poliomyelitis

1
LESSON PLAN ONPOLIOMYELITIS

• REPRESENTED BY
• PUSHPA KUMARI
• ROLL NO29
• BASIC B.SC NURSING
• FOURTH YEAR
• BATCH (2013-2017)

2
SPECIFIC OBJECTIVES

• Introduction
• Definition
• Agent and ghost
• Types of viruses
• Sign and symptoms
• Pathophysiology
• Diagnosis and prevention
• Treatment
• Environmental factors
• Control measures
• Nursing management

3
INTRODUCTION

• Polio, also known as poliomyelitis, is infectious
  viral disease transmitted through the oral route
  by ingestion of contaminated water or food or
  contact with infected sources such as unwashed
  hands.
• The virus is shed in the feces of infected
  individual for as long as 6weeks.
• The disease produces a range of presentations
  from flu-like symptoms(abortive
  poliomyelitis)that resolve in 24 to 36 hours(non
  paralytic)to paralytic poliomyelitis that attacks
  the motor neurons in the anterior horn of the
  spinal cord and brainstem.

4
DEFINITION

• Poliomyelitis is a viral disease that can affect
  nerves and can lead to partial or full paralysis.
• Poliomyelitis is the combination of two words
  polio and myelitis, where-Polio means gray
  matter and myelitis means inflammation of
  spinal cord.
• Poliomyelitis is a disease starts with fever and
  end with or without flaccid paralysis.
  

5
TYPES OF VIRUSES

• There are three types of viruses .
• TYPE-1 Includes the Brunhilde strains which are
  pathogenic to man and monkey.

• TYPE-2 Includes the Lansing strains which are
  responsible for diseases in man, monkey,
  rodents(rats, mice, etc).
• TYPE-3 includes(The Leon Strain)are pathogenic
  only to man and monkeys and differ
  immunologically from two types.

6
RESISTANCE

• The Poliomyelitis virus survives in sterile water
  at room temperature for more than 100daysin milk
  for 90daysin faeces in cold for more than
  6months.
• It withstands exposure to 0.5-1percent phenol
  solution and remains viable for several weeks at
  pH 3.8 8.5.
• It is rapidly killed on boiling.

7
AGENT

• RNA virus type I, II and III.
• Type I is a wild polio virus which causes
  paralysis.
• The virus is found in stools and oropharyngeal
  secretions of the infected persons.

8
HOST

• The portal of entry is ingestion.
• Incubation period is 7 to 14 days.
• 6 months to 3years are vulnerable group.
• .

9
SIGNS AND SYMPTOMS

• Non paralytic polio infections develop flu like
  symptoms that consist of fever, sore throat,
  headache, malaise and muscle stiffness(neck,
  back).
• Although in some case there is severe muscle
  aches and spasms, loss of reflexes and flaccid
  paralysis.
• In some individuals, the paralysis may occur
  very quickly(within a few hours after infection
  occurs).
• Sometimes the paralysis is only on one side of
  the body.
• Post polio syndrome describes symptoms that
  develop in patients about 30 to 40 years after an
  acute polio illness. The Post polio syndrome
  symptoms include muscle pain, joint pain and
  spinal changes such as scoliosis, spondylosis and
  or secondary nerve root and peripheral nerve
  compression.
• Slowly progressive muscle weakness(any muscles,
  including the eye muscles and sometimes termed
  bulbar polio) generalized fatigue and cold
  intolerance may occur.

10
PEOPLE AFFECTED BY POLIOMYELITIS
11
(No Transcript)
12
CHILD AFFECTED BY POLIO
13
CHILD AFFECTED BY POLIO
14

15
PATHOPHYSIOLOGY

• Polio virus is exerted in stool of patient, 2
  week before and 6 8 weeks after onset of
  illness.
• The virus may also be water borne, resulting from
  contamination of water and with sewage.

16
FLOW CHART

• 
  polio virus enters
• Human body through mouth and alimentary
  tract multiplies in intestine
• Enters
  regional lymph nodes
• 
  Enters blood stream
• Enters
  Brain and spinal cord
• 
  Destroy neurons
• Affects anterior horns of spinal cord,
  vestibular and cranial nerve nuclei and viral
  centers in medulla and cerebellum
• Death of
  motor nerve leads to
• Flaccid
  paralysis of skeletal muscles

17
PREVENTION

• All children should be protected by immunization
  with polio vaccine.
• Injectable polio vaccines(IPV or salk killed
  vaccine) or live attenuated.
• Oral polio vaccine(saline vaccine) should be
  given.
• OPV should be given minimum 5 doses starting from
  birth upto 5 years.

18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
WHAT IS PROGNOSIS OF POLIO?

