Communicable & Infectious Diseases Of Childhood Flashcards
Active vs passive immunity
Active: exposure
Passive: mom (placenta/breastmilk)
Immunizations
Live viruses to not give to pregnant people
MMR
Varicella
Most vaccines are IM
What are some SQ and oral
SQ: MMR, Varicella
Oral: rotavirus
Immunization contraindications
Dont give live vaccine to who? For how long
Allergic reaction or anaphylaxis with previous dose
Severe febrile illness
Do not administer live virus to a child who is:
-Severely immunocompromised
-pregnant
-received tx that provides acquired passive immunity within past 3 months (blood products/transfusion)
Immunization precautions
Reasons we may postpone vaccine
Requires what before giving
Moderate or severe illness with or without a fever
Required provider to analyze data and history of pt to determine if benefit outweigh the risks
Administration of immunizations
Obtain what
Provide what
Determine what
5 rights
Atraumatic care
Education pt on what
Obtain informed consent (verbal usually)
Provide VIS (vaccine information statement)
Determine if child is eligible for vaccine
Educate pt on side effects vs adverse reactions
Immunizations: expected reactions
SLIMAR
Swelling erythema, pain at injection site
Low grade fever
Rash
Malaise
Irritability
Arthralgia (joint pain)
Immunization documentations
Barcoding (scan and puts all info needed in)
Date, time
Vaccine given
Manufacturer lot #
Expiration date
Route and site of admin
VIS provided
Any contraindications
Fever in newborn -3months or less
What temp we treat
Newborn fevers can cause sepsis, death
(Decreased immune systems)
100.4
Acetaminophen and ibuprofen doses
Other info as well
Acetaminophen:
10-15mg/kg/dose
-q4H
Ibuprofen:
4-10mg/kg/dose
-only children 6+ months old
Commonalities of viral infections
DRTVRIFFW
Diahrea
Respiratory difficulties
Tachycardia
Vomiting
Rash
Irritability
Fatigue
Fever
Weakness
Conjuntivitis
Can be both what
Most common types
Transmission
Precautions
Viral or bacterial
Commonly staph (rather than strep)
Transmission: Direct contact
Precautions: standard
Conjunctivitis
Communicable:
Viral vs bacterial
Viral:
-appears secondary to viral infection
-self resolves 7-14 days
Bacterial:
-clears w/ abx
Conjunctivitis expected findings
CPESY
Crusting of eyelids
Pink or red sclera
Excessive tearing
Swelling of conjunctiva
Yellow-green purulent drainage
Conjunctivitis nursing management
How to treat bacterial
Interventions
Notify who
Cant use what
Abx = bacterial
Cold compress
Hand hygiene
Notify school/daycare
No contact lenses
Varicella: chicken pox
Causual agent
Transmission
Precautions
Communicable (cant return to school till what happened)
Causual agent: varicella-zoster
Transmission:
-airborne
-direct contact w/ secretions or contaminated surfaces
Precautions: airborne/contact
Communicable: 1-2 days before lesions appear until all lesions have crusted over (until crusted over you cannot return to school)
Varicella: chicken pox
Clinical manifestations
1-2 days Prior to rash
Rash
When lesions crust
1-2 days prior to rash =
-fever, fatigue, loss of appetite, HA
Rash:
-starts on trunk then spread to face and extremities
-macular/papular/clear filled vesicles
-ITCHYYY
Takes 1-3 weeks for all lesions to crust
Varicella: chicken pox
Complications
CMTS
Cellulitis
Meningitis/encephalitis
Thrombocytopenia
Lifelong latent infection (shingles)
Varicella: chicken pox nursing management
Meds (4)
Other interventions (4)
Several cases
Acetaminophen/ibuprofen
Oral antihistamines
Anti-itch lotion
Oatmeal baths
Short fingernails
Change bed linens often
Watch mental status closely
Acyclovir (in severe cases/immunocompromised)
Hand foot mouth disease (coxsackie virus)
Transmission
Precautions
Communicable
Transmission:
-direct contact w/ fecal/oral secrections
-surfaces
Precautions: contact
Communicable: (while have fever)
-2 days before rash (usually when fever starts)
-up to time fever disappears
Hand foot mouth disease (coxsackie virus)
Clinical manifestations
FLF
Complications
Fever first
Lesions (rash on hands and feet)
Fatigue
Complications:
-extensive mouth lesions (painful)
-Neonates-severe-sepsis-multiorgan failure
Hand foot mouth disease (coxsackie virus)
Nursing management
Meds (2)
Interventions (2)
Is it itchy
Resolves when?
