Nursing Care Plan for Typhoid Fever

Typhoid fever is a systemic infection characterized by continued fever, malaria, anorexia, slow pulse, involvement of lymphoid tissues, especially ulceration of Peyer's patches, enlargement of spleen, rose spots on trunk and diarrhea. Many mild typical infections are often unrecognized. A usual fatality of 10% is reduced to 2 to 3% by antibiotic therapy.

Etiologic Agent: Salmonella typosa, typhod bacillus

Source of Infection: Feces and urine of infected persons. Family contacts may be transient carrier. Carrier state is common among persons over 40 years of age especially females.

Mode of Transmission: Direct or indirect contact with patient or carrier. Principal vehicles are food and water. Contamination is usually by hands of carrier. Flies are vectors.

Incubation Period: Variable; average 2 weeks, usual range 1 to 3 weeks.

Period of Communicability: As long as typhoid bacili appear in excreta; usually from appearance of prodromal symptoms from first week throughout convalescence.

Susceptibility, Resistance and Occurence: Susceptibility is general although many adults appear to acquire immunity through unrecognized infections. Attacks rates decline with age after second or third decades. A high degree of resistance usually follows recovery.

Methods of Prevention and Control: Same preventive and control measures as in Dysentery and in addition, immunization with a vaccine of high antigenecity. Education of the general public and particularly the food handlers.

Public Health Nursing Responsibility: Teach members of the family how to report all symptoms to the attending physician especially when patient is being cared for at home. Tech, guide and supervise members of the family on nursing techniques which will contribute to the patient's recovery.

Interpret to family nature of disease and need for practicing preventive and control measures.

Nursing Care
Demonstrate to family how to give bedside care, such as tepid sponge, feeding, changing of bed linen, use of bedpan and mouth care.
Any bleeding from the rectum, blood in stools, sudden acute abdominal pain, restlessness, falling of temperature should be reported at once to the physician or the patient should be brought at once to the hospital.
Take T.P.R. and teach family member how to take and record same.

Nursing Care Plan for Cholera

A cholera is an acute serious illness characterized by sudden onset of acute and profuse colorless diarrhea, vomiting, severe dehydration, muscular cramps, cyanosis and in severe cases collapse.

Etiologic Agent: Vibrio El Tor

Sources of Infection: Vomitus and feces of infected persons and feces of convalescent or healthy carriers. Contacts may be temporary carriers.

Mode of Transmission: Food and water contaminated with vomitus and stools of patients and carriers.

Incubation Period: From few hours to 5 days; usually 3 days

Period of Communicability: 7-14 days after onset, occasionally 2-3 months.

Susceptibility, Resistance and Occurrence
Susceptibility and resistance general although variable. Frank clinical attacks confer a temporary immunity which may afford some protection, for several years.
Immunity artificially induced by vaccine is of variable and uncertain duration.
Appears occasionally in epidemic form in the Philippines
Methods of Prevention and Control

Report case at once to Health Officer.
Bring patient to hospital for proper isolation and prompt and competent medical care.
Other general preventive measures are the same as those of Typhoid and Dysentery.
All contacts of the cases should submit for stool examination and be treated accordingly if found or discovered positive.
Public Health Nursing Responsibilities

Assist family and patient to make arrangement for immediate hospitalization.
Give necessary measure to control spread of the disease.
Share with patient and family the nature of the treatment - Rehydration/replacement of lost fluids and electrolytes (Sodium chloride, Bicarbonate and Potassium).
Nursing Care

Continue and increase frequency of breastfeeding.
Give additional fluids.
Coconut water is said to be rich in potassium, one of the electrolytes found in choleric stools.
Make patients as comfortable as possible.
Give ORESOL according to required amount based on age.