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C. Major Non- Communicable Diseases
TABLE 1
CARDIOVASCULAR
DISEASES
Risk Factors
Prevention and Control
a) Hypertension




Heredity
Advancing Age
Race
High salt intake




Obesity
Excess alcohol intake
Stress
Contraceptive drugs




b) Coronary Artery Disease
 Hyperlipidemia
 Hypertension
 Smoking




Diabetes mellitus
Obesity
Sedentary lifestyle
Stress





Proper nutrition
Maintenance of ideal body weight
Smoking cessation
Early detection and modification of risk
factors
Regular exercise
Proper nutrition
Maintenance of ideal body weight
Smoking cessation
Early diagnosis and prompt treatment
Control of DM and HPN

c) Cerebrovascular Disease
CANCER
DIABETES MELLITUS
Type I (IDDM)
Type II (NIDDM)
CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
BRONCHIAL ASTHMA











Advancing age
Heredity
Race
Gender
Hypertension
Smoking
Diabetes mellitus
Heredity
Carcinogens
Chemicals
Environmental agents






Heart disease
High RBC count
Season and climate
Socioeconomic factors
Excessive alcohol intake
Drug abuse






Treatment and control of HPN
Smoking cessation
Prevention of thrombus formation
Limited alcohol consumption
Avoidance of drug abuse and cocaine
Prevention of atherosclerosis




Benzopyrene
Nitrosamines
Radiation
Viruses








Heredity
Overweight and obesity
Sedentary lifestyle
Hypertension
Hyperlipidemia
Smoking
Chronic bronchitis
Emphysema
 History of gestational DM
 Delivery of baby weighing 9lbs
 Previously identifies to have IGT









Smoking cessation
Proper nutrition
Limited alcohol intake
Maintenance of ideal body weight
Early diagnosis and prompt treatment
Maintenance of ideal body weight
Proper nutrition
Regular exercise
Smoking cessation
 Genetic predisposition
 Atopy/ allergy
 Smoking cessation
 Smoking
 Air pollution
 Recognition of triggers that exacerbate
asthma




