Workshop 2 HPA - asdasd PDF

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Workshop 2 Resources Pathophysiology textbook and Pharmacology textbook

Introduction Infectious organisms have troubled human beings since the time of bubonic fever (better known as Black Death) to more recent epidemic such as HIV, Ebola and Zika Virus. In hospitals, nurses deal with infectious organisms of all kinds. However, they all come down to four categories that are parasites, viruses, bacteria and fungi. In order to care for a client with an infectious disease nurses must be aware of the chain of infection and how to break it at each level.

Below is the chain of infection and how it could be broken.

Source Victorian Blue Book

Chain of Infection Applied to Tuberculosis Infection Control TB

  

Immunisation Handwashing Airborne

Modified google images

cation rates are as low as 5–6 cases per 100,000 population of tuberculosis (TB) in the digenous persons born in Australia, the notification rate is around 0.7 per 100,000 urrent epidemiology of TB in Australia is largely a direct effect of the global TB situation with overseas-born persons contributing the majority of the cases. Pathophysiology The tubercle bacilli establish infection in the lungs after they are carried in droplets small enough (5 to 10 microns) to reach the alveolar spaces. The bacilli proliferate inside alveolar macrophages and eventually kill the cells (cytotoxic) reducing the capacity to breath. The infected macrophages produce chemotaxins that attract leucocytes which wall off the bacteria to form granulomatous structures called the tubercles. The bacilli can enter local draining lymph nodes causing lymphadenopathy and bacteraemia. The clinical manifestation include fever, weight loss, coughing, night sweats, haemoptysis, chest pain and fatigue.

Investigations Acid fast test and CXRays

Enquiry case study

The case of Philandering George

George is a 45 - year - old man who has been admitted to the hospital with a history of fever for the past week. George has returned from an overseas trip to Bali. He is complaining of weakness, loss of appetite and being ‘generally unwell’. He has a mild cough and runny nose. He has experienced some mild stomach pains and mild nausea. He has vomited once today and passed diarrhoea-like stool. He says he has not felt right since he left Bali. His family says he is very stubborn and has been refusing to come to hospital. Further Information When George’s family left he said that he is worried that might have contracted something while oversees. He said that he had too much to drink while oversees and went back to his hotel with someone he had just met at the bar and had unprotected sex. He has burning sensation when passing urine.

His vital signs T 37.5 Pulse 101 Bp 140/83 Resp 22 He appears anxious and diaphoretic.

Activity 1 (20mins) As a class, start by brainstorming your potential causes of George’s problems and set the scene for George’s interview and how you are going to contact it. Complete this table

Potential Disease

Potential pathogenic organism

Respiratory Chlamydia

Chlamydia Trachomatis

Classification Bacteria, Virus, Parasite and Fungi Bacteria

HIV

Human Immunodeficiency Virus

Virus

Cholera

Vibrio Cholerae

Parasite

Covid-19

SARS-CoV-2

Virus

URTI Pneumonia

Different types of precautions Type of Precautions

What is involved Universal precaution

Example diseases All disease

Standard Precautions Additional Precautions/Transmission Based Precautions 

Droplet precautions



Airborne precautions



Contact precautions



Waterborne precautions

-

Negative pressure room Impervious Gowns Single toilet Double flushing

Reverse barrier nursing

Activity 2 (30mins) Your facilitator will start by allocating you a disease to investigate from your brainstorming session. You will work in groups of four. Each of the infectious disease you have brainstormed is a suspect in the case of Philandering George. You should emphasise how each of those infections can be broken at each stage of the chain of infection. Complete this table

Disease

Gastroenteritis

Organism

Escherichia coli and Campylobacter

What is the epidemiology of this diseases? What is the pathophysiology of this disease?

Estimated incidence of gastro in Australia is 17.2 cases per year.

What are the investigations necessary and how do nurses assist?

1) Damage to the villous brush border of the intestine, causing malabsorption of intestinal contents and leading to an osmotic diarrhea 2) Release of toxins that bind to specific enterocyte receptors and cause the release of chloride ions  Improve hydration and nutritional intake  IV Therapy  Antibiotics

Draw the cycle of infection for the organism

Activity 3 (30mins) Now that you have an understanding of your suspect, you need more information to solve this case. Your facilitator will sit in front of the class and your job, as a group, is to ask for more information you need to know about philandering Gorge. This information may include the physical examination and blood tests.

Assessment

Question to ask/ what to investigate

History of presenting illness

Tip This is provided in the case study but ask your friends how you investigate HPI

HPI Medical hx

Tip This is provided in the case study

Social Hx

Tip This is provided in the case study

Finding

Family Hx

Tip This is provided in the case study

Social Habits

Tip This is provided in the case study Ask your facilitator the right questions and this information will be provides

Neurological Cardiovascular Respiratory Endocrine GIT MSK Renal Integumentary Reproductive Vital Signs Diagnostics test

Activity 4 (20mins) Use all the information you have gathered to prepare to prosecute your case to the whole class. Present your synopsis of your suspect using the cycle of infection and then include or exclude your suspect as a potential cause of George’s problem. Provide concrete reasons for choosing to include or exclude. Complete this table

Nursing Issues Plan Taking antibiotics that caused nausea Reassurance and Education and vomiting Dehydration

Fluid Therapy

Activity 5 (10mins) This is your time to ask any questions in regard to the subject.

Homework Breaking the cycle of infection Homework (You are highly advised to complete this homework as your final examination questions are based on this work) Draw bacteria (gram + and gram -)

Draw a virus

Draw a typical fungus

Draw a protozoan

Identify a bacterial disease

Infectious agent

Bacterium Vibrio Cholerae

eg. Tuberculosis is caused by Mycobacterium tuberculosis

Classification

Gram -ve

Gram +ve or Gram -ve Reservoir

Human

Epidemiology

3-5 million cholera cases and 100,000-120,000 deaths due to cholera occur annually

Portal of exit

Anus in faecal waste

Mode of transmission

Drinking water or eating food contaminated with cholera bacteria

Susceptible host

Children

Pathogenesis Breaking the Cycle in a clinical environment

Breaking the cycle in a community setting

Drug Therapy

Identify a viral infection

-

Wash hands often with soap and safe water

Infectious agent

Classification DNA or RNA Reservoir Epidemiology Portal of exit Mode of transmission Susceptible host Pathogenesis Breaking the Cycle in a clinical environment

Breaking the cycle in a community setting

Drug Therapy

Identify a parasitic infection

Infectious agent

Classification Protozoa or Helminth Reservoir Epidemiology Portal of exit Mode of transmission Susceptible host Pathogenesis

Breaking the Cycle in a clinical environment

Breaking the cycle in a community setting

Drug Therapy

Identify a fungal infection

Infectious agent

Classification Single celled or multicellular

Reservoir Epidemiology Portal of exit Mode of transmission Susceptible host Pathogenesis Breaking the Cycle in a clinical environment

Breaking the cycle in a community setting

Drug Therapy...