○ headache, chill sensation, body individual produces infectious aches materials and carried out while ○ nausea and vomiting + diarrhea the patient is still a source of ○ 4th and 5th days (symptoms are infection) disinfection worst such as dry cough, dull frontal headache, increasing Hepatitis A body malaise, fever up to 40 vaccine preventable liver infection caused degrees) by HAV, characterized by the ○ 7th to 9th days (rose spots inflammation of the liver, the most benign [bacterial emboli in the dermis] and harmless type of hepatitis in the abdominal wall = generally starting within 2 to 6 weeks after pathognomonic sign) contact with the virus and although ○ in the second week, rose spot contagious, it is self limiting or kusang may be aggravated gumagaling Clinical Manifestations: Typhoid State one of the hepatitis virus that cause ○ Subsultus Tendinum or inflammation and affects the ability of the twitching of the tendon especially liver to function, this is known as in the wrist infectious hepatitis ○ Coma Vigil or the patient stares Period of Communicability: a week blankly before and a week after the appearance of ○ Carphologia or the patient symptoms mutters or mumbles deliriously Mode of Transmission: Fecal Oral Route or mahilig kumalikot sa suot nya ○ ingestion of contaminated water or sa kumot or food ○ Delirium ○ close contact with an infected Medical Management: person ○ Chloramphenicol — drug of ○ having oro anal sex choice ○ sharing of needles ○ Ampicillin Pathophysiology: ○ Co Trimoxazole ○ starts when a person ingest food ○ Ciprofloxacin / Ceftriaxone (3rd and water that is contaminated generation) with the feces of infected person Nursing Management: ○ reaches the liver ○ isolation by medical aseptic ○ interlobular infiltration which technique will cause.. ○ maintenance of fluid and ○ necrosis and hyperplasia of electrolytes balance Kupffer cells (macrophages and ○ monitor vital signs part of the immune system that is ○ prevent injury very important in liver ○ mouth care functioning) ○ cooling measures during febrile ○ bile fails to reach the intestines stage there will be manifestations of… ○ WOF signs of intestinal bleeding dark urine, pale stools, due to intestinal lesions itchiness Diagnostic: Page 7  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ HAV and HBV Complement From Course Unit: The hepatitis B virus Fixation Rate — blood test that was discovered in 1965 by Dr. Baruch can determine the presence of Blumberg who won the Nobel Prize for antigen, specific antibodies by his discovery. Originally, the virus was incubating patient serum by called the "Australia Antigen" because it antigen and complement was named for an Australian aborigine's ○ Serum Glutamic Oxaloacetic blood sample that reacted with an Transaminase (SGOT) antibody in the serum of an American ○ Serum Glutamic Pyruvic hemophilia patient. According to the Transaminase (SGPT) Centers for Disease Control and ○ Serum Alanine Transaminase Prevention (CDC), approximately 4.4 ○ Bile Examination (stool and million Americans are currently living urine) with chronic hepatitis B and C. Many ○ IgM level more people don’t even know that they Clinical Manifestations: have hepatitis. ○ fatigue, low grade fever, anorexia, nausea and vomiting Terminologies ○ pain on the right side of the 1. Cholera: is an infectious disease that abdomen beneath the lower ribs causes severe watery diarrhea, which can ○ pale stools or clay colored with lead to dehydration and even death if dark urine untreated. It is caused by eating food or ○ joint pain or arthralgia drinking water contaminated with a ○ jaundice of the skin and sclera bacterium called Vibrio cholerae. ○ intense itching 2. Dysentery: is an intestinal inflammation, Take Note: Hepatitis A does not lead to primarily of the colon. It can lead to mild chronic hepatitis or cirrhosis or severe stomach cramps and severe Medical Management: diarrhea with mucus or blood in the feces. ○ no specific treatment but bed rest Without adequate hydration, it can be is prescribed fatal. Infection with the Shigella bacillus, ○ high carbohydrate, low fat and or Entamoeba histolytica are the most CHON common cause. ○ Vitamin B Complex 3. Typhoid Fever: is a systemic infection ○ Isoprinosine caused by Salmonella Typhi, usually ○ Belladonna — plant where in the through ingestion of contaminated food or leaves and root are used to make water. The acute illness is characterized by medicine prolonged fever, headache, nausea, loss of ○ Antiemetics appetite, and constipation or sometimes ○ Vaccine (2 shots = 1st shot is 1 yr diarrhea. Symptoms are often non-specific of age then 2nd dose is 6 months and