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NUR 102 Pedi Final Assessment Content > The Child with an Infectious Disease > Flashcards

The Child with an Infectious Disease Flashcards

1
Q

Disease Process

?

Time interval between initial infection and 1st appearance of signs and symptoms

A

Incubation period

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2
Q

?

Early, mild symptoms of disease

A

Prodromal period

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3
Q

Period of Illness

* Overt signs and symptoms of disease

* WBC may increase or decrease

* Death may result if immune system or treatment fails

Period of Decline

* Signs and symptoms subside

* Vulnerable to secondary infections

A

Period of convalescence

* Regains strength and body returns to pre-disease state

* Recovery has occurred

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4
Q

Chain of Infection

* For a pathogen to maintain an infectious state it needs to be transmitted to another host

* To spread the infection, the pathogen must follow the chain of infection

Agent > Reservoir > Portal of exit > Transmission mode > Portal of entry > Host susceptibility >

A

Characteristics of the Organism (Pathogen)

  • Type (viruses, bacteria, fungi, parasites)
  • Ability to invade host
  • Virulence
  • Degree to which it causes disease

Portal of Entry

  • Eyes
  • Mucus membranes
  • Respiratory tract
  • Placenta
  • Breaks in host barriers
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5
Q

Reservoir

  • Humans
  • Animals
  • Environmental surfaces

Portal of exit

  • Respiratory tract
  • Genitourinary tract
  • Gastrointestinal tract
  • Skin/mucosal surfaces
  • Placenta
  • Blood
A

Mode of Transmission

  • Direct contact
  • Droplets
  • Vectors
  • Airborne

Characteristics of the Host

  • Lack of effective resistance
  • Changes in host defenses
  • Tissue destruction
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6
Q

Viral Infections

A

Viruses

* Small parasitic organisms

* One type of DNA or RNA

* Lack reproductive ability - need host

* Infected host can respond to that viral invasion

  • Lysis
  • Continue functioning (asymptomatic)

* May remain dormant until triggered

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7
Q

* Rubeola (“ordinary” measles, 7-day)

* Rubella (German measles, 3-day)

* Erythema infectiosum (“Fifth Disease”, Parvovirus B19)

* Roseola Infantum (Exanthem Subitum, 3-day fever)

* Coxsackievirus A (hand-foot-mouth)

* Varicella zoster infections (chickenpox, shingles)

A

* Mumps

* Cytomegalovirus (CMV)

* Infectious mononucleosis (EBV)

* Rabies

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8
Q

Viral Exanthemas (Rashes)

Rubeola (Measles) - “7-day Measles”

* Causative agent: RNA virus

* Incubation: 8-12 days from exposure to onset of symptoms

* Infectious Period: 3-5 days prior to rash through 4-6 days after onset of rash

* Transmission: Direct contact with droplets and airborne (less frequent)

* Manifestations:
- Prodromal period: 10 days of high fever, 3 C’s = __, __, and __

  • __ spots
  • Exanthem (rash) - deep red macular rash, blanches with pressure and gradually turns brownish
A

coryza, cough, conjunctivitis

Koplik

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9
Q

Therapeutic management

* Treating symptoms
* Airborne precautions
* Antipyretics
* Quiet activities and bed rest
* Fluids and humidification
* Antitussives

Prevention ⇒ immunization
> 2 doses of MMR

A
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10
Q

? (German Measles, 3-day Measles)

Causative agent: RNA virus

Incubation period: 14-21 days

Infectious period: 7 days before onset of symptoms to 14 days after appearance of the rash

Transmission: airborne particles or direct contact with droplets and transplacental transmission (congenital)

A

Rubella

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11
Q

Manifestations

* Mild disease - rash 14-21 days after exposure

* Young children - asymptomatic until the rash appears

* Older children - profuse nasal drainage, diarrhea, malaise, sore throat, headache, low grade fever, polyarthritis, eye pain, aches, chills, anorexia, and nausea

