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NRSG 206: OB > [Exam 4] Chapter 37 – Infectious or Communicable Disorder > Flashcards

[Exam 4] Chapter 37 – Infectious or Communicable Disorder Flashcards

1
Q

What do Phagocytic cells do?

A

First line of defense upon invasion of bacteria

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2
Q

Function of Lymphocytes?

A

Main source of producing an immune response, responds to viral infections

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3
Q

Function of Monocytes?

A

SEcond line of defense, and responds to larger and more severe infections

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4
Q

Infectious Process: What does the cellular response involve?

A

Arrivial of WBCs to the are.

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5
Q

Infectious Process: WBCs use phagocytosis for what?

A

Ingesting and destroying pathogen.

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6
Q

Infectious Process: What happens if bacteria escapes phagocytosis?

A

Enters blood stream and immune system activated.

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7
Q

Infectious Process: What to B / T cells do?

A

B: Produce antibodies

T: Attack the antigen directly.

They both will rememebr teh antigen.

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8
Q

Infectious Process, Fever: Infection by bacteria triggers endogenous pyrogens, what does what?

A

Trigger prostaglandin production and increases bodies temp set point. Results in shiver, that allows body temp to rise.

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9
Q

Infectious Process, Fever: What is used to decrease fevers?

A

Antipyretics to lower fever and increase comfort. Temp lower by inhibiting production of prostaglandin. Sweating results.

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10
Q

Infectious Process, Fever: When does hyperthermia occur?

A

When norml thermoregulation fails, with unregulated rise in core temp. CNS impaired here.

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11
Q

Infectious Process, Fever: Bodi produces a natural antipyretic, called what

A

Cryogen. Without this, body will rise above 105.8

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12
Q

Infectious Process, Chain of Infection: Poor hygiene habits include

A

lack of handwashing, placing toys in mouth, drooling, and leaking diapers

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13
Q

Infectious Process, Chain of Infection: What is incubation?

A

Time from entrance of pathogen into the body to appearance of first symptoms

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14
Q

Infectious Process, Chain of Infection: What is Prodrome?

A

Time of onset of nonspecific symptoms such as fever, fatigue

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15
Q

Infectious Process, Chain of Infection: What is Convalescence?

A

Time when acute symptoms of illness disappear

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16
Q

Infectious Process, Chain of Infection: What is a reservoir?

A

Place where pathogens can thrive and reproduce, such as human body or animals

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17
Q

Infectious Process, Chain of Infection: What is portal of exit?

A

Way for pathogen to exit the reservoir, such as skin or mucous membranes

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18
Q

Infectious Process, Chain of Infection: what is mode of transmission?

A

Direct transmission, such as body to body or indirect, such as through droplets

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19
Q

Infectious Process, Chain of Infection: Tier 1 for Hospital Infection Control?

A

Stand precautions, which is made for all children regardless of conditions

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20
Q

Infectious Process, Chain of Infection: Tier 2 for Hospital Infection Control?

A

Transmision based precautions, designed for children who are known or suspected to be infected.

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21
Q

Infectious Process, Health Hx: When eliciting history of present illness, inquire about what?

A

Exposure to infection

Immunization hx

Fever

Sore Throat

Lethargy

Vomiting

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22
Q

Infectious Process, Health Hx: Why would hydration be used?

A

Child who is vomiting or has diarrhea. They can replace these losses

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23
Q

Infectious Process, Health Hx: Why would fever reduction eb done?

A

Feibrile child who can’t keep up with increased metabolic demands

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24
Q

Infectious Process, Health Hx: Examples of Antipyretics?

A

Acetaminophen and Ibuprofen

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25
Q

Infectious Process, Inspection/Observation: Lethargy can indicate what?

A

Serious infection or sepsis.

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26
Q

Infectious Process, Inspection/Observation: How to assess hydration status?

A

Inspect oral mucosa, dry and pale mucous membranes, and observe for sunken eyes

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27
Q

Infectious Process, Palpation: Palpation of what shows dehydration

A

Tugor, and if the fontanels are sunken.