clinically non-distinguishable from after the first dose) other febrile illnesses. Nursing Management: 4. Hepatitis: is an inflammation of the liver ○ enteric isolation that can cause a range of health problems ○ promote bed rest and can be fatal. There are five main ○ observe for melena or blood in strains of the hepatitis virus, referred to as the stool types A, B, C, D and E. ○ skin and mouth care 5. Communicable Disease: caused by an ○ limit activity when fatigued infectious agent that are transmitted ○ plan periods of rest and activity directly or indirectly to a well person ○ gradual resumption of activities through an agency, vector, or inanimate and mild exercises object Page 8  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 6. Contagious Disease: easily transmitted 25. Concurrent: done immediately after the from one person to another discharge of infectious materials / 7. Infectious Disease: transmitted by direct inoculation through a break in the skin Week 13 | Part 2: Communicable Diseases — 8. Infection: entry and multiplication of an Nervous System infectious agent into the tissue of the host 9. Infestation: lodgement and development Meningitis (aka. Cerebrospinal Fever) of arthropods on the surface of the body inflammation or infection of the meninges 10. Asepsis: absence of disease producing which surrounds the brain and the spinal microorganisms cord 11. Sepsis: presence of infection Causes: 12. Medical Asepsis / Clean Technique: ○ ingestion of poison or drugs practices designed to reduce the number ○ reaction to a vaccine or a and transfer of pathogens pathogen (injection of certain 13. Surgical Asepsis / Sterile Technique: substances) practices that render and keep objects and Viral / Aseptic Meningitis: areas free from microorganisms ○ directly invades the meninges 14. Carrier: an individual who harbors the ○ or due to immune reaction that organism and can transmit it without does not directly affects the brain showing manifestations of the disease ○ said to be less severe and most 15. Case: a person who is infected and people recover completely manifesting the signs and symptoms of the without treatment disease ○ a complication to a viral diseases 16. Suspect: a person whose medical history such as chicken pox, measles or and signs and symptoms suggest that such german measles person is suffering from that disease ○ infants younger than 1 month or 17. Contact: any person who had been in people with weak immune close association with an infected person system are more likely to 18. Host: person, animal or plant which experience severe cases of harbors and provides nourishment for a meningitis parasite ○ Types — 19. Reservoir: natural habitat for the growth, Enteroviruses multiplication, and reproduction of (generally invade the microorganism gastrointestinal tract, 20. Isolation: separation of persons with entero means directly sa communicable diseases from other intestinal pero they can persons also reach the nervous 21. Quarantine: limitation of the freedom of system) movement of persons exposed to Arboviruses (mostly communicable diseases include arthropod borne 22. Sterilization: the process by which all viruses such as insect) microorganisms including their spores are Poliovirus (mumps, destroyed varicella zoster virus, 23. Disinfection: the process by which measles virus, etc.) pathogens but not their spores are Bacterial Meningitis: destroyed from inanimate objects ○ medical emergency and can be 24. Cleaning: the physical removal of visible life threatening dirt and debris by washing contaminated ○ spread between people in close surfaces contact ○ Causes — Page 9  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Hemophilus Influenza ○ during labor and birth in which B (HiB) the mother can pass the group B Neisseria Meningitis streptococcus and e coli to her generally affects baby adolescents ○ Neisseria Meningitis can be Streptococcus spread through droplet Pneumoniae (primary ○ via respiratory droplet through etiologic agent in older nasopharyngeal mucosa adults) ○ direct invasion through otitis Streptococcus media Agalactiae (major Clinical Manifestations: cause of meningitis in neonate) Fungal Meningitis: ○ rare form of meningitis and it only occurs in people with weakened immune system ○ Based From Course Unit — It may mimic acute bacterial meningitis. Fungal meningitis ○ fever, severe headache, stiffness isn't contagious from person to of the neck and spine, person. Cryptococcal meningitis ○ exaggerated and symmetrical is a common fungal form of the deep tendon reflexes disease that affects people with ○ Signs of Meningeal Irritation immune deficiencies, such as nuchal