Airway hyperresponsiveness
Gender
Race
Allergens







Respiratory infections
Parasitic infections
Socioeconomic factors
Family size
Diet and drugs
Obesity
Asthma triggers
 Avoidance of triggers
 Promotion of exclusive breastfeeding
(Continuation of table 1)
COMMUNICABLE DISEASE PREVENTION AND CONTROL
A. Infection- implantation and successful replication of an organism in the tissue of the host resulting to signs and symptoms as well as
immunologic response.
B. Chain of infection
Agent
Portal of exit
Reservoir
Portal of entry
Mode of transmission
susceptible host
C. Stages of infection
Incubation period
Illness stage
Prodromal stage
Convalescence
D. General care of patients with Communicable Diseases
 Health education
 Immunization
 Environmental sanitation
 Infection control
Table 2. Bacterial Infections
AGENT
TUBERCULOSIS
 Mycobacterium
tuberculosis
 M. Africanum
 M. Bovis
INCUBATION
PERIOD
 2-10 weeks
PERIOD OF
COMM.
 All throughout his
lifetime if untreated
MOT
 Airborne/
droplet
CLINICAL
MANIFESTATIONS
 Fever in the afternoon
 Night sweats
 Body malaise
 Weight loss
 Dry productive cough
 Dyspnea
NURSING INTERVENTIONS
 Immunize newborn, infants, and
grade school entrants with BCG
vaccine.
 Provide medical, laboratory and x-ray
facilities for examination of patients,
contacts and suspects as well as for
 Hoarseness of voice
 Hemoptysis
 Occasional chest pains
 Sputum positive for AFB
early treatment of cases.
 Perform diagnostic evaluation such as
sputum and smear culture, chest xray, and tuberculin skin test
 Give prescribed anti-TB drugs
Treatment: Rifampicin,
Isoniazid,
Pyrazinamide, Ethambutol,
Streptomycin
DOH Program: National Tuberculosis
Control Program
LEPROSY
 Mycobacterium
Leprae or Hansen’s
Bacillus
 5 ½ months
to 8 years
 Respiratory
droplet
 Inoculation
through skin
break and
mucous
membrane
 Early stage: Change in skin
color (reddish or white), loss
of sensation on the skin
lesion, decrease/loss of
sweating and hair growth on
the lesion, thickened and/or
painful nerves, muscle
weakness/ paralysis of
extremities, pain and
redness of the eyes, nasal
obstruction/ bleeding,
unhealed ulcers
 Late stage: Madarosis,
lagophthalmos, clawing of
the fingers/ toes,
contractures, sinking of the
nose bridge, gynecomastia,
chronic ulcers
 Administer BCG vaccination,
particularly to infants and children.
 Promote community health through
participation in:
- Seminars, workshops or
consultative meetings of other
GOs and NGOs on leprosy control
- Tri-media dissemination of leprosy
facts and NLCP-MDT Program
- Use pads, wooden handles of
utensils (hand protection), special
shoes with paddled soles (feet
protection)
- Urgent prevention of injuries to
hand, feet, and eyes to prevent
deformities
 Recommend the patient, if
necessary, to other health and allied
workers such as the physician,
dentist, social worker,
physiotherapist, mental hygienist,
occupational therapist
 Provide and arrange for home
rehabilitation.
Treatment: Rifampicin, Dapsone,
Ofloxacin,Clofazimine, Minocycline
DOH Program: National Leprosy
Control Program
DIPTHERIA
 Corynebacterium
diptheriae (KlebsLoeffler bacillus)
 2-5 days
 2-4 weeks in
untreated patients
 1-2 days in
treated patients
 Contact with
patient/
carrier or with
articles soiled
with
discharges of
infected
persons
 Nasopharyngeal and
tonsillar diphtheria: Malaise,
low grade fever, anorexia,
whitish-gray membranous
patch on tonsils, lymph node
swelling, fever, rapid pulse
 Nasal diphtheria: Coryza
with increasing viscosity,
 Immunize with three doses of
Diphtheria, Pertussis, and Tetanus
(DPT) toxoid at 4-6 weeks intervals
and then booster doses the following
year after the last dose of primary
series and another dose on the 4th or
5th year of age to all infants (6
weeks) and children.
existaxis, low-grade fever,
whitish-gray membrane may
appear on nasal septum
 Laryngeal diphtheria: fever,
harsh voice, barking cough,
respiratory difficulty with
inspiratory retraction
ANTHRAX
 Bacillus anthracis
 9 hours- 2
weeks