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28
Q

Infectious Process, Labs: Where should blood draws be done?

A

Area other that child’s bed, such as treatment room. Bed should be kept as an “Safe” area.

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29
Q

Infectious Process, Labs: What does C-Reactive Protein (CRP) test for?

A

Measures for type of protein produced in livere present during acute inflammation

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30
Q

Infectious Process, Labs: Why is stool culture done?

A

To determine if bacteria or parasite has infected the intestines

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31
Q

Infectious Process, Labs: Usual sites for obtaining blood ?

A

Superficial veins of the dorsal surface of the hand or the antecubital fossa. Jugular/Femoral vein may also be used.

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32
Q

Infectious Process, Labs: What to know for fingerprint puncture?

A

Directed to the sides of the fingertop. Great toe puncture done the same way.

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33
Q

Infectious Process, Managing Fever: Fears of fever can lead to mismanagement of fever, including?

A

Inappropriate dosing of antipyretics, awakening at night to give pyretics, or inappropriate use of nonpharmacologic treatment

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34
Q

Infectious Process, Managing Fever: Infants younger than 3 months with rectal temperature greater than 38 degrees C should be seen why?

A

Considered at risk for sepsis until proven otherwise, due to immature immune system

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35
Q

Infectious Process, Managing Fever: Major benefit of decreasing fever is what?

A

Increasing comfort in child and decreasing fluid requirements.

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36
Q

Infectious Process, Managing Fever: Why should you never give Aspirin to child?

A

Due to risk of Reye Syndrome

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37
Q

Infectious Process, Managing Fever: Causes of acetaminophen toxicity include?

A

Overdosing or incorrect dosing due to failure to understand label.

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38
Q

Infectious Process, Managing Fever: Why may there be an issue with alternating Ibuprofen/Acetaminophen?

A

Parents forget which medication is given every 4 hour, and which one is given every 6 hours.

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39
Q

Infectious Process, Managing Skin Rashes: What can relieve itching?

A

Cool compresses or cool baths

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40
Q

Sepsis: What is this?

A

Systemic overresponse to infection resulting from bacteria and viruses.

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41
Q

Sepsis: This leads to septic shock, which causes what?

A

Hypotension, low blood flow, and multisystem organ failure.

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42
Q

Sepsis: What causes this in younger and older children?

A

Younger <3 Months: E. Coli. Group B Strep, S. Aureus. Herpes

Older: N Meningitidis, S. Pneumoniae, S. Aureus

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43
Q

Sepsis: Who’s at risk for this

A

Infants < 3 months, immunocompromised children, and children with indwelling vascular catheter

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44
Q

Sepsis - Patho: How does this occur?

A

Results from floating toxins, mediated by cytokine release. Causes overproduction of proinflammatory cytokines

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45
Q

Sepsis - Patho: What results from excessive cytokine release?

A

Impaired pulmonary, hepatic, or renal function

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46
Q

Sepsis - Therapeutic Mx: How are infants treated?

A

In hospital. Admitted for close monitoring with antibiotic therapy. IV Antibiotics started immediately after blood, urine, and CSF.

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47
Q

Sepsis - Therapeutic Mx: How long is treatment done for?

A

When negative results occur. Usually after 72 hours. If not responding to treatment, sepsis may be progressing to shock.

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48
Q

Sepsis - Health Hx: Common signs and symptoms?

A

Child may not lok like

Crying more than usual

FEver

Lethargic

Poor feeding

Rash

Difficulty breathing

Seizures

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49
Q

Sepsis - Health Hx: Risk factors to look at?

A

Prematurity, lack of immunizations, immunocompromise

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50
Q

Sepsis - Health Hx: In young infants, pregnancy and labor risk factors to look at include?

A

Premature rupture of membranes

Difficult delivery

Maternal infection

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51
Q

Sepsis - Health Hx: Sepsis may occur in hospitalized child, with risk factors including what?

A

Intensive care unit stay

Presence of central line

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52
Q

Sepsis - Physical Exam, Inspection/Observation: How will they appear?

