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Pediatrics > Chapt 37 and 47: Immunologic and infectious disorders > Flashcards

Chapt 37 and 47: Immunologic and infectious disorders Flashcards

1
Q

What characteristics increases a child’s susceptibility for infection?

A
  1. immature immune system
  2. decrease inflammatory response in newborns
  3. limited exposure to infections disease
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2
Q

What are some mechanisms of immunity?

A
  1. Lymph system
  2. Phagocytosis
  3. Cellular immunity
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3
Q

When do phagocytic cells (neutrophils and monocytes) reach adult levels

A

7 years of age.

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4
Q

What are some complications and/or contradictions to take note of when talking about vaccinations?

A
  1. anaphylactic reactions
    2.allergies
  2. illness without fever associated with vaccine reaction
  3. acute febrile illness can defer the immunization until resolved
    5.Immunocompromised
    6.IVIG use
  4. Chemo
  5. Steroid use
  6. Common cold and other mild conditions are not contraindications
    See Chapter 35 for more.
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5
Q

Nursing actions for immunizations

A
  1. Consent
  2. Vastus lateralis in infants and children under 3. Deltoid for older
  3. SubQ is given in anterolateral thigh or upper arm
  4. minimize discomfort
  5. Praise after, colourful bandages
  6. have emergency medications ready
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6
Q

Information gathered when asking about infectious disorder?

A
  1. exposure
  2. fever, sore throat
  3. lethargy and malaise
  4. low appetite
  5. vomiting, coughing, rash
  6. discharge from eyes or ears
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7
Q

Information gathered when asking about immunologic disorder?

A
  1. Maternal HIV
  2. frequent recurring infections, fevers
  3. Chronic cough
  4. Serious infections, two or more
  5. Extensive eczema,
  6. Growth failure
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8
Q

What are some labs ordered for immunologic or infectious disorders?

A
  1. CBC for WBC counts
  2. Electrolyte Panel
  3. C reactive protein : elevated. @hat does elevated mean?
  4. Urine culture
  5. Cerebrospinal fluid analysis
  6. stool culture
  7. chest xrays
  8. strep test
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9
Q

methods in preventing infections

A
  1. handwashing
  2. immunizations
  3. proper preparation of food
  4. proper use of antibiotics
  5. standard precaution (tier 1) and transmission based precaution (tier2)
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10
Q

Bacterial Infections in children

A
  1. CAMRSA (Staph Aureus)
  2. Scarlet fever
  3. Diphtheria
  4. Pertussis
  5. tetanus
  6. tonsillitis
  7. otitis media
  8. Scarlet fever
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11
Q

Skin Infections

A
  1. Impetigo
  2. pyoderma
  3. cellulitis
  4. mollusum
  5. scabies
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12
Q
  1. Describe Scabies

2. Treatment

A
  1. Caused by scabies mite, inflammation occurs 30 to 60 days after exposure
  2. Permethrin, lindane, ivermectin (if greater than 15 kg)
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13
Q
  1. Describe pediculosis Capitis

2. treatment

A
  1. Head lice, lives for 48 without human host

2. pediculicide and nit removal

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14
Q

Viral skin infections

A
  1. Verruca
  2. Herpes simplex 1 and 2
  3. Varicalla Zoster
  4. Molluscum
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15
Q
  1. Superficial infections that live on the skin. aka?

2. what are some examples

A
  1. Fungal skin infection or tinea

2. Tinea capitis, tinea corporis, tinea pedis, candidiasis

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16
Q
  1. Perutis Aka
  2. transmission
  3. Characteristics
  4. Complications
A
  1. Whooping Cough
  2. Droplet and direct contacts
  3. Short rapid coughs followed by crowing or whooping sound
  4. Pneumonia, encephalopathy, death, rib fractures
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17
Q
  1. Tetanus AKa
  2. describe what it does
  3. caused by?
  4. S and S
  5. treatment and prevention
A
  1. Lock jaw
  2. Affects the body’s muscles and nerves
  3. Clostridium tetani (soil)
  4. Muscle spasm in jaw, difficulty swallowing, stiffness and pain in neck, shoulder, back
  5. Antinbiotics, TIG, Antispasmodic, wound care, vaccination and booster every 10 years
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18
Q 
Tonsillitis
1. Cause
2. Symptoms
3. Diagnosed through?
4 Treatment
A
  1. Streptococcus
  2. Sore throat, difficulty swallowing, fever, red tonsils, yellow or white coating of tonsils, enlarged neck lymph
  3. Throat culture
  4. Manage symptoms (Fluids, rest, Pain management), antibiotics
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19
Q

