Infectious Diseases Flashcards
Good things to have with you when administering immunizations to kids?
How can parents be involved?
Topical placement
Sucrose
Vapocoolant spray
Parents can just straddle the kid in their lap
How many nurses should you bring if you are doing more than one immunization?
Two nurses to do them at once.
T/F
The only required law about immunization is that parents conset
False .
They need a written source of info about the vaccine.
- they come in multiple languages
where should give vaccine in infant?
What documentation is required with immunization?
Vastus Lateralis
And make sure you go deep into the muscle. And needle must be long enough
Requires name, dose, site, and lot number
What med to give if a febrile reaction from vaccine occurs
what is a serious reaction going to look like?
Common one?
Tylenol before the visit or in office. Take them for 24 hrs.
- make sure parent doses correctly tho
- can alternate with ibuprofen
Serious rxn will present w seizures and unresponsiveness due to neuro response to body temp. (Antipyretic?) (if they have a neuro response - they may not receive another dose.
A more common rxn is when you have local warmth and tenderness in the area
Should you give a live virus to someone with a weak immune system?
Blood transfusions?
IVIG? (Immunoglobulin?)
Antibodies?
Or past rxn?
No to all of them.
Blood transfusions can be given live virus if their RBC were washed
Maternal antibodies last up to 2 months
If a parent doesn’t want to give their child a bunch of vaccines at once, what can you do?
They can come back in a week or so.
What is Varicella commonly known as?
How is it transmitted?
How long does it remain incubated?
What happens if a child itches the chicken pox? what if the pox disappear?
What precautions are needed for when in hospital?
Varicella is commonly known as chicken pox. Will start out as a macule > papule > cloudy vesicle
Mostly transmitted through contact, airborne, or contaminated objects
Incubated for 2-3 weeks but is contagious 1 day before lesions pop up.
The itching can cause a child to give themselves a secondary bacterial infection.
If they disappear it just means they internalized.
Droplet precautions and minimal contact
How can you prevent a child from scratching the chicken pox?
Will they look hot or cold environments?
Classes of allergy meds they can take?
Can they take Acyclovir?
Bathing?
Clothing?
Prevent scratching by Benadryl or make them wear mittens.
Also helps to make sure nails are cut.
Keep them cool. If they get hot, then they’ll wanna itch the chicken pox.
They can take diphen or antihistamine.
Acyclovir is not as helpful. Only really helps by a day.
Give child an oatmeal bath with warm water
Clothing should be light . Not heavy
What is Diphtheria?
How is Diphtheria transmitted?
Why is this concerning?
Diphtheria is the inflammation of the upper airway w edema & a false membrane.
Transmitted through direct contact or contaminated objects
Can obstruct airway
Complications that can arise from chicken pox?
The secondary infection ofc
But also pneumnoia and encepholpathy
What is Diptheria caused by?
Do we see it often?
Complicaitons from Diptheria?
Corny Diphtheria
No - in US we vaccinate for it.
Can have respiratory issue but also myocarditis (due to bacteria)
Neuroitis (inflammation of nerves)
How is Diphtheria treated?
Test dose?
Will they be able to be active?
Who all needs to be treated?
How to care for respiratory?
Antibiotics like PCN , erythromycin, and Cephalosporins
Give them a test dose of Equine to test for analphylaxis
No patient will need to be bed rest
Everyone who came in contact with this person
Get them O2 and watch patency. Main idea is that respiratory status is important
What is fifths disease?
Transmission of fifths disease?
Red mottling on skin due to Human Parovirus B19
Transmission is through *respiratory secretions or blood , blood products
In fifths disease, what is the bright red mottling called?
What comes after?
Can it come back? Or have issues?
Slapped cheek appearance that occurs early on
Fever, fatigue, body aches, n/v, abdominal pain
Around day 4, they will have rash on upper extremity. But then fade
but could come back w extreme temps or rubbing of clothes. Doesn’t mean they are sick again but they can have inflammatory issues in their joints.
- treat the pain w ibuprofen or something similar
Can PG mom give fifths disease to her fetus?
Where do we try to treat fifths disease?
Yes due to the teragenic property. So PG moms should not be in contact w kids who have fifths disease.
Try to do it in the home unless ofc there’s complications.
What is Roseola?
Transmission?
Response to herpes virus type 6
Most likely saliva - kids touch things and touch their mouths.
Roseola symptoms?
Main concerns with fever?
High fever at first but after about a week it goes away. And then they develop a rash. Then develop cold symptoms and enlarged lymph nodes.
Febrile seizures
Hydration
Both due to fever
Use antipyretic, tylenol, ibuprofen
What are Measles?
Koplik spots?
Measles or Rubeola are a viral infection spread through direct contact with measles.
