COMMUNICABLE DISEASES 2.4, 5.

22 o ex: virus, bacteria, fungi, spores

 Reservoir
 Transferrable diseases
o harbors disease condition
TERMS: o home of agent
o ex: animals, fomites
 Infectious – transmitted from one person to
 Exit
another; needs prolonged contact; ex: leprosy
o how disease comes out of reservoir
 Contagious – “ easily” tramsmitted; short
o ex: sneeze, blood, vesicles
exposure; ex: COVID 19
 MOT (Mode of Transmission)
 IP - Incubation period: time frame between
o agent’s method of transfer
infection and when symptoms appear
o agent’s weakest link – where chain of
 CA – causative agent
infection is easily broken  ex:
 Isolation vs reverse vs quarantine:
HANDWASHING, PPE
o Isolation – when person’s
o ex: droplet, oro-fecal
communicable ds condition is
confirmed, avoid getting others sick;  Entry
NEGATIVE AIR PRESSURE o How disease enters susceptible host
o Reverse Isolation – avoid o Ex: mouth, nose, skin, mucus
immunocompromised px from getting membranes
sick; POSITIVE AIR PRESSURE
o Quarantine – suspected px already
isolated, can put together ppl with DISEASE CONDITIONS
same condition; NEGATIVE AIR PERTUSSIS
PRESSURE
 Aka Whooping Cough
 IP: 7-14 days
EPIDEMIOLOGY – occurrence of disease condition in  CA: Bordetella pertussis
certain geological area  MOT: droplet & direct contact
 S/Sx:
 Sporadic o Catarrhal stage
o isolated cases, rare, once in a blue  Stage of increased
moon communicability
o ex: meningitis, leprosy  Flu-like symptoms (cough,
 Endemic colds, fever, body malaise)
o constantly occurring o Paroxysmal stage – paroxysms of cough
o ex: coughs and colds (pathognomonic/ hallmark sign)
 Epidemic o Convalescent stage – recovery &
o “outbreak”, increase of more than 50% healing
of the previous cases  Med Mngt:
o ex: dengue (rainy season) o O2 therapy
 Pandemic o Fluid & electrolytes (too much cough 
o worldwide (3 or more countries vomiting)
affected) outbreak o Erythromycin and ampicillin (broad-
o ex: COVID, AIDS, SARS, EBOLA spectrum antibiotics) – finish duration
to prevent drug resistance
o Bed rest
CHAIN OF INFECTION (SHARE ME) o Gammaglobulins – activates immune
system
 Susceptible Host – humans
 NSG Mngt:
 Agent – causative/ cause of disease conditions
 o Isolation  3 C’s: cough, coryza,
o Medical asepsis conjunctivitis
o Suction machine  Photophobia (dim lights, dark
o Sunshine & fresh air colored glasses, large brim
o Warm bath – good for bronchodilation hats/ sun visors)
 Rhinitis
o Eruptive stage
DIPTHERIA  Maculopapular rashes
 Intermittent fever
 CA: Corynebacterium Diptheriae o Convalescent stage – sx subsides
 IP: 1-5 days  Med Mngt:
 MOT: direct contact or soiled articles (fomites) o Antiviral: isoPRINOsine
 TYPES: o Antibiotics (Penicillin) if there is
o Nasal: white membranes on nasal complications
septum  obstruction o O2 therapy – cough and colds esp in
o Nasopharyngeal: “bull’s neck” – white children
membranes on neck  obstruct airway o IV fluids – dysphagia d/t kopliks
(dangerous!)  Nsg Mngt:
o Cutaneous: yellow spots in the skin o Isolation
 Pathognomonic sign: PSEUDOMEMBRANES o Quiet room
 Med Mngt: o Dim lights
o Penicillin o TSB  bed bath
o Diptheria antitoxin o Increase OFI
o Ice collar – applied to neck to prevent o MMR & anti measles vaccines
inflammation and pain on bull’s neck
o O2 therapy/ inhalation – maintain SpO2
& perfusion GERMAN MEASLES
o Bed rest
o *TRACHEOSTOMY SET ON BED SITE  Aka Rubella/ 3-day measles/ Tigdas hangin
 Nsg Mngt:  CA: Rubella Virus
o Absolute bed rest for 2 weeks  IP: 14-21 days
o Avoid valsalva maneuver – may cause  MOT: airborne, droplet, transplacental
bleeding  Phatog: Forsheimer’s spots: pinkish rash on the
o Soft diet – dysphagia d/t bull’s neck soft palate
(porridge, pureed foods)  S/sx:
o Vit C - enhance immune system, repair o Prodromal:
of tissues  Low grade fever
 Mild coryza