* Posterior cervical, posterior auricular, and occipital lymphadenopathy

* Pinkish rose maculopapular exanthem - on the face, scalp, and neck - pruritic

* Petechiae (spots) red or purple color or pinpoint on the soft palate - __ __

A

Forchheimer’s sign

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12
Q

Congenital rubella syndrome (CRS) - after maternal infection

  • Intrauterine growth retardation, weight less than 2500 g, failure to thrive in infancy
  • Pregnant females should avoid contact
  • Presumed contagious until one year or after repeated negative nasopharyngeal and urine cultures
A

Therapeutic management

  • Supportive and symptomatic
  • Exclusion from school and should be on droplet precautions for 7 days after onset of rash
  • Primary prevention for rubella - MMR vaccine
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13
Q

? (“Fifth Disease” Parvovirus B19)

* Causative agent: parvovirus B19

* Incubation period: 4-17 days up to 28 days

* Infectious period: shedding - 5 and 12 days - from the prodromal period until onset of rash

* Transmission: airborne respiratory droplets, blood, blood products, transplacental transmission

A

Erythema Infectiosum

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14
Q

Manifestations

* Common in children ages 5-15

* Mild systemic disease

* Prodromal period: headache, runny nose, malaise, and mild fever

* Rash:
> Intense, fiery red edematous rash on face (maculopapular rash) - “slapped cheek” appearance

> 1-4 days after facial rash appears - erythematous, maculopapular rash appears on trunk and extremities - lacy appearance

* Rash can last from 2 to 39 days; can reappear with environmental factors

A

Therapeutic management

  • Symptomatic and supportive
  • Antipyretics
  • Antihistamines
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15
Q

? (Exanthem Subitum, 3-day fever)

* Causative agent: human herpesvirus 6 (HHV-6)

* Incubation period: 5-15 days

* Infectious period: unknown most likely from febrile stage to onset of rash

* Transmission: contact with secretions such as saliva, CSF

A

Roseola Infantum

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16
Q

Manifestations

  • Prodromal period - sudden high fever 103-106, malaise, irritability, child remains active and alert - fever persists for 3-5 days
  • Mild cough, runny nose, abdominal pain, headache, V/D
  • After fever subsides within several hours to 2 days - rash appears
  • Rose-pink maculopapules or macules, blanche with pressure, whitish ring
A

Therapeutic management

  • Symptomatic
  • Antipyretics
  • Lightweight clothing
  • Cooler environmental temperatures
  • Increase fluid intake
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17
Q

Enteroviruses - ___ (hand, foot and mouth)

Causative agents: RNA viruses

Incubation period: 3-6 days

Infectious period: unknown

Transmission: fecal-oral and oral-oral: contact precautions

Manifestations

  • Prodromal period: fever
  • Vesicles in mouth, on palms of hands, soles of feet, and sometimes on buttocks
A

Coxsackievirus A

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18
Q

Therapeutic management

  • Symptomatic
  • Special attention to dehydration
  • Hand hygiene/personal hygiene/diaper changes/bathroom use
  • Analgesics (acetaminophen)
  • Soft or cool liquid diet - milk-based ice cream
  • For oropharyngeal lesions
    > Rinse mouth with salt and water or
    > “Magic mouthwash”
    * Equal parts of lidocaine gel, diphenhydramine liquid, and liquid antacid
A
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19
Q

Varicella zoster infections (chicken pox and shingles)

* Causative agent: varicella zoster virus

* Incubation period: 10-21 days

* Infectious period: 1-2 days before onset of rash and until all lesions are dried and crusted over

* Transmission: direct contact (open vesicles), droplet, airborne particles

* Immunity: either by natural disease of varicella or varicella vaccine

A
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20
Q

Manifestations: Varicella

* Prodromal period: 24-48 hours before onset of lesions
> Low-grade fever, malaise, headache, and anorexia

* On trunk and scalp
> teardrop vesicles with an edematous base > pustular vesicles > crust

A

Herpes zoster (shingles)

