Communicable Disease Flashcards
T or F: The incidence of communicable disease has declined with the introduction of vaccines.
TRUE
T or F: Complications of communicable diseases have increased.
FALSE
use of antibiotics and antitoxins
Varicella zoster distinguishing characteristics
itchy, fluid-filled vesicles
Treatment for varicella zoster
antivirals: Acyclovir
immunoglobulins
Mycoplasmal infections more common in…
fall and winter
Asthmatic bronchitis more frequent in….
fall
September spike
going back to school, weather changing
RSV season
winter and spring
Clinical manifestations of respiratory infections
cough
lower O2 sat
SOB
WOB
cyanosis
Most reliable place to check for cyanosis
mucous membranes
dusty
darker skin tones - looks ashen
Way to test SOB
ask kids to say their ABCs and see how fast they lose their breath
Nursing care management for respiratory infections
medications - bronchodilators
oxygen therapy
resp support - pressure (bipap, c-flow)
deep breathing and coughing techniques
positioning
rest and comfort
keep hydrated**
nutrition
decreased handling, clustered care
reduce temperature (=reduced HR and RR)
prevent spread
fam support
T or F: Children will most likely need oxygen therapy with a respiratory infection.
not always
also sometimes they need more support pressure wise than oxygen wise
Fifth Disease distinguishing feature
red slapped-face rash that spreads to trunk and extremities
lacy appearance
Fifth Disease treatment
for symptoms
Tylenol for fever, hydration etc.
Roseola
high fever that disappears
followed by rash on trunk, neck
then face, arms, legs
Roseola treatment
Tylenol and Advil
manage fever to prevent seizures
Mumps distinguishing feature
parotitis
Measles (Rubeola) distinguishing feature
Koplik spots 2 days before rash in mouth
flat rash
Rubella (German Measles) distinguishing features
face then neck, trunk, legs
Complications of Rubella (German Measles)
intrauterine death, spontaneous abortion
Hand, Foot, Mouth Disease distinguishing features
blisters on hand, feet, around mouth
Pertussis (Whooping Cough) distinguishing feature
short, rapid coughs followed by crowing or “whoop” sound
symptoms of choking/gasping for air
Pertussis (Whooping Cough) most common cause of death
pneumonia
Pertussis (Whooping Cough) nursing care
droplet precautions - suspected and confirmed
closely monitor cardiorespiratory function and O2 sat
maintain patent airway; keep suctioning equipment available
quiet environment
keep hydrated - small amounts of fluid, frequently
report to PH
may treat non-immunized close contacts of prophylactically
Scarlet fever distinguishing feature
strawberry tongue
Scarlet fever treatment
antibiotics
supportive therapy (analgesic, antipyretic, fluids)
Mono distinguishing feature
swollen lymph nodes
Croup distinguishing feature
hoarseness, barking, “seal” like cough
Is croup serious?
yes!
can progress to respiratory acidosis, respiratory failure, and death
Croup treatment
vaporizers, oral fluids, antipyretics
steroids (NOT bronchodilators –> lower resp only)
airway management
hydration
high humidity with cool mist
CONTINUOUS OBSERVATION AND ASSESSMENT
Upper resp infections (6)
1) Nasopharyngitis: “common cold”
2) Pharyngitis – 80-90% viral
3) Tonsillitis
4) Otitis Media
5) COVID-19
6) Croup
Otitis media
due to short and horizontal Eustachian tubes
v common: 6 months to 3 years
discharge
grabbing at ear
Otitis media treatment
antibiotics - amoxicillin
pain management and fever - Tylenol
tubes surgery
Preventing recurrence of otitis media
make sure that they’re not eating/drinking lying down (gets into tubes)
breastfeeding
avoiding tobacco smoke
COVID-19
acute, mild to severe
most frequent, serious infection: pneumonia
symptoms:
fever, cough
SOB, URT symptoms, diarrhea, loss of senses of smell or taste, myalgia, rhinorrhea, headache, abdominal pain, diarrhea, sore throat, fatigue
T or F: Lab values with COVID-19 are usually normal
TRUE
may include leukopenia, elevated C-reactive protein
but non-specific
Lower airway infections
1) Bronchitis
2) Bronchiolitis
3) Pneumonia
Bronchitis
inflammation of the large airway
cough - with OR without sputum
usually viral
Lead cause of bronchiolitis
RSV
With viral infections, which lungs are typically infected?
a) one
b) both
b) both
Bronchiolitis symptoms
both lungs affected
wheezes, crackles
Bronchiolitis treatment
suctioning*
supportive treatment* - calm, comfortable
support resp effort with high flow, c pap, bipap
saline nebulizers sometimes - mucous
RSV Bronchiolitis - infants and young children - sign
apnea
RSV Bronchiolitis - older children - sign
secondary infections typically have URT symptoms
RSV Bronchiolitis diagnosis
chest x-ray
aspiration of nasal secretion or nasopharyngeal washings
Trajectory of RSV
worse –> better –> worse again
Pneumonia - when to admit child
lower O2 sat
if they need respiratory support
dehydrated
failed oral antibiotics - will need IV
pleural effusion
Pneumonia treatment
antibiotics if bacterial
1 lung
Aspiration pneumonia
risk for child with feeding difficulties
prevention of aspiration - keep upright
Aspiration pneumonia - things to avoid
hydrocarbons, lipids
solvents
talcum powder
Asthma sign
wheezing
T or F: You may hear more wheezing after giving bronchodilators.
TRUE
because you’re helping to open up the airways, not necessarily bad because you want resp sounds over no resp sounds
Asthma treatment
bronchodilators
steroids
Cystic fibrosis
exocrine gland dysfunction that produces multisystem involvement
most common lethal genetic illness among white children
autosomal recessive - both parents have to have
Cystic fibrosis main systems affected (3)
1) resp
2) GI
3) pancreas
CF respiratory manifestations
MOST patients
abnormally thick mucous
difficult to expel
hypoxia, hypercapnea, acidosis
pulmonary hypertension, cor pulmonale (R sided heart failure), respiratory failure, and death
CF GI & pancreas manifestations
blocked pancreatic ducts
can’t release enzymes
impaired digestion/absorption of fat, steatorrhea
impaired digestion/absorption of protein
pancreatic fibrosis=DM
biliary cirrhosis
impaired salivation
Stools in someone with CF
fatty stools!
How to diagnose CF
newborn screen
CF presentation (many)
wheezing respiration
dry nonproductive cough
generalized obstructive emphysema
patchy atelectasis
cyanosis
clubbing of fingers and toes
repeated bronchitis and pneumonia
meconium ileus (thick meconium)
distal intestinal obstruction syndrome
fatty, foul stools
prolapse of the rectum
delayed puberty in females
sterility in males
parents report children taste “salty”
dehydration
hypoalbuminemia
CF nursing management
depends on symptoms and extent
pulmonary toileting
IV antibiotics, mucolytics
chest physiotherapy, puffers, aerosol treatments
nutrition
Pulmonary toileting
nutrition, medication, physio to help clear out airways
