Communicable & Infectious Diseases Of Childhood Flashcards by Brendon Allen

Active vs passive immunity

Active: exposure

Passive: mom (placenta/breastmilk)

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Immunizations

Live viruses to not give to pregnant people

MMR
Varicella

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Most vaccines are IM

What are some SQ and oral

SQ: MMR, Varicella

Oral: rotavirus

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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)

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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

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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

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Immunizations: expected reactions
SLIMAR

Swelling erythema, pain at injection site

Low grade fever

Rash

Malaise

Irritability

Arthralgia (joint pain)

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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

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Fever in newborn -3months or less

What temp we treat

Newborn fevers can cause sepsis, death
(Decreased immune systems)

100.4

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Acetaminophen and ibuprofen doses

Other info as well

Acetaminophen:
10-15mg/kg/dose
-q4H

Ibuprofen:
4-10mg/kg/dose
-only children 6+ months old

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Commonalities of viral infections

DRTVRIFFW

Diahrea
Respiratory difficulties
Tachycardia
Vomiting
Rash
Irritability
Fatigue
Fever
Weakness

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Conjuntivitis

Can be both what
Most common types

Transmission
Precautions

Viral or bacterial
Commonly staph (rather than strep)

Transmission: Direct contact
Precautions: standard

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Conjunctivitis

Communicable:
Viral vs bacterial

Viral:
-appears secondary to viral infection
-self resolves 7-14 days

Bacterial:
-clears w/ abx

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Conjunctivitis expected findings

CPESY

Crusting of eyelids

Pink or red sclera

Excessive tearing

Swelling of conjunctiva

Yellow-green purulent drainage

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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

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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)

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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

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Varicella: chicken pox

Complications

CMTS

Cellulitis
Meningitis/encephalitis
Thrombocytopenia
Lifelong latent infection (shingles)

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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)

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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

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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