Anthrax is an infectious disease caused by Bacillus anthracis. The disease is a zoonosis especially grazing animals such as sheep, goats, and cattle. Humans infected with the disease when endospores enter the body through skin abrasions or wounds, inhalation or contaminated food. Naturally humans can be infected if it comes in contact with anthrax-infected animals or contaminated animal products anthrax germs. Although rare, transmission through insect bites can also occur. Potential spread of spores by aerosol used in warfare and bioterrorism.
Cutaneous anthrax is an infection that most often occurs, and is characterized by localized skin lesions with eschar (necrotic ulcer) surrounded a central non-pitting edema. Inhalation anthrax is characterized by mediastinitis hemorhagik, progressive systemic infection, and result in high mortality rates. Gastrointestinal anthrax is rare and is associated with high mortality.
Signs and Symptoms
1. Inhalation anthrax
The first stage of early onset (1-4 days) malaise, weakness, myalgia (muscle pain), non-productive cough, chest distress, fever.
The second stage of deterioration (24 hours) acute respiratory distress, cyanosis, stridor, diaphoresis, fever, mediastinal bleeding, meningismus, septic shock, coma.
2. Cutaneous anthrax
Subfebris fever, headache, aches small red sores. Then the lesion had enlarged, become ulcers, broke and became a wound, such as papel disorders, fluid-filled vesicles and necrotic tissue ulsera shaped covered by a black crust, called dry eschar (pathognomonic) around the ulcer, often obtained erythema and edema. At the touch of edema is not soft and not dent (non pitting) when pressed also called malignant pustule.
3. Gastrointestinal anthrax
Nausea, dizziness, vomiting, no appetite, increased body temperature, vomiting brown or red, black bowel movements (melena), abdominal pain is very severe (twisting).
8 Nursing Diagnosis related to Anthrax
1. Ineffective Airway Clearance related to airway obstruction
characterized by: audible stridor, dyspnea, cough with purulent sputum, radiological examination looks mediastinal widening, pleural effusion.
2. Ineffective breathing pattern related to decreased lung expansion
characterized by: dyspnea, use of accessory muscles, increased respiration.
3. Acute pain related to the injury of biological agents
characterized by: the client complains of pain, dyspnea, rapid pulse, looked nervous.
4. Impaired swallowing related to mechanical obstruction (oropharyngeal edema)
characterized by: the client indicates difficulty in swallowing, complain of pain when swallowing.
5. Constipation related to decreased motility of the GI tract
characterized by: the client said it was difficult defecation, hypoactive bowel sounds, presence of blood in stools, hard stools.
6. Diarrhea related to an increase in GI motility
characterized by: liquid bowel movements difficult and more than 3 times / day, hyperactive bowel sounds and abdominal pain.
7. Impaired Skin Integrity related to irritant toxin anthrax bacteria
characterized by: The primary skin lesions are not painful and itchy papules, vesicles containing fluid jerni, vesicles give rise eskar central necrosis (necrotic ulcer) surrounded by edema distinctive black and purple vesicles.
8. Hyperthermia related to increased metabolic
characterized by: an increase in body temperature above the normal range (36.5 to 37.5), resipiirasi increased, and red skin.