Koplik spots are in the mouth near the buccal area. They are red with blue/white center. Dead giveaway.
Symptoms of measles?
High fever
Enlarged lymph nodes
Fatigue
Photosenstivity - light is painful to eyes. Protect from the bright lights
Skin breakdown is also a possibility - and we need to make sure that skin gets taken care of.
What are complication of Measles or Rubeola?
Can develop pneumonia, otitis, encephalopathy
Also inflammation causing edema in airway so monitor respiratory and gas exchange
What are Mumps?
Transmission?
What side?
What may children complain of?
Mumps is when there is an inflammation of salivary glands (cheek and neck area)
Transmitted by droplet and direct contact
Can be on one side or both
Children complaining of ear ache due to glands and edema
What other issue can mumps cause?
What systems do nurses need to take care of when dealing with mumps?
Mumps can cause issues such as myocarditis, joint inflammation, meningitis, and epiditis or orchitis.
- the inflammation causes sterility or reduction in sperm count
Take care of airway, cardiac, neuro, and hearing - due to ear ache . We need to follow up
How to handle mumps in hospital?
What type of diet is needed for mumps?
Pain control methods?
Droplet precautions to prevent the spread
The gland inflammation can make it hard to eat
To control pain use warm or cool compresses
Also use analgesics bc there is no antibiotic we can give
Orhcitis caused by mumps care?
Keep warm and supported
What is Rubella called?
Big concern with this?
How soon can it spread?
German measles or onset of rash
Big concern with german measles or rubella is exposure to PG women. It is very tetragenic and can result in multiple birth defects and cardiac abnormalities
- the focus is not exposing others bc the issue with the occupant is not that big od a deal
Can spread 7 days before the rash or up to 5 days after…
So who knows who they gave it to
Nursing care for Rubella?
Supportive, antipyretics, fluids.
What is Scarlet Fever?
What will the tongue look like? Tonsils?
Then what do they develop?
Wha other symptoms?
Basically strep throat
- has a sudden onset w fever
White coated tongue may be present early on but then turns redddd . Tonsils with white sots.
Develop a rash that feels like sand paper.
Abdominal pain, headache, sore throat , ya know
How is scarlet fever treated?
But why do we treat this?
Treated with antibiotics like PCN, erythromycin, cephalosporins.
Since it is strep, we are concerned about it affecting renal system and developing into glomerularnephritis - which is life threatening
- also develop otitis, tonsillar absesses, sinustis, caridits
So in short, we want to treat bc it can lead to bigger problems.
What is conjuctivitis?
What if it is caused by something viral? If it is bacterial?
What if it is severe?
Inflammation of conjuctive or redness in white of eye
If viral - we gotta wait it out. If bacterial , ointments or drops to the eye.
Severe - can be given oral antibiotics.
How to educate parents on how to clean the eye in conjuctivitis infection?
What should you do to ensure it doesn’t spread to others?
Temp of compress that can be used?
Clean the inner canthus to outer eye - to avoid pushing to other eye.
Limit sharing of linens & handwashing
warm compress
Giardia?
How does someone get this?
What happens when this gets into the stomach?
Why is it hard to dx?
Parasitic infection in the GI
Can be picked up in swimming pools or interactive fountains. Diapers. Animals.
The stomach acid activates the Giardia cyst and then it develops into mature organism.
Need a culture and it can take multiple specimens to catch it.
Why is hydration important with Giardia in infants and children?
Med that treats Giardia?
Daycare?
Bc it causes diarrhea - which is fluid loss.
We must keep the kid hydrated.
Flagyl (metronidazole) - may even make assumption this is the problem and just give it to someone to fix the issue
Becareful since daycare can spread it
What is Enterobiasis or pinworms?
What will these feel like?
What will kids act like?
Pinworm eggs that get ingested or inhaled which hatch and mature into adult organism - they migrate through GI tract and lay eggs at rectum
Will itch really bad - and this can cause the spread since they can get on fingers and under nails.
Kids will be irritable
Are pinworms visually seen?
What test can you do?
The kid has to be treated but who else?
And when?
Yes they often can be.
You can do a tape test in older kids by placing tape right on rectal area to get a sample.
Everyone in the house needs treatment . And things all over the house have to be cleaned like linens .
And then they’ll need to be treated again in 2 weeks.
What is thrush?
Where can it travel?
Treatment?
An oral yeast infection that causes white plaque in mouth
- can be caused by steroids
Can travel to GI and perineal area - will look scalded and burned down there.
Antifungals - Nystatin as oral swish and as topical too .
What impetigo caused by?
Caused by staph or strep.
When do we see impetigo a lot?
How does it start?
How is impetigo treated?
How to manage it?