* Primary infection with varicella - lays dormant

* Activation causes herpes zoster - shingles

> Must have had chickenpox previously to get herpes zoster

* Tenderness along the involved nerve and surrounding skin for approximately 2 weeks before lesions

* Rash is unilateral - along a single dermatome of one or more sensory nerves

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21
Q

Therapeutic management (chickenpox and shingles)

* Symptomatic and supportive
* Oatmeal baths
* Antipyretics (acetaminophen and NEVER ASA)
* Antihistamines
* Avoid scratching the lesions to prevent scars and infection
* Airborne and contact precautions until lesions scabbed
* Prevention through vaccination (1st dose on or before 1st birthday and booster between ages 4-6)

* For herpes zoster
> analgesics; acyclovir; airborne and contact precautions (strict isolation)

A
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22
Q

?

* Causative agent: paramyxovirus

* Incubation period: 16-18 days can go up to 25 days

* Infectious: 7 days prior to swelling (parotitis) and up to 9 days after onset

* Transmission: airborne droplets, salivary secretions, and possibly urine

Manifestations

  • Prodromal: fever, myalgias, headaches, and malaise
  • Pain with chewing, earache, pain in the jaw line in front of the ear
  • Male complication - inflammation of the testes (___ ?)
A

Mumps

orchitis

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23
Q

Therapeutic management

* Symptomatic care and adequate hydration
* Soft or liquid diet
* Avoid acidic foods such as orange juice
* Droplet precautions until 5 days after onset
* Antipyretic
* For orchitis - bedrest, intermittent application of ice packs, pain management, emotional support and diversional activities

* Prevention - vaccination with the MMR vaccine

A
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24
Q

?

* Causative agent: human cytomegalovirus

* Incubation period: unknown

* Transmission: saliva, urine, blood, semen, cervical secretions, breast milk, organ transplants

* Leading cause of hearing loss and intellectual disability in infants in the US

Therapeutic management
> Early detection of disabilities
> Hearing aids, cochlear implants, speech therapy
> Detect learning disabilities and early interventions with physical speech and cognitive therapy

A

Cytomegalovirus (CMV)

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25
Q

? (Epstein-Barr Virus [EBV])

* Incubation period: 4-7 weeks

* Infectious period: unknown

* Transmission: direct contact through saliva, intimate contact or blood

A

Infectious Mononucleosis

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26
Q

Manifestations

* Prodromal period: fever, exudative pharyngitis, lymphadenopathy (cervical, axillary, and inguinal)

* Enlarged lymph nodes, sore throat, high fever, pain with swallowing, petechiae on palate, enlarged tonsils with white exudate, and firm, tender, cervical lymph nodes

* May develop to abdominal pain with liver and spleen enlargement - hepatosplenomegaly

A

Therapeutic management

* Supportive

* Steroids PRN for acute tonsillar swelling

* Rest; avoid physical activity and contact sports to minimize the risk of rupturing the spleen

* Antipyretics

* Hydration

* Soft or liquid diet and foods; milkshakes

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27
Q

?

* Causative agent: rhabdovirus

* Incubation period: 5 days to more than 1 year

* Infectious period: 10 days

* Transmission: bites with contaminated saliva, scratches from claws of infected animals, airborne from bat infested caves

Manifestations
> Slowly developing infection
> Prodromal period: sore throat, headache, fever, anxiety
> Discomfort at the site of the bite, hyperactivity, muscle spasms (involuntary twitching) or convulsions
> Decreased ability to swallow (contractions of the mouth) resulting in drooling or aspiration
> Coma, death

A

Rabies

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28
Q

Therapeutic management

  • Prevention is important
  • Cleanse bite wound with large amounts of soap and water
  • Administer human rabies immune globulin (HRIG)
  • Rabies vaccination
A
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29
Q

Bacterial Infections

A

* Organisms that contain both DNA and RNA

* Complex cell wall

* Classified as gram-positive or gram-negative bacteria

* Bacteria secrete toxins (exotoxins, endotoxins)

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30
Q

* Whooping cough

* Scarlet fever

* Cellulitis

* Methicillin Resistant Staphylococcus Aureus (MRSA)

* Clostridium difficile (C. diff)

* Impetigo

A

Rare Viral & Bacterial Infections

* Poliomyelitis infantile paralysis

* Diphtheria

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31
Q

?

