ch 6 communicable diseases Flashcards
standard precaution measures
-barrier protection from blood and bodily fluids
-resp hygiene/cough etiquette
-safe injection practices
-hand hygiene
transmission based precautions
AIRBORNE:
-neg pressure isolation room
-N95
DROPLET:
-mask, goggles
CONTACT:
-gloves, gown, mask
examples airborne illnesses
-measles
-varicella (chickenpox)
-TB
examples droplet illnesses
-flu
-meningitis
-pneumonia
-diptheria
-pertussis
-mumps
-rubella
-epiglottitis
examples contact illnesses
-ebola
-HSV
-zoster
-skin infections: staph, impetigo, conjuctivitis, shingles
-viral illnesses (flu, covid)
what vaccine should be given at birth
hep b
what vaccines should be given at 2 months, 4 months, and 6 months old
-hep b (if not given at birth should be given at 2 months)
-tdap
-flu
-IPV (polio)
-PCV13 (pneumonia)
-RV (rotavirus)
when should second dose hep b vaccine be given
9 months old
what vaccines are given at 12 months old
-MMR
-varicella
what vaccines are given at 15 months old
-DTap
-hib (flu)
-PCV13 (pneumonia)
what vaccines are given at 4 years old
-DTaP
-IPV
-MMR
-varicella
what vaccine should be given at 11 years old
Tdap
communicable diseases
-chicken pox
-rubella
-mumps
-rubeola
-pertussis
-whooping cough
-scarlet fever
-polio
-fifth disease
-roseola
transmission and precautions for varicella
transmission: direct contact and resp secretions
precautions: airborne (and contact)
S+S varicella
-prodromal stage: slight fever, malaise
-pruritic rash
-vesicle eruption
-rash starts on chest then goes to extremities and face
Tx varicella
MEDS:
-antiviral acyclovir (zovirax)
-varicella-zoster immune globulin (variZIG)
-immune globulin IV for high risk exposure
OTHER:
-benadryl/antihistamine
-skin care to prevent secondary infections
-calamine lotion
-oatmeal bath
-keep child cool
-avoid aspirin
incubation of varicella
how long is child contagious
contagious 1 day before rash appears
contagious until vesicles are crusted
complications of varicella
-secondary infection
-encephalitis
-pneumonia
-thrombocytopenia (transient or chronic)
S+S fifth disease: 3 stages (erythema infectiosum)
STAGE 1:
-mild: fever, malaise, headache
-MOST INFECTIOUS NOW
STAGE 2:
-“slapped cheek” rash
-rash on trunk spreads to extremities except palms and soles
-circumoral pallor
STAGE 3:
-rash slowly disappears
infectious agent of fifth disease
human parvovirus b19
transmission fifth disease
droplets
nursing management and Tx fifth disease
-supportive care (antipyretics, analgesics)
-droplet precautions
-oatmeal bath
-anti-pruritics to relieve itching
-rest and fluids
-avoid exposure to direct sunlight
-avoid exposure to pregnant women
consequences in pregnant women when exposed to fifth disease
-fetal hydrops
-anemia
-spontaneous abortion
infectious agent roseola
herpes virus type 6 or 7
transmission roseola
contact with saliva/resp secretions
when is fifth disease most contagious
before rash appears
stage 1
S+S roseola
-sudden persistent high fever (3-7 days)
-normal appetite and behavior
-rash appears after fever resolves
-febrile seizures common
-encephalopathy/encephalitis may occur
precautions for roseola
standard
nursing management and Tx roseola
-antipyretics (NO ASPIRIN)
-monitor for seizures
-encourage fluids
-standard precautions, supportive care
infectious agent mumps
paramyxovirus
incubation period length of mumps
14-21 days
how long is kid with mumps infectious for
1-2 days before parotid swelling
9 days after swelling goes away
transmission of mumps
resp secretions
S+S mumps
-acute onset
-fever
-malaise
-classic sign: swelling 1+ salivary gland
-earache
-headache
-pain with chewing
-decreased appetite and activity
nursing management and Tx mumps
-antipyretics (no aspirin)
-soft foods to help with chewing pain
-droplet precautions
-avoid exposure to immunocompromised people
-encourage fluid intake
transmission precaution for mumps
droplet
infectious agent rubeola (measles)
morbillivirus
transmission rubeola (measles)
resp droplets and airborne
incubation time of rubeola
10-20 days
how long is kid with rubeola (measles) infectious for
-4 days before rash appears
-5 days after rash appears
S+S rubeola (measles): 3 stages
PRODROMAL/STAGE 1:
-nonspecific fever
-anorexia
-malaise
STAGE 2:
-conjuctivitis
-cough
-koplik spots
STAGE 3:
-dark/red or purple blotchy rash starts and face and spreads to trunk and extremities
-mildly itchy
what are koplik spots
blue gray spots on oral mucosa
associated with rubeola
nursing management and Tx rubeola
(vaccine preventable)
-cool mist vaporizer
-suction gently prn
-antipyretics
-antitussives
-cool liquids and soft/pureed foods
-vit a recommended
-bed rest
transmission precaution for rubeola
airborne
for what people does rubeola have an increased risk of death
-immunocompromised
-children <5 yo
how long is pt with rubella contagious
how long is infant with congenital rubella contagious
-7 days before rash
-5 days after rash appears
*infant with congenital rubella can shed virus until 1 yo
incubation time rubella
14-21 days
S+S rubella
PRODROMAL:
-usually absent in kids
-if present: low grade fever, headache, malaise, mild conjuctivitis, lymphadenopathy
