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Nursing 3 Exam 4 > Unit 37 Pediatric Infectious Disease > Flashcards

Unit 37 Pediatric Infectious Disease Flashcards

1
Q

What are the side effects of “killed” inactivated vaccines and live vaccines?

A

“killed” inactivated vaccines side effects:

  • Local soreness at injection site
  • Mild fever

Live vaccine side effects:
-Can obtain mild form of disease that would appear in a week or two, not the day vaccine is given

Overal usually the side effects are MILD

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2
Q

What is VAERS and who can active it?

A

Vaccine Adverse Event Reporting System

Anyone

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3
Q

What is the epidemiology triangle of disease?

A

Host

Pathogen

Environment

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4
Q

Why are children more vulnerable to infection? What age is especially at risk?

A
  • Thinner skin
  • Immunoglobulin A not at adult levels till age 5
  • Sweat glands are immature till age 3 - less able to regulate temp
  • Especially under 6 months at risk
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5
Q

What are macules, papules, and vesicles?

A

Macules - flat red spots

Papules - Raised red spots

Vesicles - blisters

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6
Q

When is septic work-up performed on infants?

A
  • When fever is approx 100.5 in infants less than 6 months of age
  • Includes hospital admission and pan-culture including lumbar puncture
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7
Q

How can infections be prevented?

A

Vaccines creating herd immunity

Handwashing

Sneezing/Coughing Hygiene

Keeping surfaces clean

Less contact with sick kids

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8
Q

What are general interventions for infection?

A
  • Fever management (treat symptoms then fever if discomfort, Ibuprofen cannot be give until 6 months old)
  • Avoid Aspirin
  • Encourage fluids
  • Provide comfort/manage pruritus (itching)
  • Keep rashes clean, dry, avoid rubbing (exudate contains the offending organism)
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9
Q

What are ways to manage pruritus?

A
  • Encourage participation in diversional activity
  • Apply cool, moist compresses to pruritic areas
  • Add emollients, cornstarch, or baking soda to bath water
  • Use tepid water and mild soaps for bathing
  • If not contraindicated, apply emollient creams or ointments frequently to prevent dryness
  • Encourage client to wear loose cotton garments and avoid clothes or blankets made from wool

-Administer antihistamines if ordered:
Diphenhydramine [Benadryl], hydroxyzine [Atarax]

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10
Q

GI illness has mainly what kind of precautions? Respiratory?

A

Contact - GI

Airborne - Respiratory

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11
Q

Describe the aspects of Chicken pox such as: the agent, source, transmission, incubation period, and if there is a vaccine.

A

Agent- Varicella zoster VIRUS

Source - Rash?

Transmission - Airborne! (also contact)

Incubation period - 2-3 weeks

There is a live vaccine that is 80% effective

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12
Q

what is the prodromal stage of chickenpox? what is the Infectious stage of chickenpox? during what time frame is it contagious? when is it no longer contagious?

A

Prodromal stage (before stage): slight fever, malaise (general ill feeling), anorexia

Contagious in first 24 hours

Infection stage:
-Macules progressing to papules to vesicle to crusted over

  • When spots are crusted over, no longer contagious
  • Pruritus can be intense
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13
Q

What immunoglobulin and antiviral can be given to a child before or with Chicken Pox? What are the complications of chicken pox?

A

If child is immunosuppressed and been exposed to virus can give [VariZIG] an immunoglobulin recently approved drug that pools antibodies to chicken pox.

-acyclovir(Zovirax) a general antiviral can be given as well

Complications: secondary bacterial infections, encephalitis (infection of brain)

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14
Q

What are the nursing interventions for chicken pox?

A
  • Strict [airborne] isolation and contact precautions when hospitalized
  • Isolate child in home until vesicles have dried
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15
Q

Describe Rotavirus. symptoms, care, immunity, and vaccine.

A
  • Serious cause of severe diarrhea in children
  • Symptoms: fever, abdominal pain, vomiting, watery diarrhea 3-8 days

Care: Supportive, oral and IV hydration*

Immunity: After infection immunity is incomplete but subsequent bouts are less severe

Live vaccine that ca be given at 1 month old unlike other vaccines

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16
Q

Describe Measles.