A

Lethargic, pale, and show signs of dehydration

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53
Q

Sepsis - Physical Exam, Inspection/Observation: What to notice in infants?

A

Quality of their cry and reaction to parental stimulation, noting weak cry or lack of smile.

54
Q

Sepsis - Physical Exam, Inspection/Observation: Petechiae may indicate what?

A

Serious bacterial infection,

55
Q

Sepsis - Physical Exam, Inspection/Observation: How does this affect respiratory?

A

May demonstrate tachypnea and increased work of breathing, such as nasal flaring and retractions

56
Q

Sepsis - Physical Exam, Inspection/Observation: What to document for VS?

A

Elevation in temperature or hypothermia

Hypoptension, along with poor perfusion, cna be worsening sign of sepsis.

57
Q

Sepsis - Labs: What labs will be done

A

CBC (WBC decreased in severe case)

C-REative Protein (Elevated)

Blood culture (Septicemia positive)

Urine culture

CSF ( reveal wbc and protein)

Stool Culture

Culture of catheters

Chest X-Ray, may reveal pneumonia

58
Q

Sepsis - Nursing Mx, Preventing Infection: What is the best way to prevent infection?

A

Handwashing. and ensuring that all equipment is clean and disposing of soiled linens.

59
Q

Sepsis - Nursing Mx, Educating Family: When should they contact provider?

A

When the infant or neonate has a fever. Especially when lethargy, poor responsiveness or lack of facial expressions occurs.

60
Q

Scarlet Fever: What is this?

A

Infection from Group A Streptococci. Usually from Throat infection (strep throat) or skin infection

61
Q

Scarlet Fever: Bacteria here produces what type of response?

A

Toxin that causes a rash. .

62
Q

Scarlet Fever: Who will develop scarlet fever?

A

Those who are infected with streptococci that produce pyrogenic exotoxins that do not have antitoxin antibodies

63
Q

Scarlet Fever: What age does this affect?

A

Those are 5-12 years old, and rare in children younger than 2

64
Q

Scarlet Fever: Transmission?

A

Through droplets and follows contact with respiratory tract secretions]

Typically seen in schools and child care centers

65
Q

Scarlet Fever: What to know about food-borne?

A

Occur due to contamination of food. Incubation period is 2-5 days. No longer contagious after 24 hours.

66
Q

Scarlet Fever: Complications of this?

A

rheumatic fever, glomerulonephritis, skin infections, abscess of throat, pneumonia and arthritis.

67
Q

Scarlet Fever, Nursing Assessment: Health hx would reveal what?

A

Fever greater than 101, body aches, loss of appetite, nausea and vomiting.

68
Q

Scarlet Fever, Nursing Assessment: How will pharynx and tonsils appear?

A

Pharyn: Very red and swollen

Tonsils: Yellow or white specks of pus, and lymph nodes may be swollen

69
Q

Scarlet Fever, Nursing Assessment: Inspect skin for most striking symptom of scarlet fever, which is?

A

Erythematous rash appearing on the face, trunk, and extremities. Absent from soles and feet. Looks like sunburn but feels like sandpaper.

70
Q

Scarlet Fever, Nursing Assessment: How long does rash last?

A

5 days, following by desquamation (peeling) on toes and fingers

71
Q

Scarlet Fever, Nursing Assessment: Appearance of tongue?

A

Will have a strawberry appearance. Later loses coating and becomes bright red

72
Q

Scarlet Fever, Nursing Assessment: How is diagnosis made?

A

Identification of Group A Strep through throat culture. Important secretions obtained are pharyngeal or tonsillar

73
Q

Scarlet Fever, Nursing Mx: Cared for how and with what treatment?

A

At home with antibiotics, mostly Penicillin V.

74
Q

Scarlet Fever, Nursing Mx: What is used in severe cases?

A

Erythromycin.

75
Q

Pertussis: What is this?

A

Acute respiratory disorder characterized by paroxysmal cough (whooping cough) and copious secretions

76
Q

Pertussis: What age sees this the most?

