typhoid disease
DESCRIPTION
typhoidTRANSCRIPT
NURSING CLIENT WITH ENDOCRINE AND GENITOURINARY DISORDER AND COMMUNICABLE
DISEASE
Typhoid fever is a systemic infection caused by Salmonella enterica serotype Typhi (S. typhi). The disease remains an important public health problem in developing countries.
About 16 million cases of typhoid fever and 600,000 deaths occur yearly worldwide and that more than 90% of this morbidity and mortality occurred in Asia
INTRODUCTION
What?
An acute illness with fever caused by infection with the Salmonella typhi
bacteria contracted from contaminated water and food. Also called enteric fever,
bilious fever and yellow jack .
TYPHOID FEVERDEFINITION
•Virulent bacterium that cause illness called Salmonella typhi.1.Bacteria
• spread through contaminated food or water and occasionally through direct contact with someone who is infected.
2.Fecal-oral route
• These people, called chronic carriers, shed the bacteria in their faeces and are capable of infecting others.
3.Typhoid carriers
ETIOLOGY
work in or travel to areas where typhoid fever is endemic
Work as a clinical microbiologist handling Salmonella typhi bacteriaHave close contact with someone who is infected or has recently been infected with typhoid fever
Have an immune system weakened by medications such as corticosteroids or diseases such as HIV/AIDS
Drink water contaminated by sewage that contains S. typhi
RISK FACTOR
Fever, often as high as (39.4 or 40 C)
Poor appetite
Weakness and fatigue
Headache
Abdominal pain
Rash
Diarrhea or constipation
CLINICAL MANIFESTATION 1st WEEK
CLINICAL MANIFESTATION con’t…
Continuing high fever
Extremely distended abdomen
Diarrhea or severe constipation
weight loss
2nd WEEK
CLINICAL MANIFESTATION con’t…
Intestinal bleedingLie motionless and
exhausted
3rd WEEK
PATHOPHYSIOLOGySalmonella typhi contracted from contaminated water and food
Ingested by human.The S.typhi survives the acidity of the stomach
It will invades the payer’s patches of the intestinal wall
The bacteria is within the macrophages and survives
Bacteria spreads via the lymphatics while inside the macrophages
Access to reticuloendothelial system,liver,spleen,gallbladder and bone marrow.
1st week: elevation of the body temperature
2nd week: abdominal pain, spleen enlargement and rose spot
3rd week: necrosis of the payer’s patches
Leads to perforation, bleeding .And if left untreated, death is imminent
PATHOPHYSIOLOGy con’t…
Blood culture (C&S)A blood culture during the first week of the fever can show S. typhi bacteria
Complete blood count (CBC)A complete blood count (CBC) will show a high number of white blood cells.
DIAGNOSTIC TEST
.
Stool C&Sstool culture may be positive for S.typhi several days after ingestion of the bacteria
Widal test
Test whereby bacteria causing typhoid fever are mixed with serum containing specific antibodies obtained from an infected individual
DIAGNOSTIC TEST CON’T…
TREATMENT
Brand name :Ci
pro (Ciproflox
acin)
Class of drugs :qui
nolone antibiotics
.
USES: This medication is used to treat a variety of bacterial
infections.
Routes : per oralDosage :Adult :500 mg orally
every 12 hours for 10 days
Side effect :nausea, vomiting,dizziness ,blurred vision,feeling nervous,sleep problems
TREATMENT CON’T…
Brand name :Ro
cephin (Ceftriaxo
ne)
group of drugs :
cephalosporin
antibiotics
Uses :It works by fighting bacteria in body
Route : intravenousDosage:Pediatric :75 to 80 mg/kg IV once a day for 5 to 14 daysAdult:2 g IV every 24 hours
Side effect : Mild
diarrhea, mild pain, swelling, nausea,vo
miting
COMPLICATION OF TYPHOID
Gastrointestinal Perforation
Myocarditis
Gastrointestinal Bleeding
GASTROINTESTINAL BLEEDING
COMPLICATION OF TYPHOID
Gastrointestinal Bleeding
Myocarditis
Gastrointestinal Perforation
GASTROINTESTINAL PERFORATION
COMPLICATION OF TYPHOID
Gastrointestinal Bleeding
Gastrointestinal Perforation
Myocarditis
MYOCARDITIS
• Nursing Diagnosis :Hyperthermia related to increased metabolic rate, illness.