rigidity AIDS. It's life-threatening if not opisthotonos (abnormal treated with an antifungal posture caused bu medication. impaired brain Chemical Meningitis: functioning) ○ caused by inflammatory reactions (+) Kernig Sign — a to certain medications and test also done when a procedures such as antibiotics, patient is lying supine NSAIDs, and the lumbar and doctor place the puncture which in some cases patient leg at both hip causes aseptic meningitis and knee and then Based From Course Unit: Chronic straighten the knee Meningitis is a slow-growing organism (positive if may pain and (such as fungi and Mycobacterium increase ang resistance tuberculosis) that invade the membranes while extending the and fluid surrounding your brain causing knee) chronic meningitis. Chronic meningitis (+) Brudzinski Sign — develops over two weeks or more. The a test done in placing the signs and symptoms of chronic meningitis patient flat in bed and a — headaches, fever, vomiting and mental doctor attempts to flex cloudiness — are similar to those of acute the neck and watch the meningitis hips and knees reaction Incubation Period: varies with extreme in the maneuver (if may limits being set from 1 to 10 days (based pain sinusuggest nito sa CU 3 to 6 days) Mode of Transmission: Page 10  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ang meningeal Aminoglycosides such inflammation) as gentamicin ○ Signs of Increased ICP ○ Digitalis — in order to control bulging fontanels in arrhythmia infants ○ Mannitol — form of diuretic in nausea and projectile order to decreased the cerebral vomiting edema severe frontal headache ○ Anticonvulsant/ Sedatives — in blurring of vision order to reduce restlessness and altered sensorium convulsion ○ Worsening Symptoms — ○ Paracetamol — to relieve delirium, deep stupor, coma headache and fever ○ sinus arrhythmia, irritability, ○ HiB / Anti Pneumonia Vaccine photophobia, biphobia and other Nursing Management: visual problems ○ Assess neurologic condition of ○ cough and colds, sore throat, the patient by observing LOC body malaise and WOF signs of increased ICP Diagnostic: (plucking at bed covers and ○ Physical Examination — projectile vomiting + seizures) patients symptoms ○ Monitor fluid balance in order ○ CSF Analysis / Lumbar to prevent dehydration pero Puncture / Spinal Tap (inserting watch out lang sa fluid overload the needle in the spinal canal and because of the danger of cerebral collecting the spinal fluid) edema Diagnostic — for ○ Position the patient or turn them analysis regularly in order to avoid bed or Therapeutic — to pressure sores reduce the ICP and to ○ WOF deterioration of patients introduce serum and condition other medications via ○ Isolation if necessary especially respiratory canal (dito if nasal culture is positive din yung injection of ○ Measure central venous pressure spinal anesthesia) as well as I/O and maintain ○ CSF Gram Staining (in order to adequate nutrition + assist in identify bacterial causes) ROM exercises ○ Smear From Petechiae & Blood Culture Poliomyelitis (aka. Infantile Paralysis / Heine - ○ CT Scan / MRI of the head (in Medin Disease) order to determine the area of “Infantile” = young children ang inflammation in the brain and the naapektuhan mentioned blood test are also “Heine” = reported the earliest case option if the lumbar tap is kumbaga kung saan unang naireport contraindicated with the patient “Medin” = first to carefully study the such as if patient has increased epidemic of poliomyelitis ICP, or trauma to lumbar “Polios” = gray matter of the nervous vertebrae) system Medical Management: “Melios” = refer to the myelin sheath of ○ Antibiotic — the nerve cells or nerve fibers IV for 2 weeks then oral an acute infectious disease usually affects antibiotics afterwards children and young adults characterized Page 11  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 by inflammation of the motor neurons of will be invasion of tonsils and the brainstems and spinal cord in short, lymph nodes (neck and ileum) changes in the CNS therefore, resulting in ○ once the virus is in the blood two pathological reflexes or paralysis followed things may happen, it can be (1) by muscular atrophy, muscle spasms or viremia halted (no clinical paresis disease) or (2) persistent Causative Agent: Polio Virus — Legio viremia Debilitans (humans are the only known ○ kapag persistent viremia there host) will be penetration of capillary 3 Identified Strains: wall and entry to CNS ○ Brunhilde — causes most severe ○ high affinity of the virus to motor epidemic, and nakita nila toh sa nerve cells chimpanzees wayback 1939 + ito ○ once attached ang virus sa motor din ang unang na