A

Those younger than 1 year, and those younger than 3 months are at greatest risk

77
Q

Pertussis: What organism causes this

A

Bordetella Pertussis

78
Q

Pertussis: Incubation period?

A

Usually starts with 7-10 days of cold symtpoms.

79
Q

Pertussis: How long to recover?

A

Cough can last 1-4 weeks and then recovery takes weeks to months

80
Q

Pertussis: Compliations of this?

A

Hypoxia, Apnea, Pneumonia, SEizures, Encephalopathy, Death

81
Q

Pertussis, Therapeutic Mx: What does this focus on?

A

Eradicating bacterial infection and providing respiratory support

82
Q

Pertussis, Therapeutic Mx: Treatment for this?

A

Antimicrobial treatment. >1 month = Macrolide drugs like erythromycin and azithromycin

< 1 month , azithromycin only.

83
Q

Pertussis, Therapeutic Mx: What cardio problems can azithromycin cause?

A

Potentially fatal heart rhythm for those at risk for cardiovascular events

84
Q

Pertussis, Nursing Assess: Most important risk factor?

A

Lack of immunization.

85
Q

Pertussis, Nursing Assess: History may reveal what symptpoms?

A

Cold and cough symptoms, progressing to paroxysmal coughing spells. Might cough 10-30 times in a row, followed by whooping sound.

86
Q

Pertussis, Nursing Assess: How will they appear during cough spells?

A

Redness in face, progressive cyanosis, and protrusion of tongue.

87
Q

Pertussis, Nursing Assess: How is this diagnosed?

A

Clinical history. Culture is gold standard.

88
Q

Pertussis, Nursing Mx: This focuses on what/

A

Providing high-humidity environment and frequent suctioning to mobilize secretions. Maintain adequate hydration and droplet precautions.

89
Q

Osteomyelitis: What is this?

A

Bacterial infection of the bone and soft tissue surrounding the bone.

90
Q

Osteomyelitis: Most common infecting organisms?

A

S. Aureus and MRSA.

91
Q

Osteomyelitis: How is this acquired?

A

Through the blood. Triggers inflamamtory response and formation of pus and edema. Small vessels thrombose and infection extends into marrow cavity. Blood supply disrupted and death of bone tissue.

92
Q

Osteomyelitis - Therapeutic Mx: How to confirm this?

A

Aspiration

93
Q

Osteomyelitis - Therapeutic Mx: Treatment?

A

4-6 week course of anti-biotics. 1-2 weeks of IV antibiotics and then oral antibiotics for rest of time.

94
Q

Osteomyelitis - Therapeutic Mx: Complications of this?

A

Bone destruction, fracture.

Recurrent infection, septic arthritis, and systemic infection

95
Q

Osteomyelitis - Nursing Assess: Risk factors for this?

A

Impetigo, infected varicella lesions, and recent trauma or infected burns.

96
Q

Osteomyelitis - Nursing Assess: What signs may they be displaying?

A

Irritability, lethargy, possible fever, and onset of pain. Refuses to walk or has decreased range of motion.

97
Q

Osteomyelitis - Nursing Assess: Lab testing for this will reveal what?

A

WBC elevated
Positive Blood Culture
Deep soft tissue swelling
Changes on Ultrasound

98
Q

Osteomyelitis, Nursing Mx: Nursing management focuses on what?

A

Assessment, pain management, and mainttenance of IV access for administration of antibodies

99
Q

Osteomyelitis, Nursing Mx: How active should child be?

A

Should be on bedrest to prevent injury.

100
Q

Rubella (German Measles): Transmission here?

A

By direct or indirect contact with droplets, primarily bby nasopharyngeal secretions.

101
Q

Rubella (German Measles): What season does this occur

A

Late winter to early spring

102
Q

Rubella (German Measles): Incubation period?

A

12-23 days

103
Q

Rubella (German Measles): Communicable when?

A

7 days before to 7 days after the rash

104
Q

Rubella (German Measles): Clinical Manifestation of this?