pink rash starts on face and spreads to rest of body within 24 hours
nursing management and Tx rubella
-antipyretics
-analgesics
-encourage fluids and food
transmission precaution for rubella
droplet
what could rubella cause in developing. fetus in 1st trimester
-fetal death
-congenital abnormalities
how long is pertussis contagious for
-most contagious during catarrhal stage
-5 days after Abx started
S+S pertussis: 3 stages
CATARRHAL STAGE:
-congestion, runny nose
-low grade fever
-non productive cough
PAROXYSMAL STAGE:
-cough more severe at night with cough spasms
-stridor “whooping”
CONVALESCENT STAGE:
-cough gradually increases
nursing management and Tx pertussis
MEDS:
-macrolide Abx: erythromycin, azithromycin, trimethoprim-sulfamethoxazole, Bactrim DS)
-antitussives (older children and adults only)
-antipyretics
OTHER:
-suction prn
-cool mist vaporizer
-rest
-fluids
transmission precaution for pertussis
droplet
transmission of polio
fecal-oral
resp
how long is kid with polio contagious for
excreted in feces for 4-6 weeks
S+S polio
-**mostly asymptomatic
-nonspecific symptoms: low grade fever, sore throat
-residual paralysis
Tx polio
-complete bed rest
-supportive care
infectious agent of scarlet fever
group a B-hemolytic strep
transmission precaution scarlet fever
droplet
how long is kid with scarlet fever contagious for
until 24 hours after start of Abx
S+S scarlet fever
PRODROMAL STAGE:
-abrupt high fever, chills, malaise
-increased HR
-vomiting
-headache
-abdominal pain
-halitosis (bad breath from bacteria)
-tonsils enlarged, “beefy red”
-sandpaper rash over trunk and extremities
-cervical lymphadenopathy
-strawberry tongue
-circumoral pallor
nursing management and Tx scarlet fever
MEDS:
-penicillin
-analgesics for throat
OTHER:
-rest
-prevention, throw away toothbrush
types conjunctivitis
-bacterial “pink eye”
-viral
-allergic
-foreign body
S+S bacterial conjunctivitis
-purulent drainage
-crusting eyelids
-inflamed conjunctiva
-swollen eyelids
S+S viral conjunctivitis
-usually with upper resp infection
-watery drainage
-inflamed conjunctiva
-swollen eyeleids
S+S allergic conjunctivitis
-itching
-watery to thick, stringy discharge
-inflamed conjunctiva
-swollen eyelids
S+S conjunctivitis caused by foreign body
-tearing
-pain
-inflamed conjunctiva
-usually only one eye infected
nursing management and Tx conjunctivitis
MEDS:
-for bacterial: topical drops or ointment, polymyxin, bacitracin
OTHER:
-wipe inner to outer eye
-warm moist compress
-no rubbing eyes
-wash hands well
2 types stomatitis
-aphthous stomatitis (canker sore)
-herpetic gingivostomatitis
infectious agent stomatitis
HSV 1
meds stomatitis
-NSAIDs
-topical anesthetic: orabase, anbesol, kank-a lidocaine
-diphenhydramine and maalox mixture (protective coating of lesions)
-sucralfate
-antivirals in severe cases: acyclovir
how do you diagnose pinworms
tape test
S+S pinworms
-itching
-irritability
-restlessness
-poor sleep
-bedwetting
Tx pinworms
-med: pin-rid
-wash all linens
-vacuum
Tx giardiasis
-metronidazole (flagyl)
-tinidazole (tindamax)
-nitazoxanide (alinia)
how is giardiasis transmitted
contaminated water (lakes, streams, swimming/wading water)
S+S giardiasis in children infants and young children (<5 yo)
-D/V
-anorexia
-failure to thrive (if chronic exposure)
S+S giardiasis in children >5 yo
-abdominal cramps
-intermittent diarrhea
-constipation
-stools that are malodorous, watery, pale, greasy
-spontaneous resolution within 4-6 wks
S+S giardiasis (rare form)
-intermittent foul smelling diarrhea
-abdominal bloating and flatulence
-sulfur tasting belches
-epigastric pain
-vomiting
-headache
-weight loss
2 kinds viral skin infections
-verruca (warts)
-molluscum
Tx verruca (warts)
-usually appear on exposed areas
-localized destructive therapy/surgery
S+S molluscum
-fleshy colored papules
-small raised lesion with dimple in center
-asymptomatic
-resolve spontaneously within 18 months
2 types fungal skin infections
-ringworm (dermatophytoses)
-tinea capitis (head) or tinea corporis (body)
Tx fungal skin infections
-topical tx
-for head: griseofulvin
Tx scabies
-scabicide (elimite)
-spread through prolonged personal contact (treat family too)
Tx head lice
-pediculides
-manual removal
-preferred OTC Tx: Nix
-wash everything
-treat family
S+S bedbugs
-intense itching
-inflammation /rash
-may progress to folliculitis/cellulitis
-may trigger asthma exacerbation, anaphylaxis
Tx bedbugs
-professional extermination
-topical application steroids
-washing linens and clothing
S+S lyme disease: 3 stages
STAGE 1
-bulls eye rash
-fever
-headache
-malaise
STAGE 2
-rash on hands and feet
-fever
-fatigue
-lymphadenopathy
-cough
STAGE 3
-systemic involvement
Tx lyme disease
<8 yrs old
>8 yrs old
<8 yrs: amoxycillin
>8 yrs: doxycycline
transmission precaution impetigo
droplet
S+S impetigo
-honey colored crusted lesions
when/where does impetigo occur more frequently
-poor hygiene
-summer months
-warm humid climates
-lower socioeconomic groups
S+S cat scratch disease
-painless non-itchy red bumps
-regional lymphadenitis
Tx cat scratch disease
supportive
maybe azithromycin
