Infectious Disease Flashcards
1
Q
Stages of Infectious Disease
A
- Incubation
- Prodrome
- Illness
- Convalescence
2
Q
Incubation
A
Time from entrance of pathogen into the body to appearance of first symptoms; during this time pathogens grow and multiply
3
Q
Prodrome
A
Time from onset of non-specific symptoms such as fever, malaise, and fatigue to more specific symptoms
4
Q
Illness Stage
A
Time during which child demonstrates signs and symptoms specific o an infection type
5
Q
Convalescence
A
Time when acute symptoms of illness disappear
6
Q
Contact Precautions
A
Gloves, proper hand hygiene after glove removal, use gloves and gowns for all interactions that involve contact with the child
7
Q
Contact Precaution Diseases
A
C. diff
8
Q
Droplet Precautions
A
Wear a mask if within 3 feet of the child
9
Q
Droplet Precautions Diseases
A
Flu and RSV
10
Q
Airborne Precautions
A
Room with negative air pressure with door closed, wear a mask or respirator (N95 respirator)
11
Q
Airborne Precautions Diseases
A
TB and measles
12
Q
Temperature routes and what qualifies as a high temperature?
A
- Oral: > 37.8 C (100 F)
- Rectal: > 38 C (100.4 F)
- Axillary: > 37.2 C (99 F)
- Tympanic: > 38 C (100.4 F)
- Temporal: > 38 C (100.4 F)
13
Q
When should you call the pediatrician for temperature?
A
- Less than 3 months, rectal temperature greater than 38 C (100.4 F)
- Greater than 3 months, temperature greater than 39 C (102.2 F)
- Fever that produces lethargy (regardless of temperature)
- Fever lasting more than 3-5 days
- Fever greater than 40.6 C (105 F)
14
Q
Treat the fever at home with…
A
- Ibuprofen
2. Acetaminophen
15
Q
Ibuprofen for fever
A
4 to 10 mg/kg/dose
- Must be greater than 6 months old
- Every 6-8 hours
- Do not exceed 4 doses in 24 hours
16
Q
Acetaminophen for fever
A
10 to 15 mg/kg/dose
- Every 4 hours
- Do not exceed 5 doses in 24 hours
17
Q
Antipyretic Action
A
They decrease the temperature set point by inhibiting the production of prostaglandins
18
Q
What should never be given to a pediatric patient (less than 19 years old) to lower a fever?
A
Aspirin - Reye’s Syndrome
19
Q
S/Sx of Sepsis
A
- Change in LOC (early sign)
- Lethargy
- Dehydration
- Hypotension (late sign)
- Poor perfusion
- Multisystem organ failure
20
Q
Why are neonates and young infants more susceptible to sepsis?
A
- Immature immune systems
- Inability to localize infections
- Lack of immunoglobulin (IgM) which is necessary to protect agains bacterial infections
* * Full workups should be done on these patients
21
Q
Anticipated Interventions for Sepsis
A
- Monitor VS (hyperthermia, tachypnea, tachycardia)
- Tests and procedures
- Isolation (contact until cause is known)
- Fluid resuscitation
- Antibiotics
- Vasopressors
22
Q
CBC for fever
A
WBC levels will be elevated; in severe cases they may be decreased (this is an ominous sign)
23
Q
C-reactive protein for fever
A
Will be elevated
24
Q
Blood culture for fever
A
Positive in septicemia, indicating bacteria is present in the blood
25
Urine culture for fever
May be positive indicating presence of bacteria in the urine
26
Stool culture for fever
May be positive for bacteria or other infectious organisms
27
Chest x-ray for fever
May reveal signs of pneumonia such as hyperinflation and patchy areas of atelectasis or infiltration
28
CAMRSA
Community-Acquired Methicillin Resistant Staphlococcus Aureus
29
S/Sx of CAMRSA
Skin and soft tissue infections are common
Look for:
- Redness
- Swelling
- Fever
- Possible drainage
30
CAMRSA Risk Factors
1. Contact sports
2. Openings in the skin
3. Contact with contaminated items and surfaces
4. Poor hygiene
5. Crowded areas
31
CAMRSA Diagnostics
Diagnosed through culture
32
CAMRSA Treatment
1. Antibiotics
2. Incision and drainage
3. Wound care
33
Scarlet Fever
1. Usually occurs with group A streptococci
2. Toxin released in blood causing rash
3. Most commonly seen in school age children (5-15) (rare under 2)
34
Isolation Precautions for Scarlet Fever
Droplet
35
When is scarlet fever no longer contagious?