A

Rash is first sign. BEgins on face and spreads head to foot. Disappears in same order it spread, usually by third day. May appear pinpoint

105
Q

Rubella (German Measles): Clinical manifestations in older children?

A

Lymphadenopathy (enlarged lymph nodes) 24 hours before onset of rash, lasting up to one-week with low grade fever.

106
Q

Rubella (German Measles): Complications?

A

Encephalitis (inflammation of the brain)

Thrombocytopenia (low platelet count)

107
Q

Rubella (German Measles): Maternal rubella during pregnancy can cause what?

A

miscarriage, fetal death, or congenital malformations

108
Q

Rubella (German Measles): Nursing implications here?

A

Comfort measures ike antipyretics and antipruritics, and analgesics for joint pain

109
Q

Rubeola (Measles): Tranmission here?

A

Direct or indirect contact with droplets, primarily by nasopharyngeal secretions. Highly contagious

110
Q

Rubeola (Measles): What season does this occur most often

A

winter to spring

111
Q

Rubeola (Measles): Incubation period?

A

10-12 days

112
Q

Rubeola (Measles): When is this communicable?

A

1-2 days before onset of symtpoms (3-5 days before onset of rash) until 4-6 days after rash has appeared

113
Q

Rubeola (Measles): First stage here?

A

Prodromal phase. 2-4 days consisting of fever, cough, coryza and conjnunctivitis

114
Q

Rubeola (Measles): What occurs in the second stage?

A

Koplik spots (bright red spots with blue white centers on mucuous membranes)

Erythematous maculopapular rash after 3-4 days after prodromal phase. Head to toe fashion.

115
Q

Rubeola (Measles): Treatment?

A

Supporitive, including antipyretics, bed rest, and fluid intake

116
Q

Rubeola (Measles): What would kids 6 months to 2 years take?

A

Possible Vit. A

117
Q

Rubeola (Measles): Complications of this?

A

Diarrhea, otitis media, and pneumonia

118
Q

Rubeola (Measles): Comfort measures?

A

Antipyretics and antipruiritics

Clean eyes with warm cloth

Cool mist to relieve cough

119
Q

Rubeola (Measles): What precautions need to be taken?

A

Air-borne until 4 days after onset of rash

120
Q

Varicella Zoster (Chickenpox): Tranmission?

A

Direct contact with infected person, nasopharyngeal secretions or via air-borne spread.

121
Q

Varicella Zoster (Chickenpox): Communicable when?

A

1-2 days before onset of rash until all vesicle crusted over (3-7 days after onset of rash)

122
Q

Varicella Zoster (Chickenpox): Symptoms present before onset of rash?

A

24-48 hours before. Fever, malaise, anorexia, headache, and mild abdominal pain.

123
Q

Varicella Zoster (Chickenpox): What are the main signs ?

A

Lesions appear ons calp, face, trunk adn then extremities. Vesicles eventually erupt and lesions scab and crust.

124
Q

Varicella Zoster (Chickenpox): Supporitve treamtent for this?

A

feveer reduction, antipruiritics, and skin care to prevent infections of lesions

125
Q

Varicella Zoster (Chickenpox): Tx?

A

Antiviral therapy and varicella zoster immune globulin may be used for those considered high risk.

126
Q

Varicella Zoster (Chickenpox): Complications of this?

A

Bacterial superinfection of skin lesions, thrombocytopenia, arthritis, hepatitis, and pneumonia

127
Q

Varicella Zoster (Chickenpox): What happens if you get this later in life?

A

Herpes Zoster (Shingles)

128
Q

Varicella Zoster (Chickenpox): Comfort measures?

A

Antipyretics and antipruritics

129
Q

Varicella Zoster (Chickenpox): Precautions here?

A

Airborne and contact for minimum of 5 days after onset of rash adn as long as lesions present

130
Q

Varicella Zoster (Chickenpox): What should you do if you come into exposure with someone with this?

A

Airborne and contact precautions for 8-21 das after exposure

131
Q

Varicella Zoster (Chickenpox): When can child return to school?

A

Once lesions have crusted

NRSG 206: OB (42 decks)

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