CHOLERA
 Vibrio cholerae
 Few hours to
5 days;
usually 1-3
days
 Stool positive
stage
 Carrier may have
organism for
several months
Direct
contact
Indirect
contact
Airborne
 Fecal- oral
 Cutaneous form:
Characterized by itching,
presence of papules which
become vesicles that evolve
to depressed black eschars.
These become painful
lesions, which if untreated,
cause death.
 Inhalational Form:
Characterized by mild
symptoms like that of
common upper respiratory
tract infection; after 3-5
days, symptoms become
acute, with fever and shock
resulting to death.
 Gastrointestinal form:
Characterized by violent
gastroenteritis, vomiting,
bloody stools leading to
death
 Sudden onset of acute and
profuse colorless diarrhea,
vomiting, severe
dehydration, muscular
cramps, cyanosis, collapse
(severe cases)
 Instruct clients on milk
pasteurization.
Treatment: Diphtheria antitoxin,
antibiotics (penicillin or erythromycin),
tracheotomy, if airway obstruction
occurs.
 Immunize high risk with cell free
vaccine
 Conduct health education on
handling potentially contaminated
articles of anthrax transmission, care
of skin abrasions, and personal
cleanliness.
 Prompt and continuous immunization
of animals at risk
Treatment: High dose penicillin
 Conduct stool examination of all the
contacts and treatment as well if found
positive
 Hospitalize patient for proper isolation
as well as for prompt and competent
medical care
 Explain treatment such as rehydration
or replacement of lost fluids and
electrolytes (NaCl, K, and bicarbonate)
Treatment: Isotonic saline solution,
isotonic sodium bicarbonate or
sodium lactate or oral glucose
electrolyte solution, Docycycline
(severe cases)
DOH Program: Integrated
Management of Childhood Illnesses;
Oresol Therapy
PERTUSSIS
 Hemophylus
pertussis or Bordet
gengou or Bordetella
pertussis, or
pertussis bacillus
 7-14 days
 7 days after
exposure to 3
weeks after typical
paroxysms
 Direct
 Indirect
through solid
linens
 Droplet
 Stage I (Catarrhal stage):
Coryza, sneezing tearing,
tickling/ dry cough, fever, loss
of appetite
 Stage II (Paroxysmal stage):
Severe, violent coughing in
clusters leading to vomiting,
cyanosis, exhaustion
 Stage III (Convalescent
stage): Decrease coughing
attacks but return with each
respiratory infection
 Routine immunization of DPT to all
infants given starting at 1 ½ months,
once month for three months
consecutively, booster at two years
and four to five years of age
 Segregation of the patient until after
three weeks from the appearance of
paroxysmal cough
 Conduct health education
 Follow the general care for nose and
throat discharges
 Train parents on handling an infant or
a child during paroxysmal cough, e.g.
giving abdominal support
 Modify diet if patient vomits after cough
paroxysms
Treatment: DPT vaccine, antibiotics
(erythromycin and ampicillin),
corticosteroids
DOH Programs: Expanded Program
for Immunization
PNEUMONIA
 Streptococcus
pneumonia
 Staphyloccocus
aureus
 Haemophilus
influenzae
 Klebisiella
pneumoniae
 1-3 days
 Droplet
 Indirect
through
contaminated
objects
 Rhinitis/ common cold, chest
indrawing, rusty sputum,
productive cough, fast
respiration, high fever,
vomiting at times,
convulsions, flushed face,
dilated pupils, severe chills
(young children), pain on
 Advise bed rest
 Provide a diet with adequate salt, fluid,
calories, and vitamins.
 Perfom tepid sponge bath (for fever).
 Advise the client to turn from side to
side, frequently.
Treatment: Cotrimoxazole, amoxicillin,
procaine penicillin
affected lung, highly colored
urine with reduced chlorides,
increased urates
BACILLARY
DYSENTERY
 27 zero-types of
germs Shigella
(dysentery bacillus)
 Four main groups: S.
Flexneri, S. Boydii, S.
Sonnei, S. Dysenterae
TYPHOID FEVER
 Salmonella typhosa,
typhoid bacillus
MENINGITIS
 Neisseria
miningitidis
 7 hours to 7
days; average of
3-5 days
 5-40 days; 
average of
10-20 days
 1-10 days
 During acute
infection until feces
are negative of the
organism
 Some remain
carriers for 2 years
As long as patient
excretes organism 
DOH Program: Integrated Program for
Childhood Illnesses
 Ingestion of
contaminated food/
water
 Flies
 Fecal- oral
 Fever and headache
 Cramping and abdominal
pain
 Persistent diarrhea
(passage of varying
amounts of blood, mucus
and pus)
 Profound prostration
 Encourage medical care for any
case of diarrhea
 Obtain stool specimens from a
person with undiagnosed diarrhea
and request examinations for
pathogens.
 Encourage the patient to eat the
therapeutic diet (low fiber, liberal
fluids).
Treatment: Ampicillin,
tetracycline, cotrimoxazole (severe
cases)
DOH Program: Integrated
Management of Childhood
Illnesses
 Fecal-oral
Ingestion of
contaminated
food, water, milk
 Continued fever, malaria,
anorexia, slowed pulse,
involvement of lymphoid
tissues particularly
ulceration of Peyer’s
patches, enlargement of
spleen, rose spots on
trunks, diarrhea
 Ask the family to report any
bleeding in the rectum, blood in
stools, sudden acute abdominal
pain, restlessness, falling of
temperature to the physician.
 Take TPR (Temperature, Pulse
and Respiration) and train the
family on taking and recording the
same. Demonstrate the procedure
of bedside care like tepid sponge
bath, feeding, changing of linen,
use of bedpan, and mouth care.
 Hospitalize the patient, if
necessary.
 Respiratory
droplet
 Direct invasion
through otitis