A
  • A virus
  • One of the most contagious illnesses in humans
  • From respiratory tract secretions, and blood urine

Transmission: airborne, direct contact

Live vaccine: When 12-15 months old given in MMR pack (Measles, Mumps, Rubella)

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17
Q

What are the defining characteristics of measles in the prodromal and infectious stages?

A

-Prodromal stage: fever, malaise, cough, conjunctivitis, KOPLIK SPOTS**

Infection Stage: rash, erythematous rash on face that spreads downward after 3-4 days rash is brownish

-Generalized lymphadenopathy, anorexia

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18
Q

What are Koplik spots?

A
  • White dots in mouth cheek area

- Occurs 2 days before the measles rash

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19
Q

What is the therapeutic management of Measles?What vitamin would you give? What are the complications?

A
  • Vitamin A supplementation to decrease mortality and morbidity
  • Hospitalization for infants or any immunocompromised patients with measles
  • Supportive care, monitoring, bedrest
  • Antipyrectics

Complications: Otitis*, encephalitis (brain infection), pneumonia, obstructive laryngitis

20
Q

What are nursing interventions for Measles?

A
  • Isolate child until 5th day of rash if hospitalized
  • Respiratory airborne precautions**
  • Cool mist vaporizer
21
Q

Describe Mumps.

A

ParamyxoVIRIS

Source: saliva

Transmission: DROPLET, and contact

Live vaccine given at 12-15 months old as MMR pack.

22
Q

What are the defining characteristics of Mumps?

A

Prodromal stage: fever, malaise, headache, anorexia, earache (24hrs before infection stage)

Infection stage: Parotitis (large swollen side of neck, parotid gland enlarged), painful and tender, max size in 1-3 days.

23
Q

What are the severe complications of Mumps?

A
  • Inflammation of the brain and/or tissue covering the brain and spinal cord. (encephalitis/meningitis)
  • Inflammation of testicles (orchitis) that could lead to sterility
  • Deafness, usually permanent
  • Inflammation of breasts/ovaries
  • Spontaneous abortion
24
Q

What is the therapeutic management of Mumps?

A
  • Analgesics
  • Antipyretics
  • Watch for complications - encephalitis, hepatitis
25
Q

What are nursing interventions for Mumps?

A
  • Droplet and contact precautions
  • Bedrest
  • Encourage fluids and soft bland diet
  • Warm or cool compress to the neck
26
Q

Describe Rubella (german measles).

A
  • rubella VIRUS
  • BIG problem for fetus if mother has

Source: nasopharyngeal secretions, blood, stool, urine

Transmission: DROPLET precautions and contact

Live vaccine given at 12-15 months and to women 3 months prior to getting pregnant

27
Q

What are the defining the characteristics of Rubella?

A
  • Low grade fever
  • Headache
  • Malaise
  • Sore throat, anorexia
  • Rash: pink-red maculo-papular first on face then progresses downward, by third day usually gone
28
Q

What is the therapeutic management for Rubella? What is the biggest complication?

A

Antipyretics

Supportive care/symptom management

Isolate from pregnant

Complication: danger to fetus

29
Q

Describe Pertussis (whooping cough). Pathogen? Source? Transmission? Vaccine?

A
  • Bacteria
  • Source: Respiratory secretions

Transmission: DROPLET and contact

-NOT a live vaccine; Dtap and TdaP (ok for immunosuppressed patients)

  • Given around 2 months to babies
  • Women should have it in 3rd trimester

-Boosters ever 5-10 years

Most dangerous < 6 months of age

30
Q

What are the defining characteristics of Pertussis?

A

Prodromal stage: URI symptoms, low grade fever

Infection stage: dry hacking cough, continues for 1-2 weeks

31
Q

What is the therapeutic management of Pertussis?

A

Antimicrobial therapy (azithromycin)

Supportive therapy: hospitalization for all infants and children who are dehydrated

Bedrest, oxygen, humidity, adequate fluids

32
Q

What are the nursing interventions for Pertussis?

A
  • Isolate child
  • Droplet and contact precautions
  • Restful environment
  • Encourage fluids in small amounts
  • Suction as needed
  • Observe for signs of airway obstruction
33
Q

Describe Streptococcal Pharyngitis. What is the agent? Signs and symptoms? How it is treated?

