Materiały źródłowe

• #1 Diphtheria Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/diphtheria/

  Diphtheria Nursing Care Management […] Nursing management of a client with diphtheria include the following: […] Assessment of a client with diphtheria include: […] History. Onset of symptoms of respiratory diphtheria typically follows an incubation period of 2-5 days (range, 1-10d); symptoms initially are general and nonspecific, often resembling a typical viral upper respiratory infection (URI). […] Physical examination. The patient has a low-grade fever but is toxic in appearance, and also may have a swollen neck; cardiac toxicity typically occurs after 1-2 weeks of illness following improvement in the pharyngeal phase of the disease, and neurologic toxicity is proportional to the severity of the pharyngeal infection. […] Based on the assessment data, the major nursing diagnosis are:

• #1 Diphtheria – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/diagnosis-treatment/drc-20351903

  Doctors may suspect diphtheria in a sick child who has a sore throat with a gray membrane covering the tonsils and throat. […] If a doctor suspects diphtheria, treatment begins immediately, even before the results of bacterial tests are available. […] Diphtheria is a serious illness. Doctors treat it immediately and aggressively. […] Children and adults who have diphtheria often need to be in the hospital for treatment. […] Recovering from diphtheria requires lots of bed rest. […] Strict isolation while you’re contagious helps prevent the spread of the infection. […] Once you recover from diphtheria, you’ll need a full course of diphtheria vaccine to prevent a recurrence. […] If you have symptoms of diphtheria or have come into contact with someone who has diphtheria, call your doctor right away.

• #1

  https://www.pediatriconcall.com/question-of-the-day/what-is-the-nursing-management-of-diptheria-and-wh/11761

  Specific antitoxin is the mainstay of therapy and should be administered on the basis of clinical diagnosis because it neutralizes free toxin only. […] Antimicrobial therapy is indicated to halt toxin production, treat localized infection, and prevent transmission of the organism to patient contacts. […] Patients with difficulty in breathing will require tracheostomy. […] Diphtheria patients need bed rest with intensive nursing care. […] Patients with laryngeal diphtheria are kept in a croup tent or high-humidity environment they may also need throat suctioning or emergency surgery if their airway is blocked. […] Care of tracheostomy tube would be required.

• #1 Diphtheria Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/782051-treatment

  Maintain close monitoring of cardiac activity for early detection of rhythm abnormalities. Initiate electrical pacing for clinically significant conduction disturbance and provide pharmacologic intervention for arrhythmias or for heart failure. […] Provide 2 large-bore IVs for patients with a toxic appearance; provide invasive monitoring and aggressive resuscitation for patients with septicemia. […] Initiate prompt antibiotic coverage (erythromycin or penicillin) for eradication of organisms, thus limiting the amount of toxin production. Antibiotics hasten recovery and prevent the spread of the disease to other individuals. […] Neutralize the toxin as soon as diphtheria is suspected. Diphtheria antitoxin is a horse-derived hyperimmune antiserum that neutralizes circulating toxin prior to its entry into the cells. It prevents the progression of symptoms. The dose and route of administration (IV vs IM) are dependent on the severity of the disease. This antitoxin must be obtained directly from the Centers for Disease Control and Prevention (CDC) through an Investigational New Drug (IND) protocol. The patient must be tested for sensitivity to the antitoxin before it is given. Antitoxin is only available in the United States. For more information regarding acquisition, see the CDC website for diphtheria antitoxin.

• #1 Diphtheria | Georgia Department of Public Health

  https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/vaccine-preventable-diseases/diphtheria

  After the provisional clinical diagnosis is made and appropriate cultures are obtained, persons with suspected diphtheria should be given antitoxin and antibiotics in adequate dosage and placed in isolation. […] Respiratory support and airway maintenance should also be administered as needed. In the United States, diphtheria antitoxin can be obtained from CDC on request. […] Treatment with erythromycin orally or by injection (40 mg/kg/day; maximum, 2 gm/day) for 14 days, or procaine penicillin G daily, intramuscularly (300,000 U/day for those weighing 10 kg or less, and 600,000 U/day for those weighing more than 10 kg) for 14 days. […] For close contacts, especially household contacts, a diphtheria toxoid booster, appropriate for age, should be given. […] Contacts should also receive antibiotics benzathine penicillin G (600,000 units for persons younger than 6 years old and 1,200,000 units for those 6 years old and older) or a 7- to 10-day course of oral erythromycin, (40 mg/kg/day for children and 1 g/day for adults). […] Contacts should be closely monitored and antitoxin given at the first sign(s) of illness.