identify out of cells magkakaroon ng the 3 strains multiplication in the cytoplasm ○ Lansing — identified way back which will cause nerve cell death 1938 from the brain and spinal = paralysis cord of the young man who Diagnostic: suffered from polio in Lansing ○ Isolation of the Virus — Throat Michigan, in the USA Swab ○ Leon — obtained in 1937 from ○ Stool Culture the brain and spinal cord of an 11 ○ CSF Culture year old boy named leon Abortive Poliomyelitis: siya ang kauna unahang ○ it accounts for 4 to 8% of all nagkaroon ng strain polio cases Mode of Transmission: ○ does not invade CNS and quite ○ Fecal Oral Route difficult to diagnose because of ○ Direct Contact non specific symptoms such as Oropharyngeal — headache and sore throat Secretions + Feces ○ slight or moderate fever ○ Indirect Contact ○ occasional vomiting through contaminated ○ low lumbar pain water, food, and utensils ○ no evidence of paralysis or maybe due to flies na ○ patient usually recovers within 72 dumadapo sa pagkain hours Period of Communicability: 1st 3 days Non Paralytic Poliomyelitis: up to 3 months of illness and most ○ all signs of abortive type is contagious during the first 2 to 3 days of present acute illness ○ when the virus reaches the CNS Pathophysiology: and still active will provide some ○ starts one the virus enters the damages such as — hamstring body through the GI tract muscle spasm, changes in deep ○ there will be multiplication of the and superficial reflexes, presence virus in the throat and small of pain in the neck, back, arms, intestine (since it can pass the legs and abdomen stomach ibig lang sabihin the ○ inability to place the head in virus can survive in acidic between the knees environment) ○ (+) Pandy’s Test — increase ○ once destroyed ang epithelial cell protein globulin in the CSF ng throat and small intestine there ○ usually lasts for about a week Page 12  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ transient pareses may occur but innervated by the motor neuron no evidence of paralysis because of the spinal cord is affected it of the number of nerves involve can be either (1) higher spinal kumbaga hindi pa sufficient paralytic poliomyelitis (upper enough yung na damage na nerve portion of spinal cord kaya the cells to cause paralysis muscle of respiration is affected ○ 50% of patient recover without resulting difficulty in breathing) significant paralysis or (2) lower spinal paralytic Paralytic Poliomyelitis: poliomyelitis (lower portion ○ all signs of abortive and non which affects the muscle of the paralytic type lower limb therefore it ○ paralysis occurs characterized by asymmetry and ○ (+) Kernig & Brudzinski Neck scattered flaccid paralysis of both Sign or one of the lower extremities, ○ urinary retention, constipation, less tendon reflexes, weakness of abdominal distention the hamstring muscle, urine ○ Virus at Medullary Area — retention, constipation and referred to as Bulbar abdominal distention) Poliomyelitis and the patient will ○ Both Brain Stem & Spinal manifest the following signs and Cord — referred to as Bulbo symptoms: Spinal Paralytic Poliomyelitis presence of difficulty in where in the neurons is totally speaking and affected including the muscles swallowing because the they innervates motor neurons in the Medical Management: brainstem is attack ○ Analgesics + Moist Heat therefore it weakens the Application together with bed cranial nerve 9 rest — for pains and leg spasms (glossopharyngeal however Morphine is nerve) and 10 (vagus contraindicated (because of the nerve) danger signs of respiratory paralysis if the face, depression) pharyngeal and ocular ○ Paralytic Type — PT, braces, muscle corrective shoes and in some (+) Hoyne’s Sign where cases orthopedic surgery (there is in the head of the patient no cure pero it can be prevented lags when the patient is by vaccinations, and therapy + elevated in supine antispasmodic drugs can improve position (parang mobility pero hindi nito mare mabigat or babagsak reverse ang permanent paralysis) ang ulo) Nursing Management: less tendon reflex ○ because of the mode of regurgitation of food transmission nurse should carry which place the patient out enteric isolation at risk for aspiration ○ observation for signs of paralysis pneumonia and other neurological damage ○ Virus at Spinal Cord — referred through performing neurological to as Spinal Paralytic assessment at least once a day but Poliomyelitis where in the do not demand any vigorous paralysis of the muscles is muscle activity from the patient Page 13  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ WOF signs of fecal impaction CHN Alert: due to dehydration and ○ Polio Vaccines