A

Agent: Group A Beta hemolytic strep
-Cause by same organism as scarlet fever

  • Razor like pain in throat
  • Highly contagious
  • White spots on tonsils
  • Ruby Red oral cavity
  • Must be treated with antibiotics to prevent immune response - antibodies can attack own tissue (heart valves, kidneys, joints)
  • After 24 hrs can go back to school, etc.
34
Q

Describe Scarlet Fever. Agent? source? transmission? treated how?

A

Agent: Group A Beta hemolytic strep
Source: Naso-pharyngeal secretions
Transmission: Droplet and contact

  • antibodies can attack own tissue (heart valves, kidneys, joints)
  • Treated with antibiotics (penicillin)
35
Q

What are the defining characteristics of Scarlet Fever?

A
  • Strawberry tongue and rash! (picture tongue like strawberry with little bumps)
  • Rash appears ~12 hrs after fever: pin head red lesions
  • Abrupt fever, possibly vomiting
  • Headache, chills, abdominal pain
  • Tonsils enlarged, reddened
36
Q

What are the nursing interventions and therapeutic management for both Scarlet Fever and Streptococcal Pharyngitis? Complications?

A

Droplet precautions for first 24 hrs

Administer oral antibiotic therapy (Penicillin)

Contagious until antibiotic given for 24 hrs

Relieve throat discomfort

Bedrest during febrile phase

Fluids during febrile period

Complications: glomerulonephritis, carditis, otitis media, peri-tonsilar abscess

37
Q

Describe Infectious Mononucleosis (“Mono”) including characteristics.

A

Agent: Epstein-Barr Virus
Source: Oropharyngeal secretions
Stand precautions only

Incubation period of 1-2 months

No vaccine

Characteristics: Malaise, sore throat, fever *splenomegaly, *fatigue, generalized lymphadenopathy

-Symptoms persist for 10 days - 6 weeks

38
Q

What are the nursing interventions and the therapeutic management of Mononucleosis?

A
  • Provide supportive care/comfort measures
  • Possible short use of penicillin
  • Analgesics
  • Rest and injury prevention** (for enlarged spleen)
  • Teach about adequate rest, injury prevention, and activity modification
39
Q

Describe Bacterial meningitis. When are vaccines recommended?

A

-Infection of membranes surrounding brain and spinal cord

  • Pneumococcal and HIB vaccines are recommended routinely starting infancy
  • Meningococcal vaccine is recommended routinely with one dose at adolescence
40
Q

What are the defining characteristics of bacterial meningitis and the complications?

A
  • Fever, chills, headache, vomiting
  • Seizures, irritability, photophobia
  • Nuchal rigidity (Pain or resistance when bending neck)
  • Possible altered LOC
  • Petechial pupular rash (bad sign that’s basically sepsis)
  • Joint pain

In infants - 2 years: Poor feeding, high pitched cry, seizures, fever, bulging fontanel

Complications: seizures, deafness, paralysis, sepsis

41
Q

What is the therapeutic management of Bacterial meningitis?

A
  • Droplet/contact precautions for at least 24 hrs
  • Prompt initiation of anti-microbial therapy AFTER lumbar puncture (after cultures)
  • Maintain hydration
  • Control seizures
  • Control temp
  • Early management of sepsis shock
42
Q

What are the nursing interventions for Bacterial meningitis?

A
  • Administer fluids and IV antibiotics
  • Droplet precautions
  • Dim lights for (photophobia), quiet environment
  • Analgesics for pain
  • Antipyretics
  • Perform neurological assessment and sepsis signs
  • I and O’s
43
Q

Describe Yeast infection and Tinea (ringworm) infection. Both funguses.

A

Yeast:

  • prevent with probiotics/acidophilus (good bacteria)
  • if thrush develops (oral candidias) use nystatin/mycostatin “swish and swallow”
  • Vaginal use the “azoles”
  • Infants use the “azoles”

Tinea (ringworm):

  • Contagious
  • Keep area dry clean
  • DON’T share clothes, towels, bed lines
  • Use topicals or flucanozole
44
Q

For what disease/virus would you give vitamin A supplementation too?

A

Measles

45
Q

How is meningitis Dx’d?

A

lumbar puncture

Nursing 3 Exam 4 (9 decks)

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