Diphtheria

  1. How is it spread
  2. Risk factors
  3. S and S
  4. Diagnosed through?
  5. Treatments and preventions
  6. Complications
A
  1. Sneezing, coughing, laughing
  2. Crowded areas, unclean environments, too young or too old, unvaccinated
  3. Sore throat, low grade fever, enlarged lymph i neck, trouble breathing, double vision, slurred speech
  4. throat culture.
    5 anti toxi, antibiotics, isolation, vaccination and boosters
  5. heart, kidney damage and failure, paralysis
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20
Q
  1. Describe otitis media
  2. Complications
  3. Risk
  4. S and S
  5. Diagnosed through?
A
  1. Infection and inflammation of middle ear
  2. impaired hearing and speech delays
  3. 2 years old or younger, school and daycare, bacterial infection (especially throat infections), winter, down syndrome, cleft palate
  4. recent respiratory infection, crying, irritability (especially around ear area), loss of appetite, N/V, drainage, bulging red tympanic membrane
  5. otoscoppy
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21
Q
  1. Medication for Otitis media

2. nursing responsibilities

A
  1. Ibuprofen or acetamenophen, antibiotics. Avoid decongestants and aspirin
  2. Comfort, manage pain, feed upright position
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22
Q

Scarlet fever

  1. causes
  2. transmission
  3. complications
  4. S and S
A
  1. Group A hemolytic streptococci
  2. droplet and direct contact
  3. Carditis, glomerulonephritis
  4. Strawberry tongue
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23
Q

Viral infections occurring in children

A
  1. Chicken pox
  2. Rubeola
  3. Roseola
  4. Rubella (measles)
    5Mononucleosis
  5. Mumps
  6. Zoonotic infections (cat scratch and rabies)
24
Q
  1. Chicken pox agents

2. eventually progress to

A
  1. Varicella zoster

2. herpes zoster (shingles)

25
Q
  1. Erythema Infectiosum agent
  2. When does slapped face disappear?
  3. describe what happens to rash?
A
  1. Parvovirus
  2. 1 to 4 days
  3. subsides but reappears when irritated.
26
Q
  1. Roseola Agent

2. S and S

A
  1. Herpesvirus type 6

2. High fever lasting 3 to 4 days, after fever, rash appears on trunk then facem and then extremities.

27
Q
  1. Rubeola Aka

2. transmitted through?

A
  1. Measles

2. Secretions and droplets

28
Q
  1. mumps agent
  2. transmitted through?
  3. S and S
  4. complications
A
  1. Paramyxovirus
  2. droplet and contact
  3. fever, HD, Malaise, parotitis
  4. Orchitis, meningoencephalitits, deafness
29
Q
  1. Rubella aka

2. complications

A
  1. German Measles

2. greatest threat to fetus

30
Q

Mononucleosis complications

1. caused by?

A

enlarged spleen and ruptured spleen

1. epstien barr virus

31
Q

how is hand foot and mouth disease transmitted?

A

direct contact

32
Q
  1. what is the most common cause of lymphadenitis in peds population?
  2. this is usually transmitted through?
  3. characteristics to know about it?
  4. how is it treated?
A
  1. Cat scratch fever
  2. scratches or bits usually form cats
  3. usually benign lasting 2 to 4 months
  4. supportive care
33
Q

care for snakebites

A

maintain a calm response
apply loose tourniquet, do not occlude
suction may be appropriate in some cases

34
Q

what is a nursing diagnosis and intervention for human bites

A

risk for infection related to laceration and infection from human bite
wound care

35
Q

common cause of conjunctivitis in:

  1. Newborn
  2. infants
  3. Children
A
  1. Newborns: chlamydia gonorrhea or herpes simplex virus
  2. Usually a sign of duct obstruction
  3. Bacterial is most common. can also be viral, allergic
36
Q

disease transmitted through ticks, mosquitos, or insects

1. what are some examples

A

Vector born diseases

1. Lyme disease, rocky mountain spotted fever

37
Q

Important things to know for rabies

A
  1. this is a common peds problem especially for children under 5
  2. Wound care and prophylactic antibiotics is the intervention
38
Q

what are some parasites to be aware of and assess for in children

A
  1. scabies and head lice
39
Q

STDs to know about

A
  1. Candidiasis
  2. trichomoniasis
  3. bacterial vaginosis
  4. Gonorrhea
40
Q
  1. Gonorrhea is caused by?
  2. thing to know about its symptoms
  3. how is it diagnosed
  4. what is the treatment? and prevention
  5. what are complications of this disease
A
  1. N. Gonorrhea
  2. Some people can be asymptomatic
  3. Urine sample and culture
  4. antibiotics for patient and partner. condom use yearly tests and sharing of info
  5. Pelvic inflammatory disease, fertility issues, epididymitis, orchitis
41
Q