Portion of a gram-negative cell and cause fever, shock, and DIC

A

Endotoxins

32
Q

?

May cause cell damage by cell lysis, inhibition of protein synthesis, or interference with passage of nerve impulses

A

Exotoxins

33
Q

?

* Causative agent: Bordetella pertussis (gram-negative bacteria)

* Incubation period: 5-21 days

* Infectious period: catarrhal stage 1-2 weeks up until the 4th week

* Transmission: direct contact or respiratory droplets from coughing

Manifestations
> 3 stages of

A

Whooping cough

34
Q

? stage

Episodes of coughing and vomiting

A

Convalescent

35
Q

? stage

Rhinorrhea, lacrimation, mild cough, and low-grade fever

A

Catarrhal

36
Q

? stage

Increased severity of cough; repetitive series of coughs with a whoop; cyanosis

Thick, tenacious mucous; protrusion of the tongue; salivation; distention of neck veins

Coughing spells may be triggered by yawning, sneezing, eating or drinking; coughing may induce vomiting

A

Paroxysmal

37
Q

Treatment regimen

  • Push fluids
  • Monitor respiratory status (with cardiopulmonary monitor), pulse oximeter and vital signs
  • Keep oxygen and suction equipment available
  • Quiet and calm environment
  • Monitor nutritional status - small frequent to avoid exhaustion
  • Erythromycin, azithromycin, or clarithromycin may be given during catarrhal stage
  • Droplet precautions
  • Prevention with vaccination administration of 5 doses of the pertussis vaccine in combination with tetanus and diphtheria (DTaP)
A
38
Q

?

* Causative agent: Group A beta-hemolytic streptococci

* Incubation period: 1-7 days

* Infectious period: acute stage until 24 hours after antibiotic therapy has begun

* Transmission: direct contact and airborne (inhalation or ingestion)

A

Scarlet fever

39
Q

Manifestations

* Prodromal period: fever, vomiting, headache, pain, pharyngitis, and chills

* Within 24 hours - rash fine red papules - axillae, groin, and neck (feels like sandpaper)

* Rash blanches on pressure (__ __)

* Desquamation (peeling of the skin) > flaking

* Tongue is coated - a white furry covering with red projecting papillae (called __ __ __) > slough off leaving a red swollen tongue (called __ __)

* Tonsils edematous and covered with grey-white exudate that can spread to the pharynx

* Petechial hemorrhages cover the soft palate

A

Pastia’s sign

  • *white strawberry tongue**
  • *strawberry tongue**
40
Q

Therapeutic management

* Diagnostic is done with rapid streptococcal screening in the office setting

* Penicillin - complete full course - 10 days

* Supportive care for symptoms like antipyretics and analgesics, antipruritics, throat lozenges, antiseptic spray (chloroseptic)

* Droplet precautions until the child has been on antibiotic for 24 hours

A

* Hydration - soft or liquid diet - avoid acidic foods or fluids - encourage ice-pops or milkshakes

* Bedrest and quiet activities - prevent fatigue

* Oral care - avoid acidic mouthwash preparations - may do saline rinses

* Complications - rheumatic fever and acute post-streptococcal glomerulonephritis

41
Q

?