 Assess neuro vital signs
 Monitor fluid balance
 Position carefully to prevent joint
stiffness and neck pain
Fever
Brudzinki’s sign
Kernig’s sign
Opisthotonus
 Nuchal rigidity
 Exaggerated symmetrical
deep tendon reflexes
media
LEPTOSPIROSIS
 Leptospira
interrogans
 6-15 days
 10-20 days after
onset
 Ingestion or
contact with nonintact skin and
mucous
membrane by
infected urine or
carcasses of wild
and domestic
animals
 Adequate nutrition and elimination
 Aseptic technique
 Isolation if nasal culture is positive
Treatment: IV antibiotics
(ampicillin, cephalosporin,
aminoglycosides)
 Leptospiremic Phase:
Presence of leptospires in the
blood and cerebrospinal fluid,
with abrupt onset of fever,
headache, myalgia, nausea,
vomiting, cough, chest pain
 Immune Phase: Appearance
of circulating IgM
 Conduct health educationon
topics such as rat eradication,
keeping the surrounding’s
clean
 Investigate contacts and
source of infection
Treatment: Penicillin, other
related B-lactam antibiotics,
tetracycline (doxycycline),
erythromycin (in patients
allergic to penicillin)
Viral Infections
AGENT
DENGUE FEVER
 Dengue virus
Types 1,2,3,4
and
chikungunya
virus
INCUBATION
PERIOD
PERIOD OF
COMM
MOT
CLINICAL
MANIFESTATIONS
NURSING INTERVENTIONS
 3-14 days;
commonly
7-10 days
 Infective to
mosquito from a
day before the
febrile period to
the end of it
 Mosquito
becomes
infective from
day 8-12 after
the blood meal
and all
throughout life
 Bite of an infected
mosquito (Aedes
aegypti, Aedes
albopictus, Aedes
polynensis, Aedes
scutellaris
simplex)
 First 4 days (Febrile or
invasive stage): high 
fever, abdominal pain
and headache, later
flushing which may be
accompanied by
vomiting, conjunctival
infections and epistaxis
 4th-7th day (toxic or
hemorrhagic stage):
lowering of temperature,
severe abdominal pain,
vomiting and frequent
bleeding in the GI tract
 Isolate the patient.
Conduct epidemiological investigation.
 Immediately refer all cases, slight or severe,
that exhibit symptoms of hemorrhage from
any part of the body to the nearest hospital.
 Organize health education programs on
environmental sanitation particularly on
eliminating mosquitoes.
 Investigate the cause of the disease.
 Keep the patient at rest.
 Maintain an elevated position of trunk and
promote vasoconstriction in nasal mucosa
membrane through an ice bag over the
forehead (nose bleeding)
in the form of
hematemesis and
melena, unstable BP,
narrow pulse pressure
and shock; death may
occur
 7th-10th day
(convalescent or
recovery stage):
generalized flushing,
regained appetite,
stable blood pressure)
MEASLES
 Filtrable virus
of measles
INFLUENZA
 Influenza
virus A, B, C
 10-12 days
(longest is
20 shortest
is 8 days)
 24-48
hours

