Exam #1 Flashcards
Immunizations, Erikson Stages, Growth & Development Milestones, Disabilities
What are the symptoms of Varicella (Chicken Pox)?
- slight fever & anorexia (first 24 hr)
- pruritic (itchy) rash
- rash develops from macule, to papule, then vesicle
- vesicles break easily and form crusts
Where on the body are Varicella vesicles spread out?
Centripetal (face and proximal extremities)
How is chickenpox spread?
- direct contact
- droplet (airborne)
- contaminated objects
When is Varicella contagious?
1 day before eruption of vesicles - 6 days after vesicle crusts have formed
When is chickenpox no longer contagious?
Around a week after the lesions crusts have form
What precautions are used for Varicella?
- standard
- airborne
- contact
How long is the incubation period for chickenpox?
2-3 weeks (usually 14-16 days)
What are symptoms of Diphtheria?
- resembles common cold
- bloody. mucopurulent nasal discharge
- low grade fever
- bull’s neck (significant swelling of the neck)
- hoarseness
- white or gray membrane on tonsils
How is Diphtheria spread?
- direct contact
- contaminated articles
What is the incubation period of Diphtheria?
Usually 2-5 days
How long is Diphtheria contagious for?
2-4 weeks (until virulent bacilli are no longer present)
How do we confirm that Diphtheria is not longer contagious?
3 negative bacterial cultures
What type of precaution is used for Diphtheria?
- standard and droplet until 2 cultures are negative
- contact precaution with cutaneous manifestations
When is Diphtheria no longer contagious?
48 hours post antibiotic treatment
What is another name for Erythema Infectiosum?
Fifth Disease
What is another name for Fifth Disease?
Erythema Infectiosum
What are the symptoms of Erythema Infectiosum?
rash (appears in 3 stages)
Explain the three stages of the rash caused by Fifth Disease:
- Erythema mainly on cheeks (1-4 days)
- Maculopapular red sports on upper & lower extremities (lasts > 1 week)
- Rash subsides (reappears if skin is irritated/traumatized)
How do children with aplastic crisis display different symptoms of Fifth Disease?
- rash is absent
- fever
- myalgia
- lethargy
- nausea/vomiting
- abdominal pain
How is Fifth’s Disease spread?
Respiratory secretions & blood
How long is Fifth’s Disease incubation period?
4-14 days
When is Fifth Disease contagious in children with aplastic crisis?
Before onset of symptoms
What precautions are used for Erythema Infectiosum?
- isolation not necessary (unless immunocompromised with aplastic crisis)
- droplet & standard if suspected parvovirus infection
Can pregnant nurses care for patients infected with parvovirus with aplastic crises?
No (low-risk of fetal death)
When is Fifth Disease no longer contagious?
When the rash disappears
What is another name for Exanthem Subitum?
Roseola Infantum
What is another name for Roseola Infantum?
Exanthem Subitum
What are the symptoms of Exanthem Subitum?
- persistent high fever (> 39.5 C/103 F) for 3-7 days
- deep decline in fever to normal, rash appearance
- rash: pink macules/maculopapule on trunk, spreads to neck, face, and extremities, fades on pressure
- bulging fontanel
- cervical & postauricular lymphadenopathy (swollen)
- inflamed pharynx, cough, coryza
What are the symptoms of Roseola Infantum?
- persistent high fever (> 39.5 C/103 F) for 3-7 days
- deep decline in fever to normal, rash appearance
- rash: pink macules/maculopapule on trunk, spreads to neck, face, and extremities, fades on pressure
- bulging fontanel
- cervical & postauricular lymphadenopathy (swollen)
- inflamed pharynx, cough, coryza
How is Exanthem Subitum spread?
- year round; no reported contact with infected individual
What age group is typically effected by Exanthem Subitum?
< 3 years old (peak: 6-15 months)
What is the incubation period for Exanthem Subitum?
5-15 days
How long is Exanthem Subitum contagious?
Not known (before symptoms appear)
What precautions are used for Exanthem Subitum?
standard precautions
When is Exanthem Subitum no longer contagious?
once the fever is gone and the rash appears
What are the symptoms of the mumps?
- earache
- enlarged parotid (look like hamster) with pain and tenderness
- fever, headache, malaise
How are mumps spread?
- direct contact
- droplet spread
How long is the incubation period for mumps?
14-21 days
How long are mumps contagious?
before and after the swelling begins
What type of precaution is used for mumps?
- droplet precaution
- contact precaution
When are mumps no longer contagious?
- children: 9 days after onset of parotid swelling
- when gland swelling subsides
What are the symptoms of measles?
- koplik’s spots on buccal mucosa
- rash (maculopapular eruption on face, spreads downward)
- conjunctivitis
What is another name for measles?
rubeola
What is another name for rubeola?
measles
How are measles spread?
- direct contact
- droplets
- primarily in winter*
How long is the incubation period for measles (rubeola)?
10-20 days
When are measles contagious?
- 4 days before rash appears
- 5 days after rash appears
What precautions are used for measles (rubeola)?
airborne
When are measles (rubeola) no longer contagious?
- 4-5 days after onset of rash
- when all signs of spots disappear
What is another name for pertussis?
whooping cough
What is another name for whooping cough?
pertussis
What are the symptoms of pertussis?
- symptoms of upper respiratory tract infection (sneezing, cough, low-grade cough)
- dry hacking cough becomes more severe with high pitched whoop sound
- cheeks flushed/cyanotic, eyes bulge, tongue protrudes
- vomiting following attack
How is pertussis spread?
- direct
- droplet
- indirect thought contaminated articles
What is the incubation period of pertussis?
6-20 days
When is pertussis contagious?
greatest during catarrhal stage (beginning; coryza, sneezing, lacrimation, cough, low-grade fever for around 1-2 weeks)
What precautions are used for pertussis?
