Question

Communicable Diseases: Expected Findings for Infectious Mononucleosis ( please fill every box!!! including Safety considerations!!!)

ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

Answer :

Infectious mononucleosis :

• It is acute self limiting infection of RE system.
• Incubation period is 4-7 weeks .
• Enlarged lymphnodes in neck .

Alteration in health (diagnosis ) : infectious mononucleosis .

Pathophysiology :

• EBV is transmitted his intimate contact with body secretions , primarly oropharyngeal secretions . EBV infects the B cells in the oropharyngeal epithelium. The organism may also be shed from the uterine cervix ,implicating the role of genital transmission in some cases .on rare occasion EBV is spread via blood transfusion.
• Circulating B cells spread the infection throughout the entire reticular endothelial system ,i.e liver ,spleen and peripheral lymph nodes .EBV infection of B lymphocytes results in a humoral and cellular response to the virus .the humoral immune response directed against EBV structural protein is the basis For the test used to diagnose EBV infectious mononucleosis .how ever ,the T lymphocyte response is essential in the control of EBV infection , the natural killer Nk cells and predominantly CD8 cytotoxic T cells control proliferating B lymphocytes infected with EBV.
• The T lymphocyte cellular response is critical in determining the clinical expression of EBV viral infection .A rapid and efficient T cell response results in control of the primary EBV infection and life long suppression of EBV.

Health promotion and disease prevention :

• Avoid close contact with body fluid secretions ,particularly saliva .
• If slpenic ruprure is recognised and expenditiously treated surgically ,the prognosis is good .
• Patient with EBV infectious mononucleosis who become asplenic as the results of splenic rupture and or surgical removal should be treated .
• Close monitoring .
• early detection and prompt treatment
• Early identification .

Risk factors :

• The only predisposing risl factors For EBV infectious mononucleosis is close contact with an individual infected with EBV.
• EBV commonly persists in oropharyngeal secretions For months after clinical resolution of EBV infectious mononucleosis .
• Patients with congenital immunodeficiencies are predisposed to EBV induced lymphoprolifirative disorders and malignancies .
• Acquired immunodeficiencies due to the effects of immunosuppression or infectious disease induced immunosuppression may predispose to oral hairy leukoplakia or non hodgekin lymphoma .
• Burkitt lymphoma has a distribution that is the same as the distribution of malaria .the geographic location predisposes to burkitt ltmphoma in children

Signs and symptoms :

• Fever
• Lymphadenopathy
• Pharyngitis .
• Rash
• Peri orbital edema
• Bradycardia
• Later physical findings includes hepatomegaly ,palatal petechiae , jaundice, uvular edema ,splenomegaly .
• CNS findings associated with EBV mononucleosis are rare usually occur later in the course of illness .
• Splenic tenderness
• Jaundice

Laboratory tests :

• EBV infection induces specific antibodies to EBV and various unrelated non EBV heterophile antibodiies .
• These heterophile antibodies react to antigens from ani.al RBCs .
• Sheep RBC s agglutinate in the presence of heterophile antibodies andcare the basis For the paul bunnell test .
• Agglutination of horse RBC on exposure to heterophile antibodies is the basis of the monospot test.
• The heterophile antibody test
• The latex agglutination assay

Medications :

• No effective antiviral therapy is available For EBV virus infectious mononucleosis in immunocompetent persons .acyclovir and ganciclovir may reduce EBV shedding but are ineffective clinically .
• Short course of corticosteroids are indicated For EBV infectious mononucleosis

Nursing care :

Close monitoring of patient with extreme tonsillar enlargement For airway obstruction .

Educate the patient to take balanced they in appropriate manner .

Encouraged to rest as much as possible and refrain from active physical activity For 3 weeks .

Advice to come For regular followups .

Encourage patient to drink plenty of water to prevent dehydration.

Advice them to avoid intimate contact with others

Adminitration of analgesics and antipyretic medication as ordered by doctor .

Monitor vital signs .

Advise patient that they may feel some lethargy For about 2-3 months following infection.

Complications :

Extreme enlargement of the tonsils may results in airway obstruction.

Rncephalitis and myocarditis are rare complications

Splenic rupture is a rare complication,but potentially lethal

Rare patients with EBV infectious mononucleosis develop lymphoma .

Therapeutic procedures :

Surgery is necessary For spontaneous splenic rupture .

Safety considerations :

Avoiding close contact with infected people .