Analgesics/antipyretics
Oral fluids and washes
Hand washing and hygiene
Not itchy
Resolves (1 week) quickly
Erythema infectiosum (fifth disease)
Causal agent
Transmission
Precautions
Communicable
Causal agent: parvovirus B19
Transmission:
-droplet
-contact with blood products
-transplacental transmission (dont be around if preg)
Precautions: Droplet
Communicable :
-no longer contagious once rash appears
Erythema infectiosum (fifth disease)
Clinical manifestations
Prodromal (before rash)
Rash
Prodromal: before rash: (most contagious)
-flu-like symptoms
-low grade fever
-runny nose
-HA
Rash: 7days-several weeks
-flushed red cheeks (slapped cheeks) (hallmark)
-“lacy” rash on trunk and extremities (itchy)
-pain in joints
-rash reappears with sunlight or irritation for 1-3 wks (scared parents that their getting sick again)
Erythema infectiosum (fifth disease)
Complications
Self limiting
Arthritis
Arthralgias
Pregnancy: loss of fetus
Erythema infectiosum (fifth disease)
Nursing managment
Meds/ interventions
Dont care for pts if?
Stay away from what?
Antipyretics
Antipruritics
Oatmeal baths
Do not care for pts if preg
Stay out of sunlight
mumps (parotitis)
Causual agent
Transmission
Precautions
Communicable period
Causual agent: paramyxovirus
Transmission:
-droplets or contact w/infected droplets
Precautions:
droplet
Communicable period:
1-2 days before swelling to 9 days after onset of parotitis
Mumps (parotitis)
Clinical manifestayion
FFPPHEL
Unique:
Pain with chewing
Painful sweeling of parotid gland
Earache
Loss of appetite
Common:
Fever
Fatigue
HA
Mumps (parotitis)
Complications
HHOOGTMEP
Hepatitis
Hearing impaired/loss
Orchitis (inflammation of testicles)
Oophoritis (inflammation of ovaries)
Glomerulonephritis
Thrombocytopenia
Meningitis
Encephalitis
Pancreatitis
Mumps (parotitis)
Nursing management
Normal interventions
Unique
Isolation until when
Fever and pain managment
Fluids
Icepacks if orchitis present
Isolation until 9 days after unset of parotid swelling
Rubella (German measles)
Transmission
Precaution
Communicable period
Transmission:
-direct or indirect contact with nasopharyngeal droplets
-blood, stool, urine, transplacental (dont care for pts if preg)
Precaution: Droplet
Communicable period:
-7days before onset of symptoms to 7days after rash appears
Rubella (german measles)
Common s/s
Unique ones (what is the 1st sign)
Info on rash
Common:
Low grade fever
HA
Malaise
Unique:
Pinkish rash (pinpoint) first sign
-begins on face, neck, scalp and spreads
-rash fades in order in which its presents
Mild pruritis
Joint pain
Lymphadenopathy
Rubella (german measles)
Complciations (3)
Thrombocytopenia
Encephalitis
Congenital rubella (if preg you can get this)
-developmental delay
-retinopathy
-cardiac anomalies
-deafness
-miscarriage
Rubella (german measles)
Nursing management
Meds
Why wouldnt you care for these pts
Antipyretics
Antipruritics
Analgesics (joint pain)
If pregnant
Rubeola (measles)
Transmission
Precautions
Communicable period:
Its highly what
Transmission:
-direct or indirect contact with droplets
-primarily nasopharyngeal secretions
-urine and blood
Precautions: airborne until 4 days after onset of rash
Communcable period:
1-2 days before onset of symptoms (3-5days before rash) and 4-6 days after appearance of rash
