Typhoid fever is a serious bacterial infection caused by Salmonella typhi that primarily affects the gastrointestinal system and can lead to life-threatening complications if left untreated. This nursing diagnosis focuses on identifying symptoms, preventing complications, and implementing effective care strategies for patients with typhoid fever.
Causes (Related to)
Typhoid fever can affect patients through various transmission routes and risk factors:
- Bacterial infection caused by Salmonella typhi
- Consumption of contaminated food or water
- Poor sanitation and hygiene practices
- Travel to endemic areas
- Close contact with infected individuals
Risk Factors include:
- Limited access to clean water
- Poor hand hygiene
- Compromised immune system
- Travel to endemic regions
- Food handling practices
Environmental factors including:
- Poor sanitation infrastructure
- Limited access to healthcare
- Overcrowded living conditions
- Inadequate food safety measures
Signs and Symptoms (As evidenced by)
Typhoid fever presents with characteristic signs and symptoms that develop gradually over time.
Subjective: (Patient reports)
- Gradually increasing fever
- Persistent headache
- Generalized body weakness
- Abdominal pain
- Loss of appetite
- Malaise
- Dry cough
- Changes in bowel habits
Objective: (Nurse assesses)
- Sustained fever (103°F-104°F/39.4°C-40°C)
- Rose spots on the trunk and abdomen
- Bradycardia relative to fever
- Enlarged spleen and liver
- Abdominal tenderness
- Changes in mental status
- Signs of dehydration
- Decreased bowel sounds
Expected Outcomes
The following outcomes indicate the successful management of typhoid fever:
- The patient will maintain a normal temperature within 5-7 days of treatment
- The patient will demonstrate adequate hydration status
- The patient will maintain stable vital signs
- The patient will show improved appetite and oral intake
- The patient will remain free from complications
- The patient will demonstrate an understanding of prevention measures
- The patient will return to normal daily activities within 4-6 weeks
Nursing Assessment
Monitor Vital Signs
- Check temperature pattern
- Monitor heart rate for relative bradycardia
- Assess blood pressure
- Track respiratory rate
- Document fever curve
Assess Gastrointestinal Status
- Monitor bowel movements
- Assess abdominal pain
- Check for hepatosplenomegaly
- Document dietary intake
- Note the presence of rose spots
Evaluate Hydration Status
- Monitor fluid intake and output
- Assess skin turgor
- Check mucous membranes
- Monitor urine output
- Assess for signs of dehydration
Check for Complications
- Monitor for intestinal perforation
- Assess for GI bleeding
- Watch for neurological changes
- Check for peritonitis
- Monitor for sepsis
Review Risk Factors
- Assess travel history
- Document vaccination status
- Review hygiene practices
- Check living conditions
- Evaluate food handling practices
Nursing Care Plans
Nursing Care Plan 1: Hyperthermia
Nursing Diagnosis Statement:
Hyperthermia related to systemic bacterial infection as evidenced by temperature 103.5°F, warm skin, and relative bradycardia.
Related Factors:
- Systemic bacterial infection
- Inflammatory response
- Altered thermoregulation
Nursing Interventions and Rationales:
- Monitor temperature q4h
Rationale: Tracks fever pattern and response to treatment - Administer antipyretics as ordered
Rationale: Helps reduce fever and associated discomfort - Provide a tepid sponge bath
Rationale: Aids in temperature reduction through evaporative cooling - Maintain hydration
Rationale: Prevents complications of sustained fever
Desired Outcomes:
- Temperature will decrease to normal range within 5-7 days
- The patient will report improved comfort
- The patient will maintain adequate hydration
Nursing Care Plan 2: Risk for Deficient Fluid Volume
Nursing Diagnosis Statement:
Risk for Deficient Fluid Volume related to sustained fever, gastrointestinal losses, and decreased oral intake as evidenced by poor skin turgor and decreased urine output.
Related Factors:
- Sustained high fever
- Diarrhea
- Poor oral intake
- Increased metabolic demands
Nursing Interventions and Rationales:
- Monitor intake and output strictly
Rationale: Ensures early detection of fluid imbalance - Administer IV fluids as ordered
Rationale: Maintains adequate hydration status - Assess skin turgor and mucous membranes q4h
Rationale: Provides early indicators of dehydration
Desired Outcomes:
- The patient will maintain adequate hydration
- The patient will demonstrate improved skin turgor
- The patient will maintain adequate urine output
Nursing Care Plan 3: Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to inflammatory process as evidenced by verbal reports of abdominal pain and guarding behavior.
Related Factors:
- Inflammatory process
- Hepatosplenomegaly
- GI inflammation
- Tissue inflammation
Nursing Interventions and Rationales:
- Assess pain characteristics regularly
Rationale: Helps monitor disease progression and complications - Position patient for comfort
Rationale: Reduces abdominal discomfort - Administer prescribed pain medication
Rationale: Provides pain relief and comfort
Desired Outcomes:
- The patient will report decreased pain levels
- The patient will demonstrate improved comfort
- The patient will maintain normal activity levels as able
Nursing Care Plan 4: Risk for Infection Transmission
Nursing Diagnosis Statement:
Risk for Infection Transmission related to the presence of infectious bacteria as evidenced by active typhoid fever infection.
Related Factors:
- Presence of S. typhi bacteria
- Poor hand hygiene
- Limited knowledge of transmission prevention
- Inadequate sanitation practices
Nursing Interventions and Rationales:
- Implement contact precautions
Rationale: Prevents bacterial transmission - Teach proper hand hygiene
Rationale: Reduces risk of spreading infection - Educate about proper food handling
Rationale: Prevents contamination and spread
Desired Outcomes:
- No new cases will develop among contacts
- The patient will demonstrate proper hygiene practices
- The patient will verbalize understanding of prevention methods
Nursing Care Plan 5: Imbalanced Nutrition: Less than Body Requirements
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to decreased appetite and GI inflammation as evidenced by weight loss and poor intake.
Related Factors:
- Decreased appetite
- GI inflammation
- Nausea
- Altered absorption
Nursing Interventions and Rationales:
- Monitor daily nutritional intake
Rationale: Ensures adequate nutrition for recovery - Provide small, frequent meals
Rationale: Improves tolerance and intake - Monitor weight regularly
Rationale: Tracks nutritional status
Desired Outcomes:
- The patient will demonstrate an improved appetite
- The patient will maintain a stable weight
- The patient will achieve adequate nutritional intake
References
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