• #1 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Diphtheria treatment begins immediately sometimes even before the lab test results are confirmed. Your healthcare provider will prescribe diphtheria antitoxin to stop damage to your organs. Theyll also prescribe antibiotics, typically penicillin or erythromycin, to fight infection. […] People with diphtheria are kept in isolation to prevent others from becoming infected. An infected person is no longer contagious around 48 hours after taking antibiotics. When treatment ends, tests will be run again to make sure the bacteria are gone. Once the bacteria are gone, you will get a vaccine to prevent future infections. […] Diphtheria can result in a number of long-term complications, including blockage of your air passages, injury to your heart muscle, injury to your nerves, sluggishness or lethargy, paralysis (being unable to move), and lung infection or loss of lung function.

• #1 FloridaHealthFinder | Diphtheria | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/001608

  Diphtheria antitoxin is given as a shot into a muscle or through an IV (intravenous line). The infection is then treated with antibiotics, such as penicillin and erythromycin. […] You may need to stay in the hospital while getting the antitoxin. Other treatments may include: Fluids by IV, Oxygen, Bed rest, Heart monitoring, Insertion of a breathing tube, Correction of airway blockages. […] People without symptoms who carry diphtheria should be treated with antibiotics.

• #1

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Diphtheria is an urgent notifiable condition that must be notified immediately to the department by medical practitioners and pathology services. Exclusion periods apply to both cases and contacts. […] Case management involves diphtheria antitoxin, antibiotic therapy and infection control. […] Management of cases involves diphtheria antitoxin, antibiotic therapy and infection control. Consult the current version of Therapeutic guidelines: antibiotic. Specialist infectious diseases advice should always be sought on clinical suspicion of a case of diphtheria. […] Diphtheria antitoxin should be given if there is strong clinical suspicion, immediately after specimens are taken and without waiting for laboratory confirmation. The dosage will depend on severity, which is assessed by the extent of the pharyngeal membrane and duration of disease.

• #1 Diphtheria Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/diphtheria/

  Hyperthermia related to the release of an exotoxin. […] Imbalanced nutrition: less than body requirements related to painful swallowing. […] Ineffective airway clearance related to pseudomembrane blocking the airway. […] The nursing care planning goals for Diptheria includes: […] The client will be able to maintain a normal body temperature. […] The client will be able to demonstrate and maintain a normal body weight. […] The client will be able to maintain a clear airway. […] The nursing interventions for Diptheria are the following: […] Improve thermoregulation. Maintain room temperature; advise the client to wear thin clothes that absorb sweat easily; encourage to increase oral fluid intake, and administer antipyretics as ordered. […] Improve caloric intake. Monitor calorie intake and quality of food consumption; provide foods that stimulate the appetite, and measure the bodyweight daily.

• #1 Diphtheria Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/diphtheria/

  Improve airway clearance. Auscultate breath sounds, note the presence of an additional breath sounds; place the client in a comfortable position that can aid maximum lung expansion; help performs chest physiotherapy; and suction secretions as needed. […] Nursing goals are met as evidenced by: […] The client was able to maintain a normal body temperature. […] The client was able to demonstrate and maintain a normal body weight. […] The client was able to maintain a clear airway. […] Documentation in a client with diphtheria include: […] Individual findings, include factors affecting, interactions, nature of social exchanges, specifics of individual behavior. […] Cultural and religious beliefs, and expectations. […] Plan of care. […] Teaching plan. […] Responses to interventions, teaching, and actions performed. […] Attainment or progress toward the desired outcome.

• #1 Diphtheria Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient Medications

  https://emedicine.medscape.com/article/782051-followup

  Monitor for serum sickness or hypersensitivity reactions in patients treated with DAT. […] The following medications may be necessary: Bronchodilators (may be beneficial for patients with mild respiratory symptoms), Antipyretics, Antibiotics – Penicillin, erythromycin. […] Intensive care unit admission is recommended for patients with impending respiratory compromise. […] Isolation may be indicated. […] Contact/respiratory isolation is indicated for prevention and deterrence of spreading the infection. […] Complications may include the following: Respiratory failure due to pseudomembrane formation or aspiration, tissue edema, and necrosis, Cardiac – Myocarditis, cardiac dilatation and failure, mycotic aneurysm, endocarditis, Rhythm disturbances – Heart block, including AV dissociation and dysrhythmias, Secondary bacterial pneumonia, Cranial nerve dysfunction and peripheral neuropathy, total paralysis, Optic neuritis, Septicemia/shock (rare), Septic arthritis, osteomyelitis (rare), Metastasis of infection to distant sites such as spleen, myocardium, or CNS (rare), Death.

• #1 Diphtheria Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient Medications

  https://emedicine.medscape.com/article/782051-followup

  Complete age-appropriate immunization schedule. […] Treat all household and other close contacts with antibiotics as mentioned above. All suspected and confirmed carriers should be treated with erythromycin or penicillin for 14 days. […] Follow-up pharyngeal cultures must be obtained post treatment, confirming eradication of the bacterium. […] Provide supportive care, continuation of antibiotic treatment, and antipyretics for fever. […] Closely observe for development of primary or secondary bacterial pneumonia. […] Perform serial ECGs to detect cardiac abnormalities. […] Provide physical therapy for patients with neurologic dysfunction. […] Patients with endocarditis may require valve replacement, especially with previous prosthetic valves. […] Respiratory isolation may be indicated.