• Goal : Client can maintain the normal body temperature without complication
NURSING CARE PLAN 1
Nursing Intervention Rationale
Monitor patient temperature degree and patterns Fever pattern may aids in diagnosing underlying disease.
Observe for shaking chills and profuse diaphoresis Chills often precede during high temperatureand in presence of generalized infection.
Wash hands with anti-bacterial soap before and after each care of activity and encourage proper hygiene.
Reduces cross contamination and preventsthe spread of infection.
Provide tepid sponge baths and avoid the use of ice water and alcohol.
May help reduce fever .Use of ice water andalcohol may cause chills and can elevatetemperature.
Monitor for signs of deterioration of condition or failure to improve with therapy.
May reflect inappropriate antibiotic therapy.
NURSING CARE PLAN 2
• Nursing Diagnosis : Risk for imbalance nutrition related to disease process. • Goal : Patient will be maintain the nutrition balance and body weight status
Nursing Intervention Rationale
Monitor the Input & Ouput Chart To maintain nutrient status of patient
Assess client’s nutritional patterns Offer client their favorite food to ensure patient taken the diet
Recommend bed rest / activity restrictions during the acute phase, balanced body weight each day
To minimize the pain and to maintain patient weight
Record or report such things as nausea, vomiting, stomach pain and distension.
To do further management to reduce the symptom
Collaboration with a nutritionist for dietary administration
To maintain patient taken diet well
NURSING CARE PLAN 3
• Nursing Diagnosis : Increase frequency of bowel movement related to disease process.
• Goal : Client will maintain the hydration of body from over diarrhea
Nursing Intervention Rationale
Monitor the vital sign such as pulse and respiration To monitor patient from over dehydration
Monitor the Input & Output chart. To maintain the fluid balance in patient body
Encourage the patient to eat more nutritious food such as fruit & vegetable. To prevent patient from get constipation
Encourage pt to drink plenty of water at least 2.5 liters / 24 hours. To maintain hydration status of patient
Observe the drip infusion & administer the medication as ordered by doctor.
To prevent infection and maintain fluid balance
Wash hand before and after handling something
Avoid drinking untreated water
Avoid raw food and vegetables
Choose well-cooked food
HEALTH EDUCATION
HEALTH EDUCATION con’t…Avoid popsicles and flavored ices that may have been made with contaminated water.
Avoid eat the foods and beverages from the street vendor
Remember taking antibiotics injection as doctor orders
Getting vaccinated before travelling to another country where common gets the typhoid.
Follow up with the doctor
Salmonella Typhi causes a protracted bacteremic illness referred to as typhoid fever. Since humans are the only reservoir for S. Typhi, infection is most often acquired through ingestion of food or water contaminated by feces and urine of infected persons and chronic carriers.
Typhoid fever is characterized by the gradual onset of fever, headache, malaise, anorexia, abdominal pain, hepatosplenomegaly, rose spots, and changes in mental status. Laboratory diagnosis can be made by culture of stool, blood and widal test.
SUMMARY
Antimicrobial therapy is indicated for patients with typhoid fever. Typhoid fever cases should be excluded from food handling, and from direct care of infants, elderly,immunocompromised, and hospitalized or institutionalized patients. An individual may return to normal duties after 3 consecutive negative stool culture taken at least one month apart, and at least 48 hours after completion of antibiotic therapy. If without prompt treatment, it can cause serious complications and can be fatal.
SUMMARY con’t…
• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002308/• http://en.wikipedia.org/wiki/Typhoid_fever• http://www.nhsdirect.wales.nhs.uk/encyclopaedia/t/article/typhoidfever/• http://www.nhs.uk/Conditions/Typhoid-fever/Pages/Introduction.aspx• http://www.answers.com/topic/typhoid-fever#Signs_and_symptoms• http://en.wikipedia.org/wiki/File:Typhoid_inoculation2.jpg• http://www.nlm.nih.gov/medlineplus/ency/article/001332.htm• http://www.livestrong.com/article/133749-an-introduction-typhoid-fever/• http://en.wikipedia.org/wiki/File:ForskeligeVeje_ad_hvilkenBroen_kan_inf
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REFERENCES