Chapter 45 Flashcards
Mode of transmission
Direct
•Direct: Physical contact between source of infection and new host
Mode of transmission
Indirect
Pathogens survive outside humans before causing infection
Antigen
Foreign substance – triggers immune response
Antibody
Protein made by the body in response to antigen
Active
Body makes antibodies without presence of clinical disease (example: tetanus vaccine
Passive
Antibodies made by another human or animal and given to another person – does not confer long-term immunity (example: tetanus immunoglobulin)
Killed virus vaccine example
inactivated polio/IPV)
Toxoid example
•Tetanus is a bacterial exotoxin
Live virus vaccine
MMR, varicella, what else?)
Recombinant form
(hepatitis B, pertussis) – DNA alteration of the organism
•Conjugated (Hib) – antigen/carrier protein
antigen/carrier protein
Reasons why parents don’t vaccinate
•Concern that vaccine is dangerous (autism, SIDS)
•Vaccine might not fully prevent disease
•Does not want government to monitor vaccination status
•The disease is not a threat anymore
•Side effects from vaccine do not justify benefit
•Belief that they can control child’s susceptibility to disease
•Poor experience prior – d/t:
–Procedure – site update
–Poor education on side effects and believe of reaction
Chicken pox varicella
- Agent: Herpes Varicella
- Transmission: Airborne, direct contact
- Systemic manifestations: Fever, malaise, headache, abdominal pain
- Skin manifestations: Clear, fluid-filled vesicles all over the body
- Treatment: Supportive
- Nursing: Isolation, symptom management
Cox hand foot and mouth disease
•Agent: Coxsackievirus A16, Enterovirus 71
•Transmission: Fecal-oral and respiratory routes
•Systemic manifestations: Fever, sore throat
•Skin manifestations
–Herpangina: Papulovesicular lesions in pharynx only
–Hand, foot, and mouth disease: Papulovesicular lesions on inside of cheek, gums, tongue, as well as hands and feet
•Treatment: Supportive
•Nursing: Isolation, topical lotions, cool drinks
Diphtheria
- Agent: Corynebacterium diphtheriae
- Transmission: Contact with nasal or eye discharge
- Systemic manifestations: Fever, anorexia, rhinorrhea, cough, stridor
- Oral manifestations: Tonsils, pharynx covered in thick, bluish-white patch
- Treatment: Antibiotics, IV antitoxin
- Nursing: Isolation, monitor for respiratory distress, administer antibiotics
Erythema Infectiosum (Fifth Disease)
- Agent: Human parvovirus B19
- Transmission: Respiratory secretions and blood
- Systemic manifestations: Flu-like illness
- Skin manifestations: Fiery-red rash on cheeks (“slapped face” appearance) – lace-like rash on trunk and limbs
- Treatment: Supportive
- Nursing: Isolation, fever control, antipruritics, soothing baths (oatmeal)
Haemophilus Influenzae Type B
- Agent: H. influenzae bacteria (several serotypes exist)
- Transmission: Direct contact or droplet inhalation
- Systemic manifestations: Viral upper respiratory tract infection that invades bloodstream – may cause meningitis, cellulitis, epiglottitis, pneumonia, or sepsis
- Skin manifestations: None specific
- Treatment: Antibiotics
- Nursing: Isolation, prophylaxis for close contacts, antipyretics
Measles (Rubeola)
- Agent: Morbillivirus – “Hard Measles”
- Transmission: Airborne, droplet, and contact
- Systemic manifestations: High fever, conjunctivitis, cough, anorexia, malaise
- Koplik spots – clustered white lesions on buccal mucosa – prodromal 2-3 days before rash – red, blotchy, maculopapular
- Treatment: Supportive – antibiotics for secondary infections
- Nursing: Isolation, antipyretics, antitussives, monitor respiratory status
Mono
- Agent: Epstein-Barr virus
- Transmission: Direct contact with secretions
- Systemic manifestations: Malaise, headache, fatigue, fever, posterior lymphadenopathy – weakness and lethargy may persist for months
- Skin manifestations: None specific
- Treatment: Supportive
- Nursing: Antipyretics, bed rest during acute phase
Mumps parotitis
- Agent: Rubulavirus
- Transmission: Contact with respiratory secretions
- Systemic manifestations: Malaise, fever, pain with chewing, parotid gland swelling
- Skin manifestations: None specific
- Treatment: Supportive – disease is usually self-limiting
- Nursing: Isolation, comfort
Pneumococcal Infection
- Agent: Streptococcus pneumoniae
- Transmission: Respiratory secretions, droplet