• #1 Diphtheria | Nursing Times

  https://www.nursingtimes.net/infection-prevention-and-control/diphtheria-23-09-2003/

  Diphtheria is an acute bacterial disease caused by Corynebacterium diphtheriae. […] Patients with diphtheria require immediate isolation in hospital. […] Treatment consists of an antitoxin and an antibiotic. […] The antitoxin must be administered immediately because once the toxin is fixed to the tissues it cannot be neutralised by the antitoxin. […] The antibiotic needs to be administered for one week to completely eliminate the bacteria. […] Infection does not confer immunity so the patient should receive immunisation before discharge. […] Diphtheria immunisation is recommended for all infants from two months old, as part of routine infant vaccinations. […] A booster dose is also recommended for children immediately before school entry and again for school leavers aged 15 to 19 years.

• #1 Controlling Spread of Diptheria | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/diphtheria-0

  Maintain Droplet Precautions for respiratory diphtheria in healthcare facility or home until two successive pairs of nose and throat cultures obtained not 24 hours after completion of antimicrobial therapy and 24 hours apart are negative. […] If an avirulent (nontoxigenic) strain is documented, isolation is not necessary. […] Contacts whose occupations involve handling food or working with unimmunized children must be excluded from work until two successive pairs of nose and throat cultures, obtained not 24 hours after completion of antimicrobial therapy and 24 hours apart, are negative. […] Close contacts are defined as those who sleep in the same house or who share food, drink, or eating/drinking utensils with the case, or otherwise share saliva with case such as child care contacts, and healthcare workers in contact with the cases oral or respiratory secretions.

• #1 Controlling Spread of Diptheria | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/diphtheria-0

  Place cases of respiratory diphtheria in Droplet Precautions until two cultures from both the nose and the throat are negative for toxigenic C. diphtheriae. […] Treat with appropriate antibiotic, and evaluate cases and symptomatic close contacts for initiation of therapy with DAT. […] Cases and symptomatic close contacts that are not up to date should be immunized with a diphtheria toxoid-containing preparation appropriate for age during convalescence. […] All close contacts (regardless of culture result or immunization status) should begin antibiotic prophylaxis with oral erythromycin. […] Contacts who do not sleep in the same house as the case; do not share food, drink, or eating/drinking utensils with the case; and are not healthcare workers in contact with the cases oral or respiratory secretions should be immunized with the appropriate diphtheria toxoid-containing preparation. […] Vaccination, including routine childhood vaccination and Td boosters beginning at age 11-12 years and continuing every 10 years thereafter, is the best preventive measure against diphtheria.

• #1

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Parenteral antibiotic treatment is usually required initially, and can be either erythromycin or penicillin. These can be substituted with equivalent oral formulations once the patient can swallow comfortably. Antibiotics should be continued to complete a total of 14 days of treatment. […] Use standard precautions with additional respiratory precautions for respiratory tract diphtheria, and standard precautions with additional contact precautions for cutaneous diphtheria, until the case is shown to be clear of carriage via two negative cultures taken at least 24 hours apart, collected at least 24 hours after completing antibiotics. The disease is usually not highly contagious after 48 hours of antibiotic therapy. […] A prophylactic course of 7 days of oral erythromycin or a single dose of benzathine penicillin IM is recommended for close contacts. Such contacts should also be kept under surveillance for 7 days, regardless of their immunisation status. […] Contacts are excluded from childcare and school until cleared by the department. Other contacts are advised to exclude themselves from work, and particularly food handling, until bacteriologic examination shows that they are not carriers of the organism.

• #1 Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/update-on-immunization-and-pregnancy-tetanus-diphtheria-and-pertussis-vaccination

  Obstetric care providers should administer the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine to all pregnant patients during each pregnancy, as early in the 27-36 weeks of gestation window as possible. […] Pregnant women should be counseled that the administration of the Tdap vaccine during each pregnancy is safe and important to make sure that each newborn receives the highest possible protection against pertussis at birth. […] If not administered during pregnancy, the Tdap vaccine should be given immediately postpartum if the woman has never received a prior dose of Tdap as an adolescent, adult, or during a previous pregnancy. […] A woman who did not receive the Tdap vaccine during her most recent pregnancy, but received it previously as an adolescent, adult, or during a prior pregnancy should not receive Tdap postpartum.