is keep in a immobility so we can give freezer about negative 15 until sufficient fluid negative 25 degrees celsius ○ repositioning to avoid bed sores because the vaccine is sensitive (every 2 hours + keep the bed dry to heat so if the clinical instructor kasi bed sores ay naattract sa asked a student nurse to get a vial moisture) of OPV titingnan mo yung ○ hand hygiene + oral and skin care vaccine sa loob ng freezer hindi ○ proper disposal of excreta and outside the freezer vomitus ○ upon administering the vaccine ○ emotional support instruct the mother to avoid How can we prevent it? — Polio breastfeeding for about 15 to 30 Vaccines (critical in prevention and mins prior giving the oral polio control of infectious diseases) vaccine to promote efficient ○ Salk Vaccine / Inactivated Polio absorption of the medication Vaccine (IPV) Based From Course Unit: developed wayback ○ Polio mainly affects children 1955 by Dr. Jonas Salk? younger than 5. However, anyone IM or intradermal who hasn't been vaccinated is at injection because it risk of developing the disease. produce antibodies in Paralytic polio can lead to the blood of all 3 types temporary or permanent muscle of polio and if infection paralysis, disability, bone occurs the antibodies deformities and death. Of the 3 will prevent the spread strains of wild poliovirus (type 1, of virus to the central type 2 and type 3), wild nervous system poliovirus type 2 was eradicated it may not give a strong in 1999 and no case of wild immunity as a live poliovirus type 3 has been found vaccine so need nya ng since the last reported case in several booster Nigeria in November 2012. Both consist of inactivated strains have officially been poliovirus strain of all certified as globally eradicated. the 3 strains As of 2020, wild poliovirus type No VAPP — there is no 1 affects two countries: Pakistan vaccine associated and Afghanistan. The strategies poliomyelitis kasi hindi for polio eradication work when naman sya live vaccine they are fully implemented. This ○ OPV is clearly demonstrated by India’s predominant vaccine success in stopping polio in developed by Dr. Albert January 2011, in arguably the Sabin in 1950s most technically challenging attenuated trivalent place, and polio-free certification vaccine (tatlo yung of the entire WHO Southeast function nya) Asia Region in March 2014. risk of VAPP but due to ○ There are two vaccines for immunodeficiency polio: Oral Polio Vaccine (OPV) and/or susceptibility to and the Inactivated Polio Vaccine illness (IPV). In the Philippines still Page 14  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 using OPV, IPV does not replace for: difficulty breathing, the OPV vaccine, but is used weakness, hoarseness or with OPV to strengthen a child's wheezing, rapid heart rate, hives, immune system and protect them dizziness and get medical help from polio. IPV Salk are killed immediately. formulized virus, given SC or ○ The Centers for Disease Control MI, include circulating antibodies and Prevention (CDC) advises but not local (intestinal taking precautions to protect the immunity), prevents paralysis but people from polio if traveling does not prevent re-infection, anywhere there's a risk of polio. difficult to manufacture and Adults who have been vaccinated costly and not useful with who plan to travel to an area controlling epidemics. OPV where polio is occurring should Sabin are live attenuated virus, receive a booster dose of given orally, immunity is both inactivated poliovirus vaccine humoral and intestinal, induces (IPV). Immunity after a booster antibody quickly, prevents lasts a lifetime. paralysis and prevent re-infection, easy to manufacture Leprosy (aka. Hansen's Disease / Hanseniasis) and cheaper and can be chronic systemic infection that primarily effectively use in controlling affects the peripheral nerves, skin, upper epidemics respiratory tract, eyes, and nasal mucosa ○ The most effective way to and it is characterized by progressive prevent polio is vaccination. cutaneous lesions, deformities and Most children in the United disabilities States receive four doses of associated with stigma or shame and inactivated poliovirus vaccine contrary to popular belief hindi sya (IPV) at the following ages: two contagious and it has low infectivity months, four months, between 6 Based From Course Unit: These bacteria and 18 months, Between ages 4 grow very slowly and it may take up to 20 and 6 when children are just years to develop signs of the infection. It entering school. IPV is safe for can also be called Hansenosisand Lepra. It people with weakened immune is a chronic disease of the skin, peripheral systems, although