* Bacterial infection of the subcutaneous tissue and dermis

* Causative agents: Haemophilus influenzae type B, Group A streptococci, and Staphylococcus aureus

  • Manifestations*
  • Affected area red, hot, tender, and indurated
  • If Haemophilus influenzae - affected area may have purplish tinge
  • With periorbital cellulitis - edema and purple discoloration of the eyelids and decreased eye movement
    > ___ - red streaking of surrounding area and enlarged regional lymph nodes (lymphadenitis)
  • Fever, malaise, and headache
A

Cellulitis

Lymphangitis

42
Q

Therapeutic management

* Initial dose of IM or IV antibiotic - ceftriaxone

* Extremity - oral antibiotics such as cephalosporin, cloxacillin, or dicloxacin

* Joint or face - IV antibiotics; incision and drainage

* Rest with elevated extremity

* Warm moist soaks
* Analgesics and antipyretics
* Frequent hand washing

A
43
Q

Methicillin Resistant Staphylococcus Aureus (MRSA)

* Causative agent: Staphylococcus aureus (a gram-positive cocci)

* May cause cellulitis

* Transmission: contact
> Can be hospital-acquired or community-acquired
> Source of most skin and soft tissue infections

Manifestations
- HA-MRSA: are medical device-related infections, pneumonia (VAP), and catheter related bloodstream infections

  • CA-MRSA: are infections of skin and soft tissue
A

Therapeutic regimen

* Warm soaks
* Severe cases - incision and drainage and IV vancomycin or linezolid
* Blood cultures
* Most cases - treated with a 5-10 day course of oral vancomycin, clindamycin, sulphamethoxazole-trimethoprim or linezolid

* Handwashing important for prevention

* Contact precautions

44
Q

Clostridium difficile (C. diff)

* Causative agent: Clostridium difficile (gram-positive anaerobic bacterium)

* Transmission: contact (fecal-oral)

* Incubation period: unknown

* Manifestations
> May be asymptomatic
> May have watery diarrhea, abdominal cramps, fever, and possible systemic toxicity
> Associated with antibiotic therapy

A

Diagnosis - identification of toxins in stool

Treatment regimen:
- Initial treatment would be cessation of antibiotic
- C. difficile associated diarrhea (CDAD)
> Includes a 7-10 day course of oral metronidazole for mild-to-moderate disease
> or vancomycin for more severe diseases

* Contact precautions (requires meticulous hand hygiene)

* C. difficile spores are not killed by alcohol-based hand sanitizers

45
Q

?

* Highly contagious

* Incubation period: 7-10 days

* Transmission: direct contact or indirect contact

* Causative agent: Staphylococcus aureus, group A beta hemolytic streptococci or both

A

Impetigo

46
Q

Manifestations

* __ __ - small vesicles - progress to bullae - lesions filled with serous fluid and later become pustular - rupture - a shiny lacquered-appearing lesion surrounded by a scaly rim

* __ __ - vesicle or pustule - ruptures - honey-colored crust erosions that bleed easily when crusts are removed

* May be pruritic
* Located around the mouth and nose
* Usually resolve within 12-14 days with treatment

A

Bullous impetigo

Crusted impetigo

47
Q

Therapeutic regimen

  • Topical and oral antibiotics
  • Gently wash 3x/day with warm soapy washcloth, crust soaked, and carefully removed

* Topical ointment - muciprocin (Bactroban) or bacitracin (Baciguent) x7-10 days

* Good hand washing and careful hygiene

* NOT attend school or daycare for 24 hours after beginning treatment

A

* Child should sleep alone and bathe alone daily

* Caregiver should wear gloves when caring for the child

* Complete full course of topical or systemic antibiotics as prescribed

* Keep fingernails short and wash child’s hands frequently with antibacterial soap

* Do not share towels, combs or eating utensils with the infected child

48
Q

Poliomyelitis Infantile Paralysis

* Causative agent: polio virus

* Incubation period: 7-10 days

* Infectious period: just before and after onset of symptoms 1-6 weeks

* Transmission: fecal-oral or oral-oral: direct and indirect contact

Manifestations

  • Prodromal period: fever, headache, nausea, vomiting, abdominal pain, mild neck, back, and leg stiffness
  • Intense pain, tremors of extremities, and paralysis due to CNS involvement
  • Difficulty swallowing and respiratory paralysis
A

