Ch. 6 & 32 Flashcards
CDC transmission based precautions
- standard
- contact
- droplet
- airborne
contact precautions
anyone in the room must wear
- gloves
- gown
droplet precautions
any in the room must wear
- surgical mask
airborne precautions
any in the room must wear
- N95 respirator
communicable disease: definition
an infectious disease transmissible by direct or indirect contact (ie a surface it could be on)
nursing goals with communicable diseases
- assist in the identification of the infectious agent (assessments, history, etc.)
- identify potentially infectious cases
- recognize diseases that require medical intervention
- implement appropriate nursing interventions
- educate patients and families
prodromal symptoms: definition
s/sx of an illness that appear before the characteristic s/sx of the disease
constitutional symtoms: definition
symptoms that can affect multiple body systems
incubation period: definition
time between exposure and onset of symptoms
examples of prodromal symptoms
fever
malaise
anorexia
examples of constitutional symptoms
fever
irritability
examples of incubation period
2-3 weeks
several days
agent
the causative organism
source
where it came from
where it can be found
transmission
how it is spread
what is needed during the incubation period?
quarantine needed
precautions needed
period of communicability
how long a person is considered contagious
distribution
how it appears on a human
- rash (pattern)
- sx (order of sx)
specific management
using a particular medication to treat a specific organism/infection
ie antibiotic for infection
support management medication is
medication that is not specific to illness, but resolves general non-specifc symptoms
ie tylenol for fever
complications
signs of decline
worsening of condition
- may put patient at risk for hospitalization or death
prevention
teach family and patient so that they can prevent illness from occurring again
nursing care of communicable disease
- nursing interventions: what we do to promote/improve health
- anticipatory guidance: how to prevent, follow-up appt, more tests
- patient and family education: how to use thermometer, how to set up humidifier
subjective data collection
- known exposure?
- community exposure?
- prodromal symptoms?
- constitutional symptoms?
- immunization?
- history of having disease?
- history of comorbidity/risk factors?
timeline of communicable disease
- stage of susceptibility
- exposure
- stage of subclinical disease
- pathologic changes
- onset of symptoms
- stage of clinical disease
- usual time of diagnosis
- stage of recovery, disability or death
nursing care management: prevent spread
- institute precautions
- HW
- primary prevention (immunization)
- antibiotics
nursing management: prevent complications
- immunocompromised
- immunoglobulin
- booster vaccine
- antivirals
- antibiotics
- vit A supplementation
nursing care management: providing comfort and support
- calm skin manifestations (cool compress, bath, lotion, creams)
- antipyretics
- oral symptoms (lozenges, gargling, rinses, magic mouthwash)
- quiet activity/distraction vs. bedrest
varicella: source
- primary secretions of respiratory tract
- skin lesions
varicella: transmission
- direct contact
- droplet (airborne),
- contaminated objects
varicella: incubation
2-3 weeks
varicella: period of communicability
1 day before eruption of lesions (prodromal) until 6 days after first crop of crusts form
varicella: prodromal s/sx
- slight fever
- malaise
- anorexia
- macule to papule to vesicle (varying stages at once)
varicella: distribution
- centripetal (starts in center of body)
- spreads to face and extremities
- less on distal limbs
varicella: constitutional s/sx
- fever from lymphadenopathy
- irritability from pruritis
varicella: specific management
- antiviral treatment (Zovirax)
- immune globulins
varicella: supportive management
- antihistamines
- skin care to prevent secondary infection
varicella: complications
- secondary infections (cellulitis, PNA: pneumonia, sepsis)
- skin infections from itching
- scarring
- pneumonia
- encephalitis
- arthritis
- ataxia
- thrombocytopenia
varicella: nursing interventions
- standard, airborne, and contact precautions until crusted
- skin care
- nail care
- watch for respiratory symptoms
varicella: anticipatory guidance
- keep environment cool (decreases # lesions)
- pressure vs scratching
varicella: patient and family education
avoid ASA: aspirin (Reye syndrome)
varicella: prevention
- immunizations
- antiviral therapy for immunocompromised patients, pregnant women, and newborns
- no longer contagious after all lesions have scabbed
- usually managed at home (limit exposure)
varicella: nursing management
- supportive management
- VS
- antipyretics, antipruritics prn
- airborne and contact precautions
- encourage fluids
- distraction (to prevent itching)
- calamine lotion; oatmeal baths, oatmeal soap
- head to toe assessment includes lungs, cardiac, neuro
varicella is a ____ disease
self-limiting
measles is also known as
rubella
varicella: agent
varicella
varicella is also known as
chicken pox
measles: agent
virus
measles: source
- resp tract secretions
- blood and urine of infected person
measles: transmission
- direct contact
- more common in winter months
measles: incubation
10-20 days
measles: period of communicability
- 4-5 days prior to rash
- prodromal phase
measles: prodromal s/sx
- fever
- malaise
- after 24 hours coryza, cough, conjunctivitis, Koplik spots
measles: distribution
-rash appears 3-4 days after start of prodromal stage
- begins as maculopapular on face and gradually spreads down body (confluent initially then discrete
measles: constitutional s/sx
- anorexia
- abdominal pain
- malaise
- lymphadenopathy (generalized)
measles: specific management
none
- prevention
measles: supportive management
- bed rest while febrile,
- antipyretics,
- antibiotics to prevent secondary infection in susceptible children
measles: complications
- OM,
- bacterial PNA,
- obstructive laryngitis,
- laryngotracheitis;
- encephalitis (rare but often fatal)
- croup
- diarrhea
measles: prevention
childhood immunizations
- cannot begin until 12 months of age
measles: nursing interventions
- Vitamin A supplementation (dose is age dependent);
- isolation until day 5 of rash;
- airborne precautions,
- rest during fever;
- quiet play;
- eye care;
- vaporizer
measles: anticipatory guidance
- petroleum to nares and lips;
- skin barrier ointment;
- bland foods;
- fluids;
- dim lights (photophobia)
measles: patient and family education
- clean skin
- tepid baths
can measles resolve without treatment?
yes
how contagious is measles?
highly contagious