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ADN005 Pediatrics > Week 2 Chapter 37 > Flashcards

Week 2 Chapter 37 Flashcards

1
Q

Types of Infectious Diseases

A

Bacterial
Viral
Zoonotic and Vector Borne
Parasitic and helminthic
STIs

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2
Q

Infectious process

A

Organism Enters and multiplies
Causes damage to tissues and cells
Body response -1. Vascular -2. Cellular

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3
Q

1st line of defense and phagocytic cells

A

Granulocytes

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4
Q

Neutrophils including

A

Bands, segs, and PMNs

Eosinophils, basophils

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5
Q

Produce and maintain immune response, respond to viral infections

A

Lymphocytes

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6
Q

Produce antibodies and bind to neutralize antigen

A

B Cell

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7
Q

T Cell

A

Attack antigen directly

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8
Q

NK cells (innate immunity)

A

Destroy foreign material

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9
Q

Second line of defense and responds to larger and more severe infections

A

Monocytes

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10
Q

Infection stimulates the release of the endogenous pyrogens

A

Fever

(interleukins, tumor necrosis factor, and interferon)

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11
Q

Pyrogens act on the hypothalamus and trigger prostaglandin production, which increases the body set of temperature

A

True

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12
Q

Vasoconstriction is response

A

Cold

Vasodilation is heat response

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13
Q

Decrease heat loss and allow the body’s temperature ….

A

Rise to the new set point resulting in fever

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14
Q

General Guidelines of fever

A

Any temperature above 38.1 C

Infants younger than 3 months >38C < 36C SEE DOCTOR!!!

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15
Q

How many times do you asses temperature?

A

Every 4-6 hours

Use same site and device
Assess I and Os
Keep linens and clothing clean and dry

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16
Q

Acetaminophen recommended dose

A

10-15 mg/ kg
Every 4-6 hours

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17
Q

Ibuprofen 5-10 mg/ kg dose

A

Every 6-8 hours

No more than 4 doses in 24 hour period

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18
Q

Stages of Infectious Diseases

A

Incubation - Entrance
Prodrome- Nonspecific symptoms
Illness- S/S of disease
Convalescence - Acute symptoms begin to disappear

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19
Q

Methods of Preventing Infectious Disease

A

Hand Washing
Adequate Immunizations
Proper Handling of food
Judicious Antibiotic

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20
Q

Chain of Infection

A

Infectious Agent
Reservoir
Portal of Exit
Mode of Transmission
Portal of Entry
Susceptible Host

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21
Q

Limiting Spread of Infections

A

Standard - Tier 1
Transmission based- Tier 2
Airborne
Droplet
Contact

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22
Q

Pediatric physiology and Immune System

A

More susceptible of infection

Newborns display decreased inflammatory response to invading organisms, contributing increased risk for infection

Infant limited exposure and loses passive immunity=Higher risk of infection

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23
Q

Cellular immunity is generally functional at birth

A

True

Humoral occurs when body encounters and then develops immunity to new disease

Disease protection from immunization is incomplete

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24
Q

Common Treatments and Medications for Infectious Disorders

A

Tx
Hydration and Fever Reduction

Medications
Antibiotics
Antivirals
Antipyretics
Antipruritic

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25
Q

What information is obtained in health Hx?

A

Past medical Hx, birth hx, family hx, previous illness or surgery

Hx of current illness

S/S

Any changes in usual behaviors
Any known exposure

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26
Q

Assessments made during a physical exam include

A

Inspection and observation
Skin, mouth, throat, and hair lesions or wounds
Hydration status and vital signs

Palpation
Skin
rash
lymph nodes

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27
Q

Common Labs for Infections

A

CBC
ESR
CRP
Blood Culture Sensitivity
Stool Culture
Urine Culture
Wound Culture
Throat Culture
Nasal Swabs
LP
Chest X Ray

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28
Q

Sepsis

A

Systemic overresponse to infection from bacteria and viruses and can lead to septic shock