 Lymphadenopathy
MEASLES o Eruptive:
 Forsheimer’s spots
 Aka Rubeola/ Morbilli/ Tigdas  Testicular pain  slight
 CA: Rubeola Virus possibility of sterilization
 MOT: airborne (>3ft) and droplet (<3ft)  Polyarthralgia (joint pain)
 IP: 1-2 weeks  already infectious o Convalescent: recovery
 Pathog: Koplik’s spots – inflammation lesions in  Med Mngt: Symptomatic tx
the inner cheek or buccal mucosa  Nsg Mngt:
 S/Sx: o Isolation
o Pre-eruptive/ Catarrhal stage o Dim lights
 o Mild (not irritant to throat) but  Aka Elephantiasis
nourishing diet  CA: Wuchereria bancrofti
o Good ventilation  IP: 9-12 months; not exact- may take months to
o MMR vaccine years
o Immune serum globulin  if (+)  MOT: mosquito (aeses poecillus)  need
exposure  activates immune system multiple exposure before infected
 prevents full blown disease process  S/Sx:
o Elephantiasis  enlargement of a body
part, esp. a limb
CHICKENPOX o Headache
o Chills & fever
 Aka Varicella/ Bulutong tubig
o Dolor, tumor, rubor (arms, legs, and
 CA: Herpesvirus varicellae
scrotum)
 IP: 3 weeks
 Dx tests: CFA – Circulating Filarial Antigen 
 MOT: direct contract, fomites
finger prick blood droplet
 S/Sx:
 Med Mngt:
o Fever
o DOC: Hetrazan
o Rash
o Surgery: removal of enlarged scrotum,
 Starts at unexposed part –
extremities
usually trunk  centripetal
o Decrease fortified salt intake  avoid
 Macule  Papule  Vesicle 
urine retention
Pustule  crusted (if all
 Nsg Mngt:
crusted, no longer
o Sleep under mosquito nets
communicable)
o Use mosquito repellants (OFF lotion)
o Celestial maps – scabs/ crust
o Stay indoors at dusk & dawn (active
 Med Mngt:
times of mosquito)
o Zoverax, Acyclovir (Antivirals)
o Antihistamines  crusting itchy 
fresh wound again = communicable
DENGUE FEVER
o Calamine lotion  topical anti itch
o No no to salicylates  may cause  Aka: Infectious Thrombocytopenic Purpura/
bleeding of lesions & REYE’S Breakbone fever/ Dandy (Slave) fever - bc px’s
SYNDROME  swelling brain & liver walk looks like slave
(esp. <8 y/o)  DENGUE HEMORRHAGIC FEVER (DHF)
o May lead to shingles  painful rashes o Result of 2nd dengue infection
usually on torso o Severe form of Dengue  life
o Antipyretics threatening
 Nsg Mngt: o Characterized by bleeding and shock
o Respiratory isolation until all vesicles  DENGUE SHOCK SYNDROME (DSS)
have crusted o The most fatal form of dengue
o Disinfect linens under sunlight or by o Characterized by profound shock –
boiling sudden and fast progression
o Cut fingernails  CA: Flavivirus & Arboviruses
o Use mittens  Vector: Aedes Aegypti – common household
mosquito
 MOT: mosquito bite
FILARIASIS  IP: 14 days, average is 7-10days
 Dx tests:
 Sporadic cases, still happens in PH
o Rumpel Leed test
  Aka tourniquet test In tune of Pamela 1:
 Presumptive screening test only
 Med Mngt:
 Criteria:
o Analgesics
 6months or older
o Hydration:
 Fever >3days
 DHN d/t destruction of platelets
 No signs of DHF
 concentration of blood
 Positive: 10 or more petechiae
 IVF – isotonic fluids
per square inch in the
o O2 therapy
antecubital area
o Sedatives (anxiety or apprehension)
o Platelet count (decreased) –
confirmatory!  Nsg Mngt:
o Dengue spot test – detect IgM & IgG o Do recognize the critical period 
antibodies (serum or plasma) DEFERVESCENCE: fever has subsided
o Dengue Ns1 antigen – rapid Dx and rapid deterioration happens (24-48
hrs)
procedure to test for dengue virus
o WOF: dengue encephalopathy 
 S/Sx: Dengue fever
altered mentation may indicate
o Sudden onset fever (39-40C), chills
intracranial bleeding
o Headache, ocular pain, myalgia,
o Monitor VS  WOF shock
arthralgia
o Proper observations
o Malaise & anorexia
o *Tawa-tawa: DOH - promotes cell
o Rash – maculopapular/ petechial 
production & prevents platelet
appears at end of febrile period
destruction  not recommended
o Abdominal pain & tenderness 
