Respiratory Diseases Past Paper PDF

TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing...

TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila Student: Lopez, Gerlene C. Section: 3NU06 Lecturer: Ma’am Harriet P. Valeros RESPIRATORY DISEASES Diseases / Alternative Name / Sign and Symptoms Diagnostic Examination Nursing Intervention Medical Interventions Description / Causative Agent Pathognomonic Sign Disease: Tuberculosis Signs and Symptoms: AFB Smear - Sputum Smear 3 Important Aspects of Care Directly Observed Treatment Short Coughing that lasts three or more ○ Done upon rising DIET - if px have anorexia (small Course (DOTS) Alternative Name: Koch’s disease, weeks ○ 3 consecutive days frequent feedings; high protein) All are hepatotoxic Phthisis, Galloping consumption, Chest pain or pain with breathing ○ SPUTUM not saliva DRUG - strict compliance (right H - Isoniazid (INH) TB/PTB or coughing ○ No gargle w/alcohol, no food dosage) kills bacteria Coughing up blood ○ Deep Breath, Hold Breath, REST SE; tingling and numbness of Description: A highly infectious Loss of Appetite Cough on receptacle hands and feet; neuropathy disease that affects the lungs and is Fever at night Chest X-ray Contraindicated nursing care: (decreases Vit B6 levels) characterized by persistent cough, ○ due to cortisol release ○ To determine lung involvement CHEST CLAPPING - stimulates NX: Administer in an EMPTY chest pain, and loss of weight due to a ○ cortisol is an endogenous Tuberculin Test (Mantoux Test) hemoptysis stomach; Vit B6 to counteract bacterial infection by Mycobacterium steroid ○ To determine EXPOSURE to TB peripheral neuropathies; avoid tuberculosis. It can be transmitted ○ released during tremendous (possible that all Filipinos will Proper disposal of taking alcohol through droplets in the air when an amount of stress test +) nasopharyngeal secretions R - Rifampicin affected individual unwell through ○ Highest in daytime, lowest at ○ 0.1 cc PPD read after 48-72 Cough manners Stops RNA-polymerase (kills coughing or sneezing. TB can be nighttime hours bacteria) inactive in a given body without the ○ ↑cortisol = ↓temp ○ ID; repeat 5-10 cm away if SE: heartburn, anorexia, n/v, person exhibiting signs but still has ○ ↓cortisol = ↑temp (lower release wheel was not formed cramps, diarrhea, headache, mycobacteria present or it can be none to combat fever) ○ 15 mins, for allergic reaction dizziness, confusion, visual active and can be transmitted to the Night sweats ○ Hard raised induration (raise of disturbances, presence of community. Fatigue the skin) reddish-orange secretion (urine, Chills ○ 0.4 mm is + if stool), stains contact lenses Causative Agent: Unintentional weight loss immunosuppressed, high NX: Give drug BEFORE meals or Mycobacterium tuberculosis, prevalence at bedtime; avoid taking alcohol; Mycobacterium bovis Pathognomonic Sign: ○ 5-9 mm is + if HIV inform client about the reddish presence of caseating ○ 10 mm or more = + for TB secretion Mode of Transmission: Airborne granulomas in tissue samples exposure Birth control less effective Droplet Transmission Cow’s milk presence of cavitary lesions in ○ 5 mm = Sunburn easily containing M. bovis the lungs, visible on chest X-rays HIV/AIDS/Immunocompromised Z - Pyrazinamide Genexpert Test Oral Incubation: 4 to 12 weeks ○ Molecular TB test 10% of presumed or measured body weight Unexplained chronic diarrhea for > 1 month Unexplained persistent fever that could be intermittent or constant > 1 month Persistent oral candidiasis Oral hairy leukoplakia Pulmonary tuberculosis Severe bacterial infections  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila (pneumonia, empyema, pyomyositis, bone or joint infection, meningitis, bacteremia) Acute necrotizing ulcerative stomatitis, gingivitis, or periodontitis Unexplained anemia at 1 month Esophageal candidiasis Extra pulmonary tuberculosis Kaposi's sarcoma ○ malignancy of the vascular endothelium manifested by pink, purple, painless, spot in skin (leopard like) Pathognomonic Sign: Kaposi’s Sarcoma  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila CIRCULATORY DISEASES Diseases / Alternative Name / Sign and Symptoms Diagnostic Examination Nursing Intervention Medical Interventions Description / Causative Agent Pathognomonic Sign Disease: Dengue Hemorrhagic Fever Signs and Symptoms: Tourniquet test (Rumpel-Leed e Watch for bleeding Symptomatic and supportive Grade I test) Epistaxis treatment Alternative Name: DHF, Dandy Fever, High grade fever (3-5 days) ○ presumptive test that checks for ○ cold compress