After 24 hours of antibiotic therapy
36
S/Sx of Scarlet Fever
1. Acute and abrupt onset of symptoms
2. Sore throat
3. N/V
4. Headache
5. Rash
6. Strawberry tongue
7. Enlarged cervical lymph nodes
37
Interventions for scarlet fever
1. Throat swab (rapid and overnight)
2. Antibiotics (PCN/erythromycin)
3. Education for family
38
Comfort measures for scarlet fever patient
1. Cool mist humidifier
| 2. Soft foods, warm liquids like soup, or cold foods life popsicles
39
Is there a vaccination for scarlet fever?
No
40
What is diphtheria?
Infection of the nose, larynx, throat, tonsils, or pharynx
- Upper airway obstruction and suffocation from pseudomembraneous growth
- Neck becomes edematous and lymphadenopathy
41
Isolation precautions for diphtheria
Droplet
42
Is there a vaccine for diphtheria?
Yes
- DTaP for children less than 7
- Tdap for children older than 7
43
S/Sx of diphtheria
1. Fever
2. Sore throat
3. Poor PO intake due to difficulty swallowing (dehydration)
4. Respiratory distress
5. Pseudomembrane
6. Bull's neck
44
Interventions for diphtheria
1. Antibiotics and antitoxin (to encourage sloughing of the membrane)
2. Bedrest
3. Hydration
4. Airway management
45
How is diphtheria diagnosed?
Throat culture
46
Pertussis
Whooping Cough
- Acute bacterial respiratory infection
- Copious secretions
47
Is there a vaccine for pertussis?
Yes
- DTaP for children less than 7
- Tdap for children older than 7
48
Isolation precautions for pertussis
Droplet
49
S/Sx of pertussis
1. "Whooping" cough
2. Cyanosis
3. Vomiting
4. Difficulty eating
5. Increased secretions
6. Lethargy
7. Dehydration
50
Pertussis Diagnostics
This diagnosis may be confirmed by a variety of laboratory tests
51
Pertussis Interventions
1. Antibiotics
2. Hydration
3. Humidified oxygen
4. Suction
* * A high humidity environment is needed
* * Cough may take months to completely go away
52
Tetanus
- Bacterial infection from soil, dust, and feces
- Toxins are produced and released
- Enters through a break in the skin (wound, burn, street drug injections)
53
Is there a vaccination for tetanus?
Yes
- DTaP for children less than 7
- Tdap for children older than 7
54
S/Sx of tetanus
1. Wound
2. Headache
3. Increased muscle tone and spasms
4. Cramping of jaw (lock jaw)
5. Difficulty swallowing
6. Stiff neck
7. Seizures
8. Fever
9. Opisthotonos (abnormal posturing)
10. HTN
11. Tachycardia
55
Tetanus Interventions
1. Airway management
2. Reduce anxiety and stimuli
3. Manage pain, spasms, seizures
4. Nutrition and fluid management
5. Antibiotics and antitoxins
6. Wound care
7. Education for family
56
Tetanus Complications
1. Breathing problems
2. Fractures
3. Hypertension
4. Dysrhythmias
5. Blood clots in lungs
6. Pneumonia
7. Coma
8. Death
57
Isolation Precautions for Tetanus
Not contagious from person to person. Standard precautions are sufficient.