- Systemic manifestations: Related to area of infection (otitis, sinusitis, bacteremia, pneumonia, meningitis)
- Skin manifestations: None specific
- Treatment: Antibiotics (many resistant strains exist)
- Nursing: Isolation, antipyretics, encourage fluids
Poliomyelitis
- Agent: Poliovirus
- Transmission: Fecal-oral, possibly respiratory
- Systemic manifestations: May be mild or severe – CNS symptoms, respiratory weakness, paralysis
- Skin manifestations: None specific
- Treatment: Supportive
- Nursing: Monitor respiratory status, comfort
Roseola Infantum (Exanthem Subitum, Sixth Disease)
- Agent: Herpesvirus type 6
* Transmission: Possibly respiratory secretions of healthy individuals -
Rotaviru
- Agent: Reoviridae family of rotaviruses
- Transmission: Fecal-oral route
- Infants/young children
- Systemic manifestations: Fever (acute onset), vomiting, diarrhea (10-20 stools per day)
- Skin manifestations: None
- Treatment: Rehydration (oral or IV); no antiviral therapy is available, but is preventable by vaccine
- Nursing: Hand hygiene; monitor intake and output
Rubella German measles
- Agent: Rubella (Latin for “little red”) RNA Virus
- Transmission: Droplet or direct contact
- Systemic manifestations: Low-grade fever, headache, malaise, anorexia
- Skin manifestations: Pink, nonconfluent, maculopapular rash that starts on face.
- Treatment: Supportive – disease usually mild. Prenatal exposure causes birth defects
- Nursing: Isolation, especially from pregnant women – comfort measures
Strep A
•Agent: Group A streptococci (GAS)
•Transmission: Contact with respiratory secretions – direct contact
•Systemic manifestations: Pharyngeal (sore throat, fever)
•Skin manifestations: Pyodermal
impetigo – honey-colored lesions
•Treatment: Antibiotics – uncomplicated impetigo treated topically
•Nursing: Usually cared for at home – fever management, warm fluids
Tetanus
- Agent: Clostridium tetani or tetanus bacillus
- Transmission: Via wounds in the skin
- Systemic manifestations: Neck or jaw stiffness, facial spasms, prolonged muscle contraction
- Skin manifestations: None specific
- Treatment: Tetanus immune globulin – respiratory monitoring and ventilation
- Nursing: Wound care, monitor respiratory status, hydration
Lyme disease
- Agent: Borrelia burgdorferi, a spirochete
- Transmission: Tick bite (infected spirochete transmitted when tick draws blood)
- Systemic manifestations: Malaise, headache, mild fever, joint aches
- Skin manifestations: Red, “bulls-eye” rash around tick bite
- Treatment: Antibiotics
- Nursing: Discuss prevention of tick bites and proper tick removal – treatment usually occurs at home, rest and completion of antibiotics
Malaria
- Agent: Plasmodium (four species exist)
- Transmission: Via infected female mosquito bite
- Systemic manifestations: Malaise, headache, vomiting, diarrhea, high fever spike every 48 to 72 hours
- Skin manifestations: None specific
Rabies
- Agent: Rhabdoviridae (two types-one in dogs, one in wildlife)
- Transmission: Infected saliva from bite of rabid animal
- Systemic manifestations: Long incubation period – headache, fever, malaise, difficulty swallowing (leads to hydrophobia) – untreated, leads to coma and death
- Skin manifestations: None specific
- Treatment: Human rabies immune globulin for passive immunity – rabies vaccine for active immunity
- Nursing: Administration of vaccine and education about side effects
Rocky Mountain spotted fever
- Agent: Rickettsia rickettsii
- Transmission: Transmitted by infected ticks
- Systemic manifestations: May be mild (malaise, fever) to severe (encephalitis, shock)
- Skin manifestations: Maculopapular rash (extremities, then trunk)
- Treatment: Doxycycline
- Nursing: Prevention of tick bites – standard precautions, administer antibiotics, monitor for worsening symptoms
you will never get the same what virus
rhinovirus
allergies to
eggs, gellantin, neomycn
required elements of documented immunizatons
Date of administration
Vaccine given
Manufacturer, lot number, and expiration date
Site and route of administration
Name, title, and address of nurse administering vaccine
storage
Store frozen vaccines (Varicella, MMRV, and Zoster) in a freezer between -58°F and +5°F (-50°C and -15°C). Store all other routinely recommended vaccines in a refrigerator between 35°F and 46°F (2°C and 8°C). The desired average refrigerator vaccine storage temperature is 40°F (5°C).