Highyl contagious
Rubeola (measles)
Clinical manifestations
Prodromal phase
Spots
Rash
Prodromal phase (3-4 days prior to rash)
-fever, fatigue, cough, runny nose, sore throat, conjunctivitis
Koplik spots:
-white spots with reddened background on mucosa (cheeks)
-2-3 days before primary rash
Rash:
Red, blotchy, begins on head and proceeds downward and outward
-ITCHY
Rubeola (measles)
Complications
EBOP
Otitis media
Bronchitis
Pneumonia
Encephalitis
Rubeola (measles)
Nursing management
Meds (3)
Interventions(2)
Antipyretics
Antipruritics
Antitussives
Coolmist humidifier
Monitor resp status
Epstein-barr virus: mononucleosis
Tranmission
Precautions
Diagnoses
Tranmission: saliva
Precaution: standard
Diagnoses:
-physical assessment, symptoms, blood test
Epstein-barr virus: mono
Communicablility
Healthy people can carry EBV in saliva Transmitting the virus for a lifetime
Those with mono can transmit it for months after symptoms have gone away
Epstein-barr virus: mono
Clinical manifestations
Common: (3)
Unique: (4)
Common:
-fever
-lethargy
-HA
Unique:
-red/large tonsils
-lymphadenopathy (neck,groin,armpits)
-splenomegaly
-hepatomegaly
Epstein-barr virus: mono
Nursing management
Meds
Avoid what
Antipyretics
Pain relievers
Steriods (if airway patency is a concern)
Avoid contact sports/strenuous activities for:
4-6 weeks or until splenomegaly resolves
Pertussis (whooping cough)
Transmission
Precautions
Communicable period
Transmission:
-direct contact
-respiratory droplets
Precautions: droplet
Communicable period:
-most contagious during catarrhal stage (7-10days) before onset of paroxysmal stage (1-4weeks)
Pertussis (whooping cough)
Catarrhal stage (when)
Paroxysmal stage (when)
Convalescent stage (when)
Catarrhal stage (7-10 days):
-nasal congestion, low grade fever, mild cough
Paroxysmal stage (1-4 weeks):
-cough (severe/spasms/thick mucous)
-forceful inspiration thru narrow glottis (stridor)
-cyanosis, post-tussive emesis
Convalescent stage (6 weeks after paroxysmal stage)
-symptoms gradually subside
Pertussis (whooping cough)
Therapeutic management
Macrolide abx
Erythromycin/azithromycin
Corticosteriods
Pertussis (whooping cough)
Physical assessment
Prevention?
Resp status
Emergency equipment at bedside
Prevent stimulating cough
DTaP (children)
Tdap (adults)
Group A streptococcus
Transmission
Precautions
Communicability
Transmission:
-contact with resp secretions
-direct contact w/ infected skin
Precautions: droplet
Communicability:
-highest during acute infection
-no longer infectious 24 hrs after starting abx
Group A streptococcus (pharngeal)
Clinical manifestations
Main ones: (2)
Others: (6)
Main ones:
Fever
Red pharngitis w/ exudate
Others:
Dysphagia
Malaise
Chills
HA
Abd pain
Vomiting
Group A streptococcus (scarlet fever)
What causes it
S/s
Bacteria releases toxin (causes rash and red tongue)
Rash in axillary, groin, neck
Sandpaper feel
Blanches w/ pressure
Sore throat
White coating early in illness
Strawberry tongue by day 4-5
Group A streptococcus (scarlet fever)
Complications
Result from extension of strep infections
-acute rheumatic fever(cardiac issues)
-acute glomerulonephritis
-sepsis
Group A streptococcus (scarlet fever)
Nursing management
Penicillin
Amoxicillin