• #1 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Yes. There are many different vaccines in the U.S. that are designed to stop diphtheria. Several of them protect you against multiple infections at once, such as pertussis (whooping cough) and tetanus as well as diphtheria. There are different immunization schedules for getting the series of shots, including booster shots after the first ones are given. […] Treatment for diphtheria can be effective. But, even with treatment, roughly 1 out of 10 people might die. For those without treatment, one out of two patients may die. Vaccination is the best choice. If you havent been vaccinated, make an appointment with your healthcare provider. […] Yes. When treated immediately, diphtheria is managed successfully with antitoxins and antibiotics. Vaccination can prevent diphtheria altogether. […] Call your healthcare provider immediately if you or a family member has been exposed to diphtheria. If youre not sure whether youve been vaccinated against diphtheria, schedule an appointment right away. […] Diphtheria is a serious, life-threatening illness that must be treated immediately. If you havent already been vaccinated against diphtheria, or if youre not sure your vaccinations are up to date, schedule an appointment with your healthcare provider right away.

• #1 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Implement evidence-based strategies for the timely and accurate evaluation and diagnosis of diphtheria in clinical practice. […] Apply comprehensive knowledge of diphtheria pathogenesis and toxin distribution in developing effective management plans. […] Select appropriate interventions, including antitoxins and antibiotics, for treating diphtheria, considering individual patient factors. […] Coordinate care efforts for patients with diphtheria, emphasizing the importance of a cohesive and integrated healthcare approach. […] Management includes patient isolation and the administration of antitoxin and antibiotics. […] The primary treatment approaches for diphtheria involve promptly administering antitoxins and antibiotics. Additionally, the patient should undergo a thorough assessment for potential respiratory and cardiovascular instabilities.

• #2 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Diphtheria is a toxin-mediated infection primarily caused by Corynebacterium diphtheriae, a member of the Corynebacterium species. This infectious disease is characterized by skin and mucosal infections, occasionally progressing to focal infection after bacteremia. The clinical manifestations of C diphtheriae infection are diverse and depend on factors such as the anatomical site of infection, the immune status of the host, and the production and systemic distribution of toxins. […] This comprehensive activity provides an in-depth exploration of diphtheria, covering its epidemiology, pathogenesis, clinical features, diagnosis, and management. Emphasizing the collaborative role of an interprofessional healthcare team, the activity aims to equip healthcare professionals with the knowledge and skills necessary for the practical evaluation and management of patients affected by this highly contagious disease.

• #2 Diphtheria | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/112524

  Diphtheria typically initiates with nonspecific flu-like symptoms, including fever, sore throat, and cervical lymphadenopathy. The average incubation period spans 2 to 5 days, ranging from 1 to 10. A travel history from an endemic region with no vaccination records is often indicative. In such instances, healthcare practitioners should be alert to the hallmark features of the disease, notably the presence of a thick, gray, adherent pseudomembrane covering the tonsils and throat. Respiratory tract involvement is common, commencing with mild erythema that later evolves into a merging pseudomembrane. […] The primary treatment approaches for diphtheria involve promptly administering antitoxins and antibiotics. Additionally, the patient should undergo a thorough assessment for potential respiratory and cardiovascular instabilities. In suspected cases of diphtheria, antitoxin should be administered urgently based on clinical judgment without waiting for laboratory confirmation. Suspected cases must be isolated, and stringent droplet precautions should be implemented. Furthermore, the patient should be evaluated for signs of respiratory distress, and ensuring an airway is imperative. Early management also involves continuous cardiac monitoring to address any potential cardiovascular complications.

• #2 Diphtheria Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/782051-treatment

  Careful assessment of airway patency and cardiovascular stability. Patients should be transported to the nearest hospital. […] Treatment of diphtheria should be initiated even before confirmatory tests are completed due to the high potential for mortality and morbidity. […] Isolate all cases promptly and use universal and droplet precautions to limit the number of possible contacts. […] Secure definite airway for patients with impending respiratory compromise or the presence of laryngeal membrane. Early airway management allows access for mechanical removal of tracheobronchial membranes and prevents the risk for sudden asphyxia through aspiration. Consider involving ENT or operating room personnel for intubation and securing of airway if there is suspicion for loss of the airway or respiratory failure.

• #2 Diphtheria Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/diphtheria/

  Hyperthermia related to the release of an exotoxin. […] Imbalanced nutrition: less than body requirements related to painful swallowing. […] Ineffective airway clearance related to pseudomembrane blocking the airway. […] The nursing care planning goals for Diptheria includes: […] The client will be able to maintain a normal body temperature. […] The client will be able to demonstrate and maintain a normal body weight. […] The client will be able to maintain a clear airway. […] The nursing interventions for Diptheria are the following: […] Improve thermoregulation. Maintain room temperature; advise the client to wear thin clothes that absorb sweat easily; encourage to increase oral fluid intake, and administer antipyretics as ordered. […] Improve caloric intake. Monitor calorie intake and quality of food consumption; provide foods that stimulate the appetite, and measure the bodyweight daily.