- standard
- droplet
When is pertussis no longer contagious?
- 5 days after antibiotic treatment
OR - 3 weeks from onset of coughing
What are the 3 different ways poliomyelitis is manifested?
- abortive/inapparent: fever, sore throat, headache, anorexia, n/v, abdominal pain
- nonparalytic: more severe manifestations of abortive with pain and stiffness (neck, back, legs)
- paralytic: recovery and then signs of CNS paralysis
How is poliomyelitis spread?
- direct (active infection)
- fecal-oral route
- pharyngeal-oropharyngeal routes
- LIVE oral polio vaccination (no longer available in the U.S.)
What is the incubation period of poliomyelitis?
7-14 days
When is poliomyelitis contagious?
- virus detected in throat 1 week after infection
- virus detected in feces 4-6 weeks after infection
What precautions are used for poliomyelitis?
contact precautions
When is poliomyelitis no longer contagious?
around 10 days after onset of symptoms
What is another name for rubella?
German measles
What is another name for German measles?
rubella
What are the symptoms of rubella?
- low grade fever, mild conjunctivitis, sore throat, lymphadenopathy
- rash on face, rapidly spreads down (neck, arms, trunk, legs)
How is rubella spread?
- respiratory droplets (cough/sneeze)
- direct contact with mucous secretions
What is the incubation period for rubella?
14-21 days
How long is rubella contagious for?
7 days before rash appears, 5 days after it appears
What precautions are used for rubella?
droplet precautions
When is rubella no longer contagious?
around 1 week after rash onset
What are the symptoms of scarlet fever?
- abrupt, high fever
- pulse increased out of proportion to fever
- halitosis
- enlarged tonsils, covered in patches of exudates
- pharynx is swollen and beefy red
- tongue covered in papillae, red & swollen (white strawberry tongue)
- rash: red, pinhead-sized lesions (absent on face, present in folds of joints)
How is scarlet fever spread?
- direct contact
- droplet spread
- contaminated articles
- ingestion of contaminated milk/food
How long is the incubation period for scarlet fever?
2-5 days
How long is scarlet fever contagious for?
During incubation period (~10 days)
What precautions are used for scarlet fever?
- standard
- droplet (until 24 hr after initiation treatment)
When is scarlet fever no longer contagious?
24 hours after the first dose of antibiotics
At what ages is the Hepatitis B vaccination given?
- birth
- 2 months
- 6 months
What vaccines are given at birth?
Hepatitis B
At what ages is Hib vaccine given at?
- 2 months
- 6 months
- 1-1.5 y/o
At what ages is DTap given?
- 2 months
- 6 months
- 1-1.5 y/o
- 4-6 y/o
At what ages is inactivated polio vaccine given?
- 2 months
- 6 months
- 4-6 y/o
At what ages is rotovirus vaccine given?
- 2 months
- 6 months
At what ages is PCV (pneumococcal) vaccine given?
- 2 months
- 6 months
- 1-1.5 y/o
What vaccines are given at 2 months?
- Hepatitis B
- DTaP
- Rotovirus
- Hib
- Inactivated polio
- PCV
What vaccines are given at 6 months?
- Hepatitis B
- DTaP
- Rotovirus
- Hib
- Inactivated polio
- PCV
At what ages is the MMR vaccine given?
- 1-1.5 y/o
- 4-6 y/o
At what ages is the varicella vaccine given?
- 1-1.5 y/o
- 4-6 y/o
What vaccines are given at 1-1.5 years of age?
- MMR
- Hepatitis A
- DTaP
- Hib
- PCV
- Varicella
What vaccines are given at ages 4-6 y/o?
- Varicella
- DTaP
- Inactivated polio
- MMR
At what ages is Tdap given?
11-12 y/o
At what ages is HPV vaccine given?
11-12 y/o
At what ages is the meningococcal vaccine given?
- 11-12 y/o
- 16-18 (booster)
What vaccines are given at 11-12 y/o of age?
- Tdap
- HPV
- Meningococcal
What vaccines are given at the ages of 16-18 y/o?
Meningococcal booster
what is the rooting reflex?
baby’s head will turn, open their mouth, and follow wherever you stroke the corner of their mouth
When does the rooting reflex disappear?
4 months
What is the moro reflex?
The baby’s arm will splay out when you slightly drop them (scare)
When does the moro reflex disappear?
4 months
What is the plantar grasp reflex?
Putting fingers under toes will cause them to curl
When does the plantar grasp reflex disappear?
8 months
What is the palmar grasp reflex?
Baby’s hand will grasp finger
When does the palmar grasp reflex disappear?
3 months
What is the tonic neck reflex?
Extending one of the baby’s arms will cause the head to turn in that direction
When does the tonic reflex disappear?
4 months
What is the stepping reflex?
If you hold the baby upright, they will lift their legs up like stepping
When does the stepping reflex disappear?
3-4 weeks
What is the Babinski reflex?
Drawing finger up from heel to pad of foot causes the toes to hyperextend
When does the Babinski reflex disappear?
After 1 year
What is the extrusion reflex?
Infant protrudes tongue if you touch/depress their tongue
When does the extrusion reflex disappear?
4 months
What is the perez reflex?
While infant is prone, pressing your thumb along their spine (from sacrum to neck) will cause them to flex extremities (elevates pelvis and head)
When does the perez reflex disappear?
4-6 months
What is the trunk incurvation (Galant) reflex?
Stroking infant’s back alongside spine causes hips to move toward stimulated side
When does the trunk incurvation (galant) reflex disappear?
4 weeks
What is the crawling reflex?
When on abdomen, infant makes crawling movements with their extremities
When does the crawling reflex disappear?
6 weeks