Treatment regimen

  • Mechanical ventilation
  • Physical therapy
  • Analgesics
  • Contact precautions

Prevention - routine immunization (polio)

49
Q

Diphtheria

* Causative agent: Corynebacterium diphtheriae (gram-positive non-motile bacillus)

* Incubation period: 2-6 days

* Infectious period: 2-4 weeks untreated or 1-2 days treated

* Transmission: direct contact with respiratory secretions

Manifestations

  • Prodromal period: resemble common cold
  • Gradually progresses to nasal discharge of foul-smelling mucopurulent material and brassy cough
  • Low-grade fever
  • Hallmark sign - “bullneck” or neck edema
  • May lead to myocarditis, HF, paralysis, and airway obstruction
A

Treatment regimen

* IV diphtheria antitoxin

* IV antibiotics - erythromycin or penicillin G within 3 days of symptom onset

* Bed rest

* Droplet precautions

* Prevention - with vaccination (DTaP)

50
Q

Fungal Infections

A

* Normal human flora (mouth, intestine, vagina, skin)
* Transmitted through inhalation or penetration of tissue
* Slow growth
* Resistant to temperatures and most antibiotics
* Pathogenic fungi: molds and yeasts

* Infections caused by fungi are classified as:

  • Opportunistic
  • Systemic
  • Subcutaneous
  • Superficial (skin and nails)
51
Q

?

Ringworm of the scalp

Interventions: oral griseofulvin for at least 6 weeks

A

Tinea capitis

52
Q

?

Jock itch

* Not contagious - results from poor hygiene, friction from tight clothing, and obesity

* Interventions: clotrimazole cream or lotion

A

Tinea cruris

53
Q

?

Athlete’s foot

Interventions: clotrimazole (Lotrimin) cream, lotion or spray; Miconazole (Monistat) or oxiconazole (Oxistat) 2x/day until lesions have cleared for 1 week

A

Tinea pedis

54
Q

?

Ringworm of the body

Interventions: Clotrimazole (Lotrimin) cream or lotion or Miconazole (Monistat) 2x/day for 4 weeks

* Keep dry and avoid contact, handwashing

Tinea infections are transmitted from person to person, animal contact, or by contact with contaminated fomites (combs, hats, headrests, pillows)

A

Tinea corporis

55
Q

Candidal Infections - Candidiasis

Oral = ?

> Superficial fungal infection of oral mucous membranes resulting from an overgrowth of C. albicans

Manifestations
- white curd-like plaques on tongue and buccal mucosa

Diaper area

  • Lesions caused by passage of C. albicans through the intestine
  • Manifestations: bright red and coalesced lesions may spread to the child’s abdomen and thighs
A

thrush

56
Q

Therapeutic Management

* Nystatin oral suspension (100,000 units per mL) every 6 hours until 3-4 days after the symptoms have resolved
> Applied to mucous membranes of the mouth (gums, tongue, and buccal mucosa); applied after feedings

* Pacifiers, nipples, and bottles should be cleaned thoroughly

* Teach hand hygiene technique

* If breastfeeding - breast should also be treated with Nystatin

A

* Encourage small frequent feedings and for older children - cool liquids

* Oral fluconazole may be given as an alternative

* Candidal diaper dermatitis treated with topical antifungal agent - Nystatin or clotrimazole (Lotrimin)
> Leave diaper area exposed to air to reduce moisture

57
Q

Rickettsia Infections

?

