TYPHOID FEVER

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TYPHOID FEVER:

TYPHOID FEVER PRESETENTION BY GROUP 3

DEFINITIONS:

DEFINITIONS DELIRIUM: mental excitement marked by an irregular expenditure of nervous energy incherent talk and delusions WIDAL REACTION: an agglutination test for the presence of antibodies against the salmonella organisms that cause typhoid fever TYPHOID FEVER: an infection of the digestive system by the bacterium salmonella typhi

definition:

definition AGRANULOCYTOSIS: a condition in which there is a marked decrease or complete absence of granular leukocytes in the blood RELAPSE: the return of adisease after an interval of convalecent STUPOR: a state of semi unconsciousness, occuring in the course of many varieties of mental illness in which the patient does mot move or speak

Causative Agent:

Causative Agent Salmonella Typhi

AETIOLOGY :

AETIOLOGY Typhoid fever is caused by a bacilli called salmonella typhi . Humans are the only host to the bacterium salmonella typhi , so the source of contamination is an infected person or a carrier. It is a gram negative bacilli

PowerPoint Presentation:

Motile gram-negative Anaerobes : can live in the absence of free oxygen Non-lactose fermenting Resistant to bile salts GENERAL CHARACTERISTICS OF SALMONELLA

Incubation Period:

Incubation Period First 8-14 days after ingestion

PATHOPHYSIOLOGY:

PATHOPHYSIOLOGY The bacilli salmonella typhi is shed in feaces and urine of typhoid fever infected person or a carrier. Salmonella typhi is spread mainly through the contamination of water, food or milk, these can be contaminated in cases where sanitation and water supply are not adequate. Flies also spread salmonella typhi when they have contact with faeces and or urine which is infected.

PATHOPHYSIOLOGY:

PATHOPHYSIOLOGY When a person is infected with salmonella typhi their will be 8 to 14 days of incubation period. During this period the salmonella typhi will invade the lymphoid tissue in the wall of the small and large intestines, more especially the aggregated lymph follicles and solitary lymph nodes. It then enters the blood vessels and spread to the liver, spleen and gall bladder. This is followed by the inflammation of the small and large imtestines .

PATHOPHYSIOLOGY:

PATHOPHYSIOLOGY The inflammed intestines may peforate causing peritonitis. The bacteria will spread to other parts like the kidneys.

Pathophysiology:

Pathophysiology Salmonella Typhi survives the acidity of the stomach invades the Peyer’s Patches of the intestinal wall macrophages (Peyer’s Patches) ‏ the bacteria is within the macrophages and survives bacteria spreads via the lymphatics while inside the macrophages

Pathophysiology:

Pathophysiology access to Reticuloendothelial system, liver, spleen, gallbladder and bone marrow First week: elevation of the body temperature Second week: abdominal pain, spleen enlargement and rose spots Third week: necrosis of the Peyer’s Patches leads to perforation, bleeding and, if left untreated, death is imminent

SINGS AND SYMPTOMS:

SINGS AND SYMPTOMS The sings and symptoms is gradually 8 to 14 days after infection. The common sings and symptoms of typhoid fever include the following: FIRST WEEK 1 Step ladder type fever; the fever is due to presence of bacteria. Fever [usually higher in the evening] - Intermittent Fever initially - Sustained Fever to high temperatures later 2 Severe headache; this is because of high blood pressure due to dilated blood vessels.