it's not certain nerves and nasal mucosa, when contracted just how protective the vaccine is they are called “Living Dead”, and are in cases of severe immune perceived to be caused by sin. In 1873, deficiency. Common side effects Dr. Gerhard Henrik Armauer Hansen are pain and redness at the of Norway was the first person to identify injection site. Allergic reaction to the germ that causes leprosy under a the vaccine - IPV can cause an microscope. Hansen's discovery of allergic reaction in some people. Mycobacterium leprae proved that leprosy Because the vaccine contains was caused by a germ, and was thus not trace amounts of the antibiotics hereditary, from a curse, or from a sin. streptomycin, polymyxin B and Causative Agent: Mycobacterium Leprae neomycin, it shouldn't be given to (acid fast bacilli) anyone who's reacted to these ○ will attack cutaneous tissue and medications. Signs and peripheral nerves symptoms of an allergic reaction ○ produces skin lesions, anesthesia, usually occur within minutes to a infection and deformities few hours after the shot. Watch Mode of Transmission: Page 15  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ Airborne through respiratory Neural Involvement Clinical droplet Manifestations: ○ Inoculation through skin break ○ claw hand or the atrophy of the and mucus membranes hand muscles (prolonged contact) ○ loss sensation, paralysis and ○ Take Note that this is not pass peripheral anesthesia on from a mother to her unborn ○ corneal insensitivity (cornea is baby nor through sexual contact not being sensitive when assess Pathophysiology: with the use of cotton tip ○ starts with the entry of the applicator) causative agent or the ○ eyelid paralysis or the mycobacterium leprae lagophthalmos ○ attack the peripheral nerves ○ conjunctivitis, blindness, especially the ulnar, radial, photophobia posterior, popliteal, anterior, ○ Neuritic Pain = shooting or tibial and facial nerves burning pain due to nerve ○ damage to skins fine nerves damage causes anesthesia (numbness or Skin Involvement Clinical muscle atrophy, paralysis), Manifestations: anhidrosis (impaired sweating in ○ Lepromatous (can invade tissues one or several areas of the body), in every organ of the body) — and dryness of skin there will be lesion of Tuberculoid: Neural / Indeterminate — multiple, symmetrical Paucibacillary (based on WHO and erythematous and Classification) sometimes appearing as ○ characterized by regions of skin macules or papules with that have lost sensation and are smooth surfaces surrounded by border of nodules poor lidifying borders ○ non infectious type and has a raise and ○ nerve involved is usually indurated centers asymmetry common areas of lesions ○ low number of bacteria in skin which are enlarged lesions includes face, earlobes, Lepromatous: Progressive / Borderline nose, eyebrows, — Multibacillary (based on WHO foreheads Classification) thickened facial skin or ○ skin cells are infected and leonine facies parang disfiguring nodules form all over kumukulubot ang the body mukha ○ infectious type Madarosis = loss of ○ minimal cellular immune eyebrows and eyelashes response nasal collapse may ○ skin lesions usually described as occur secondary to infoltrated nodules and plaque + septal perforation damages in the respiratory tract, ○ Tuberculoid — eyes, testes, and nerve may be purely neural or involvement seems to be simultaneously affect symmetric the skin ○ large numbers of bacteria can be the initial lesion often a found in the lesions sharp demarcated hyper Page 16  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 pigmented macule that mycobacterium leprae which is is a void or circular usually done in the forearm raised, large, (parang skin testing lang and this erythematous plaques is useful din in determining the with clearly defined type of leprosy) borders a positive finding common lesion sites indicate cell mediated includes buttocks, face immunity such as and limbs activation of phagocyte additionally the and the release of perineum scalp axila cytokines in response to may also be observed bacillus = observed in with lesion after client with tuberculoid assessment form of leprosy if not treated properly as a negative finding with the disease progress, a lepromatous form of lesion tends to destroy leprosy where in it is the normal skin organs suggested lack of such as sweat glands resistance to disease and and hair follicles we can find on the skin Diagnostic: lesions large amount of ○ identification of signs and hansen's bacillus and symptoms (according to WHO this is also indicator of leprosy is diagnosed by finding at worsen prognosis least one of the cardinal sign