* Rickettsiae - small, parasitic bacteria

Causative agent: Rickettsia rickettsii
Reservoir: Wild rodents and dogs
Vector: ticks (wood, dog, or Lone Star)
Incubation period: 2-14 days
Transmission period: bite of infected tick

A

Rocky Mountain Spotted Fever

58
Q

Manifestations

  • Headache, fever, and anorexia, restlessness
  • Maculopapular rash (wrists, palms, ankles, and soles)
  • Hemorrhagic and necrotic lesions may appear
A

Therapeutic managment

  • Doxycycline (may stain teeth - use straws and flush mouth after adminstration)
  • Fluoroquinolone as an alternative
  • Treatment lasts 7-10 days
59
Q

Borrelia Infections

Lyme Disease

* Causative agent: Borrelia burgdorferi (spirochete)

* Vector: Tick

* Incubation period: 3-33 days

* Infectious period: not communicable from one person to another

* Transmission: bite of infected deer tick

A

Manifestations

  • Early localized stage
  • Early disseminated stage
  • Late disseminated
60
Q

__ __ stage

  • Intermittent, chronic arthritis, profound fatigue, chronic neurological manifestations
A

Late disseminated

61
Q

__ __ stage

  • Severe headaches with myelitis, N/V, facial nerve paralysis (Bell’s palsy), forgetfulness or decreased concentration, and cerebral ataxia
  • General lymphadenopathy and joint and muscle pain
A

Early disseminated

62
Q

__ __ stage

  • Local reactions - erythematous papule at bite site - erythema migrans or “bullseye rash” and flu-like symptoms (headaches, chills, fatigue, muscle aches, and pains)
A

Early localized

63
Q

* Primary prevention - anticipatory guidance and measures to prevent and avoid insect bites

  • Protective, light-colored clothing
  • Inspect skin thoroughly after exposure to heavily wooded area
  • Proper use of insect repellents (DEET - not over 30%)

* Oral antibiotic therapy - doxycycline, amoxicillin, or cefuroxime - 14-21 days

* If neurologic or cardiac symptoms - IV ceftriaxone 2-3 weeks

* Analgesics and antipyretics (fever, arthralgias, headaches)

A

Helminthic Infections

  • Tapeworms
  • Roundworms
  • Pinworms
  • Hookworms

Education focus on medication administration, primary prevention (personal hygiene and health habits), and identifying resources for basic living needs (running water)

64
Q

?

Handling or eating infected beef or pork

Manifestations
> Asymptomatic, abdominal pain, nausea, anorexia, weight loss, insomnia

Treatment
> Praziquantel, niclosamide

A

Tapeworms

65
Q

?

Ingestion or inhalation of eggs, transfer from hands to mouth

Manifestations: nocturnal anal itching, sleeplessness

Treatment: Pyrantel pamoate, mebendazole, albendazole

A

Pinworms

66
Q

?

Ingestion of eggs from contaminated soil or food, transfer to mouth from fingers, toys, or other vectors

Manifestations: abdominal pain or distention, abdominal obstruction, vomiting with bile staining, pneumonitis

Treatment: Mebendazole, albendazole, ivermectin

A

Roundworms

67
Q

?

Skin penetration from direct contact with contaminated soil

Manifestations: dermatitis, blood loss - anemia, pneumonitis, malnutrition

Treatment: Mebendazole, albendazole, pyrantel pamoate

A

Hookworms

68
Q

Sexually Transmitted Diseases (STDs)

* Chlamydia (chlamydial infection)

* Gonorrhea

* Human Papillomavirus (HPV)

* Herpes simplex virus

* Syphilis

* Trichomoniasis

A
69
Q

Chlamydial Infection

* Most prevalent

* Transmission: during birth with infected mother or through sexual activity

* Manifestations
> __ __ - watery discharge - purulent; eyelids edematous and conjunctiva inflamed; mucoid rhinorrhea; may progress to infection of nasopharynx with progression to pneumonia

> Adolescents - urethritis with dysuria; urinary frequency; mucopurulent vaginal discharge

A

Neonatal conjunctivitis

Therapeutic management

* Conjunctivitis and pneumonia: 14-day course of erythryomycin

* Genital tract infection - single dose of azithromycin or 7-day course of doxycycline

* Treat all sexual partners

70
Q

Gonorrhea

* Transmission: intimate contact (perinatally - during birth, sexual abuse, sexual intercourse)

* Manifestations
> __ __: 1-4 days after birth - thick purulent discharge from eyes may progress to corneal ulceration, rupture, and blindness
- Prophylactic treatment with ophthalmic antibiotic ointment immediately after birth