• #2 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  In suspected cases of diphtheria, antitoxin should be administered urgently based on clinical judgment without waiting for laboratory confirmation. […] Early management also involves continuous cardiac monitoring to address any potential cardiovascular complications. […] Diphtheria antitoxin (DAT), derived from horse antiserum, is crucial in treatment. […] The antibiotics of choice for treating diphtheria are erythromycin or penicillin G. […] Close contacts, including household members and individuals in direct contact with the infected patient, should receive contact prophylaxis. […] Ensuring timely and comprehensive antibiotic treatment is essential for the individual patient, preventing potential outbreaks and minimizing the risk of complications in the broader community.

• #2 Diphtheria Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/782051-treatment

  Maintain close monitoring of cardiac activity for early detection of rhythm abnormalities. Initiate electrical pacing for clinically significant conduction disturbance and provide pharmacologic intervention for arrhythmias or for heart failure. […] Provide 2 large-bore IVs for patients with a toxic appearance; provide invasive monitoring and aggressive resuscitation for patients with septicemia. […] Initiate prompt antibiotic coverage (erythromycin or penicillin) for eradication of organisms, thus limiting the amount of toxin production. Antibiotics hasten recovery and prevent the spread of the disease to other individuals. […] Neutralize the toxin as soon as diphtheria is suspected. Diphtheria antitoxin is a horse-derived hyperimmune antiserum that neutralizes circulating toxin prior to its entry into the cells. It prevents the progression of symptoms. The dose and route of administration (IV vs IM) are dependent on the severity of the disease. This antitoxin must be obtained directly from the Centers for Disease Control and Prevention (CDC) through an Investigational New Drug (IND) protocol. The patient must be tested for sensitivity to the antitoxin before it is given. Antitoxin is only available in the United States. For more information regarding acquisition, see the CDC website for diphtheria antitoxin.

• #2 Diphtheria 📞 | Health and Human Services North Dakota

  https://www.hhs.nd.gov/health/diseases-conditions-and-immunization/immunizations/diphtheria

  Diphtheria treatment involves using diphtheria antitoxin to stop the bacteria toxin from damaging the body. This treatment is very important for respiratory diphtheria infections, but it is rarely used for diphtheria skin infections. Antibiotics are used to kill and get rid of the bacteria. This is important for diphtheria infections in the respiratory system and on the skin and other parts of the body (e.g., eyes, blood). […] People with diphtheria are usually no longer able to infect others 48 hours after they begin taking antibiotics. […] People with diphtheria should be excluded from child care, school, work, or other activities until they have completed their course of antibiotics and are feeling better.

• #2 Diphtheria (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/diphtheria.html

  Diphtheria is a bacterial infection. It spreads easily and happens quickly, and mainly affects the nose and throat. Children under 5 and adults over 60 years old are particularly at risk for getting it. […] Children and adults with diphtheria are treated in a hospital. After a doctor confirms the diagnosis through a throat culture, the infected person gets a special anti-toxin, given through injections or an IV, to neutralize the diphtheria toxin already circulating in the body, plus antibiotics to kill the remaining diphtheria bacteria. […] A person with diphtheria must be isolated. Family members and other close contacts who haven’t been immunized, or who are very young or elderly, must be protected from contact with the patient. […] With prompt care in a hospital, most patients recover from diphtheria. After the antibiotics and anti-toxin take effect, they will need bed rest for a while (4 to 6 weeks, or until full recovery). Bed rest is particularly important if someone develops myocarditis (inflammation of the heart muscle), which can be a complication of diphtheria. […] After recovery, people who had diphtheria should still get all the diphtheria vaccine shots to protect them from another infection. Having had the disease doesn’t guarantee lifetime immunity.

• #2 Diphtheria Nursing Care Management: Study Guide – Nurseslabs

  https://nurseslabs.com/diphtheria/

  Improve airway clearance. Auscultate breath sounds, note the presence of an additional breath sounds; place the client in a comfortable position that can aid maximum lung expansion; help performs chest physiotherapy; and suction secretions as needed. […] Nursing goals are met as evidenced by: […] The client was able to maintain a normal body temperature. […] The client was able to demonstrate and maintain a normal body weight. […] The client was able to maintain a clear airway. […] Documentation in a client with diphtheria include: […] Individual findings, include factors affecting, interactions, nature of social exchanges, specifics of individual behavior. […] Cultural and religious beliefs, and expectations. […] Plan of care. […] Teaching plan. […] Responses to interventions, teaching, and actions performed. […] Attainment or progress toward the desired outcome.

• #2 FloridaHealthFinder | Diphtheria | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/001608

  Diphtheria antitoxin is given as a shot into a muscle or through an IV (intravenous line). The infection is then treated with antibiotics, such as penicillin and erythromycin. […] You may need to stay in the hospital while getting the antitoxin. Other treatments may include: Fluids by IV, Oxygen, Bed rest, Heart monitoring, Insertion of a breathing tube, Correction of airway blockages. […] People without symptoms who carry diphtheria should be treated with antibiotics.

