8.4 Emerging Infectious Disease Concepts and Nursing Care Flashcards

1
Q

Emerging Boundaries

A
  • Threat of increase incidence in infection in the future

Due to
- Changes/Evolution of existing organisms
- Known infections spreading to new geographic areas
- Previously unrecognized infections appearing in areas undergoing ecological transformation
- Old infections re-emerging due to antimicrobial resistance

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2
Q

MDR-TB

A
  • Multidrug resistant
  • Resistant to isoniazid and rifampin (the most potent drugs against TB)
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3
Q

XDR

A
  • Extensively resistant TB
  • Resistant to isoniazid and rifampin as well as fluoroquinolone and at least one of the three injectable second-line drugs (amikacin, kanamycin, capreomycin)
  • Treatment is much less effective
  • Patients with HIV who develop XDR-TB are much more likely to develop the disease (from latent stage) and have higher risk of death
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4
Q

TB

A
  • 20% of cases are resistant to at least 1 of the first/second line drugs
  • 5% are resistant to both isoniazid and rifampicin
  • 10% are either XDR or total drug resistant
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5
Q

Risk Factors of Developing TB

A
  • Do not take TB medication regularly
  • Do not finish full course of antibiotics
  • Re-develop TB after taking TB medications in the past
  • Spending time with someone who has drug-resistant TB
  • Comes from an area in the world with drug-resistant TB
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6
Q

Collaborative Problems

A
  • Ineffective gas exchange and airway clearance
  • N95 masks must be worn (airborne precautions)

Education
- Patients may have unwanted side-effects from their antibiotics such as nausea, hearing loss, and fatigue. They must finish their course of antibiotics even though it may impair the patients ability to work or continue with ADLS

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7
Q

Lyme’s Disease

A
  • Caused by Borrelia Burgdorferi
  • Transmitted through infected black-legged ticks

Diagnosis
- Based on symptoms, physical findings, exposure to ticks, and lab tests
- If untreated can spread to joints, heart and nervous system

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8
Q

Lyme’s Disease Early S/S

A
  • Fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes

Erythema Migrans (EM) Rash
- Begins at site of tick bite in about 7 days but could range between 3-30
- Expands gradually overtime up to 12 inches
- Clears as it enlarges making it look like a bulls-eye

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9
Q

Lyme’s Disease Late S/S

A
  • Occurs days to months later
  • Severe headache and neck stiffness
  • Arthritis (severe joint pain and swelling, particularly knees and other large joints)
  • Facial Palsy (loss of muscle tone or drooping of one/both sides of the face)
  • Intermittent pain in tendons, joints, bones
  • Heart palpitations, irregular HB (Lyme’s Carditis)
  • Dizziness/SOB
  • Inflammation of brain/spinal cord
  • Nerve pain
  • Shooting pain or numbness or tingling of hands/feet
  • Short-term memory
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10
Q

Lyme’s Disease Medication

A
  • Doxycycline
  • Cefuroxime
  • Amoxicillin
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11
Q

Post Treatment Lyme Disease Syndrome (PTLDS)

A
  • Chronic Lyme’s Disease
  • Fatigue/muscle aches lasting longer than 6 months
  • Can disable a person

IV Treatment
- Ceftriaxone and Penicillin

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12
Q

Chronic Wasting Disease

A
  • Transmissible spongiform encephalopathy
  • Affects deer, elk, and moose
  • Caused by proteins that malfunction (prions)
  • Fatal to animals but has not been transmitted to people
  • Venison from hunters should be tested if it is harvested in an area where it has been found
  • No treatment
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13
Q

Influenza

A
  • Respiratory virus
  • Flu season is October-March (peaks in December and February)

Type A
- Highly contagious and causes moderate-severe illness in all ages. Easily mutates

Type B
- Stable virus that causes mild symptoms. Primarily affects children, college campuses, and long-term care settings

Type C
- EXTREMELY BENIGN, patients may not even feel symptoms.

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14
Q

Pandemic

A
  • Worldwide spread of new disease
  • Viruses that have caused past pandemics typically originate from animal influenza viruses
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15
Q

Ebola

A
  • Natural reservoir is unknown however most likely bats
  • Africa is high risk because 4/5 virus strains occur from animals native to there

Transmission
- Direct Contact (broken skin or mucous membranes)
- Blood/bodily fluids (semen)
- Objects such as needles/syringes that have been contaminated with blood
- Infected bats, apes, monkeys

S/S
- These do not show up right away
- DOES NOT SPREAD UNTIL HOST HAS DEVELOPED SYMPTOMS

Prevention of Spread
- PPE
- Obtain blood specimens
- Medication administration
- Cleaning vomit/diarrhea
- Communication with team members
- Showering after doffing PPE

  • N95 respirator, 2 gloves, face shield
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16
Q

Zika

A
  • Transmitted through mosquitos
  • Can also transmit through blood transfusions, sex, and perinatal

Incubation time - 2-12 days
- Mild symptoms lasting a few days (low grade fever, maculopapular rash, muscle pain, joint pain (swelling), headache, pain behind the eyes, conjunctivitis)
- Symptoms often go unnoticed

Prevention
- Reduce breeding of Aedes Mosquitos
- Insect repellent

Pregnancy
- Passed through pregnancy
- Causes defects (microcephaly, incomplete fetal brain development)
- Passed during sex as well even if asymptomatic
- Women who plan to be pregnant should not travel 3 months prior to areas where Zika is common.
- NO VACCINE

17
Q

Diarrheal Disease

A
  • Always a risk, transmitted through oral ingestion

Bacteria - Campylobacter Salmonella, Shigella, E-Coli

Parasitic - Giardia, Cryptosporidium, Entamoeba Histolytica

Viral - ROTAVIRUS and CALICIVIRUS (NOROVIRUS). Associated with long-term care facilities and cruise ships

18
Q

Vessel Sanitation Program (VSP)

A
  • Requires cruise ships to log and report number of passengers who have symptoms of GI illness
  • Report must be sent if 2% of passengers have GI illness
  • Additional report should be sent if the number reaches 3%
19
Q

Care of Diarrheal Disease

A
  • History of recent travel, use of antibiotics, food eaten
  • Hydration status

Mild
- Dry oral mucous membranes of mouth and increased thirst

Moderate
- Sunken eyes, loss of skin turgor, increased thirst, dry oral mucous membranes
- Hospitalization for rehydration

Severe
- Shock (rapid weak pulse, cyanosis, cold extremities, rapid breathing, lethargy)
- IV fluid replacement
- Mental status monitoring
- Critical care management

20
Q

Oral Rehydration Solution

A
  • 6 teaspoons sugar
  • 1/2 teaspoon salt
  • 1 liter of boiled water