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nformation for Patients TUBERCULOSIS

Description and Causes: Infection caused by the leptospirosis bacteria. Spread through the urine of infected animals (e.g. rodents like rats, cattles, pigs) Human contact with the urine of an infected animal and/or with substances contaminated with the urine may cause the disease. Can also be acquired through broken skin and mucous membrane (eyes, nose, sinuses, mouth) contact with the contaminated water or soil. Signs and Symptoms: High fever Headaches Chills Muscle aches Vomiting Red eyes Abdominal pain Diarrhea Rash Leptospirosis associated with liver and kidney disease is called Wells syndrome and is characterized by yellowing of the body (jaundice) Patients with Wells syndrome can also develop kidney and liver failure and have more serious involvement of the organs affected like widespread bleeding Prevention: Avoid swimming or wading in water that may be contaminated with animal urine Eliminating contact with potentially infected animals Wearing protective clothing when exposed to water and soil which may be contaminated with the bacteria Travelers who are going to an area where leptospirosis is common and who will be engaged in activities that increase likelihood of exposure can take 200 mg of Doxycycline per week by mouth starting before and during the time period of potential exposure Treatment: Intravenous antibiotics (e.g. Penicillin or Ceftriaxone) as treatment, oral antibiotics for prophylaxis.

Supportive therapy measures may be taken (e.g. dialysis, detoxification) Severely ill patients need hospitalization for IV fluid, antibiotic treatment and close monitoring. Severe liver and kidney manifestations of the infection may require intensive medical care and sometimes dialysis treatment.

Reference: Approved by: Marc Evans Abat, MD Subject Matter Expert Department of Medicine, UPM-PGH Information, Publication and Public Affairs Office, University of the Philippines Manila and the Department of Medicine, UPM-Philippine General Hospital

nformation for Patients TEPID SPONGE BATH

What is tepid sponge bath? Tepid sponge bath is a bath with water below body temperature, usually in the range of 80 to 90 F (26.6 - 35). This type of bath maybe ordered to reduce the clients elevated temperature. Prepare the Equipment: (a) Bath basin. (b) Tepid water 80 to 90 F (26.6 - 35) (c) Washcloth (4) (d) Bath thermometer (e) Bath blanket (f) Patient thermometer Procedure: 1. Explain the procedure to the patient, provide privacy and make sure the room is warm and free of drafts. 2. Give the client the opportunity to use a urinal or bedpan before the bath. 3. Take the patients temperature before the bath. 4. Note whether the patient has had an antipyretic (such as aspirin or ibuprofen) to reduce fever. Give as ordered by the doctor. 5. Add tepid bath water to the bath basin 80 to 90 F (26.6 - 35). Use a bath thermometer. 6. Place moist cool cloths wrung out just enough to prevent dripping in the clients axillae and groin. 7. Beware of the patient's first reaction to a tepid sponge bath is a sensation of chilliness, which disappears as the body adjust to the waters temperature. Therefore, continue the bath long enough to allow for this adjustment (at least 25 30 min). Monitor the clients body temperature throughout the procedure to determine the treatments effects. 8. Sponge each limb for at least 5 min and the back of the buttocks for at least 10-15 min. 9. Stop the procedure if the patient becomes very chilled or begins to shiver. 10. Stop sponging as soon as the patients temperature approaches the normal range (about 38.7 C or 100 F orally). Give the patient a bath blanket.

11. Wash the hands. Document the treatment, noting his or her reactions. Be sure to record the temperatures, before, during or after the procedure. 12. Take the clients temperature 30 minutes after you complete the bath. Report the temperature immediately if it has fallen to low ( below about 37.5 C or 99.5 F).

Reference: "Textbook of Basic Nursing" (9th Edition); Caroline Bunker Rosdahl and Mary T. Kowalsi; 2007

mpormasyon para sa mga Pasyente


Ang DENGUE ay isang sakit na mula sa kagat ng lamok na may dalang Dengue virus. Ang panahon ng inkubasyon pagkatapos kagatin ng lamok na may dalang virus ay mula tatlo hangang limang araw bago lalabas ang sintomas ng Dengue.