• #2

  https://www.pediatriconcall.com/question-of-the-day/what-is-the-nursing-management-of-diptheria-and-wh/11761

  Specific antitoxin is the mainstay of therapy and should be administered on the basis of clinical diagnosis because it neutralizes free toxin only. […] Antimicrobial therapy is indicated to halt toxin production, treat localized infection, and prevent transmission of the organism to patient contacts. […] Patients with difficulty in breathing will require tracheostomy. […] Diphtheria patients need bed rest with intensive nursing care. […] Patients with laryngeal diphtheria are kept in a croup tent or high-humidity environment they may also need throat suctioning or emergency surgery if their airway is blocked. […] Care of tracheostomy tube would be required.

• #2 Diphtheria Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient Medications

  https://emedicine.medscape.com/article/782051-followup

  Monitor for serum sickness or hypersensitivity reactions in patients treated with DAT. […] The following medications may be necessary: Bronchodilators (may be beneficial for patients with mild respiratory symptoms), Antipyretics, Antibiotics – Penicillin, erythromycin. […] Intensive care unit admission is recommended for patients with impending respiratory compromise. […] Isolation may be indicated. […] Contact/respiratory isolation is indicated for prevention and deterrence of spreading the infection. […] Complications may include the following: Respiratory failure due to pseudomembrane formation or aspiration, tissue edema, and necrosis, Cardiac – Myocarditis, cardiac dilatation and failure, mycotic aneurysm, endocarditis, Rhythm disturbances – Heart block, including AV dissociation and dysrhythmias, Secondary bacterial pneumonia, Cranial nerve dysfunction and peripheral neuropathy, total paralysis, Optic neuritis, Septicemia/shock (rare), Septic arthritis, osteomyelitis (rare), Metastasis of infection to distant sites such as spleen, myocardium, or CNS (rare), Death.

• #2 Diphtheria Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient Medications

  https://emedicine.medscape.com/article/782051-followup

  Cardiac involvement is associated with a very poor prognosis, particularly AV and left bundle-branch blocks (mortality rate 60-90%). […] Bacteremic disease carries a mortality rate of 30-40%. […] High mortality rate is seen with invasive disease. […] High mortality rates are seen in individuals younger than 5 years and in those older than 40 years. […] Widespread awareness of the need for universal immunization is indicated. […] Stress the importance of seeking medical attention in all cases of contact with suspected diphtheria cases.

• #2 Diphtheria | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/diphtheria.html

  For healthcare personnel who have an exposure to diphtheria, regardless of vaccination status: […] Exclude from work and obtain nasal and pharyngeal swabs for diphtheria culture. […] Implement daily monitoring for the development of signs and symptoms of diphtheria for 7 days after the last exposure. […] For healthcare personnel with respiratory diphtheria infection, exclude from work until: […] For healthcare personnel with cutaneous diphtheria infection or other diphtheria infection manifestations, determine the duration of exclusion from work in consultation with federal, state, and local public health authorities. […] Prevention of transmission of C. diphtheriae in healthcare settings involves: […] excluding potentially infectious HCP from work. […] Treatment for diphtheria is begun at the first sign(s) of clinical illness. […] Administration of PEP or treatment for diphtheria does not always eliminate the carrier state. […] For HCP identified as toxin-producing C. diphtheriae carriers, positive post-treatment cultures typically prompt administration of additional courses of treatment.

• #2

  https://www.health.vic.gov.au/infectious-diseases/diphtheria

  Parenteral antibiotic treatment is usually required initially, and can be either erythromycin or penicillin. These can be substituted with equivalent oral formulations once the patient can swallow comfortably. Antibiotics should be continued to complete a total of 14 days of treatment. […] Use standard precautions with additional respiratory precautions for respiratory tract diphtheria, and standard precautions with additional contact precautions for cutaneous diphtheria, until the case is shown to be clear of carriage via two negative cultures taken at least 24 hours apart, collected at least 24 hours after completing antibiotics. The disease is usually not highly contagious after 48 hours of antibiotic therapy. […] A prophylactic course of 7 days of oral erythromycin or a single dose of benzathine penicillin IM is recommended for close contacts. Such contacts should also be kept under surveillance for 7 days, regardless of their immunisation status. […] Contacts are excluded from childcare and school until cleared by the department. Other contacts are advised to exclude themselves from work, and particularly food handling, until bacteriologic examination shows that they are not carriers of the organism.