Medical Management: which includes loss of sensation ○ Sulfone Therapy — in a pail or hypopigmented skin bacteriostatic (capable in patch, thickened or large inhibiting the growth of bacteria) peripheral nerves with loss of use principally for the sensation, weakness of the treatment of leprosy and muscle supplied by the nerve and its effectivity may be presence of acid fast bacilli) due primarily to the anti ○ Slit - Skin Smear serves as the inflammatory rather confirmatory test than antibacterial effect Take Note, lepromatous rehabilitation, client, nodules should be recreational, and biopsied and nasal occupational therapy mucosa should be Brand Name = Dapsone scrapped ○ Multiple Drug Therapy ○ Blood Tests Multibacillary increased RBC and ESR (Lepromatous) = decreased serum Dapsone 100 mg + calcium , albumin and Rifampicin 600 mg + cholesterol Clofazimine 50 mg for ○ Lepromin Test or an 12 months (after taking immunologic test that indicates 12 monthly doses of the resistance of the host to MDT they are mycobacterium leprae and done considered cured) via intradermal injection of Paucibacillary inactivated form of the (Tuberculoid) = Page 17  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Rifampicin + Dapsone ○ seen commonly in soil with for 6 months (after animal and human feces, saliva, taking 6 monthly doses and dust of MDT they are Releases 2 Types of Toxins: considered cured) ○ Tetanospasmin which is Nursing Management: responsible for muscle spasm ○ if admitted in the hospital, (often referred to as neurotoxin) isolation and medical asepsis ○ Tetanolysin which is responsible should be practiced for RBC Destruction by ○ moral support and increasing the permeability of the encouragement cell membrane through they cell ○ full and wholesome nutritious lysis diet Mode of Transmission: ○ attention to personal hygiene ○ Puncture Wound or Ragged ○ terminal disinfection Traumatic Wound, Burns or Prevention: Crash Injury (contaminated ○ avoidance of prolonged skin to with dust, soil, or animal excreta skin contact containing the causative agent) ○ BCG vaccination ○ Umbilical Stump (especially if ○ good personal hygiene delivered with faulty cord ○ adequate nutrition and health dressing or born to mother education (about s/sx, MOT, without tetanus toxoid awareness in order to reduce immunization) discrimination) ○ Cleaning of Ears (with sharp objects) Tetanus (aka. Lock Jaw) ○ Circumcision, Ear Piercing, and infectious bacterial disease which Dental Extraction produces a potent exotoxin with Take Note: Tetanus Toxoid 1 is given as prominent systematic neuromuscular early as possible during the pregnancy effect such as generalized spasmodic then the Tetanus Toxoid 2 is after 4 weeks contractions of the skin muscles as or 1 month after the first dose tapos manifested by acute onset of hypertonia Tetanus Toxoid 3 naman is after 6 months (increased tightness of the muscle tone of the second dose then yung Tetanus and reduced capacity of the muscle to Toxoid 4 is after 1 year and Tetanus stretch due to damage on the motor nerve Toxoid 5 is after 1 year din pathways) and the infection lead to painful Pathophysiology: skeletal muscles contraction ○ entry of clostridium tetani in Causative Agent: Clostridium Tetani wounds or break in skin ○ anaerobic gram positive so it ○ upon entry they will multiply moves, survives and can rapidly in short there will be local reproduce even without oxygen multiplication and release of and since they are non exotoxins encapsulated, they form spores + ○ toxin absorbed by bloodstream resistant sila sa heat, desiccation and lymphatics and intro and disinfectant peripheral motor nerves ○ drumstick appearance because of ○ tetanospasmin (high affinity to its round terminal spores with CNS issue and spinal motor slender body ganglia) ○ inhibition of muscle relaxation ○ = Hyperexcitability / Spasm Page 18  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 Neonate Clinical Manifestations: Take Note: ○ 1st manifestation seen feeding and sucking difficulties ○ cry excessively pero voiceless ○ an attempt to suck results in spasm and cyanosis ○ tonic or rigid muscular contractions ○ spasm or convulsion even the slightest stimuli ○ the jaw become so stiff ○ flaccidity >> exhaustion >> death Older Children & Adult Clinical Medical Management: Manifestations: ○ Specific — ○ Localized Tetanus (increased thoroughly cleaning and muscle tone near the wound) washing of the wound ○ Systemic or Generalized ATS, TAT, TIG within hypertonicity and 72 hours hyperactive deep tendon Tetanus Toxoid IM, 0.5 reflexes mL tachycardia, profuse Pen G Na (common sweating antimicrobial drug used Trismus or neck and