> Females - purulent vulvovaginitis
> Males - urethritis

A

Ophthalmia neonatorum

Therapeutic management

  • Ceftriaxone for children and adolescents
  • Cefotaxime for infants
  • Sexual partners should also be treated
71
Q

Human Papillomavirus (HPV)

* Responsible for common wart and genital warts (condylomata acuminata)

* Transmission: direct sexual contact; multiple sexual partners; or perinatal contact during birth

> Children with anogenital warts should be investigated for sexual abuse

* Manifestations: anal genital warts; found in moist areas (labia minora, vagina, cervix, anus, rectum, and glans of the penis)

A

Therapeutic management: most resolve spontaneously;

  • Topical gels, creams, cryotherapy, electrocautery laser treatment or surgical removal
  • Screening for cervical cancer - Papanicolau (Pap) test
  • Vaccinations
    > HPV 6/11/16/18 vaccine (Gardasil) females and males ages 9-26
    > Recommendation is for females ages 11-12 to be immunized with one of the HPV vaccines
    > Males can receive the HPV 9 or HPV 4 vaccine
72
Q

Herpes Simplex Virus

* Most frequent STD in US

* Causative agent: Herpes Simplex Virus type 2 (genital herpes)

* Incubation period: 2-14 days

* Transmission: Direct sexual contact with infected person

  • Infected mother can transmit to newborn with vaginal delivery
  • Women with active HSV advised to have C-section delivery
A

Manifestations

  • Vesicles on the vulva, perineum, perianal area
  • Pain and tenderness in the affected area
  • Flu-like symptoms (fever, malaise, dysuria, and enlarged lymph nodes)
  • Virus remains dormant in the nerve ganglia and reappear with stressful trigger

Therapeutic management

  • Culture from the secular fluid confirms diagnosis
  • No cure for HSV 2
  • Acyclovir (Zovirax) - reduce symptoms and shedding time
  • Infected neonates - treated with parenteral acyclovir
  • Adolescents treated for 10 days with oral acyclovir, valacyclovir, or famciclovir
73
Q

Syphilis

* Transmission: intimate contact; transplacentally or sexually

* __ syphilis transmitted through placenta or during birth
> Symptoms within the first 3 months of life

* __ syphilis transmitted through sexual contact

Manifestations

  • Rhinitis, maculopapular rash, hepatosplenomegaly
  • Bones, teeth, eyes, and eighth cranial nerve involved - teeth notched (Hutchinson’s teeth) and hearing loss may occur around age of 8-10

Treatment: penicillin and tetracycline

A

Congenital

Acquired

74
Q

Trichomoniasis

* Transmission: perinatal contact during delivery, sexual activity

Manifestations

  • Mostly asymptomatic in males
  • Females - dysuria, vaginal itching, burning, frothy yellowish green foul-smelling discharge
  • Classic - strawberry cervix

Therapeutic management

  • One dose of metronidazole (Flagyl, Protostat) or tinidazole
  • Sexual partners should also be treated

Prevention is major nursing goal

A
75
Q

Nursing Considerations

* Prevention, early identification, and treatment are major goals of nursing care related to any STD

  • Nurse plays key role in educating
  • Being non-judgmental
  • Reassuring confidentiality
  • Build trust and rapport with adolescents
    > School nurses - healthcare professional with whom adolescents establish trusting relationships

To prevent STDs - encourage abstinence for adolescents who are not sexually active and condoms for those who are sexually active

A

Nursing Diagnosis Associated with Infectious Process

  • Acute Pain
  • Impaired comfort
  • Impaired skin integrity
  • Risk for infection
  • Risk for imbalanced body temperature
  • Ineffective thermoregulation
  • Deficient fluid volume
  • Impaired swallowing
  • Fatigue
  • Deficient knowledge
  • Social isolation
  • Deficient diversional activity

NUR 102 Pedi Final Assessment Content (2 decks)

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