Nursing Diagnosis for Tetanus

Tetanus is caused by the bacterium Clostridium tetani, the spores of which are widespread in the environment. The disease is caused by the action of a neurotoxin, produced by the bacteria when they grow in the absence of oxygen, e.g. in dirty wounds or in the umbilical cord if it is cut with a non-sterile instrument.
Tetanus is characterized by muscle spasms, initially in the jaw muscles. As the disease progresses, mild stimuli may trigger generalized tetanic seizure-like activity, which contributes to serious complications and eventually death unless supportive treatment is given.
Tetanus can be prevented by the administration of tetanus toxoid, which induces specific antitoxins. To prevent maternal and neonatal tetanus, tetanus toxoid needs to be given to the mother before or during pregnancy, and clean delivery and cord care needs to be ensured.



Nursing Diagnosis for Tetanus

1. Ineffective airway clearance

2. Ineffective Breathing Pattern

3. Hyperthermia

4. Altered Nutrition: Less than body requirements

5. Risk of fluid and electrolyte imbalance

6. Risk for injury

7. Knowledge deficient

8. Disturbed sleep pattern

Nursing Interventions for Tetanus