Mga Uri ng Dengue:

Dengue Fever Dengue Hemorrhagic Fever Dengue Shock Syndrome

Mga Palatandaan:
Mataas na lagnat mula 2-7 araw Pananakit ng kasukasuhan at kalamnan Panghihina Pagkawala ng ganang kumain Pamumula ng balat Pananakit ng tiyan at pagsusuka Pagdurugo ng ilong at gilagid
Pag-iwas at Pagsugpo: Mag4S Laban sa Dengue 1. Search and Destroy Para di maipunan ng tubig at pamugaran ng kiti-kiti: Palitan ang tubig at linisin ang flower vase minsan sa isang Lingo. Takpan ng lupa o buhangin ang mga butas sa paligid ng inyong bahay. Takpan ang mga timba, drum o iba pang imbakan ng tubig. Tanggalin at butasan ang mga gulong sa ibabaw ng inyong bubong o mga gulong sa inyong paligid. Itaob ang mga bote, lata at iba pang maaaring pag-ipunan ng tubig at pangitlugan ng lamok. Linisin at alisin ang tubig sa paminggalan. 2. Self-Protection Measures Iwasan ang maikling kasuotan upang di medaling makagat ng lamok. Maaari ring gumamit ng mosquito repellant sa araw. 3.Seek Early Consultation Kung may lagnat na ng 2 araw at may rashes sa balat, pumunta at komunsulta agad sa pinakamalapit na health center o ospital. 4. Say No to Indiscriminate Fogging Yes to Fogging only during outbreaks.


nformation for Patients DENGUE

A disease caused by a family of viruses that are transmitted by mosquitoes. After being bitten by a mosquito carrying the virus, the incubation period ranges from three to 15 (usually 5 to 8) days before the signs and symptoms of dengue appear in stages.

Types of Dengue:
Dengue Fever Dengue Hemorrhagic Fever Dengue Shock Syndrome

General Symptoms:
Headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the dengue triad) of fever, rash and headache (and other pains) is particularly characteristic of dengue fever. Fever and other signs of dengue last for two to four days, followed by a rapid drop in body temperature (defervescence) with profuse sweating. This precedes a period with normal temperature and a sense of well-being that lasts about a day. A second rapid rise in temperature may follow. A characteristic rash appears along with or after the fever and spreads from extremities to cover the entire body except the face. The palms and the soles maybe bright red and swollen.

Specific Symptoms:
Dengue Fever:
Includes the general symptoms mentioned Starts with chills, headache, pain upon moving the eyes, and low backache Painful aching in the legs and joints occurs during the first hours of illness. Temperature rises quickly to as high as 40 C with relatively low heart rate (relative bradycardia) and relatively low blood pressure (relative hypotension. Eyes become reddened. A flushing or pale pink rash comes over the face and then disappears. The glands (lymph nodes) in the neck and groin are often swollen. General symptoms as mentioned plus Bleeding with easy bruising, blood spots in the skin (petechiae). Vomiting up blood (hematemesis).

Dengue Hemorrhagic Fever:

Blood in the stool (melena), bleeding gums and nosebleeds (epistaxis). Pneumonia is common and inflammation of the heart (myocarditis) may be present. Causes abdominal pain which may herald the beginning of ultraabdominal hemorrhage (bleeding). Patient with DHF must be monitored closely for the first few days since shock may occur or recur precipitously (dengue shock syndrome). Shock occurs two to six days after the start of symptoms with sudden collapse, cool clammy extremities (the trunk is often warm), weak pulse and blueness around the mouth (circumoral cyanosis).