over forehead Oral fluids and electrolyte Break bone fever Headache, peri-orbital pain capillary fragility Melena Antipyretics Joint & bone pain ○ pedia: 3-5 mins ○ cold compress over stomach ○ (don’t use aspirin) Description: Tropical disease caused Abdominal pain ○ adults: 5-10 mins area and avoid eating dark Platelet transfusion by different strains of dengue virus N/V ○ + if > 20 petechiae formation in colored foods Convulsions which are transmitted by mosquitoes Petechial formation 1 square inch Gingival bleeding ○ Dilantin Herman’s sign – generalized NS1 antigen, DENGUE DUO ○ offer ice chips, use soft bristle Bleeding- FFP, Platelet conc Causative Agent: Arthropod-Borne flushing of the skin Platelet count (decreased) toothbrush virus Grade II Hematocrit Hematemesis arbovirus belonging to the Grade I s/sx ○ NPO family Flaviviridae Bleeding Observe for signs of shock 4 serotypes Epistaxis ○ (DENV1, 2, 3, 4) GI Bleeding Preventive: Aedes aegypti Aedes Gum Bleeding Grade III C - chemically treated mosquito nets albopictus- tiger Grade II s/sx L - larvae eating fish mosquito Culex Circulatory failure E - environmental sanitation (4pm fatigans Cold, clammy skin habit) decreased BP A - anti mosquito soaps (basil, citronel) Mode of Transmission: Vector rapid, weak pulse N - Natural mosquito repellants (neem transmission increased RR tree, eucalyptus, oregano) Grade IV Incubation: 4-6 days Grade III s/sx Period of Communicability: 3-5 days Hypovolemic shock Profound bleeding Pathognomonic Sign: bleeding manifestations, such as petechiae, bleeding gums, and hematemesis (vomiting blood) Disease: Malaria Signs and Symptoms: Malarial Smear collect at the Cold Stage Antimalarial agents  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila Cold stage peak of fever Provide warmth to patient Chloroquine (drug of Choice) Alternative Name: Ague, King of Chilling manifestations (10-15 ○ classic and most used Add clothing Quinine Tropical Disease minutes) diagnostic test; blood smear on Warm drinks ○ neurologic toxicity, muscular Hot Stage (4-6 hours) a microscope slide that is Hot water bags twitching, delirium, convulsion Description: Infectious disease that is Fever stained (Giemsa stain) to show Socks ○ Primaquine arthropod-borne, characterized by chills Headache the parasites inside red blood Hot Stage ○ Fansidar followed by fever occurring regular Abdominal pain cells Lower temperature intervals Vomiting Quantitative Buffy Coat (QBC) TSB Diaphoretic Stage ○ rapid test for malaria Light, loose clothing Causative Agent: Excessive sweating feeling of Antipyretics Plasmodium weakness due to the past Diaphoretic Stage (From Female anopheles mosquito) stages px underwent Keep the patient comfortable Species: with dry, warm clothes, P. vivax Pathognomonic Sign: replacing fluid loss causes benign tertian malaria Periodic fever attacks with a pattern of Monitor V/S P. falciparum fever spikes followed by periods of Diet high calories, vitamins and malignant tertian malaria; Most feeling well minerals frequently encountered here ff Fluid and electrolytes balance by vivax; most fatal; multiplies rapidly Preventive: P. malariae Advise malaria chemoprophylaxis less frequent; causes quartan when traveling to malaria endemic malaria areas P. ovale Limit dusk to dawn exposure, rarely seen wear protective clothing, sleep under mosquito nets and use Mode of Transmission: Vector topical repellents Transmission Incubation: P. falciparum: 12-14 days P. vivax/ovale: 13-17 days P. malariae: 28-30 days Period of Communicability: Infective as long as gametocytes & asexual forms remain in blood Disease: Leptospirosis Signs and Symptoms: Blood examination Do not give calcium- rich foods Antibiotics  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila Septicemic/septic stage LAT (tetracycline binds with Penicillin Alternative Name: Orange Eye, Mud High fever (4-7 days) ○ Leptospira Agglutination Test calcium) Doxycycline fever, Swamp fever, Canicola fever, Headache LAAT Symptomatic and supportive Tetracycline Weil’s Disease, Swine herd’s Disease, N/V ○ Leptospira Antigen-Antibody care ○ (not given to < 8 yrs old and Ictero-Hemorrhagia Abdominal pains Test Monitor urine output pregnant women) Joint pain Liver function test Description: Bacterial disease that Respiratory distress BUN, Creatinine Preventive: Prophylaxis affects humans and animals which can Immune or toxic stage Eradicate rats ○ doxycycline 100 mg p.o q12 x 7 be mistaken for other diseases With or without Jaundice (4-30 ○ environmental sanitation, rat days days) poisons