medicine
hepatic involvement
 S/sx: DHF
o Hemorrhagic manifestations 
SCHISTOSOMIASIS
epistaxis, gum bleeding, ecchymosis,
hematemesis, hematochezia (fresh)/  Aka: Bilharziasis/ Snail Fever
melena (dry blood)  CA: Schistosoma Japonicum (bacteria) 
o Phatog sx: Herman’s Sign  skin unique to Ph
appears purple (blood extravasated)  Vector: Oncomelania quadrasi (Snails)
o Hepatomegaly  MOT: ingestion od infected water & thru skin
o Hypovolemic shock pores
 WHO DHF GRADING SCALE  IP: 14-82 days
o Grade I – no shock, (+) tourniquet test  S/Sx:
 butlig & lagnat o Swimmer’s itch (cercarial dermatitis)
o Grade II – no shock, spontaneous o Bloody mucoid stool
bleeding, (+) tourniquet test  dudugo o Phatog: Liver probs  main target of ds
dugo  Icteric
o Grade III – (+) shock!  low BP!  Jaundice
o Grade IV – profound shock,  Dx test:
unmeasurable BP  late sx  NO BP o Confirmatory: Cercum ova precipitin
AT ALL! test  egg of oncomelania quadrasi
seen on fecalysis
 Med Mngt: DOC - Praziquantel for 6 months PO
3x/day
 Nsg Mngt:
o Reduce snail density in environment
  Remove weeds  Pyrazinamide – 500mg (5
 Proper irrigation  snails thrive syllables) - hyperuricemia
in stagnant waters  Ethambutol – 400mg (4
 Proper waste disposal syllables) eyes  optic neuritis
o Prevent bathing in snail infested areas  Streptomycin – 1g -
o Expose snails to sunlight  80% of snail nephrotoxic, ototoxic
body is water o Pregnant: IRE!  only safe TB drugs
o Must be taken on empty stomach
o No longer contagious after 2-3 wks of
PULMONARY TUBERCULOSIS (PTB) MDT & 2 consecutive (-) sputum test
 Nsg Mngt:
 CA: Mycobacterium tuberculosis
o Adequate rest
 MOT: airborne, droplet, fomites
o Proper nutrition  well-balance diet +
 S/Sx:
inc. CHON & vit C
o Initially asymptomatic
o Religious intake of meds  compliance
o Phatog sx: Hemoptysis
o Semi fowlers – to enhance lung
 Classifications: accdg. To exposure
expansion
o Class 0 – no exposure, no infection o Primary prevention: BCG vaccine, public
o Class 1 – (+) exposure, (-) infection education
o Class 2 – (+) infections, no disease  (+) o Prevention of spread:
PPD test, but no clinical evidence of  N95 mask worn by HCP
active PTB  Face mask worn by Px
o Class 3 – (+) disease, clinically active  Isolate
o Class 4 – (+) disease, not clinically active  Handwashing
o Class 5 – suspected, Dx pending  Proper disposal of secretions
 Dx test:
o Sputum exam – confirmatory: 3
consecutive (+) results RABIES
o PPD (Purified Protein Derivative)/
tuberculin/ Mantoux/ skin test –  AKA: Lyssa/ Hydrophobia
determines exposure  CA: Rhabdovirus – “rhabdo” means bullet 
o CXR – determines extent of damage  virus is bullet shaped  can cross BBB
measures nodules, cavities, infiltrates  Vector: Dogs & cats, Rodents have dry bite so
 Med Mngt: not carriers
o DOTS (Direct Observed Treatment Short  IP: usually 2 weeks, can be up to 10 years
Course) – RN need to witness Px  S/Sx: once manifestations appear  no cure 
swallowed drug  to ensure DEATH!
compliance o Prodromal stage/ Invasion
o MDT (Multi Drug Therapy)  giving  Salivation
multiple drugs in a systematic manner  Irritability
bc TB is know to be very resistant  Pain in the bite site
 RIPES – dosage - S/E o Excitement/ Neurological Stage
 Rifampicin – 400-450mg  Excitation & Apprehension
(4syllables) - red-orange  Nuchal rigidity
discoloration of urine & other  Twitching
body secretions  Aerophobia
 Isoniazid – 300mg (INH) - o Terminal/ Paralytic  Death
peripheral neuritis  give vit B6  Med Mngt:
(Pyridoxine) o Tetanus Toxoid (TT)
 o Anti-tetanus Serum (ATS) Antibodies Nnemonic: NAPAPA ABAG ABAG
o Anti-rabies vaccine
 Nsg Mngt:
o Isolate
o Darken room
o No water on site: IVF wrapped securely
o Vaccination of all dogs
o Confine the dog for 10-14 days  check
brain for Negri bodies (confirmatory for
rabies infection)