Dengue Shock Syndrome:

Effective vector (mosquitoes) control measures through: Preventing mosquitoes from accessing or egg-laying habitats by environmental management and modification Disposing of solid waste properly and removing artificial man-made habitats, especially those that may cause water stagnation (e.g. old cans, tires or other containers). Covering, emptying, and cleaning of domestic water storage containers on a weekly basis. Applying appropriate insecticides to water storage outdoor containers. Using personal household protection, such as window screens, long-sleeved clothes, insecticide-treated materials, coils and vaporizers, especially in high risk areas. Improving community participation and mobilization for sustained vector control. Applying insecticides as space spraying during outbreaks as one of the emergency vector control measures. Active monitoring and surveillance of vectors to determine effectiveness of control interventions.

No specific treatment but early detection and access to proper medical care is essential. If with high index of suspicion, immediate medical consultation is recommended. All patients need adequate fluid hydration and nutrition. Cyanotic (bluish) patients are given oxygen. Vascular collapse (shock) requires immediate and aggressive fluid replacement. Blood transfusions may be needed to control bleeding in severe cases.

Reference: Approved by: Marc Evans Abat, MD Subject Matter Expert Department of Medicine, UPM-PGH Information, Publication and Public Affairs Office, University of the Philippines Manila and the Department of Medicine, UPM-Philippine General Hospita

nformation for Patients BLOOD TRANSFUSION

What is blood transfusion?

In a blood transfusion, donated blood is added to your own blood. A blood transfusion may also be done to supplement various components of your blood with donated blood products. In rare cases, a blood transfusion is done with blood that you've donated ahead of time before you undergo surgery. During a typical blood transfusion, certain parts of blood are delivered through an intravenous (IV) line that's placed in one of the veins in your arm. A blood transfusion usually takes one to two hours, though in an emergency it can be done much faster. A blood transfusion boosts blood levels that are low, either because your body isn't making enough or because blood has been lost during surgery, injury or disease.

Why it is done?
There are many reasons people receive blood transfusions, including surgery, injury and disease. Blood has several components, including red cells, white cells, plasma and platelets. You'll receive a transfusion that provides the part or parts of blood that will be most helpful for you. Whole blood means the blood contains all its parts, but whole blood is rarely used for transfusion. Researchers are working on ways to develop an artificial blood, but so far there's no universally accepted replacement for human blood.

What are the risks?

Blood transfusion is a common procedure that usually goes without complications. But there are some risks. Some transfusion reactions happen during the transfusion, while others may take several weeks to develop or become noticeable. Below are the risks: Allergic reaction and hives Fever Acute immune hemolytic reaction Lung injury Bloodborne infections Delayed hemolytic reaction Iron overload Graft-versus-host disease

How will you prepare?

Your blood will be tested before a transfusion to determine whether your blood type is A, B, AB or O and whether your blood is Rh positive or Rh negative. Donated blood that is compatible with your blood type will be selected for the transfusion. You don't need to change your activity levels or diet before a transfusion.

If you've had a reaction to prior blood transfusions, be sure to tell your doctor.

What can you expect?

Blood transfusions are usually done in a hospital, outpatient clinic or doctor's office. A blood transfusion typically takes one or two hours, depending on which parts of the blood you receive and how much blood you need. You're usually seated or lying down for the procedure.

During the procedure

Before the transfusion begins, an identification check will be done to ensure you're being given the correct blood. Then an IV line with a needle is inserted into one of your blood vessels, and the donated blood that's been stored in a plastic bag enters your bloodstream through the IV. A nurse will monitor you throughout the procedure. If you develop a fever, shortness of breath, pain at the site of transfusion or chills, or if you feel itchy or uneasy, tell your nurse immediately.

After the procedure

The needle and IV line will be removed. You may develop a small bruise around the IV site, but this should go away with time.

What are the results?

You may need further blood testing to see how your body is responding to the donor blood and to check if your blood levels have reached an appropriate level. For example, if before the transfusion you were anemic, meaning you had low levels of red blood cells, your doctor will check to see how much the transfusion raised your red blood cell count. Or, if you've had low platelets because of chemotherapy drugs, your doctor may test your blood to see whether the transfusion sufficiently boosted your platelet count. Some conditions require repeated blood transfusions.