Causative Agent: Leptospira Anicteric Avoid wading in contaminated interrogans spirochetes Low grade fever pool of water/ swamps Meningeal manifestation Mode of Transmission: Urine of rats; through convulsion and affects farm animals such as cattle, pig, disorientation horses, rats; Skin penetration, through Icteric (Weil’s Syndrome) direct contact with urine, blood or tissue Jaundice from an infected animal; can enter Hemorrhages through broken skin or through the soft Hepatomegaly tissues on the inside of the mouth, nose Renal involvement or eyes; Can be transmitted by the Orange eyes semen of infected animal; Human to Convalescence stage human transmission is very rare Relapse during 4th to 5th weeks Incubation: 5-14 days with a range of Pathognomonic Sign: 2-30 days Weil’s disease Period of Communicability: may be excreted after a month to 11 months Disease: Japanese Encephalitis Signs and Symptoms: EEG Same as meningitis Symptomatic Initial signs (within 24 hours) - appears Lumbar Puncture Provide comfort Anticonvulsant Alternative Name: Brain Fever after 6-8 days from mosquito bite ○ keep px in a quiet, well ○ for seizure ventilated room; encourage oral Mannitol Description: Uncommon but serious Purulent discharge hygiene and bed bath. ○ to decrease ICP condition in which the brain becomes Sudden Fever Prevent from complications Corticosteroids inflamed resulting from either a viral Irritability ○ turn the px at least q2 hours Paracetamol infection or due to the body’s own Nausea increase oral fluid intake, Mechanical ventilation immune system mistakenly attacking Chills encourage high caloric diet,  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila brain tissue; one of a group of Headache moisten lips with mineral oil. mosquito-borne virus, arbovirus, Vomiting with stiffness (neck) Monitor intake and output. diseases that can affect the central Neurologic manifestations nervous system Dizziness Preventive: Conjunctivitis Eradicate mosquito thru DOH program Causative Agent: Culex Arthralgia Vaccination of equine or swine tritaeniorhynchus Myalgia identification of vectors and eliminating Decreased IQ and serious brain breeding grounds, destruction of larvae, 3 main categories of viruses inducing damage. and screening homes primary encephalitis: Worsened Symptoms (1) Common viruses, including HSV Rigidity (herpes simplex Ataxia virus) and EBV (Epstein-Barr virus); speech difficulties (2) Childhood viruses, including ocular palsy measles and mumps, flaccid paralysis (3) Arboviruses (spread by mosquitoes, Seizures ticks, and other insects), including Confusion Japanese encephalitis, West Nile loss of consciousness encephalitis, and tick-borne coma encephalitis Pathognomonic Sign: Mode of Transmission: mosquito-bite high fever, headache, and altered mental status Incubation: 4-21 days Disease: Filariasis Signs and Symptoms: Circular filarial antigen (CFA) Health education to control Ivermectin Edema in arms, breast, leg, and mosquito Albendazole Alternative Name: Elephantiasis genital area Diethylcarbamazine Skin hardens and thickens Preventive: ○ (DEC) (6 mg/kg per day) for 12 Description: Parasitic disease caused Control mosquito through DOH days in bancroftian filariasis and by microscopic, threadlike african eye Pathognomonic Sign: measures 6 days brugian filariasis worm hydrocele (fluid accumulation in the repeated 1-6 monthly intervals if scrotum) necessary Causative Agent: Wuchereria bancrofti- thread worm Mode of Transmission: transferred person to person with circulating microfilariae by mosquito bites  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila Incubation:10-12 months Disease: Schistosomiasis Signs and Symptoms: Stool exam Maintain fluid and electrolyte Effective only when given early at the Itchiness at the site of ○ look for egg of parasite, kato balance. course of disease Alternative Name: Snail Fever, penetration katz technique Patient education Praziquantel (Biltricide) Bilharzia, Blood fluke ○ “swimmer’s itch” Blood exam Lower temperature ○ 30 mg/kg BID Low grade Fever, myalgia and ○ COPT (circumoval precipitin Fuadin IM or IV Description: Acute and chronic cough test) Preventive: disease caused by parasitic worms. Dysentery – like symptoms ELISA Snail Control (Oncomelania Emaciations from chronic disease quadrasi) Causative Agent: Hepatomegaly ○ use of molluscicides Schistosoma japonicum splenomegaly Environmental Sanitation (intestinal tract; oriental lymphadenopathy ○ proper disposal of excretion schistosomiasis), Enlarged abdomen S. mansoni ○ because of inflamed