4 days before
and 5 days
after the
appearance of
rashes
 Until 5th day of
illness and up
to 7 days in
children
 Place an ice bag on the abdomen (melena)
 Advise to avoid unnecessary movement
Observe signs of deterioration (shock) like
low pulse, cold clammy skin, and
prostration.
 Prevent shock by preparing the patient
mentally and physically and providing
warmth through lightweight covers
 Encourage the patient to follow a
therapeutic diet i.e. low fat, low fiber, nonirritating, and non- carbonated
 Droplet
 Indirect through
articles/ fomites
freshly
contaminated
with secretions of
infected persons
 Fever, rashes, coryza,
presenc of Koplik’s
spots on the cheeks
and morbiliform rash
affecting the face, body
and extremities ending
in branny
desquamation (3rd or
4th day)
 Emphasize the significance of immediate isolation
when early catarrhal symptoms appear.
 Explain the importance of taking the immune globulin
(gamma globulin). Refer to a physician or clinic
providing this service.
 Protect eyes of patients from bright lights.
 Put the patient in a wee-ventilated room free from
drafts and chilling to avoid complications of
pneumonia.
 Monitor correct technique of giving sponge for
comfort of patient
 Prepare treatment and medication made by the
physician.
 Airborne
 Direct contact
with droplet
 Sudden onset of fever
(39ºC- 40ºC), malaise,
sore throat, cough,
rhinorrhea, headache,
myalgia
 Gastrointestinal
symptoms: Nausea,
vomiting, abdominal
pain, diarrhea
 Quarantine the patient during the acute stage.
 Immediately report the cases to local health officer.
 Instruct the client on proper sneezing and coughing
techniques as well as proper disposal of
contaminated objects
 Keep the patient warm and without drafts in bed. Use
lukewarm sponge for fever.
 Advise patients to stay in bed during epidemics.
Treatment: Aspirin or acetaminophen in children
(uncomplicated cases), amantadine, oseltamivir
phosphate, zanamivir (antiviral agents)
SEVERE ACUTE
RESPIRATORY
SYNDROME
 SARS CoV,
new virus
from
Coronavirus
family
HEPATITIS A
 Hepatitis virus
A
 2-10 days
after
exposure
to a SARS
case
 15-60 days;
average 30
days
 Person-to-person
through respiratory
droplets
 Direct contact with
body fluids of an
infected person
 Fomites or orofecal
spread, aerosol
transmission
(uncommon)
 1 week before
and 1 week after
the appearance
of symptoms
 Fecal-oral, poor
sanitation, personto-person,
waterborne, foodborne (shellfish),
blood transfusion
 Prodromal period:
Sudden onset of fever:
(>38ºC), cough,
myalgia, chills,
headache and body
malaise
 Lower Respiratory
Phase: Severe, dry,
non-productive cough,
shortness of breath
and/or difficulty in
breathing, progressing
to hypoxemia
 Laboratory Findings:
CXR may be normal
(febrile prodrome), may
show early infiltrates
progressing to more
generalized patchy,
interstitial infiltrates;
respiratory distress
syndrome (severe
cases); low white cell
and platelet count and
abnormal liver function
(some)
 Other symptoms:
muscular stiffness,
confusion, dizziness,
rash, night sweat,
nausea, diarrhea
 Body malaise,
headache, anorexia,
abdominal pain,
nausea and vomiting,
fever,
lymphadenopathy,
 Precautions, written below must be taken when
entering all ICU, MICU, CCU, SICU, and respiratory
therapy units, regardless of whether the hospital or
unit is known to have SARS cases.
 Leave all personal belongings, not relevant to the
visit in the unit.
 Before entering the unit, wear N95 or FFP-1 grade
mask, eye protector (goggles), hair cover or cap,
long sleeves solid front disposable laboratory gown,
rubber gloves (in handling equipment), and shoe
cover.
 Spread paper towel on the working surface.
 Sterilize equipment according to hospital procedures
by a member of the ICU staff before returning it to
the office.
 Give immune globulin intramuscularly or
subcutaneously within a few days of exposure.
 Use hand gloves in handling bedpans and fecalcontaminated linens
 Advise the patient to rest during acute or
symptomatic stage
(rare)
RABIES
Rhabdovirus
 1 week- 7
days and
half months
in dogs
10 days-15
years in
human
 3-5 days before
the onset of
symptoms until
the entire
course of illness
Bite of infected
animals
jaundice, clay-colored
stools
 Incubation Period:
Signs of inflammation
and wound healing
 Prodrome (2-10 days
non-specific): Malaise,
anorexia, fatigue,
fever, headache,
apprehension, anxiety,
agitation, irritability,
depression, insomnia
 Acute Neurologic/
Excitation Stage (2-7
days):
 Observe signs of CNS
involvement like
hydrophobia,
hyperactivity, aphasia,
disorientation,
hallucinations,
seizures, bizarre
behavior, nuchal
rigidity, increased deep
tendon reflexes
 Paralysis Stage: Coma
and/or sudden death
VARICELLA
 Herpes virus
varicellae
 10-21 days
 direct contact with
vescicles of
infected patients
 indirect through
linens and fomites
 airborne-droplet
 Pre-eruptive stage:
mild fever and malaise
 Eruptive stage:
 Rash starting from the
trunk spreading to the
other parts of the body
 Red papules where
contents become milky
and pus-like in 4 days
 Vescicular lesions
which are pruritic
Treatment: Gamma globulin vaccine
 Know the history of exposure and development of
characteristic symptoms.
 Note for the presence of rabies antibodies in the
patient’s blood and Negri bodies in samples of brain
tissue of infected animal.
 Immediately wash the wound and the surrounding
area with soap and water.
 Bring the patient to Emergency Department for
further cleansing and flushing of wound.
 Administer tetanus prophylaxis and antibacterial
therapy, as required.
 Recommend the use of active and passive
immunization.
Treatment: Antiseptics (povidone iodine, alcohol),
tetanus-diphtheria vaccine, rabies immune globulin
(Rig), human diploid cell vaccine
DOH Program: National Rabies Prevention and
Control Program