1. Verify doctors written prescription and make a treatment card according to hospital policy. 2. Observe ten (10) Rs when preparing and administering any blood or blood components. 3. Explain the procedure/rationale for giving blood transfusion to reassure patient and significant others and secure consent. Get patient histories regarding previous transfusion. 4. Explain the importance of the benefits on Voluntary Blood Donation (RA 7719 National Blood Service Act of 1994). 5. Request prescribed blood/blood components from the blood bank to include blood typing and cross matching and blood result of transmissible disease. 6. Use a clean and safe container to get the prescribed blood or blood product from hospital blood bank and keep it at room temperature. 7. Assess patients condition. The doctor and the nurse should counter check the compatible blood and blood product to be transfused against the cross matching sheet noting ABO grouping and RH, serial no. of each blood unit, and expiry date with the blood bag label and other laboratory blood exams as required before transfusion (Hgb and Hct). 8. Get the baseline vital signs - BP, RR, and temperature before transfusion. Refer to MD accordingly. 9. Give pre-med 30 minutes before transfusion as prescribed. 10. Prepare equipment needed for BT (IV injection tray, compatible BT set, IV catheter/G 16 to 19 and/or as appropriate, plaster, tourniquet, blood, blood components to be transfused, Plain NSS 500 cc, IV set, needle gauge 16 to 18 (only if needed), IV hook, gloves, sterile 2x2 gauze or transparent dressing, etc. 11. Do hand hygiene before and after the procedure. 12. If main IVF is with dextrose 5% initiate an IV line with appropriate IV catheter/G 18 and 19 and/or as appropriate, with Plain NSS, on another site, anchor catheter properly and regulate IV drops. 13. Open compatible blood set aseptically and close roller clamp. Spike blood bag carefully; fill the drip chamber at least half full; prime tubing and remove air bubbles (if any). Use needle G 16 to 19 and/or as appropriate for adults or G. 22 to 24 for pedia (if blood is given through the Y injection port.) 14. Disinfect the Y-injection port of IV tubing (plain NSS) and insert the needle from BT administration set and secure with adhesive tape. 15. Close roller clamp of IV fluid of Plain NSS or regulate to KVO while transfusion is going on. 16. Transfusion the blood via the injection port and regulate at 10 15 gtts/min. Initially for 15 minutes and then at the prescribed rate (usually on the patients condition) 17. Monitor the patient within the first 5 to 10 minutes of transfusion and refer immediately to the MD for any adverse reaction. 18. Observe/ Assess patient on an on-going basis for any untoward signs and symptoms such as flushed skin, chills, elevated temperature, itchiness, urticaria and dyspnea. If any of these symptoms occur, stop the transfusion, open the IV line with Plain NSS and regulate accordingly, and report to the doctor immediately. 19. Swirl the bag gently from time to time to mix the solid with the plasma N.B. one B.T. set should be used for 1-2 units of blood. 20. When blood is consumed, close the roller clamp of BT, and disconnect from IV lines then regulate the IVF of plain NSS as prescribed. 21. Continue to observe and monitor patient post transfusion, for delayed reaction could still occur. 22. Re-check Hgb and Hct, bleeding time, serial platelet count within specified hours as prescribed and/or per institutions policy. 23. Discard blood bag and BT set and sharps according to Health Care Waste Management (DOH/DENR). 24. Fill-out adverse reaction sheet as per institutional policy and return the blood bag and whole set to the blood bank or laboratory for examination. 25. Remind the doctor about the administration of Calcium Gluconate if patient has several units of blood transfusion (3-5 more units of blood). 26. Document time of discontinuance, status of insertion site and integrity of IV catheter and endorse accordingly. Reference: Nursing Standards of Intravenous Practice 9th Edition (ANSAP)