58
Tetanus booster
If it has been more than 5 years since the last tetanus dose, a booster may be needed. This can help neutralize the poison and prevent it from entering the nervous system.
59
Tuberculosis
Infection where bacteria multiply in the alveoli and inflammatory exudate forms
60
S/Sx of Tuberculosis
1. Cough
2. Fever
3. Malaise
4. Weight loss
5. Anorexia
6. Pain/tightness in chest
7. Possibly hemoptysis
8. Could be asymptomatic (latent infection)
61
Isolation Precautions for Tuberculosis
Airborne
62
Tuberculosis Nursing Management
1. Oral/IM therapy (6-9 months)
2. Adequate nutrition
3. Rest
4. Comfort measures (fever reduction, preventing exposure to other infectious diseases, and preventing reinfection)
63
Exanthems Infections
(Rash or skin eruptions)
1. Measles (Rubeola)
2. German measles (Rubella)
3. Varicella zoster (Chicken pox)
4. Erythema infectiosum (parvovirus B19 or 5th disease)
5. Exanthem suitum (roseola infantum or 6th disease)
6. Hand, foot, and mouth disease (mouth only Herpangina)
64
Non-Exanthems Infections
1. Mononucleosis (covered in respiratory lecture)
| 2. Mumps
65
Mumps (bacterial or viral?)
Viral Infection
66
S/Sx of Mumps
1. Low grade fever
2. Malaise
3. Poor PO intake
4. Headache
5. Abdominal pain
6. Parotitis (swelling of the neck)
7. Orchitis (inflammation of testicle)
8. Oophoritis (inflammation of ovary)
* * Up to half of people with mumps will have nonspecific or mild respiratory symptoms or no symptoms at all
67
Isolation Precautions for Mumps
Droplet
68
Mumps Diagnostics
Diagnosed by laboratory tests and clinical presentation
69
Is there a vaccine for mumps?
Yes, with 2 doses of MMR
70
Mumps Interventions
1. Fever management (acetaminophen and ibuprofen)
2. Pain management
3. Oral fluids
4. Ice pack (for orchitis)
71
Isolation Precautions for Mumps
Hospitalized children should be confined to respiratory isolation to prevent spread of the disease.
72
Rubella (virus or bacterial?)
Virus
73
Isolation Precautions for Rubella
Droplet
74
Is there a vaccine for rubella?
Yes, MMR
75
S/Sx of rubella
1. Rash on face (spreads head to foot, and also disappears this way)
2. Itching
3. Fever
4. Malaise
5. Upper respiratory infection
6. Lymphadenopathy
7. Inflammation/pain in joints
* * Milder than rubeola
76
Rubella Interventions
1. Fluids
2. Antipyretics
3. Antipuritics
4. AVOID contact with pregnant women
77
How can rubella affect pregnant women?
1. Fetal death
2. Miscarriage
3. Congenital malformations
78
Isolation Precautions for Rubeola
Airborne
79
Rubeola (virus or bacterial?)
Virus
80
Isolation Precautions for Rubeola
Airborne
81
Is there a vaccine for rubeola?
Yes, MMR
82
S/Sx of Rubeola
1. Fever
2. Coryza (stuffy/runny nose)
3. Cough
4. Conjunctivitis
5. Koplik spots (on tongue)
6. Erythematous rash (spreads from head down and outward)
83
Rubeola Interventions
1. Antipyretics
2. Antipruritics
3. Warm, moist cloth to eyes
4. Humidified air
84
Varicella Zoster (bacterial or virus?)
Caused by human herpes virus 3
85
Isolation Precautions for Varicella Zoster
Contact and airborne precautions
86
Latency of Varicella Zoster
Lifelong latent infection
| - Reactivation results in shingles
87
S/Sx of varicella zoster
1. Fever
2. Headache
3. Anorexia
4. Mild abdominal pain
5. Rash (often first sign)
6. Intense pruritis (appears on scalp, face, trunk, then extremities)
7. Macules/papules/fluid-filled vesicles (lesions erupt then lesions scab and crust)
88
Varicella Zoster Interventions
1. Antipyretics
2. Antipruritics
3. Fluids
4. Skin care
89
What causes roseola infantum?