Respiratory isolation
Proper hygiene
Disinfect linens under the sunlight or through boiling
Cut fingernails short
Pruritus control
Treatment: Zoverax, Acyclovir, Antipyretic
Parasitic Infections
AGENT
SCHISTOSOMIASIS
 Schistosoma
japonicum
 S. mansoni
 S. haematobium
PARALYTIC SHELLFISH
POISONING
 Pyromidium
bahamamense var.
compressum
INCUBATION
PERIOD
 2 mos
 GIT
MOT
 ingestion of contaminated
water
 direct contact with open
skin through an
intermediate host
(oncomelania quadrasi)
 diarrhea, bloody stools,
enlargement of abdomen,
splenomegaly, weakness,
anemia, inflamed liver
 Eating of raw or
insufficiently cooked
 Numbness of the face,
particularly around the mouth,
vomiting,
seafood ( shellfish,
mollusks) during red tide
season
PARAGONIMIASIS
 Paragonimus
westermani
HELMINTHIASES
a. Hookworm infestation
 Ancylostoma
duodenale
b. Roundworm infestation
 Ascaris lumbricoides
CLINICAL
MANIFESTATIONS
 GIT
 Eating raw/ half- done
crab’s meat
 Skin (bare
feet)
 GIT
 Direct contact through skin
of foot
 Fecal-oral
NURSING INTERVENTIONS
 Examine contacts for infection from a common
source
 Convince the people to have a stool
examination annually
Treatment : Praziquantel, Oxam niquine (S.
mansoni), Metrifonate (S. haematobium)
dizziness, headache, tingling
sensation, paresthesia, eventual
paralysis of hands and feet,
floating sensation, weakness,
rapid pulse, ataxia, dysphagia
(severe cases) total muscle
paralysis with respiratory arrest
resulting to death
 Induce vomiting
 Remind the people on the following:
a.
b.
Bivalve mollusks (talaba, halaan, kabiya,
abaniko) should be avoided during red tide
season.
Vinegar hastens Pyromidium (toxin)
production; cooking does not completely
destroy the toxin
 Cough (long duration), coughing  Treat infected person.
out of blood/ blood streaked
 Dispose human feces properly.
sputum
Treatment: Praziquantel and Bithionol
a. Hookworm infestation
 Irritation, pruritus, and edema
at the site of entry with
pustule formation,
pneumonitis, hemorrhage with
fever, sore throat, crackles
and cough, fatigue, nausea,
weight loss, dizziness,
melena, uncontrolled
 Treat infected individual
 Conduct health education on personal hygiene,
proper feces disposal, and proper handling,
processing, and serving of pork and its
products.
 Encourage the use of shoes and slippers in
walking on the soil.
 Discourage use of night soil and sewage
effluents as fertilizer.
FILARIASIS
 Wuchereria bancrofti
 Brugia malayi
 Brugia timori
SCABIES
 Sarcoptes scabiei
 Skin
 Skin
 Mosquito (Aedes poecillus)
bite
 Direct contact with infected
individuals, their clothes
and bedding
 Crowding and lack of
personal hygiene
(predisposing factors)
diarrhea, and anemia, which
may lead to cardiomegaly,
heart failure and massive
edema
b. Roundworm infestation
 Vague stomach discomfort
(mild), stomach pain (severe),
vomiting, restlessness,
disturbed sleep, intestinal
obstruction (extreme cases),
pneumonitis (due to migration
of larvae to the lungs)
 Provide foods rich in iron to treat muscle
wasting and anemia of the patient (hookworm
disease).
 Follow-up stool examination 1-2 weeks after the
treatment (ascariasis).
a. Asymptomatic Stage
 Presence of microfilariae in
the blood
 No clinical signs and
symptoms for years or for
life
 Others progress to chronic
and acute stages
 Increase in microfilariae
b. Acute Stage
 Lymphadenitis
 Lymphangitis
 Funiculitis
 Epidydimitis
 Orchitis
c. Chronic Stage
 Hydrocele
 Lymphedema
 Elephantiasis
 Advocate control of vector through
implementation of environmental sanitation and
use of insecticides
 Primary Symptom: severe
itching, specifically at night
 Frequent scratching leads to
secondary skin infection (feels
hot and burning , a minor
discomfort)
 Wide skin area is infected
Treatment: Mebendazole
Treatment: Diethylcarbamazine Citrate (DEC)
 Examine the whole family for infection.
 Follow the general guideline for control of
infectious diseases.
 Monitor the lesions in infected areas and
systemic manifestation of infection.
 Advise the client to consume a diet rich in
Vitamins A and C.
with severe secondary
infection: fever, headache,
malaise, secondary dermatitis
 Destroy the parasite to relieve itching as well as
to lessen skin irritation.