liver, (intestinal tract and common in resulting from the accumulation Africa), of eggs in the organ S. haematobium (urinary tract and most Pathognomonic Sign: common in Middle East) Katayama fever, "splashing sound" or "egg Mode of Transmission: Skin granulomas" in the liver or other penetration of free-swimming fork-tailed tissues seen on imaging or biopsy. cercariae, ingestion of contaminated water; Transmitted through intermediary host a tiny snail called Oncomelania quadrasi; feces of infected person contaminate freshwater sources containing parasite eggs, which hatch in water Incubation: 2-6 weeks to 2 months Disease: Rabies Signs and Symptoms: History of animal bite Wash the wound immediately Post Exposure Prophylaxis (PEP) ANIMALS Observation of dog for 10 days with soap and water, povidone Wash lesions well with soap and Alternative Name: Hydrophobia, Dumb Stage ○ dead or with behavior within 10 iodine for 15 minutes. water Lyssa, La Rage complete change in disposition days (rabid) Do not cover or suture the Administer tetanus booster withdrawn, stays in one corner Virus culture and isolation of wound. If suturing is necessary, ○ consists of a dose of human  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila Description: Primarily a disease of quote-depressive behavior saliva and throat ensure that RIG has been rabies immune globulin (HRIG) animals (dogs, cats and other Hyperactive Fluorescent rabies antibody applied locally and rabies vaccine given on the mammals); is a vaccine-preventable manic behavior (FRA) Capture the animal and keep under day of the rabies exposure, and viral disease that transmits from ○ walks to and from ○ most definitive diagnosis veterinary surveillance then a dose of vaccine given mammals to humans that causes acute Furious Stage Brain Biopsy If animal remains healthy in 10 again on days 3, 7, and 14. encephalitis easily agitated; ○ negri bodies days For people who have never been bites, If animal dies vaccinated against rabies, post Causative Agent: Rhabdovirus fearful look **not suitable for detecting rabies Provide a dim & quiet exposure prophylaxis (PEP) drooling of saliva infection before onset of clinical environment should always include Mode of Transmission: Bite, abrasion ○ animal expected to die signs unless hydrophobia and Room should be away from administration of both HRIG and or lick on a damaged skin or mucous HUMANS aerophobia are present sub-utility rooms (area for rabies vaccine. membrane Prodromal/Invasive Stage washing: avoid sound of water) Combination of HRIG and numbness on site Restrain patient even before vaccine is recommended Incubation: 10 days - 15 years sore throat aggressive behavior sets in ○ for both bite and non-bite (longest is 32 years) flu – like symptoms Wear protective barriers exposures, regardless of the marked insomnia interval between exposure and Period of Communicability: lifelong Restless Preventive: initiation of treatment. copious salivation Preventable but not curable Administration of RIG on wound Irritable Immunization of animals site apprehensive All animals should be caged or Active: slight photosensitivity chained PVCV: purified vero cell vaccine sensitive to sound and Stay away from stray animals (verorab) temperature. 0.50 cc/vial (IM)/.1cc (ID) Pain in the site bite Site: Deltoid or Vastus lateralis Aches and body pain Schedule: Verorab: Excitement stage Day 0: 2 vials-1 vial for each site aerophobia Day 7: 1 vial Hydrophobia Day 21: 1 vial px fears water due to Day 90: booster dose of 1 vial in laryngospasm case dog dies in 10 days difficulty in swallowing Purified duck embryo profuse drooling IM deltoid or SubQ OD for 14 days Marked excitation and Lyssavac N apprehension ○ no skin test, cloudy solution Nuchal rigidity Lyssavac plain Convulsions ○ with skin test pink in color Delirium Passive: Paralytic Stage For immediate effect Spasms stops but paralysis set Given up to 7 days after being  TRINITY UNIVERSITY OF ASIA St. Luke’s College of Nursing Cathedral Heights, 275 E. Rodriguez Sr. Ave. New Manila, Quezon City, Metro Manila from toes upward in a matter of bitten, minutes Deep IM at buttocks area Respiratory paralysis and cardiac Single dose failure Animal Serum (ERIG) equine rabies immunoglobulin Pathognomonic Sign: hydrophobia Eg. ARS(antirabies serum); (fear of water) HyperRAB Skin testing done 40 IU/kg body weight Human serum (HRIG) human rabies immunoglobulin (administered only once at the start of anti rabies prophylaxis) E.g. Rabuman; Imogam Skin testing is not necessary; 20 IU/kg body weight.