Herpes virus 6 and virus 7 ("sixth disease")
90
Isolation Precautions for roseola infantum
Transmission unknown = Standard Precautions
91
S/Sx of roseola infantum
1. High fever for 3-5 days that stops abruptly
2. Rash within 12-24 hours of fever and lasts 1-3 days
3. Rash - pinkish red, flat, or raised spots that blanch when touched
92
Roseola Infantum Interventions
1. Antipyretics
2. Antipruritics
3. Fluids
93
Erythema Infectiosum (virus or bacterial?)
Virus also known as "fifth disease"
94
Isolation Precautions for Erythema Infectiosum
1. Droplet transmission
2. Most children are no longer contagious once rash appears
3. Avoid contact with pregnant women
95
S/Sx of Erythema Infectiosum
1. Low grade fever
2. Headache
3. Upper respiratory infection
4. Rash
5. Pain or swelling in the joints
96
Describe the erythema infectiosum rash
1. Starts as erythematous flushing of the cheeks ("slapped cheek")
2. Spreads to trunk, then move peripherally
3. Lace-like appearance
4. Can disappear and reappear with sunlight exposure
97
Erythema Infectiosum Interventions
1. Antipyretics
2. Antipruritics
3. Fluids
98
Hand, Foot, and Mouth Disease (virus or bacterial?)
Virus
99
Hand, Foot, and Mouth Disease Transmission
Transmitted by direct contact with oral/fecal secretions
100
S/Sx of Hand, Foot, and Mouth Disease
1. High fever (1st symptom)
2. Vesicles on tongue and oral mucosa which leads to ulcers
3. Vesicles on hands and feet (football shaped)
4. Pain, decreased PO intake, drooling
5. Dehydration is biggest complication
101
Hand, Foot, and Mouth Disease Interventions
1. Antipyretics
2. Pain control
3. Fluids
4. Magic swizzle mouthwash (has lidocaine in it)
102
Cat Scratch Disease
Introduced by a cat bite or scratch
| - Cats receive bacteria from flea bites
103
Isolation Precautions for Cat Scratch Disease
Standard Precautions (no person to person transmission)
104
S/Sx of Cat Scratch Disease
1. Lymphadenopathy
2. Fever
3. Fatigue
4. Headache
5. Abscess
6. Recent exposure to cat scratch or bite
7. Skin papule or pustule
8. Anorexia
105
Rabies (viral or bacterial?)
Viral
106
Rabies Transmission
Close contact with infected saliva, usually by rabid animal bite
107
Cat Scratch Disease Interventions
1. Antibiotics
2. Abscesses may need incision and drainage
3. Education
108
Cat Scratch Disease Education
1. Avoid rough play with cats/kittens
2. Wash bites with soap and water
- Cats should not lick child's open wounds
3. Flea control
109
Cat Scratch Disease (viral or bacterial?)