a. Wash with soap and water; soak, scrub
skin to remove scaling and crusting debris.
b. Apply a scabicide like Lindane 1% (Kwell),
Crotamiton, 6-10% precipitate of sulfur in
petrolatum, benzyl benzoate emulsion for a
more rapid effect.
c. Instruct client or parents to launder all
clothing and bedding with enough heat to
kill mites.
d. Use topical antipruritic to control itching two
to three weeks after destruction.
Sexually Transmitted Diseases
AGENT
AIDS/HIV
 Retrovirus
(Human T-cell
lymphotropic virus
3 or HTLV-3)
MOT
CLINICAL MANIFESTATIONS
NURSING INTERVENTIONS
 Skin contact
 Blood transfusion
 Contaminated syringes,
needles, nipper, razor
blades
 Direct contact with open
 Wounds or mucous
membrane with
contaminated blood, body
fluids, semen, vaginal
discharges
 Prodrome: Fatigue, malaise, fever, weight loss,
lymphadenopathy, persistent diarrhea, recurrent oral
thrush, extensive herpes of mucus membranes,
folliculitis, blue or brown spot on skin (may indicate
Kaposi’s sarcoma)
 Appearance of Disease: Pulmonary syndrome
(dyspnea, hypoxemia, chest pain, pulmonary
infiltration), CNS syndrome (dementia, confusion,
headache, neurologic symptoms), GI syndrome
(diarrhea, weight loss, colitis), fever of unknown origin,
malignancies (Kaposi’s sarcoma)
 Participate in prevention, case-finding and
supportive care during management of AIDS cases.
 Protect oneself form being infected through
 Careful handling of sharp instruments contaminated
with potrentially infectious material from AIDS
patients
 Preventing contact of open skin lesions with material
from AIDS patients.
 Wearing gloves and gowns as protection from
contamination
 Thorough washing of hands immediately after
contact with patients
 Label contaminated blood and specimens.
 Clean blood spills with a disinfectant solution like
sodium hypochlorine (household bleach).
 Place contaminated articles in impenetrable bag and
label properly.
 Place needles in a puncture resistant container.
Disposable needles are preferred.
Treatment: Reverse Transcriptase inhibitors, Protease
inhibitors.
DOH Programs: 4C’s in the Management of AIDS
 Compliance
 Counseling
 Contact tracing
 Condoms
GONORRHEA
 Neisseria
gonorrheae
SYPHILIS
 Treponema
pallidum
 Sexual activity, orogenital
and/or anogenital
contacts
 Incubation period: 3-21
days; average of 3-5
days
 Period of comm.: as
long as the
microorganism is present
 Women: vaginal discharge/ abnormal uterine bleeding,
urinary frequency and pain, pelvic infection, nausea
and vomiting, fever, abdominal pain/ tenderness,
disseminated gonococcal infection
 Men: Acute anterior urethritis, purulent discharge
followed by painful urination, spread of infection to
posterior urethra, prostate, seminal vescicles and
epidydimis, prostatitis, pelvic pain, fever, epidydimitis,
post gonococcal urethritis and urethral stricture
 Anorectal Manifestations: Anal and rectal burning,
itching, bleeding, mucopurulent discharge or painful
defecation (may be asymptomatic)
 Pharyngeal Manifestations: Sore throat but may be
asymptomatic
 Adult Gonococcal Conjunctivitis: (Gonococci usually
reach the eyes through the fingers
 Sexual contact
 Blood transfusion
 Transplacental route
 Incubation period: 10-90
days. Average of 3 weeks.
 Period of comm.: variable
and indefinite
 Primary Syphilis: Appearance of a painless, firm and
smooth chancre at the inoculation site, regional
lymphadenopathy, early invasions of the blood
 Secondary Syphilis: Healed chancre, widespread
skin (palms and soles) and mucous membrane rash,
presence of treponema in lesions, lymphadenopathy,
fever, involvement of various organs such as liver,
eyes, bones, and CNS
 Latent Syphilis: Absence of clinical symptoms, (+)
serological test for the organism
 Tertiary Syphilis (5-30 years after the primary syphilis):
Paralysis, delusions, blindness, deafness, tabes
dorsalis gait, cardiovascular abnormalities, presence
of gummata
 Congenital Syphilis: Miscarriage, stillbirth, bone
malformation, widespread skin rash, meningitis,
 Follow the nursing interventions in the Nursing
Process for Control and Management of Infectious
Diseases.
 Advocate regular check-ups for persons at risk.
Treatment: Ceftriaxone, Doxycycline, Penicillin





