MUMPSMUMPS(Epidemic(EpidemicParotitis)Parotitis)

Baby with mumpsMumps an acute contagious

disease, the characteristic feature of w/c is swelling ofone or both parotid glands

caused by a mumps virus w/c is a member of the family Paramyxomviridae, genus Paramyxovirus, is antigenically related to the parainfluenza viruses.

Pathophysiology:

The primary site of viralreplication is the epitheliumof the upper respiratorytract, and rarely, theinfection can remainlocalized to the respiratorytract. Usually, the virusspreads quickly to the locallymphoid tissue andviraemia often follows,enabling the virus to travelto distant parts of the body.

Infected mononuclear cellsare also a means of spreadof the virus. Mumps virushas an affinity for glandularepithelium; virus replicationoften occurs in the parotidgland ductal epithelium,causing interstitial edema,local inflammation, andpainful swelling of the gland.

Mode of transmission: Direct contact w/ the

infected person.

Contact w/ secretionsfrom the mouth & noseof an infected person.

Contact w/ articles inhis/her immediateenvironment w/c havebeen freshly soiled w/secretion from thenasopharynx.

Incubation Period: 12-26 days, usually18 days

Period of Communicability: Begins before the glands

are swollen & remains for anunknown length of time, but it is presumed to last as longas any localized glandular swelling remains.

Signs & Symptoms: painful swelling in front of

ear, angle of jaws & down the neck

fever

malaise

loss of appetite

swelling of one or both testicles (orchitis) in some boys

Risk Factors: Failure to receive mumps

immunizations during childhood

Exposure to someone who has mumps

Age: 2-12 or 10-19

Being born before 1956 and never having mumps, or not being vaccinated after first birthday

Season: winter / spring

Travel to high-risk regionsof the world: Africa, general Indian subcontinent region, and Southeast Asia. These areas have a very low rate of vaccination.

Diagnosis: Physical examination

confirms the presence of swollen glands.

A blood, urine, or cerebrospinal fluid (CSF) test can be used if there are complications.

Treatment: There is no specific treatment for mumps. Ice or heat packs appliedto the neck area and acetaminophen (Tylenol) may help relieve pain.

Complications:

Orchitis for male adult – if it occurs, the scrotum should be supported by a suspensory from the start.

Encephalitis or meningitis, the swelling of the brain and/or spinal cord.

Infection or inflammation of the ovaries or breasts in females who have experienced puberty.

Prevention:A. Active Immunization

(MMR)

MMR immunization (vaccine) protects against measles, mumps, and rubella. It should be given to children 12 - 15 months old. The vaccine is givenagain between ages 4 - 6, or between ages 11 - 12, if it wasn't given before.

MMR Route: Subcutaneous or IM

MMR Dose: The first is given at12 to 15 months of age, and the second is given just before entering elementary school. The second dosage of MMR is not a "booster" dose. It is used to provide immunity for the small but significant portion of people who fail to respond to the first dose.

B. Reporting of Cases to Health Authorities

c. Isolation of Patient

Common Nursing Diagnosis & Interventions:

1. Acute Pain

Assess the pain using 0-10 scale.

Provide quiet environment, calm activities.

Provide comfort measures (ex. Change of position, use of hot or cold applications on the swollen jaws).

Encourage verbalization of feelings.

Encourage diversional activities (ex. TV or radio) .

Instruct in / encourage use of relaxation exercises such as focused breathing.

Administer analgesics as prescribed by the physician.

2. Hyperthermia

Monitor vital signs.

Perform TSB.

Discuss importance of adequate fluid intake.

Maintain bedrest.

Administer antipyretics as ordered.

3. Altered Nutrition: less than body

requirement Determine ability to chew,

swallow & taste.

Discuss eating habits, including food preferences andintolerances.

Give whatever the patient tolerates that is suitable for hisage.

Soft, bland diets are generallyprescribed as long as the jaws are sore.

Sour foods or fruit juices are disliked because of the burningor stinging sensation they elicit.

Frequent antiseptic mouth washes maybe helpful in addition to regular oral hygiene and brushing the teeth.

4. Body Image Disturbance

Assess physical influence of illness orcondition on the client’s emotional state.

Assess client’s current level of adaptation.

Encourage client & SO’s to communicatefeelings w/ each other.

Listen to the client’scomments and responses to the situation.

Assume all individuals are sensitive to changes in appearance but avoid stereotyping.

Evaluate level of client’s knowledge ofanxiety related to situation. Observe emotional changes.

Provide accurate information about the client’s condition.