SINGS AND SYMPTOMS:

SINGS AND SYMPTOMS EPISTAXIS; it is due to rapture of vessels because of high pressure of blood due to high fever Anorexia this is due to impaired metabolism because of antibodies reaction Malaise; Due to invention of bacteria

SINGS AND SYMPTOMS:

SINGS AND SYMPTOMS 6 Drowsiness Constipation is more common than Diarrhea SECOND WEEK Spleenomegaly Dehydration Cough

SINGS AND SYMPTOMS:

SINGS AND SYMPTOMS Abdominal distention Diarrhoea Red rose spot; These are Blanching pink macular spots 2-3 mm over trunk THIRD WEEK Haemorrhage Perforated ulcer Tremours

SINGS AND SYMPTOMS:

SINGS AND SYMPTOMS Muscle weakness Coma

INVESTIGATIONS:

INVESTIGATIONS HISTORY:the history will reviel signs and symptoms. History should also include level of hygene . PHYSICAL EXANINATION: palpitations can be done to examine the spleen. Percussion can also be bone to rule out complications such as perforation LAB INVETIGATION 1 st WEEK Blood culture for the bacteria 2 nd week Stool for MCS

INVESTIGATIONS:

INVESTIGATIONS 3 rd WEEK Urine and stool

Laboratory Exam:

Qurrataini I. Balocang MED IA 20 Laboratory Exam Blood Culture -Best Test Sensitivity in first week Bone Marrow culture -Higher sensitivity than Blood Culture Fecal culture -Low sensitivity (~33%) Salmonella serology ( Widal's Test) -Poor Test Specificity -Low Test Sensitivity (70%)

MEDICAL MANAGEMENT:

MEDICAL MANAGEMENT DRUGS If a case of typhoid fever is diagnosed and confirmed a wide range of antibiotic are available for treatment. Most common antibiotic include: Ampicilin Cefotaxine Ciprofloxacin nalidixic

MEDICAL MANAGEMENT:

MEDICAL MANAGEMENT Tetracycline Chloraphenical : Is a very effective antibiotic in the treatment of typhoid fever. It is given orally in capsule form 0.5g 3 times a day for a week or more. Agranulocytosis may arise from prolonged use of Chloraphenical . In cases where a relapse occurs it should be treated the same way the intiation case was treated.

MEDICAL MANAGEMENT:

MEDICAL MANAGEMENT DIET AND REST Rest and diet should also be emphasised . Diet should be rich in protein

SURGICAL MANAGEMENT:

SURGICAL MANAGEMENT In severe cases surgical intervesion can be employed. Cholecystectomy can be done which is the surgical removal of the gall bladder

NURSING MANAGEMENT:

NURSING MANAGEMENT AIMS To eliminate the causative agent To promote rest and sleep To prevent complications To prevent cross infection

NURSING MANAGEMENT:

NURSING MANAGEMENT ENVIROMENT Because the germ is passed in the feces of infected people, only people with active diarrhea who are unable to control their bowel habits (infants, certain handicapped individuals) should be isolated . Vistors should be allowed and their should be provided with disinfected personal protective wear to prevent cross infection .

NURSING MANAGEMENT:

NURSING MANAGEMENT Health workers should also wear protective wear when attending to the patient Other isolation techniquis such as; Hand washing Marked utensils Regarding screens as clean, etc Should be practiced to prevent sprayed of infection.

NURSING MANAGEMENT:

NURSING MANAGEMENT POSITON

NURSING MANAGEMENT:

NURSING MANAGEMENT NUTRITION Easily digested food should be given to the patient. High fiber diet is appropriate to over came the constipation. Food rich in proteins should be given for the repair and growth of cells that are damaged in the intestine, but food should be given in small amounts but increased gradually as the patient tolerant. Plenty of fluids should be given in order to add up to the lost fluid in diarrhoea . Vitamins should be given in high amounts for boosting the immune system

NURSING MANAGEMENT:

NURSING MANAGEMENT HYGIENE

NURSING MANAGEMENT:

NURSING MANAGEMENT ELIMINATION

NURSING MANAGEMENT:

NURSING MANAGEMENT OBSERVATION

NURSING MANAGEMENT:

NURSING MANAGEMENT PSYCHOLOGICAL CARE

NURSING MANAGEMENT:

NURSING MANAGEMENT REST AND SLEEP

NURSING MANAGEMENT:

NURSING MANAGEMENT EXERCISE