Poliomyelitis (2)

8/3/2019 Poliomyelitis (2)

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LECTURER : MS. LYNIE JOHARI


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GROUP MEMBER

y Martina Abdul Latif

y Mazliana Abdul Majid

y Maznah Mohd Nor

y Merghie Masugi

y Noorafeah Ariffin

y Norlinda Sayuti

yNorain Mohd Yussof

y Roslina Yusof

y Roozneh Jahimin

y Siti Hadriani Kasi

y Siti Rohana Lias

y Steefy Grace Mickey

y Sujilawathy Ismail

ySyazawardah Syaripuddin


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Definition

yPoliomyelitis is an infectious viral disease thataffects the central nervous system and cancause paralysis.

y It is also called polio or infantile paralysis.y Most commonly infects younger children,

although older children and adults can beinfected.


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Etiology / Causes.

yCauses of Poliomyelitis is byinfection genus enterovirus known

as Poliovirus.


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Incubation period

yThe incubation period ranges fromthree to 21 days.

y

But cases are most infectious fromseven to ten days before and after theonset of symptoms.


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Modes of transmission

y Direct person-to-person contact

yContact with infected mucus or phlegmfrom the nose or mouth

yContact with infected fecesyBy eating contaminated foods, with

waste products from

the intestines (feces) or dropletsof moisture (saliva) from an infectedperson.


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Clinical manifestation

y Headache

y Slight fever

y Malaise

yVomiting

y Diarrhea

yFatigue

y Skin rash or lesionyAbnormal sensations


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Complication

y Aspiration pneumoniay Cor pulmonale (a form of heart failure found on the

right side of the circulation system)y High blood pressurey

Kidney stonesy Lack of movementy Lung problemsy Myocarditisy Paralytic ileus (loss of intestinal function)

y Permanent muscle paralysis, disability, deformityy Pulmonary edemay Shocky Urinary tract infections


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management

y Rehabilitation Program

Physical Therapy:

Physical therapy plays an important role in

rehabilitation for patients with poliomyelitis.Patients with muscle paralysis benefit from frequent

passive range of motion (PROM) and splinting of jointsto prevent contracture and joint ankylosis.

Chest physical therapy (CPT) helps patients with

bulbar involvement prevent any pulmonarycomplications, such as atelectasis. Frequentrepositioning of paralyzed patients helps to preventbedsores .


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Cont

y Occupational Therapy

yPatients with paralysis of the extremities maybenefit from hand or arm splints, knee or

trochanter rolls, a footboard, or Multi-Podusboots to prevent foot drop, ulcers, and otherdeformities.

y Hot packs also are helpful to relieve themuscle pain.


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Cont

y Speech Therapyy Speech therapist needs to be involved early to

perform an evaluation of the safety of swallowing.

y Decisions on the appropriate consistency of oralfoods and use of various strategies/techniques

greatly reduce the risk of aspiration.


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Cont.

y Recreational Therapy

y Patientsmayattend leisureactivitiestoreducestressand learn howto getinvolvedin groupactivities.


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Preventive measure


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Nursing diagnosis Goal Nursing intervention

Potential altered skinintegrity related toimmobility.

Patient will maintain anintact skin.

Immobility.Assess the patientability to change position.Monitor the skincondition.Carry out pressure

area 4 hourly.Keep patient skin cleanand dry.Reduce pressure onthe skin.Provide good skin care,

reposition the patientoften, and keep bedlinens dry.

Nursing Care Plan


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Cont.Impaired physicalmobility

Patient will maintainand improve functionalabilities.

Complete bed rest.Monitor patient'slevel of consciousness.To alleviatediscomforts,use foamrubber pads andsandbags or light

splints as ordered.Physiotherapy may benecessary.Moist heatapplication to decreasemuscular pain.


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Cont.

Constipation relatedto immobility.

Patient will pass outnormal stool.

Encourage oralintake of food andfluid.Increase fiber diet.Plenty of fluid(if not

contraindicated).Prevent fecalimpaction by givingenough fluids toensure an adequatedailyurine output of

low specific gravity.Give stool softenerasprescribed.


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Nursing Intervention

y Maintain a patent airway, and keep a tracheotomytray at the patients bed side.

y Encourage a return to mild activity as soon aspossible.

y Prevent fecal impaction by giving enough fluids toensure an adequate daily urine output of low specificgravity.

y Provide tube feedings when needed

y Wash hands thoroughly after contact with thepatient or any of his secretions and excretions.


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Cont .

yFrequently check blood pressure, especially ifthe patient has bulbar poliomyelitis.

yAssess bladder retention that cause muscle

paralysis.y Have the patient wear high-top sneakers or

use a footboard to prevent foot drop.

yProvide emotional support to the patient andhis family


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Conclusion

yPoliomyelitis is infectious virus diseasethataffect the central nervous system.

y Caused by poliovirus.

y Infected through the fecal oral route.


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References

http://nursingcrib.com/case-study/poliomyelitis/5/

http://www.nursing-

lectures.com/2011/03/poliomyelitis-nursing-intervention-and.html

ursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-poliomyelitis.html


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Documents

Poliomyelitis (2)