to decrease number of facial muscle rigidity clostridium tetani and painful involuntary also prevent the bacteria muscle contractions from multiplying and Risus Sardinicus = reproducing Pathognomonic Sign neurotoxins) Opisthotonos or Muscle Relaxant (in abnormal posture due to order to treat lockjaw impaired brain and muscle stiffness) functioning ○ Non Specific — in severe cases Oxygen laryngospasm followed NGT Feeding by accumulation of Tracheostomy for secretions in the lower emergency airway airway which results in Fluid & Electrolytes respiratory depression If necessary, patients due to involvement if may be admitted to the respiratory muscles ICU. intermittent tonic Nursing Management: convulsion may last for ○ maintain adequate airway several minutes which ○ cardiac monitoring may result in cyanosis ○ maintain patent IV line and eventually death ○ wound care fracture of the vertebrae ○ avoid stimulation may also occur in ○ prevent contractures and pressure presence of severe sores spasms which may lead ○ monitor vital signs and provide to coma and death comfort measures Page 19  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 ○ warn visitor not to upset or Medical Management: as of now there is overlays stimulate the patient no definite medication indicated wag kamo mag ingay or kahit air ○ Induce Vomiting current such as electric fan ○ Charcoal Hemoperfusion is a ○ ROM exercises method of extracorporeal elimination (removal of toxins Red Tide (aka. Paralytic Shellfish Poisoning) with the use of hemodialysis red tide is caused by population explosion machine instead of the regular of toxic naturally occuring microscopic dialyzer used by dialysis patient) phytoplanktons (dinoflagellates) in which blood circulates through a syndrome of characteristic symptoms activated charcoal containing predominantly neurologic which occur cartridge which is added in the within minutes or several hours after circuit of hemodialysis machine ingestion of poisonous shellfish ○ Gastric Lavage & Gavage Causative Agent: Single Celled ○ Early Stage — Organism — Dinoflagellates Alkaline Fluids ○ explosions are caused by (NaHCO3) environmental conditions that Coconut Milk can be promotes growth of used as irritants because microorganisms such as shellfish toxins have heavy rainfall preceded reduced patency in by prolonged summer alkaline environment low salinity and calm but this should be done seas in initial stage of Seafoods that are unsafe to eat are… poisoning ○ Quahogs Nursing Management: ○ Soft Shell Clams ○ Health Teaching — ○ Oysters shellfish affected by red ○ Scallops tide must not be cooked ○ Moon Snails with vinegar because it ○ Lobster and Crabs increases the toxin by 15 Clinical Manifestation: times greater ○ usually occurs within 30 mins toxin of red tide is not after ingestion totally destroyed by ○ initial sign includes slight cooking perioral tingling of the lips and avoid bivalve mollusks tongue that spreads to the face, or yung mga may takip neck fingertips and toes such as tahong, talaba, ○ Drunken Condition — loss of halaan, kabiya, abaniko, coordination and tulya but if mahilig ○ symptoms may be aggravated by ka sa shellfish aba mag alcohol consumption intay ka muna kung ○ floating sensation and weakness pwede na ba sasabihin ○ total muscle paralysis with or irereport naman yun respiratory paralysis ng BFAR kasi sila ang victims who survived responsable sa pag lilift the first 12 hours have a ng Red Tide greater chance of contamination sa area survival Red Tide Based From Course Unit Page 20  OUR LADY OF FATIMA UNIVERSITY - COLLEGE OF NURSING NCMB 312: Care of Client with Problem in Oxygenation, Fluid & Electrolytes Transcribed By: Tirados, Lagrimas & Victorino Section: BSN 3 - Y1 - 4 A "red tide" is a common term used for a Blooms are caused by environmental harmful algal bloom.Harmful algal conditions that promote explosive growth. blooms, or HABs, occur when colonies of Factors that are favorable to the rapid algae—simple plants that live in the sea increase include warm sea surface and freshwater—grow out of control while temperatures, and high nutrient content. producing toxic or harmful effects on The similarity of these alga and people, fish, shellfish, marine mammals, heterotrophs often makes it difficult to and birds. The human illnesses caused by identify the precise cause of a harmful HABs, though rare, can be debilitating or algal bloom, and to predict its impact on even fatal. the affected ecosystem. While many people call these blooms 'red Red Tide is a global phenomenon. tides,' scientists prefer the term harmful However, since the 1980s harmful red tide algal bloom. One of the best kn