PATIENT’S PROFILE

Name: Ms. JD

Age: 20 y/o

Gender: Female

Civil Status: Single

Birth date: 11/13/1989

Nationality: Filipino

Religion: Roman Catholic

Address: Novaliches Qc

Educational Background: High school Graduate

Occupation: None

Date of admission: 08/29/2010

Time of admission: 12:26 pm

Chief complaint: body malaise

Mode of arrival: via stretcher

Admitting diagnosis: typhoid fever dengue

Final Diagnosis: typhoid fever

Attending Physician: Dr. X44

Source of information: Patients, patient’s chart, Record’s section

II. NURSING HISTORY

1. Childhood illness- other than chicken pox, fever and common colds the patient said she
didn’t experienced illness.

2. Immunization- patient reported that she was not sure if she had completed all the
immunization when she was young.

3. Allergies- clients reported that she has no any allergies to food and medications.

4. Hospitalization- The patient reported that she never been hospitalized since her childhood
5. Medications- 7 days prior to admission to SLH due to prominent symptoms the patients was
rushed to QCGH and advised to take paracetamol.
6. Foreign Travel- NONE

B. History of Present Illness

2 weeks prior to admission the experienced intermittent fever, abdominal pain, headache,
vomiting, and blood tinge gum from bleeding, loss of appetite, body malaise.

C. Family Health History

A. Psychological Health

1. Coping Pattern- Ms. JD has the ability to deal with her anxiety and problems, they provide a
starting point for developing a plan and determine what information they need to solve their
problem.

2. Interaction Pattern- according to her she can understand both English and Tagalog and can
speak and understand bisaya language.

3. Cognitive Pattern- Ms.JD is a high school graduate. She was not able to finish college
because of poverty. But she can read and understand and speak English nicely.

4. Self Concept-

5. Emotional-she easily gets emotional when the concern is about her family. She reported that
she cannot live without her family besides her.
B. Sociocultural Health

1. Cultural Pattern- Ms. JD reside in Novaliches Quezon City She can speak tagalong and
English, but most of the time she speak tagalong. They have own their house in the address says
above and living peacefully with her family.

2. Significant Relationships- Her family is the most important for her. She wants to be with
them always. It’s her family who helps her in times of her needs and also supports her in times of
stress.

3. Recreation Pattern- Her usual activities are reading, walking and watching T.V. She is also
loves surfing the net.

4. Environment- According to her they reside in a friendly neighborhood but with poor drainage
system in their breeding grounds of mosquitoes are rampant on their neighborhood.

5. Economics
OBJECTIVES
•GENERAL OBJECTIVE
This case study aims to identify and determine the general health problems and
needs of the patient with an admitting diagnosis of typhoid Fever. This also intends to
help patient promote health and medical understanding of such condition through the
application of the nursing skills.
•SPECIFIC OBJECTIVES
-To raise the level of awareness of patient on health problems that he may encounter.
-To facilitate patient in taking necessary actions to solve and prevent the identified
problems on his own.
-To help patient in motivating him to continue the health care provided by the health
workers.
-To render nursing care and information to patient through the application of the nursing
skills.
OVERVIEW
· Fever from bacterial food poisoning.
· An acute systemic febrile infection caused by SALMONELLA TYPHI, a
serotype of SALMONELLA ENTERICA.
· Serious infection marked by intestinal inflammation and ulceration;
caused by Salmonella typhosa ingested with food or water.
INTRODUCTION
A gastrointestinal condition mainly in the developing world. It is caused by a
bacterial infection, usually as a form of food poisoning. Typhoid fever is
unrelated to the similarly named typhus (a tick-borne infection).
DEFINITION
Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in
industrialized countries. However, it remains a serious health threat in the
developing world. Typhoid fever spreads through contaminated food and water
or through close contact with someone who's infected. Signs and symptoms
usually include high fever, headache, abdominal pain, and either constipation or
diarrhea.
When treated with antibiotics, most people with typhoid fever feel better
within a few days, although a small percentage may die of complications.
Vaccines against typhoid fever are available, but they're only partially
effective. Vaccines are usually reserved for those who may be exposed to the
disease or are traveling to areas where typhoid fever is common.
SIGNS AND SYMPTOMS
FIRST STAGE
Once signs and symptoms do appear, you're likely to experience:
· Fever, often as high as 103 or 104 F (39 or 40 C)
· Headache
· Weakness and fatigue
· A sore throat
· Abdominal pain
· Diarrhea or constipation
· Rash
Children are more likely to have diarrhea, whereas adults may become severely
constipated. During the second week, you may develop a rash of small, flat,
rose-colored spots on your lower chest or upper abdomen. The rash is
temporary, usually disappearing in two to five days.
SECOND STAGE
If you don't receive treatment for typhoid fever, you may enter a second
stage during which you become very ill and experience:
· Continuing high fever
· Either diarrhea that has the color and consistency of pea soup or severe
constipation
· Considerable weight loss
· Extremely distended abdomen
The typhoid state
By the third week, you may:
· Become delirious
· Lie motionless and exhausted with your eyes half-closed in what's known
as the typhoid state
IMPROVEMENT
Improvement may come slowly during the fourth week. Your fever is likely to decrease
gradually until your temperature returns to normal in another week to 10 days. But signs
and
symptoms can return up to two weeks after your fever has subsided.
TREATMENTS AND DRUGS
Antibiotic therapy is the only effective treatment for typhoid fever.
Commonly prescribed antibiotics
In the United States, most doctors prescribe ciprofloxacin for nonpregnant
adults. Women who are pregnant and children most often receive ceftriaxone
(Rocephin) injections, because ciprofloxacin has been associated with problems
in these groups. All of these drugs can cause side effects, and long-term use
can lead to the development of antibiotic-resistant strains of bacteria.
Problems with antibiotic resistance
In the past, the drug of choice was chloramphenicol. Doctors no longer
commonly use it, however, because of severe side effects, a high relapse rate
and widespread bacterial resistance. In fact, the existence of antibioticresistant
bacteria is a growing problem in the treatment of typhoid, especially
in the developing world. In recent years, S. typhi also has proved resistant to
trimethoprim-sulfamethoxazole and ampicillin.
Supportive therapy
Other treatment steps aimed at managing symptoms include:
· Drinking fluids. This helps prevent the dehydration that results from a
prolonged fever and diarrhea. If you're severely dehydrated, you may
need to receive fluids through a vein in your arm (intravenously).
· Eating a healthy diet. Non bulky, high-calorie meals can help replace
the nutrients you lose when you're sick.
NURSING INTERVENTION
INDEPENDENT:
-Monitor patient temperature degree and pattern.
-Observe for shaking chills and profuse diaphoresis
-Wash hands with anti-bacterial soap and after each care of activity and
encourage proper hygiene.
-Provide tepid sponge baths and avoid the use of ice water and alcohol.
-Monitor for signs of deterioration of condition or failure to improve with
therapy.
COLLABORATIVE:
-administer antipyretics as prescribed.
-administer antibiotics as prescribed.