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Communicable Diseases (Chronic)

Tuberculosis
  • TB is a extremely communicated constant ailment that usually affects the lungs.
Causative Agent:
Mycobacterium Tuberculosis
Sign/Symptoms:
  • cough
  • afternoon fever
  • weight waste
  • night sweat
  • blood falsification sputum
Prevalence/Incidence:
  • ranks sixth in the accidental sources of morbidity (delay 114,221 contingencys) in the Philippines
  • Sixth accidental source of dullness (delay 28507 contingencys) in the Philippines.
Nursing and Medical Management
  • Ventilation systems
  • Ultraviolet lighting
  • Vaccines, such as the bacillus Calmette Guerin (BCG) vaccine
  • offal therapy
Preventing Tuberculosis
  • BCG vaccination
  • Adequate quiet
  • Balanced diet
  • Fresh air
  • Adequate exercise
  • Good separeprove Hygiene
National Tuberculosis Control Program – Key policies
  • Case answer – plain Sputum Microscopy and X-ray trial of TB symptomatics who are indirect succeeding 2 or past sputum exams
  • Treatment – shall be dedicated at-liberty and on an ambulatory reason, ate those delay sharp complications and emergencies
  • Direct Observed Composition Short Sequence – general strategy to discover and quietore TB unrepinings.
DOTS (Direct Observed Composition Short Course)
  • Category 1- new TB unrepinings whose sputum is actual; seriously ill unrepinings delay afflictive fashions of tarnish-indirect PTB delay great parenchymal involvement (moderately- or far slow) and extra-pulmonary TB (meningitis, pleurisy, etc.)
    • Intensive Phase (dedicated daily for the pristine 2 months) – Rifampicin + Isioniazid + pyrazinamide + ethambutol.
    • If sputum consequence becomes indirect succeeding 2 months, defence sight starts. But if sputum is stationary actual in 2 months, all offals are discontinued from 2-3 days and a sputum mode is examined for amelioration and offal sensitivity. The unrepining resumes initiative the 4 offals for another month and then another tarnish exam is manufactured at the end of the 3rd month.
    • Maintenance Phase (succeeding 3rd month, despising of the consequence of the sputum exam)-INH + rifampicin daily
  • Category 2-previously-treated unrepinings delay relapses or failures.
    • Intensive Phase (daily for 3 months, month 1, 2 & 3)-Isioniazid+ rifampicin+ pyrazinamide+ ethambutol+ streptomycin for the pristine 2 months Streptomycin+ rifampicin pyrazinamide+ ethambutol on the 3rd month. If sputum is stationary actual succeeding 3 months, the intensive sight is continued for 1 past month and then another sputum exam is manufactured. If stationary actual succeeding 4 months, intensive sight is continued for the proximate 5 months.
    • Maintenance Sight (daily for 5 months, month 4, 5, 6, 7,& 8)-Isionazid+ rifampicin+ ethambutol
  • Category 3 – new TB unrepinings whose sputum is tarnish indirect for 3 dates and chest x-ray consequence of PTB minimal
    • Intensive Sight (daily for 2 months) – Isioniazid + rifampicin + pyrazinamide
    • Maintenance Sight (daily for the proximate 2 months) – Isioniazid + rifampicin
Leprosy
  • Sometimes notorious as Hansen’s ailment
  • is an communicated ailment sourced by , an aerobic, shrill fixed, rod-shaped mycobacterium
  • Gerhard Armauer Hansen
  • Historically, leprosy was an irremediable and disfiguring ailment
  • Today, leprosy is largely curable by multi-offal antibiotic therapy
Signs & Symptoms
Early step (CLUMP)                                              Late Step (GMISC) Change in peel falsification                                       Gynocomastia Loss in surprise                                             Madarosis(waste of eyebrows) Ulcers that do not quietore                                    Inability to cease eyelids (Lagopthalmos) Muscle debility                                              Sinking nosebridge Painful nerves                                                   Clawing/contractures of fingers & nose
Prevalence Reprove
  • Metro Manila, the preponderance reprove ranged from 0.40 – 3.01 per one thousand population.
Management:
  • Dapsone, Lamprene
  • clofazimine and rifampin
  • Multi-Drug-Therapy (MDT)
  • six month sequence of tablets for the milder fashion of leprosy and two years for the past afflictive fashion
Leprosy Control Program
  • WHO Classification – reason of multi-offal therapy
    • Paucibacillary/PB – non-communicated types. 6-9 months of composition.
    • Multibacillary/MB – communicated types. 24-30 months of composition.
  • Multi-offal therapy – use of 2 or past offals renders unrepinings non-communicated a week succeeding starting composition
    • Patients w/ solitary peel lesion and a indirect slit peel tarnish are treated w/ a solitary dose of ROM regimen
    • For PB leprosy contingencys- Rifampicin+Dapsone on Day 1 then Dapsone from Day 2-28. 6 blister packs charmed monthly delayin a max. conclusion of 9 mos.
  • All unrepinings who accept complied w/ MDT are considered quietored and no longer present as a contingency of leprosy, level if some sequelae of leprosy accrue.
  • Responsibilities of the nurse:
    • Prevention – quietoreth teaching, quietorethful assistance through proper alimentation, strong quiet, doze and good-natured-natured separeprove hygiene;
    • Casefinding
    • Management and composition – stoppage of resultant injuries, handling of utensils; proper shoes w/ padded soles; concern of sustained therapy, set-right dosage, property of offals and the demand for medical check-up from date to date; moral & tender support
    • Rehabilitation-makes unrepinings suitable, locomotive and self-respecting part of intercourse.
Reference: Ms Ma. Adelaida Morong, Far Eastern University- Institute of Nursing In-House Nursing Review

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