HEPATITIS

 Types:
o HEPA A – infectious hepa
o HEPA B – serum hepa
o HEPA C – post transfusion hepa
o HEPA D – delta agent hepa
(complication of Hepa B)
o HEPA E – enteric heap
 2 MOT:
o Orofecal: Hepa tAE
o Blood borne – BCD
 Onset:
o Acute – heap A & E
o Chronic – heap B, C & D
 Stages:
o Pre-icteric: fatigue, N/V, anorexia
o Icteric: Jaundice, dark urine, acholic
(grey-colored) stool
o Post-icteric: recovery stage
 Med Mngt:
o Antibiotics  depends on amount and
duration of hepa
 4. The weakest link, in the chain of infection
is *
a. Portal of entry, prevention is better than cure.
b. Portal of exit, if proper isolation technique is
observed, it will prevent spread of infection.
c. Mode of transmission. – break the link
d. Causative agent, identifying properly the cause,
will give immediate and proper medical and nursing
interventions.

 
5. It is a type of a carrier of which a person
POST-TEST: incubates the illness. *
a. Incubatory carrier

COMMUNICABLE b. Convalescent carrier

c. Intermittent carrier

DISEASE NURSING
d. Chronic carrier

Total points13/25
 
 PREPARED BY: PROF. ARCHIE ALVIZ 6. A student asked a nurse, on what is the
  difference between a vaccine and toxoid. *
a. Toxoid is live attenuated bacteria while vaccine
1. The nurse understands that an infection
contains bacterial endotoxins.
becomes contagious when it? * b. Vaccine is stronger than a toxoid.
a. It is communicable. c. Toxoid are live attenuated toxins while vaccines
b. It is infectious, affecting other person contains contain dead bacteria.
c. It is easily transmitted from one person to d. Toxoid contains modified bacteria toxins while
another. vaccine has weakened bacteria.
d. It does not infect a person.

 
2. If greater than expected number of cases of CLIENTS WITH LEPTOSPIROSIS  
a given disease arises suddenly in a specific
7. The causative agent of leptospirosis is *
area over specific period, it can be a. Interogans leptospira
considered * b. Leptospira interogans
a. Endemic c. Interogans Leptos
b. Sporadic d. Lepto Interogans
c. Pandemic
d. Epidemic  
  8. Leptospirosis’ mode of transmission is
3. When a microbe has the ability to survive through direct contact with *
a. Droplet
outside the body, this is known as *
b. Soiled clothing with secretions
a. Specificity
c. Vegetation contaminated with urine of infected
b. Virulence
host
c. viability
d. Infected rats
d. antigenecity
   