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29
Q

Septic Shock can lead to

A

Hypotension, low blood flow, and multisystem organ failure

Most common causative agents
- E Coli, Group Strep, Staph A, Nessieria Meningitiidis

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30
Q

Infants less than 1 month of age, immunocompromised children, children with chronic condition, and children with an indwelling catheter are at a higher risk

A

True

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31
Q

Therapeutic Management of Sepsis

A

Admitted for close monitoring
IV antibiotics started immediately (after cultures obtained)

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32
Q

Lab and Diagnostic Tests for Sepsis

A

CBC Count: WBC Usually elevated
C Reactive Protein: Elevated
Blood Culture: Positive in Septicemia
Urine Culture: May be positive
CSF Analysis: May reveal increased WBCs and protein and low glucose
Stool Culture: May be positive for bacteria or other infectious organisms
Culture of tubes, catheters, or shunts suspected to be infected
Chest Radiograph: May reveal signs of pneumonia

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33
Q

Bacterial Infections

A

Children are at high risk of developing bacterial infections, which can result in life threatening illness

Community Acquired MRSA
Scarlet Fever
Diphtheria
Pertussis
Tetanus
Pertussis
Tetanus
Botulism
Osteomyelitis
Septic Arthritis

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34
Q

Minor skin rashes to abscesses to serious, life- threatening infections
- Sepsis, necrotizing pneumonia, osteomyelitis

A

CAMRSA

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35
Q

Direct person to person contact, resp. droplets, blood or sharing personal items (hairbrushes, towels, sports equipment)

A

CAMRSA

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36
Q

Best Barriers for CAMRSA

A

Intact Skin and mucous membranes
Proper hand hygiene

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37
Q

Diagnosis of CAMRSA

A

Through culture
I & D, aspiration, culture

Tx with antibiotics

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38
Q

Group A streptococci
Throat Infection (strep)

A

Scarlet Fever

Streptococcal skin infection (rare)

Bacteria produces a toxin that causes a rash

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39
Q

5-15 years of age, rare in children less than 3

A

Scarlet Fever

40
Q

S/S of Scarlet Fever

A

Fever >101, chills, body aches, loss of appetite, N/V, sore throat, strawberry tongue, sandpaper rash

Complications: Rheumatic Fever, glomerulonephritis

41
Q

Therapeutic management of Scarlet Fever

A

PCN, erythromycin
Hydration, comfort measures (cool mist humidifier, popsicles, soup)

42
Q

Diphtheria Nursing Management

A

Administration of antibiotics and antitoxin
Droplet Precautions

43
Q

Corynebacterium diphtheriae bacteria in airway

A

Diphtheria

44
Q

S/S of Diphtheria

A

Nasal discharge, sore throat, weakness, fever, headache, bluish skin, swollen neck “Barking “ cough. Painful swallowing and difficulty breathing.

45
Q

Prevention of Diphtheria

A

DtaP vaccine injections plus TdaP adult booster

46
Q

Complications of Diphtheria

A

Airway blockage, pneumonia, heart damage, nerve damage, paralysis, death.

47
Q

Epidemiology of Diphtheria

A

Spread via direct contact or through the air

Bacteria produce diphtheria toxin which prevents normal cell function

outbreaks are rare but still occur among unvaccinated populations

6-7 avg. number of people are infected person will infect while contagious

5-20 % rate of fatality depending on age
50% rate of fatality prior to vaccine and modern medication

48
Q

Pertussis

A

Whooping cough. Bordetella Pertussis bacteria in upper respiratory.

49
Q

Symptoms Pertussis

A

Low fever
Runny nose
Mild Cough
Apnea
Coughing fits ending in a “whoop” vomiting exhaustion

50
Q

Prevention of Pertussis

A

DTaP vaccine injections plus Tdap adult booster

51
Q

Complications of Pertussis

A

Earache, pneumonia, encephalopathy, seizures, cerebral hypoxia, fractured ribs, failure to thrive, death.

