typhoid

1. NURSING CLIENT WITH ENDOCRINE AND
GENITOURINARY DISORDER AND COMMUNICABLE
DISEASE

2. Typhoid fever is a systemic infection caused by
Salmonella enterica serotype Typhi (S. typhi). The
disease remains an important public health problem in
developing countries.
About 16 million cases of typhoid fever and 600,000
deaths occur yearly worldwide and that more than
90% of this morbidity and mortality occurred in Asia

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

4. •Virulent bacterium that cause illness
1.Bacteria called Salmonella typhi.
2.Fecal- • spread through contaminated food or
water and occasionally through direct
oral route contact with someone who is infected.
• These people, called chronic
3.Typhoid carriers, shed the bacteria in their
carriers faeces and are capable of infecting
others.

5. work in or travel to areas where typhoid fever is endemic
Work as a clinical microbiologist handling Salmonella typhi
bacteria
Have close contact with someone who is infected or has
recently been infected with typhoid fever
Have an immune system weakened by medications such as
corticosteroids or diseases such as HIV/AIDS
Drink water contaminated by sewage that contains S. typhi

6. 1st WEEK
Poor appetite
Fever, often as high as
(39.4 or 40 C)

7. 2nd WEEK
Continuing high Extremely
fever distended
abdomen
Diarrhea or severe weight loss
constipation

8. 3rd WEEK
Lie motionless and
Intestinal bleeding exhausted

9. Salmonella typhi contracted from
contaminated water and food
Ingested by human.The S.typhi survives
the acidity of the stomach
It will invades the payer’s patches of the
intestinal wall
The bacteria is within the macrophages
and survives
Bacteria spreads via the lymphatics while
inside the macrophages

10. Access to reticuloendothelial
system,liver,spleen,gallbladder and bone
marrow.
1st week: elevation of the body temperature
2nd week: abdominal pain, spleen enlargement
and rose spot
3rd week: necrosis of the payer’s patches
Leads to perforation, bleeding .And if left
untreated, death is imminent

11. Blood culture (C&S)
A blood culture during the first week of
the fever can show S. typhi bacteria
Complete blood count (CBC)
A complete blood count (CBC) will show
a high number of white blood cells.

12. . Stool C&S
stool culture may be positive for S.typhi
several days after ingestion of the bacteria
Widal test
Test whereby bacteria causing typhoid
fever are mixed with serum containing
specific antibodies obtained from an
infected individual

13. Brand name :Cipro USES: This medication is used to
(Ciprofloxacin) treat a variety of bacterial
Class of drugs :quinolone infections.
antibiotics.
Routes : per oral Side effect
:nausea, vomiting,dizziness
Dosage :Adult :500 mg orally ,blurred vision,feeling
every 12 hours for 10 days nervous,sleep problems

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

15. COMPLICATION OF TYPHOID
Gastrointestinal Gastrointestinal
Bleeding Perforation
Myocarditis

16. GASTROINTESTINAL BLEEDING

17. COMPLICATION OF TYPHOID
Gastrointestinal Gastrointestinal
Bleeding Perforation
Myocarditis

18. GASTROINTESTINAL PERFORATION

19. COMPLICATION OF TYPHOID
Gastrointestinal Gastrointestinal
Bleeding Perforation
Myocarditis

20. MYOCARDITIS

21. • Nursing Diagnosis :Hyperthermia related to increased metabolic
rate, illness.
• Goal : Client can maintain the normal body temperature without
complication
Nursing Intervention Rationale
Monitor patient temperature degree and patterns Fever pattern may aids in diagnosing underlying disease.
Observe for shaking chills and profuse diaphoresis Chills often precede during high temperature
and in presence of generalized infection.
Wash hands with anti-bacterial soap before and after Reduces cross contamination and prevents
each care of activity and encourage proper hygiene. the spread of infection.
Provide tepid sponge baths and avoid the use of ice May help reduce fever .Use of ice water and
water and alcohol. alcohol may cause chills and can elevate
temperature.
Monitor for signs of deterioration of condition or failure May reflect inappropriate antibiotic therapy.
to improve with therapy.

22. • Nursing Diagnosis : Risk for imbalance nutrition related to disease
process.
• Goal : Patient will be maintain the nutrition balance and body weight status
Nursing Intervention Rationale
Monitor the Input & Ouput Chart To maintain nutrient status of patient
Assess client’s nutritional patterns Offer client their favorite food to ensure patient
taken the diet
Recommend bed rest / activity restrictions during To minimize the pain and to maintain patient
the acute phase, balanced body weight each day weight
Record or report such things as nausea, vomiting, To do further management to reduce the symptom
stomach pain and distension.
Collaboration with a nutritionist for dietary To maintain patient taken diet well
administration

23. • Nursing Diagnosis : Increase frequency of bowel movement related
to disease process.
• Goal : Client will maintain the hydration of body from over diarrhea
Nursing Intervention Rationale
Monitor the vital sign such as pulse and respiration To monitor patient from over dehydration
Monitor the Input & Output chart. To maintain the fluid balance in patient body
Encourage the patient to eat more nutritious food such as
To prevent patient from get constipation
fruit & vegetable.
Encourage pt to drink plenty of water at least 2.5 liters /
To maintain hydration status of patient
24 hours.
Observe the drip infusion & administer the medication as To prevent infection and maintain fluid balance
ordered by doctor.

24. Wash hand before and after
handling something
Avoid drinking untreated water
Avoid raw food and vegetables
Choose well-cooked food

25. Avoid popsicles and flavored ices that may have
been made with contaminated water.
Avoid eat the foods and beverages from the
street vendor
Remember taking antibiotics injection as doctor
orders
Getting vaccinated before travelling to another
country where common gets the typhoid.
Follow up with the doctor

26. Salmonella Typhi causes a protracted bacteremic
illness referred to as typhoid fever. Since humans
are the only reservoir for S. Typhi, infection is
most often acquired through ingestion of food or
water contaminated by feces and urine of infected
persons and chronic carriers.
Typhoid fever is characterized by the
gradual onset of
fever, headache, malaise, anorexia, abdomi
nal pain, hepatosplenomegaly, rose
spots, and changes in mental status.
Laboratory diagnosis can be made by
culture of stool, blood and widal test.

27. Antimicrobial therapy is indicated for patients with typhoid
fever. Typhoid fever cases should be excluded from food
handling, and from direct care of
infants, elderly,immunocompromised, and hospitalized or
institutionalized patients. An individual may return to normal
duties after 3 consecutive negative stool culture taken at least
one month apart, and at least 48 hours after completion of
antibiotic therapy. If without prompt treatment, it can cause
serious complications and can be fatal.

28. • http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002308/
• http://en.wikipedia.org/wiki/Typhoid_fever
• http://www.nhsdirect.wales.nhs.uk/encyclopaedia/t/article/typhoidfever/
• http://www.nhs.uk/Conditions/Typhoid-fever/Pages/Introduction.aspx
• http://www.answers.com/topic/typhoid-fever#Signs_and_symptoms
• http://en.wikipedia.org/wiki/File:Typhoid_inoculation2.jpg
• http://www.nlm.nih.gov/medlineplus/ency/article/001332.htm
• http://www.livestrong.com/article/133749-an-introduction-typhoid-fever/
• http://en.wikipedia.org/wiki/File:ForskeligeVeje_ad_hvilkenBroen_kan_inf
iceres_medTyfusbaciller.png