9. As a Public Health nurse, who of the 14. Humans diagnosed with Lyssa will usually
following group you should emphasize on last for 2 to 6 days if not given with medical
their awareness with leptospirosis. * attention. This is mainly due to *
a. Medical health Workers a. Respiratory paralysis
b. Street and Market Vendors b. Systemic Viremia
c. Masseurs c. Shock
d. Miners d. Renal collapse

   
10. As a prophylaxis for leptospirosis, a client 15. As a public nurse you should remind the
asked the nurse, on what measures he can public about rabies infection, that they can do
take * which of the following actions to prevent and
a. Take a vaccine manage rabies, EXCEPT? *
b. Take a toxoid a. Can ask for anti-tetanus immunization
c. Take doxycycline b. Can wash wound thoroughly with soap and water
d. Take penicillin c. Immunized pet once to protect from infection
  d. Consult veterinarian or trained personnel when
11. The nurse educated a client who recovered observing pets suspected with rabies.

from leptospirosis not to do which of the  

following activities right after the discharge? * 16. This is considered as the most definitive
a. Do hiking in parks
confirmatory test for rabies. *
b. Drinking too many water
a. Complete blood count
c. Donating blood  there is remnants of the
b. Viral isolation for fluorescent rabies antibody 
disease in his blood
negri bodies
d. The client is not restricted to anything
c. CSF Analysis
  d. There is no confirmatory test for rabies.

12. When clients treated with leptospirosis are  

allergic to penicillin’s, the nurse should expect 17. A client with rabies was manifesting
what drugs that can be given in replace to hydrophobia. The nurse should remind the
penicillin? * family to do the following actions, except? *
a. Erythromycin a. Not mentioning the word “water” in front of the
b. Dapsone client.
c. Ampicillin b. Not to drink water within the sight of the patient.
d. Praziquantel c. Not to ask client during lucid intervals, if he likes
to take a bath.
  d. Not to drink water, so the client will not be thirsty.
13. It has been known that this disease can  
sometimes by biphasic. The second phase 18. The initial intervention for a bite from an
may occur to clients, this phase is known as * animal suspected to have rabies is *
a. Weil’s disease
a. Admission in an rabies facility
b. Mud Fever
b. Observation for the bite area
c. Trench Fever
c. Thoroughly wash the bite area
d. Seven days Fever
d. Give vaccine, so to stop the spread of infection.
 
CLIENTS WITH RABIES
19. The nurse will give rabies immune globulin 24. The client complains of intense pain, the
the patient. The student nurse assisting nurse should avoid which of the following
understands this as * actions? *
a. The client will receive passive immunization – a. Analgesics for the pain
immunoglobulins are like antibodies b. Moist heat applications
b. The client will receive natural passive c. Morphine for the intense pain  respiratory
immunization depressant
c. The client will receive natural active immunization d. Guided imagery
d. The client will receive active immunization
 
  25. Clients with poliomyelitis are at risk of the
20. The nurse should do the following nursing following complications except? *
actions in caring a client with rabies on a. Pulmonary edema
excitation phase, except? * b. Skeletal-muscle deformities
a. Wearing gown for protection c. Pneumonia
b. Avoid to be bitten by the client d. Hypotension
c. Keep the room well lighted to provide safety
d. Rotating the injection site for rabies vaccine

 
21. You are in the community and you
assisted a boy who was bitten by a dog. The
bite area was bleeding. You should *
a. Stop the bleeding, immediately
b. Wash the area with water and soap
c. Do not stop the bleeding
d. Assess the client’s level of consciousness.

CLIENTS WITH POLIOMYELITIS  

22. Poliomyelitis is caused by *

a. Bacteria, that belong to the genus of polio
b. Virus, with serotypes of I,II and III (Brunhilde,
Lansing, Leon)
c. Spirochetes, old strain
d. The exact cause is unknown

 
23. This is when the respiratory center of the
client is already affected. *
a. Non paralytic poliomyelitis
b. Paralytic poliomyelitis
c. Non Bulbar paralytic poliomyelitis
d. Bulbar paralytic poliomyelitis