NR 503 Week 5 Assignment-Infectious Disease Paper

NR 503 Week 5 Assignment-Infectious Disease Paper

A communicable disease is an illness that is spread by an infectious agent (Hunter & Reddy, 2013). Clostridiodes difficile (C. difficile) is an example of one where more and more cases are appearing. This paper will discuss the disease, the determinants of health, the epidemiological triad of C. difficile, and the role of FNP in managing infectious diseases.

Introduction of C.difficile

 difficile is a bacteria that produces toxins A and B (Nagy, 2018). These two toxins are responsible for diarrhea to occur (Nagy, 2018). It can be transmitted directly or indirectly by ingesting C. difficile spores or by altering normal intestinal flora by antibiotic therapy. Common C. Difficile infection (CDI) symptoms are diarrhea and mild abdominal cramping and tenderness (Nagy, 2018). In severe cases, individuals can be hospitalized. Severe illness involves episodes of watery diarrhea 10-15 times daily, abdominal cramping, tachycardia, dehydration, kidney failure, and leukocytosis (Nagy, 2018).

The first complication of C. difficile is dehydration, which leads to loss of fluids, electrolytes, and hypotension. Dehydration can quickly occur, and the kidney function deteriorates. In rare incidences, the colon cannot release gas and stool, resulting in the colon becoming extremely distended (megacolon). If untreated, CDI can immediately progress to death.

The treatment for C. difficile varies depending on symptoms. Individuals with mild symptoms may not need treatment. If the infection is from antibiotic use, not taking the antibiotic may be all that is required to stop the signs. However, there will be cases where more potent antibiotics are necessary, such as oral vancomycin or fidaxomicin (Kelly, Lamont, & Bakken, 2019).

NR 503 Week 5 Assignment-Infectious Disease Paper

CDI is responsible for 15-25% of all cases, a remarkable increase in incidence since the start of the 21st century (Depestel & Aronoff, 2014). From 2006-2010, the prevalence of this infection increased from 26.2 to 33.1 per 100,000 population (Smith, Wuerth, Wiemken, & Arnold, 2015). One study from 2001-2010 showed an 8.8% rate of mortality in older people compared to adults, which was 3.1% (Pechal, Lin, Allen, & Reveles, 2016). Within 30 days of the initial diagnosis of CDI, about 29,000 individuals have died (Centers for Disease Control and Prevention, 2015).

There are specific groups that have a higher incidence of this infection. These groups include critically ill, oncological patients, hematopoietic stem cell and organ transplant, inflammatory bowel disease, renal disease, pregnant women, and children (Cózar- Llistó, Ramos-Martinez, & Cobo, 2016). It is essential to be aware of these high-risk groups because these individuals have a higher risk of complications.

Determinants of Health

 CDI is among the most common problems in nursing homes and hospitals where antibiotics are frequently administered. Within the past 20 years, the incidence and mortality rate of CDI has increased (Goudarzi, Seyedjavadi, Goudarzi, Aghdam, & Nazeri, 2014). The incidence rate has increased by 2 to 4-fold in the past ten years, and the prevalence rate has increased from 7.1% to 26.6% (Goudarzi et al., 2014).

There are two groups of risk factors: primary and secondary. Primary risk factors include male gender, age over 65, prolonged hospital stay, and antimicrobial therapy (Goudarzi et al., 2014). The significant secondary risk factors are comorbidities, immunodeficiency, malnutrition, inflammatory bowel disease, and diabetes (Goudarzi et al., 2014).

The epidemiological triangle is a framework used to explain the interaction of three components of communicable diseases (Lanzas, Dubberke, Lu, Reske, & Grohn, 2013). The first component is the infectious agent, which is Clostridium difficile. The second component is the host, who can be anyone. The last component is the environment. C. difficile bacteria are found throughout the environment, water, human and animal feces, and food products such as processed meats (Nagy, 2018). Included in the environment is a mode of transmission, direct and indirect. C. difficile can be indirectly by ingesting food containing the bacteria or directly transmitted through physical contact via touching a contaminated surface or item, such as hands, tables, toilets, and door handles. Therefore, hand hygiene with soap and water is imperative in preventing the spread of C. difficile.

Role of FNP

 FNPs provide comprehensive care through health promotion, disease management, education, and preventative health services (American Association of Nurse Practitioners, 2019). Infectious diseases vastly impact healthcare. FNPs can utilize the Johns Hopkins Nursing Evidence-Based Practice model to manage infectious diseases. Diagnosis and treatment of patients are done carefully and accurately, and evaluation of antibiotics is necessary to decrease unnecessary antibiotic exposure. FNPs educate their patients on the importance of hand hygiene, thoroughly cooking food, staying up to date with immunizations, and annual visits.

Conclusion

 difficile is a highly contagious infection. Knowing the characteristics, epidemiology, management, and high-risk populations of CDI is critical. As healthcare providers, knowing these vital pieces of information can help understand and help reduce the spread of the infection.

References

American Association of Nurse Practitioners. (2019). Nurse practitioners in primary care. Retrieved from https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioners-in-primary-care

Cózar-Llistó, A., Ramos-Martinez, A., & Cobo, J. (2016). Clostridium difficile Infection in Special High-Risk Populations. Infectious diseases and therapy, 5(3), 253-69.

DePestel, d. D., & Aronoff, d. M. (2014). Epidemiology of Clostridium difficile infection. Journal of Pharmacy Practice, 26(5), 464-475.

Goudarzi, M., Seyedjavadi, S. S., Goudarzi, H., Aghdam, E. M., & Nazeri, S. (2014). Clostridium difficile infection: Epidemiology, pathogenesis, risk factors, and therapeutic options. Scientifica, 2014, 1-10.

Hunter, D. J., & Reddy, K. S. (2013). Noncommunicable diseases. The New England Journal of Medicine. 369, 1336-1343.

Lanzas, C., Dubberke, E. R., Lu, Z., Reske, K. A., & Gröhn, Y. T. (2011). Epidemiological model for Clostridium difficile transmission in healthcare settings. Infection control and hospital epidemiology, 32(6), 553-61.

Nagy, E. (2018). What do we know about the diagnostics, treatment, and epidemiology of Clostridioides (Clostridium) difficile infection in Europe? Journal of Infection and Chemotherapy, 24(3), 164-170.

Smith, A. M., Wuerth, B. A., Wiemken, T. L., & Arnold, F. W. (2015). Prevalence of Clostridium difficile infection presenting to US EDs. The American Journal of Emergency Medicine, 33(2), 238-243.

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