In the summer due to moisture of swimming and sweating - and when there is a break in skin, then there is an infection.
Starts as small vesicle then spreads . Will be honey crusted.
Treated w antibiotics. Can also be given the topical antibiotic too if it is mild. If it is extensive - may start with IV antibiotics and then switch.
- make sure they are on antibiotics for 24 hrs.
Just keep it dry. And make sure to not allow other kids around until after 24 hrs antibiotics
What is Cellulitis ?
What are the organisms responsible?
A bacterial infection of the SQ tissue probably through break in skin
- lots of parents think it is a mosquito bite lmao but then it spreads and look scary quick
Staph, strep, H. Influenza
What can Cellulitis lead to if not treated?
Route of antibiotics?
Deeper infections to the bone - so we want it treated.
IV first and then IM or oral .
What are Tineas?
Capitis
Coporis
Cruris
Pedis
Type of organism that we classify by location and is from a fungus and it multiplies.
Capitis is head lice
Coporis is ring worm of body
Cruris is genital or jock itch
Pedis is athetes foot
- wrestlers also have their own name
How is Tinea diagnosed?
How does it affect the skin?
May just do some clinical exams and then scrape off the skin to do a microscopic look at it.
Can cause hair loss in the area . Photosensitivity may occur. May have a very noticeable appearance too .
How is Tinea treated?
How to stop it from spreading?
Treated w antifungal. Can take two weeks.
Keep clean and dry. No sharing towels or anything . Wear flip flops everywhere if you’re around people in wet areas.
How does tinea act?
How is it spread?
Attaches to epidermis & then multiplies.
Animals but also shared item s
How is Tinea treated?
Oral Griseofulvin (penetrates into hair follice and tissue to treat)
Topical
- azole
Selenium sulfide shampoo.
Where can tinea corporis look like
Type of treatment given?
What if it is spread by pets?
Ring like
Flaky
Scaly
Treated topically - maybe 2 or 3x a week. Beyond edges of lesions to treat all of it
Treat pets too
Tineo cruris
Jock itch
Not highly contagious but is more from tight clothing & sweating . Even in obesity due to skin folds.
- educate them on how to avoid this again by wearing lose clothing and hygiene
Treat w topical lotion or powder
Tinea Pedis
Athletes foot
Peeling, fissures in between clothes
topical treatment
wear ventilated shoes. So the skin can breath.
Keep dry and clean .
General care for tinea
Good hygiene and washing hands & after treatment Don’t share fabrics or shoes Sleep alone Shower shoes Cotton socks Loose clothing No scratching
Atopic Dermatitis or Infantile Eczema?
How early can it occur? When can it disappear by?
Who do we see it in?
What can this increase for them?
What causes lesions to appear>
Not an infectious disorder but it is mistaken to be.
Early ish like 2-3 months. Can disappear by 3 years old. So they can outgrow it.
Child w family history of eczema but also allergies.
Can increase staph infection (like cellulitis).
Scratching can cause it the eczema to come out
Eczema common areas?
How does it present first?
Common symptom?
Is there treatment?
Very common in cheeks, scalp, trunk, and extremties — so like everywhere lmao. But very much in folds. Anicubtal or popliteal
Vesicle > papule > crusting
DRY skin and itching
Not exactly. We use tx to try to reduce flare ups.
- also use tepid water , mild soap or none
- just keep skin from being dry
- can use wet wraps at 10 min at time
- topical steroids , use sparingly
- remove allergens
- oral immumodulators to lower immune response (given for organ transplant)
- keep nails short or mittens
- loose clothing for temp to reduce itching
Pediculosis
Transfer?
What does it look like?
Can kids go to school w head lice?
Treatment?
Combs?
Education?
Head lice
Transfer through nit eggs laying around
Looks like little white eggs in hair . Old nit shells further from shaft. well as pearly new eggs. Hatch in 7-10 days.
- they feed off blood.
Kids are able to go to school bc it is not actually harmful.
Pediculoside. OTC Prythethrin and Piperonyl and then rinse after 10 min
Malathion - dry option that you leave over night
- everyone should be checked
But also need to go in and remove the nits w comb
- fine hair is not easy to do
Educate parents that everything should be washed or sealed in trashbag to make sure it doesn’t spread. They will die bc of no blood
- dont let people share combs or hats.
- may even want to treat after 1 week to make sure you got everything
What is scabies?
Mites that burrow under skin and lay eggs that causes extremely itchy lesions.
- in between skin and limbs. Will develop a crack where they burrowed.
Scabies treatment?
Permethrin over the entire body that is left on for overnight or 8-14 hrs and then washed off
Everyone in contact should be treated.
Symptoms go away after 2 or 3 weeks.