• #2 Diphtheria – IAFFDiphtheria – IAFF

  https://www.iaff.org/infectious-disease/diseases/diphtheria/

  Diphtheria is a vaccine preventable disease. Diphtheria, tetanus and pertussis are combined in one vaccination for children. Adults should receive the tetanus and diphtheria booster every ten years. […] In addition to vaccination, you can help prevent the spread of diphtheria by: […] Using Droplet and Universal Precautions […] Hand hygiene (wash with soap and water or using an alcohol based hand rub) […] Personal protective equipment (PPE) (gloves, gowns, goggles, and respiratory protection). IAFF recommends P100 respirators for all patients with respiratory symptoms such as cough. […] Post exposure prophylaxis for anyone who has encountered diphtheria includes immunization with the diphtheria toxoid or a booster if already vaccinated. Treatment of suspected diphtheria is with an antitoxin as well as antibiotics such as penicillin. Symptoms can be improved with oxygen, bed rest, IV fluids as needed and a breathing tube.

• #2 Diphtheria | Georgia Department of Public Health

  https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/vaccine-preventable-diseases/diphtheria

  After the provisional clinical diagnosis is made and appropriate cultures are obtained, persons with suspected diphtheria should be given antitoxin and antibiotics in adequate dosage and placed in isolation. […] Respiratory support and airway maintenance should also be administered as needed. In the United States, diphtheria antitoxin can be obtained from CDC on request. […] Treatment with erythromycin orally or by injection (40 mg/kg/day; maximum, 2 gm/day) for 14 days, or procaine penicillin G daily, intramuscularly (300,000 U/day for those weighing 10 kg or less, and 600,000 U/day for those weighing more than 10 kg) for 14 days. […] For close contacts, especially household contacts, a diphtheria toxoid booster, appropriate for age, should be given. […] Contacts should also receive antibiotics benzathine penicillin G (600,000 units for persons younger than 6 years old and 1,200,000 units for those 6 years old and older) or a 7- to 10-day course of oral erythromycin, (40 mg/kg/day for children and 1 g/day for adults). […] Contacts should be closely monitored and antitoxin given at the first sign(s) of illness.

• #2 Diphtheria | Texas DSHS

  https://www.dshs.texas.gov/vaccine-preventable-diseases/vaccine-preventable-disease-conditions/diphtheria

  Diphtheria is caused by the toxins released by the bacteria Corynebacterium diphtheriae. […] Diphtheria is usually spread from person-to-person from respiratory secretions. Occasionally, there may be transmission from contact with skin lesions. […] Respiratory diphtheria (includes laryngeal, pharyngeal and tonsillar diphtheria) presents as a sore throat with low-grade fever. Within 2-3 days, a membrane forms that may cover the throat, tonsils, larynx, nose and/or the soft palate. Neck swelling is usually present in severe disease. The membrane can lead to airway obstruction, coma and death. […] Cutaneous diphtheria presents as infected skin lesions which lack a characteristic appearance. Cutaneous diphtheria is generally not toxigenic (the bacteria does not release toxins). […] Diphtheria toxoid (contained in Tdap, DTP, DTaP, DT or Td vaccines) can prevent this disease. Vaccination against diphtheria is recommended for children and adults. […] Respiratory diphtheria has become an extremely rare disease in the U.S. There has not been a case in Texas in over 30 years. Diphtheria is still present in other parts of the world and may be imported by international travelers.

• #2 Diphtheria | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/diphtheria

  If diphtheria is suspected, treatment begins before the test results are back from the laboratory. Treatment may include: hospitalisation, isolation to prevent the spread of infection, antibiotics, such as penicillin, to destroy the bacteria, diphtheria antitoxin given, other medicines to reduce the risk of adverse reactions to the vaccine, for example corticosteroids, adrenaline or antihistamines, surgery to remove the grey membrane in the throat, if necessary, treatment of complications, for example medications to treat myocarditis, bed rest for about six weeks or longer, depending on the severity of the illness. […] The best prevention against diphtheria is immunisation. […] People who are caring for someone with diphtheria should practise strict hygiene for example, wash hands frequently, particularly before handling, preparing or eating food and get a booster vaccination. All contacts should also receive a course of antibiotics.

• #2 Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/update-on-immunization-and-pregnancy-tetanus-diphtheria-and-pertussis-vaccination

  Pregnant women should be counseled that Tdap vaccination during each pregnancy is safe and important to make sure that each newborn receives the highest possible protection against pertussis at birth. […] The American College of Obstetricians and Gynecologists encourages obstetriciangynecologists and other obstetric care providers to strongly recommend and offer Tdap vaccination to all pregnant women between 27 weeks and 36 weeks of gestation in each pregnancy. […] Additionally, efforts to stock the Tdap vaccine in the obstetriciangynecologists or other health care providers office and administer it as early in the recommended window as possible offers the best chance of vaccine acceptance and neonatal protection. […] If a Td booster vaccination is indicated during pregnancy (ie, more than 10 years since the previous Td vaccination) then obstetriciangynecologists and other health care providers should administer the Tdap vaccine during pregnancy within the 27-36 weeks of gestation window. […] To ensure protection against maternal and neonatal tetanus, pregnant women who have never been vaccinated against tetanus should begin the three-vaccination series, containing tetanus and reduced diphtheria toxoids, during pregnancy.