• The prognosis for patients with polio depends on
  the extent of damage caused by the polio virus.
• Many patients may have few if any symptoms and
  will have an excellent prognosis.
• As the symptoms of paralysis worsen(decreased
  ability to breath or swell ow) the patients
  prognosis decreases.
• Many patients who developed more severe polio
  symptoms developed life long disabilities or
  death.

22
TREATMENT FOR POLIO

• Once the virus that causes polio has infected a
  person, there is no treatment that will cure
  polio.
• Early diagnosis and supportive treatments such as
  bed rest, pain control, good nutrition and
  physical therapy to prevent deformities from
  occurring over time can help to reduce the long
  term symptoms due to muscle loss.
• Some patients, unfortunately, may require
  extensive support and care, for example, some
  require breathing assistance and special diets if
  they have difficult in swallowing while other
  patients may require splints and for leg braces
  to avoid extremely pain, muscle spasms and limb
  deformities.

23

24
ENVIRONMENT

• Polio viruses can live in moist environment in
  water for 4 months and feces for 6 months.
• Open air defecation will enhance the fly
  breeding.
• The rainy season is favorable for multiplication
  of bacteria.

25
CONTROL MEASURES

• Presence of single case will cause more
  infections. Hence, cases are to be identified and
  treated properly.
• Control the source of infection through cases and
  careers.
• Epidermiological investigations to be done
  immediately even for a single case.
• Two stool specimen should be taken within 14
  days.
• Another specimen should be taken after 60 days to
  confirm residual paralysis.
• Surveillance of cases in the field and also in
  the hospitals.
• Proper treatment and nursing care.

26
NURSING MANAGEMENT

• Bed rest, because physical activity increases the
  risk of paralysis of fatigued muscles.
• Isolation of child and concurrent disinfection.
  Make the child lie in neutral position on firm
  mattress with foot board. This help to prevent
  overstretching of paralyzed muscles.
• Painful or tender limbs should be immobilized.
• Vital signs should be monitored.

27
Continued

• If cyanosis is seen, start oxygen therapy.
• Apply hot packs to relieve muscle pain and
  tenderness.
• Diet should be nutritious and easy to swallow.
  Feed the patient in low fowlers position.
• Indwelling catheterization for urine retention.
• Antipyretics to reduce fever.
• Suctioning to clear pharynx of secretion.
  Ventilator care.

28
SUMMARY

• Poliomyelitis is a disease caused by infection
  with the poliovirus. It is a viral disease that
  can affect nerves and can lead to partial or full
  paralysis. The virus spread by direct person to
  person contact, contact with infected mucus of
  phlegm from the nose or mouth, contact with
  infected feces.
• The virus enters through the mouth and nose,
  multiplies in the throat and intestinal tract and
  then absorbed and spread through the blood and
  lymph system. Non paralytic polio infections
  develop flu like symptoms that consists of fever,
  sore throat, headache, muscle stiffness. Post
  polio syndrome symptoms include muscle pain,
  joint pain and spinal changes.
• All children should be protected by
  immunization with polio vaccine. Proper treatment
  and nursing care should be given to control
  poliomyelitis.

29
CONCLUSION

• From this lesson plan I conclude that I learnt
  lots of things about poliomyelitis. After doing
  this lesson plan I have come to know many thing
  about the poliomyelitis. Poliomyelitis is a viral
  disease that can affect nerves and can lead to
  partial or full paralysis. It is a disease caused
  by infection with polio virus. The virus spread
  by direct person to person contact or contact
  with infected feces.
• I learnt about the risk factors, symptoms,
  diagnosis, treatment, prevention, types, clinical
  features, patophysiology and complications of
  poliomyelitis. I also learnt the nursing
  management for poliomyelitis.

30
BIBLIOGRAPHY

• Kumari Neelam, Essentials of Community Health
  Nursing Edition 2011, S. Vikas and company,
  Jalandhar city India. Page no. 388, 389, 390,
  391,392.
• kamalam s, essentials in community Health
  Nursing, second edition 2013, Jitendar P. vij,
  panamacity India. Page no. - 300, 301, 302, 539,
  540.
• Datta parul, Pediatric Nursing, second edition
  2009, Japee Brothers Medical Publishers, Replika
  Press Pvt.Ltd, India. Page no. -
• Panjarathinam R.S, Microbiology in Nursing,
  second edition, New Central Book Agency(P) Ltd.,
  Kolkata. Page no. 181, 182, 183, 184.
• Sharma Rimple, essentials of Pediatric
  Nursing, First Edition, Raj kamal Electric
  Press, Haryana. Page no. 702, 703, 704, 705,
  706, 707.

31

• THANK YOU