HPV

  1. AKA, has a strong link with?
  2. Manifestations?
  3. Diagnosed through?
  4. Therapeutic management and prevention
A
  1. Anogenital warts, closely related to cervical carcinoma
  2. warts on or near vulva, vagina, cervix, anus, penis, or scrotum
  3. wart biopsy
  4. topical medication, lasers, cold or heat on warts, surgery. prevention through condoms, yearly testing, and sharing of info
42
Q
  1. the viral infection of t-lymphocytes
  2. risk factors?
  3. what are some objective information that can point to infection?
  4. Diagnosed through?
  5. Complications?
A
  1. HIV
  2. Infants breast fed by infected parent, Blood contact, sexual abuse, unprotected sex, IV drug use and tattoos
  3. can have no symptoms and progress to immunocompromised, hepatomegaly, dermatitis, recurrent fevers and infections, chronic diarrhea, and lastly wasting (severe)
  4. ELISA test and western blots for 18 months or older, for younger we use PCR and virus culture.
  5. organ dysfunction. opportunistic infections
43
Q

Nursing actions for HIV

A
  1. Standard precaution
  2. High calorie, high protein, Nutritional supplements
  3. Oral and skin care
  4. Pain management
  5. Medications (anti retroviral, antibiotics, IVIG)
  6. Monitor labs (CBC, WBC, Liver function test, CD4 count)
  7. educate about lifelong adherence to medication, monitor symptoms, high risk behaviors, immunizations
44
Q
  1. How is HBV transmited?
A
  1. Body fluids
45
Q

common treatments for infectious disorders

A

Hydrations
fever reduction
isolation precautions
Nutritious foods

46
Q

Common medications for infectious disorders

A 
Antibiotics
antivirals
antipyretics
antipruritic
analgesics
antihistamines
47
Q

Nursing Management of a Child with an

Infectious or Communicable Disease

A

Assess pain and response to interventions frequently.
Administer analgesics and anti pruritics as ordered.
Apply cool compresses or baths to areas of pruritus.
Provide fluids frequently.
Provide cool mist humidification.
Dress the child in light clothing.
Use diversional activities and distraction.
Assess temperature at least every 4 to 6 hours, 30 to 60 minutes after
antipyretic is given and with any change in condition.
Use same site and device for temperature measurement.
Administer antipyretics per physician order
Notify physician of temperature per institution or specific order guidelines.
Keep linens and clothing clean and dry.
Encourage child to press on rather than scratch the area of pruritus.

48
Q

Describe and identify the types of Primary Immunodeficiency. Causes?

A

1 Mostly hereditary and congenital
2.Humoral deficiency, cellular immunity deficiency, phagocytic system defects,
complement deficiency
3. Genetics, chronic disease, use of immunosuppressive meds, malnutrition, prematurity, and HIV

49
Q

what can be assessed for Immune deficiency

A
  1. Chronic diarrhea
  2. Failure to thrive
  3. History of severe infection in early infancy
  4. Persistent thrush
  5. Pneumonia
  6. Low immunoglobulins
50
Q

1.Symptoms of autoimmune disease

A

1Fatigue, achy muscles, Low grade fever, Hair loss, Skin rashes

51
Q

Common autoimmune diseases in children

A 
Addison's disease -affects the adrenal glands
autoimmune hepatitis- affects the liver
Crohn's disease- affects the gastrointestinal tract
multiple sclerosis (MS)- affects the central nervous system
type 1 diabetes -affects the pancreas
ulcerative colitis- affects the gastrointestinal tract
juvenile dermatomyositis- affects the skin and muscles
juvenile idiopathic arthritis -affects the joints and sometimes the skin and lungs
lupus -affects the joints, skin, liver, kidneys, heart, brain and other organs
scleroderma -affects the skin, joints, intestine and sometimes the lungs
52
Q 
Immunologic Disorders: Systemic Lupus
Erythematosus
1. manifestations and effects to body
2. Diagnosed through?
3. Treatments
A
  1. Rash on face, fever, joint pain, muscle ache, hair loss. effects include: Damage to skin, joints, kidneys, heart and brain
  2. HBG, HCT platelet count decrease. WBC is low, positive ANA (antinuclear antibodies), decreased complement c3 and c4
  3. No cure. management of symptoms. Drugs include :symptoms, corticosteroids, immunosuppressive drugs, acetaminophen or nonsteroidal anti inflammatory drugs (NSAIDs), such as ibuprofen or
53
Q

common allergens

A 
Cow’s milk
Eggs
Peanuts
Tree nuts
Sesame seeds
Kiwi fruit
Fish and shellfish
54
Q

how are allergies diagnosed

A

Skin prick test, Radioallergosorbent blood tests

55
Q

Treatment of allergies

A

Antihistamines, education on avoidance, epi pen for anaphylaxis. Teach
patient and parent how to use it.

Pediatrics (15 decks)

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