Chapter 08: Communicable Diseases

Funding local government provision of safe water

Using the power to impose quarantine

 Requiring pasteurization of all milk

Regulating disposal of waste (garbage and feces)

 Give samples of the organism to three different researchers and see whether all three researchers can grow it successfully.

Grow the organism on the diseased tissue and then see whether, when spread on normal tissue, the organism continues to grow.

 Identify microorganisms under a microscope and grow them on the tissue that the disease usually infects.

Identify the organism, isolate the organism, and see if the organism produces disease.

They help keep the environment free of the infectious agent.

They help the host resist the infection.

The kill the entire infectious agent upon contact with it.

They reduce the time during which the disease is contagious in the infected person.

 Creation of effective broad-spectrum antibiotics

National immunization campaigns to protect children

Growth of hospitals and medical and nursing schools in the twentieth century

Safe water and sewage systems, as well as milk pasteurization

They account for 25% of all physician visits and are still a major cause of death.

They are not a community/public health problem in the United States.

 They are a major source of morbidity in the world, but not in the United States.

They are rarely fatal in the United States.

People had stopped getting immunizations for measles and other diseases.

 The measles vaccine was no longer effective against the agent because the virus had mutated.

The measles vaccine did not provide lifetime immunity.

 Thousands of ineffective contaminated vaccine doses had unknowingly been injected.

 People had stopped getting immunizations for mumps and other diseases.

 The mumps vaccine is no longer effective against the agent because the virus had mutated.

The mumps vaccine does not provide lifetime immunity.

Thousands of ineffective contaminated vaccine doses had unknowingly been injected.

Fairly high, as there is no way to prevent being exposed to measles during childhood

Fairly low, as measles usually hits in late adolescence now

Low, as most of the childs playmates have been immunized

Very high without the protection of immunization

Adolescents who have not yet received their booster shots

Persons older than 65 who live in nursing homes and other extended-care facilities

Elementary school children who have not been immunized

Young adults who have never been exposed to the agent before

Antibiotics wont be helpful in treating this infection, but they may allow bacteria that will be immune to antibiotics to develop, putting you at high risk for getting sicker.

Ill write you a prescription for a special new research drug that works wonders with viral respiratory infections. Then the FNP writes a prescription for a placebo.

Im the expert. Ill decide when you need an antibiotic. And you do not need one.

Of course; I always try to meet the needs of my clients. Which antibiotic do you find works best for you?

The woman who has been taking antituberculosis medication for 3 months

The elderly woman who recently emigrated with her family from Asia

A full-time nurse at the local public health clinic

A volunteer nurse aide at the sexually transmitted disease clinic

Drug-resistant Salmonella infection

Hepatitis B virus (HBV)

Multidrug-resistant tuberculosis (MDR-TB)

Sexually transmitted diseases (STDs), including acquired immune deficiency syndrome (AIDS)

Ticks can carry noroviruses, which are then easily spread from person to person.

Ticks can carry hantavirus, which is 30% to 40% fatal.

Ticks can carry Lyme disease, which is the most common vector-borne disease in the United States.

Ticks can carry West Nile virus, which causes disease that is currently considered an epidemic.

You should avoid forested areas to protect yourself.

Dont touch any dead birds or other small animals.

 Wear insect repellent because the disease is spread by infected mosquitoes.

 The disease is present in only isolated areas of the United States.

 The young woman who has just passed the National Council Licensure Examination (NCLEX) and is beginning employment

The middle-aged man who, along with a wife and oldest child, works at a relatives restaurant

The young woman whose first child has just been enrolled in daycare

A middle-aged woman who cares for her elderly mother and father in their home when not at work as a receptionist

The staff working in the operating room and the emergency department, where open wounds are frequent

 The clients with indwelling portals of entry, such as Hickman catheters

The cleaning/maintenance personnel, who must maintain high standards of cleanliness in the hospital

The visitors coming into the facility, who are bringing outside organisms into the hospital

 Ensuring total compliance by clients to their treatment regimens

 Balancing individual autonomy against community protection

Providing home care versus insisting that the client come to the clinic

Allowing human immunodeficiency virus (HIV) carriers, even if licensed professionals, to be employed within health care agencies

 Diagnose the disease, ask patients to name contacts, and then find those contacts.

Diagnose the problem, treat it, and then interview the client.

 Identify the disease, isolate the causative agent, and determine the method of transmission.

Use the media to share symptoms and causes and then have professionals available to answer telephone calls, being sure to obtain names of infected persons.

 How easily the agent can mutate to a form that can survive

 How invasive and virulent the organism is

How much of the agent must be present to produce an illness

How specific the host must be for the organism to thrive

. The backpacker refilled his water container from a faucet in the park labeled potable water.

 The biologist decided to set up his living quarters in one of the dusty caves, which he first swept out.

The nursing assistant first put on a pair of gloves and then picked up the soiled dressing.

 The waiter went to the rest room, scrubbed his hands, and then returned to serving the meal.

The nurse who has received three doses of hepatitis B vaccine

The parents who took their child to a neighbors house to expose the child to the mumps

The adult who received three doses of live antigen polio vaccine

The newborn who had not yet received any immunizations

 More people came each night with used needles, asking to exchange them.

The local health department reported a downward trend in newly diagnosed human immunodeficiency virus (HIV) infection.

Persons who stayed at the shelter frequently expressed appreciation to the nurse.

The staff of the homeless shelter stated that they had been serving fewer clients.

The U.S. Department of Health and Human Services

The Centers for Disease Control and Prevention

The local health department

The state health department

Attending a free community screening

 Engaging in breast self-examination (women) or testicular self-examination (men)

Following up on any positive screening test

 Immunization according to the recommended schedule

Attending the free immunization clinic to say hello to his social contacts

Bringing his elderly wife and both receive the influenza immunization

Realizing that at his advanced age, hes already immune to influenza, and so he does not need to attend the clinic

Recalling that he and his spouse received an influenza vaccine last year, and so they already have immunity

A member of the janitorial staff who cleans floors and equipment in the hospital

 An adult male who is a firefighter and a trained paramedic

The family nurse practitioner who sees private clients for health teaching

 The nurse who is a first assistant to the physician in the operating room

Hepatitis B antibody titer

Human immunodeficiency virus (HIV) test

Mantoux test for tuberculosis exposure

Urine test for drug use

The laboratory results were inconclusive, and the test must be repeated.

The test result came back negative, but he will be asked for a donation.

The test result came back positive, and the staff want to support him emotionally when this information is shared with him.

 The staff want to counsel him on safer sex practices regardless of the test results.

Checking with the local public health department regarding current epidemics or precautions

Eating correctly, exercising every day, and getting adequate sleep

Performing frequent hand-washing with soap and water, especially before eating or touching the face

 Visiting a health care provider once a year for scheduled screenings

As a literal captive audience, prisoners are a group in which treatment can be enforced.

 Risk for infection is nearly five times higher among prisoners than in the general population.

There can be no stigma or discrimination, inasmuch as all prisoners are equal before the law.

This will help protect the public when prisoners are released because if the infection is diagnosed, it can then be treated.

Upon telephoning the man, the nurse shared that he had been named as a contact and he needed to come in and be tested

When the man came to the STD clinic, he was interviewed, including being asked if he had ever used drugs for recreational purposes.

When the man was found to test positive for an STD, he was interviewed regarding contacts and asked whether he wished to discuss the problem with his wife or if he wanted the nurse to talk to his wife.

When the man was not home, the nurse told another person who answered the phone that the STD clinic had called and to please have the man call this number.