Typhoid

OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING DHAMTARI

4. CHIEF
COMPLAIN

5. Typhoid fever is a systemic infection caused by
Salmonella enterica serotype Typhi (S. typhi). The
disease remains an important public health problemin
developingcountries.
About 16 million cases of typhoid fever and600,000
deaths occur yearly worldwide and that more than
90% of this morbidity and mortality occurred inAsia

7. What?
An acute illness with fever caused by
infection with the Salmonella typhi
bacteria contracted fromcontaminated
water and food. Also called enteric
fever, bilious fever and yellow jack.

9. CON…
Typhoidis a bacterial infection that can lead to a
high fever, diarrhea, and vomiting. It can be
fatal. It is caused by the bacteria Salmonella
typhi. The infection is often passed on through
contaminated food and drinking water, and it is
more prevalent in places where handwashingis
less frequent.
ACCORDING TO LIPPIN COTT

10. •Virulentbacteriumthat causeillness
called Salmonellatyphi.
1.Bacteria
•spreadthroughcontaminatedfoodor
waterandoccasionallythroughdirect
contactwithsomeonewhoisinfected.
2.Fecal-
oralroute
•These people, called chronic
carriers, shed the bacteria in their
faeces and are capable ofinfecting
others.
3.Typhoid
carriers

12. work in or travel to areas where typhoid fever isendemic
Work as a clinical microbiologist handling Salmonellatyphi
bacteria
Have close contact with someone who is infected orhas
recently been infected with typhoidfever
Have an immune system weakened by medications suchas
corticosteroids or diseases such asHIV/AIDS
Drink water contaminated by sewage that contains S.typhi

13. Poorappetite
Fever, often as highas
(39.4 or 40C)
1
stWEEK

14. Continuinghigh
fever
Extremely
distended
abdomen
Diarrhea orsevere
constipation
weightloss
2
ndWEEK

15. Intestinalbleeding
Lie motionlessand
exhausted
3
rdWEEK

18. Salmonella typhi contractedfrom
contaminated water andfood
Ingested by human.The S.typhisurvives
the acidity of thestomach
It will invades the payer’s patches ofthe
intestinalwall
The bacteria is within themacrophages
andsurvives
Bacteria spreads via the lymphaticswhile
inside themacrophages

19. Access to reticuloendothelial
system,liver,spleen,gallbladder andbone
marrow.
1
st week: elevation of the bodytemperature
2
nd week: abdominal pain, spleenenlargement
and rosespot
3
rd week: necrosis of the payer’spatches
Leads to perforation, bleeding .And ifleft
untreated, death isimminent

23. Blood culture(C&S)
A blood culture during the first weekof
the fever can show S. typhibacteria
Complete blood count(CBC)
A complete blood count (CBC) willshow
a high number of white bloodcells.

25. .
StoolC&S
stool culture may be positive for S.typhi
several days after ingestion of thebacteria
Widaltest
Test whereby bacteria causing typhoid
fever are mixed with serumcontaining
specific antibodies obtained from an
infectedindividual

29. Brand name:Cipro
(Ciprofloxacin)
Class of drugs:quinolone
antibiotics.
USES: This medication is usedto
treat a variety of bacterial
infections.
Routes : peroral
Dosage :Adult :500 mgorally
every 12 hours for 10days
Sideeffect
:nausea,vomiting,dizziness
,blurred vision,feeling
nervous,sleepproblems

30. Brandname:Rocephin
(Ceftriaxone)
group of drugs :cephalosporin
antibiotics
Uses :It works by fightingbacteria
inbody
Route :intravenous
Dosage:
Pediatric :75 to 80 mg/kgIV
once a day for 5 to 14 days
Adult:2 g IV every 24hours
Side effect : Mild diarrhea,mild
pain, swelling,nausea,vomiting

31. COMPLICATION OFTYPHOID
Gastrointestinal
Perforation
Myocarditis
Gastrointestinal
Bleeding

32. GASTROINTESTINAL BLEEDING

33. COMPLICATION OFTYPHOID
Gastrointestinal
Bleeding
Myocarditis
Gastrointestinal
Perforation

34. GASTROINTESTINAL PERFORATION

35. COMPLICATION OFTYPHOID
Gastrointestinal
Bleeding
Gastrointestinal
Perforation
Myocarditis

36. MYOCARDITIS

37. •Nursing Diagnosis :Hyperthermia related to increasedmetabolic
rate,illness.
•Goal : Client can maintain the normal body temperaturewithout
complication
NursingIntervention Rationale
Monitorpatienttemperaturedegreeandpatterns Fever pattern may aids in diagnosingunderlyingdisease.
Observeforshakingchillsandprofusediaphoresis Chillsoftenprecededuringhightemperature
and in presence of generalizedinfection.
Wash hands with anti-bacterial soap before andafter
each care of activity and encourage properhygiene.
Reduces cross contamination andprevents
the spread ofinfection.
Provide tepid sponge baths and avoid the useofice
water andalcohol.
May help reduce fever .Use of ice waterand
alcohol may cause chills and canelevate
temperature.
Monitorforsignsofdeteriorationofconditionorfailure
to improve withtherapy.
May reflect inappropriate antibiotictherapy.

38. •NursingDiagnosis:Riskforimbalancenutritionrelatedtodisease
process.
•Goal: Patientwillbemaintainthenutritionbalanceandbodyweightstatus
NursingIntervention Rationale
Monitor the Input & OuputChart Tomaintainnutrientstatusofpatient
Assess client’s nutritionalpatterns Offer client their favorite food toensurepatient
taken thediet
Recommend bed rest / activity restrictionsduring
the acute phase, balanced body weight eachday
Tominimizethepainandtomaintainpatient
weight
Record or report such things as nausea,vomiting,
stomach pain anddistension.
Todofurthermanagementtoreducethesymptom
Collaboration with a nutritionist fordietary
administration
To maintain patient taken dietwell

39. •Nursing Diagnosis : Increase frequency of bowel movement related
to diseaseprocess.
•Goal : Client will maintain the hydration of body from overdiarrhea
NursingIntervention Rationale
Monitorthevitalsignsuchaspulseandrespiration Tomonitorpatientfromoverdehydration
Monitor the Input & Outputchart. Tomaintainthefluidbalanceinpatientbody
Encourage the patient to eat more nutritious foodsuchas
fruit &vegetable.
To prevent patient from getconstipation
Encourage pt to drink plenty of water at least 2.5liters/
24hours.
To maintain hydration status ofpatient
Observe the drip infusion & administer themedicationas
ordered bydoctor.
Topreventinfectionandmaintainfluidbalance

40. Wash hand before andafter
handlingsomething
Avoid drinking untreatedwater
Avoid raw food andvegetables
Choose well-cookedfood

41. Avoid popsicles and flavored ices that may have
been made with contaminatedwater.
Avoid eat the foods and beverages fromthe
streetvendor
Remember taking antibiotics injection asdoctor
orders
Getting vaccinated before travelling toanother
country where common gets thetyphoid.
Follow up with thedoctor