Bacterial
110
S/Sx of Rabies
1. History of attack
2. Exposure to bats
3. Fever
4. Headache
5. Malaise
6. Changes in LOC
7. Progressive neuro symptoms (insomnia, confusion, hallucinations, hypersalivation)
8. Pain
9. Pruritis
10. Paresthesia at the bite site
111
Rabies Interventions
1. Wound irrigation with soap, water, iodine
2. Administration of human rabies immune globulin (HRIG)
3. Prompt vaccination
4. EMLA cream - topical analgesic
112
Vector-Borne Infections
1. Lyme disease
| 2. Rocky Mountain Spotted Fever
113
Lyme Disease
1. Caused by an infected tick (mice or deer)
2. Most common vector borne disease in US
3. Prevalent in the summer months
4. Prognosis is excellent with treatment
114
Isolation Precautions for Lyme Disease
Standard Precautions
115
S/Sx of Lyme Disease
1. History of tick bite
2. Fever
3. Malaise
4. Headache
5. Myalgia (muscle pain)
6. Joint pain
7. "Bull's eye" rash (erythema migrans)
116
Lyme Disease Interventions
1. Antibiotics
- Doxycycline for children greater than 8
- Amoxicillin for children younger than 8
2. Education - prompt and proper tick removal
117
Procedure for Proper Tick Removal
1. Use fine-tipped tweezers
2. Protect fingers with a tissue, paper towel, or latex gloves
3. Grasp tick as close to the skin as possible and pull upward with steady, even pressure
4. Do not twist or jerk the tick
5. Once the tick is removed, clean site with soap and water, rubbing alcohol, or iodine scrub and wash your hands
6. Save the tick for identification in case the child becomes sick. Place in a sealable plastic bag and put it in your freezer. Write date of bite on the bag.
118
Rocky Mountain Spotted Fever
1. Caused by an infected tick (7 days post bite)
2. Fatal without prompt treatment
3. Complications and long-term effect if not treated promptly
119
Rocky Mountain Spotted Fever Complications
1. Pulmonary edema
2. Cerebral edema
3. Multiorgan damage
4. Partial paralysis of the lower extremities
5. Hearing loss
6. Loss of bladder and bowel control
7. Movement and language disorders
120
S/Sx of Rocky Mountain Spotted Fever
1. History of tick bite
2. Fever
3. Headache
4. Malaise
5. N/V
6. Myalgia
7. Anorexia
8. Late Signs:
- Rash
- Abdominal pain
- Joint pain
- Diarrhea
121
Describe the rocky mountain spotted fever rash
Non-itchy, spreads rapidly over the entire body
122
Rocky Mountain Spotted Fever Interventions
1. Antibiotics - doxycycline for ALL ages
| 2. Education of prompt and proper tick removal
123
Scabies
Mites that burrow into the skin
124
Isolation Precautions for Scabies
Transmitted through prolonged, close personal contact.
| ** Contact precautions
125
S/Sx of Scabies
1. Pruritus and rash on hands, feet, and in body folds
| 2. May include excoriations, vesicles, pustules, or lesions
126
Scabies Interventions
Scabicide cream - entire body, 8-14 hours, strict adherence
127
Scabies Education
1. Prophylactic therapy
2. Clean bedding and clothing
3. Vacuuming
128
Head Lice
Insects that cling to the scalp and neck and feed on human blood
129
Isolation Precautions for Head Lice
Transmitted through direct contact with hair and personal belongings (brush, comb, hat, etc)
** Contact Preacutions
130
S/Sx of Head Lice
1. Eggs and adult lice with the naked eye
| 2. Extreme pruritus
131
Head Lice Interventions
1. Pediculicide shampoo - strict adherence
| 2. Retreatment is recommended after 9 days
132
Head Lice Education
Check hair shafts after treatment, treat bedmates prophylactically, disinfect headgear, towels, linen, soaking combs
133
Parasitic Infections
1. Scabies
| 2. Head lice
134
Helminthic Infections
Pinworms
135
Isolation Precautions for Pinworms
Transmitted by fecal-oral route by contaminated hands, toys, bedding, clothing, toilet seats
** Standard Precautions
136
S/Sx for Pinworms
1. Anal itching, restlessness, weight loss
2. Worms in the perianal region. Rarely seen in stool. Most easily viewed when child is sleeping. Can use transparent tape to view under a microscope.
137
Pinworm Interventions
1. Antihelmintic agents - Mebendazole, pyrantel pamoate, albendazole
2. Education
138
Education for Pinworms
Reinfections occurs easily, showers when infected (not baths), frequent changing of underclothes and bedding, personal hygiene - short fingernails, avoid scratching perianal area, avoid nail biting, hand hygiene, clean toilet seats daily, all family members should be treated (transmitted easily)