Universal precautions
In secondary syphilis, keep lesions dry
IN Cardiovascular syphilis, Check CV status
In neurosyphilis, Check LOC, and neurovital signs
Encourage patient to have a post treatment followup.
 VDRL testing

Treatment: Penicillin G
hepatosplenomegaly
CHLAMYDIA
 Chlamydia
trachomatis
 Sexual and congenital
contact ( children born
from infected mother may
acquire associated
conjunctivitis, otitis
media, and pneumonia
during vaginal delivery).


Women: slight vaginal discharge (sometimes), itching
and burning of vagina, painful intercourse, abdominal
pain, fever (late stages)
Men: Discharge from penis, burning and itching of
urethral opening, burning sensation during urination
 Control the discomfort and improve the fluid and
nutritional status.
 Give analgesics for abdominal discomfort.
 Apply heat to the abdomen externally and warm
douches vaginally as prescribed to improve
circulation.
 Control the infection.
 Follow the guidelines for asepsis.
 Give appropriate antibiotics and chemotherapeutic
agents as prescribed.
 Place the patient in a Semi-fowler’s position to
facilitate drainage.
 Discourage use of tampons.
 Monitor and document the progress of the patient
(vital signs, responses to therapy, nature and
amount of vaginal discharge.
 Disinfect utensils, bedpans, toilet seats, and linens.
 Encourage use of contraceptives after the
completion of treatment.
 Prevent complications from untreated or recurrent
infection.
Treatment: Doxycycline, Azithromycin
TRICHOMONIASIS
 Trichomoniasis
vaginalis
HEPATITIS B
 Hepatitis B virus
 Sexual contact
 Contact with wet objects
 Contact with infected
blood through broken
skin and mucous
membrane of mouth,
rectum, genitals
 Sexual contact
 Using contaminated
personal items (razor,

Women: white or greenish-yellow odorous discharge,
vaginal itching soreness, painful urination
 Loss of appetite, easy fatigability, malaise, joint and
muscle pain, low grade fever, nausea, vomiting, right
sided abdominal pain, jaundice, dark-colored urine
 Incubation Period: 50-189 days or 2-5 mos; average
of 90 days
 Period of comm.: During the latter part of the
incubation period and during the acute phase
 Same as in other STDs.
 Give oral medications, as prescribed by the
physician.
 Perform the applicable guidelines in the control of
infectious diseases.
 Immunize against Hepatitis B, particularly infants and
at- risk groups, with negative HB- Ag test
 Practice asepsis in handling body fluids and dealing
with clients
nail clipper, toothbrush)
that may cause skin
break.
 Use of contaminated
instruments for injection,
ear piercing,
acupuncture, tattooing.
 Use of contaminated
hospital and laboratory
equipment (e.g. dialysis
apparatus)
 Prenatal transmission