• #2 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Diphtheria treatment begins immediately sometimes even before the lab test results are confirmed. Your healthcare provider will prescribe diphtheria antitoxin to stop damage to your organs. Theyll also prescribe antibiotics, typically penicillin or erythromycin, to fight infection. […] People with diphtheria are kept in isolation to prevent others from becoming infected. An infected person is no longer contagious around 48 hours after taking antibiotics. When treatment ends, tests will be run again to make sure the bacteria are gone. Once the bacteria are gone, you will get a vaccine to prevent future infections. […] Diphtheria can result in a number of long-term complications, including blockage of your air passages, injury to your heart muscle, injury to your nerves, sluggishness or lethargy, paralysis (being unable to move), and lung infection or loss of lung function.

• #3 Diphtheria | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/112524

  Diphtheria antitoxin (DAT), derived from horse antiserum, is crucial in treatment. Antitoxin functions by neutralizing unbound diphtheria toxin circulating in the blood. The antitoxin becomes ineffective once the toxin has bound to the cell membrane. The dosage of antitoxin is tailored to the patient’s clinical state and the severity of the condition, and it can be administered intramuscularly or intravenously. […] The antibiotics of choice for treating diphtheria are erythromycin or penicillin G. Erythromycin is prescribed at a dose of 500 mg 4 times a day for a 2-week duration. Penicillin G is administered intramuscularly, with a dosage of 300,000 units every 12 hours for patients weighing 10 kg or less and 600,000 units every 12 hours for those weighing more than 10 kg. Once the patient can take oral medication, oral penicillin V can be initiated at a dose of 250 mg 4 times daily for 2 weeks. Early initiation of antibiotics is crucial to eliminate the organism promptly, limiting toxin release, expediting patient recovery, and preventing infection spread to close contacts. […] Patients with suspected or confirmed diphtheria require immediate isolation and appropriate medical management.

• #3 Controlling Spread of Diptheria | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/diphtheria-0

  Place cases of respiratory diphtheria in Droplet Precautions until two cultures from both the nose and the throat are negative for toxigenic C. diphtheriae. […] Treat with appropriate antibiotic, and evaluate cases and symptomatic close contacts for initiation of therapy with DAT. […] Cases and symptomatic close contacts that are not up to date should be immunized with a diphtheria toxoid-containing preparation appropriate for age during convalescence. […] All close contacts (regardless of culture result or immunization status) should begin antibiotic prophylaxis with oral erythromycin. […] Contacts who do not sleep in the same house as the case; do not share food, drink, or eating/drinking utensils with the case; and are not healthcare workers in contact with the cases oral or respiratory secretions should be immunized with the appropriate diphtheria toxoid-containing preparation. […] Vaccination, including routine childhood vaccination and Td boosters beginning at age 11-12 years and continuing every 10 years thereafter, is the best preventive measure against diphtheria.

• #3 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Diphtheria treatment begins immediately sometimes even before the lab test results are confirmed. Your healthcare provider will prescribe diphtheria antitoxin to stop damage to your organs. Theyll also prescribe antibiotics, typically penicillin or erythromycin, to fight infection. […] People with diphtheria are kept in isolation to prevent others from becoming infected. An infected person is no longer contagious around 48 hours after taking antibiotics. When treatment ends, tests will be run again to make sure the bacteria are gone. Once the bacteria are gone, you will get a vaccine to prevent future infections. […] Diphtheria can result in a number of long-term complications, including blockage of your air passages, injury to your heart muscle, injury to your nerves, sluggishness or lethargy, paralysis (being unable to move), and lung infection or loss of lung function.

• #3 Diphtheria: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/17870-diphtheria

  Yes. There are many different vaccines in the U.S. that are designed to stop diphtheria. Several of them protect you against multiple infections at once, such as pertussis (whooping cough) and tetanus as well as diphtheria. There are different immunization schedules for getting the series of shots, including booster shots after the first ones are given. […] Treatment for diphtheria can be effective. But, even with treatment, roughly 1 out of 10 people might die. For those without treatment, one out of two patients may die. Vaccination is the best choice. If you havent been vaccinated, make an appointment with your healthcare provider. […] Yes. When treated immediately, diphtheria is managed successfully with antitoxins and antibiotics. Vaccination can prevent diphtheria altogether. […] Call your healthcare provider immediately if you or a family member has been exposed to diphtheria. If youre not sure whether youve been vaccinated against diphtheria, schedule an appointment right away. […] Diphtheria is a serious, life-threatening illness that must be treated immediately. If you havent already been vaccinated against diphtheria, or if youre not sure your vaccinations are up to date, schedule an appointment with your healthcare provider right away.

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