52
Q

Therapeutic Management Pertussis

A

Infants< 1 month
-azithromycin
Infants> 1 month
- erythromycin
- clarithromycin
- azithromycin

Nursing management
- High humidity
- Suctioning
- Observe for airway obstruction
- Encourage fluids
- Droplet Precautions

53
Q

Epidemiology

A

Spread via coughing, sneezing, and other close contact

54
Q

Tetanus

A

Lockjaw cause clostridium tetani bacteria and its toxin

55
Q

Symptoms of Tetanus

A

Muscle Spasms in jaw, face, throat, chest, neck, back, abdomen, buttocks, fever, trouble swallowing, rapid heart rate, incontinence

56
Q

Prevention of tetanus

A

DTaP vaccine or tetanus toxoid vaccine

57
Q

Complications of Tetanus

A

Prolonged muscle contractions and tears , fractures, suffocation, heart attack, death.

58
Q

Epidemiology of Tetanus

A

Bacteria in soil enter flesh via a wound from contaminated object

59
Q

Therapeutic Management of Tetanus

A

Support Respiratory and CV function
Stopping toxin production
Neutralizing unbound toxins
Controlling muscle spasms
Administer tetanus immunoglobulin and tetanus vaccine
IV antibiotics
- Standard precautions

60
Q

Toxin is produced in the immature intestines of young children resulting from infection of Clostridium Botulinum

A

Botulism

61
Q

Rare but can cause serious paralytic illness of arms, legs, trunk, and respiratory system if left untreated

A

Botulism

62
Q

Infant botulism is the most common in the United States and result from the ingestion of bacterial spores in environmental dust/ soil

A

Botulism

63
Q

S/ S of Botulism

A

Infants- constipation, poor feeding, listlessness, generalized weakness, weak cry

Older Children- Double blurred vision, drooping eyelids, difficulty swallowing, slurred speech, muscle weakness

64
Q

Therapeutic Management of Botulism

A

Supportive- maintaining respiratory and nutritional status
- Administration of botulinum immune globulin or botulism antitoxin

65
Q

Bacterial infection of the bone and soft tissue

A

Osteomyelitis

S. Aureus most common, MRSA on the rise

Spread through the blood

66
Q

S/S Osteomyelitis

A

Irritability, lethargy, fever, onset of pain, refusal to walk, decreased ROM, swelling, warmth and tenderness to affected bone.

67
Q

Therapeutic Management of Osteomyelitis

A

Therapeutic management

Aspiration is necessary to confirm diagnosis and identify microbes

4-6 week course of antibiotics

Pain assessment and management

68
Q

Condition in which bacteria invade the joint space, most often the hip or knee

A

Septic Arthritis

Usually occurs in children younger than 3 years old

69
Q

Bacteria gain access to the joint through the bloodstream or direct puncture from injections, venipuncture, wound infection, surgery or injury

S. Aureus is the most common

A

Septic Arthritis

70
Q

When is Septic Arthritis considered a medical emergency?

A

Destruction of the joint cartilage can occur within a few days

71
Q

S/S Septic Arthritis

A

Ill- appearing, fever, pain, refusal to bear weight or straighten the affected extremity, joint swelling and warmth

72
Q

Complications of Septic Arthritis

A

Permanent deformity, leg length discrepancy, long term decreased ROM

Therapeutic Management
- Pain management
-IV antibiotics
- PT, crutch teaching

73
Q

Viral Infections Occurring in Children

A

Viral Exanthems- characteristic rashes found in certain viral illnesses

Rubella (German)
Rubeola ( measles, has Koplik spots)
Varcella Zoster
Parvovirus B19 (slapped cheek or 5th disease)
Roseola Infantum ( exanthem subitum or sixth disease)

74
Q

German measles caused by virus

A

Rubella Virus

75
Q

S/S Rubella

A

Low fever
rash
swollen glands
joint pains
headache

Prevention with MMR Vaccine and injection

76
Q

Complications of Rubella

A

Congenital rubella syndrome in fetus

Blindness, deafness, heart disease, intellectual disability, death

77
Q

Spread via coughing, sneezing, and other close contact

A

Epidemiology

Typically mild and short of duration

78
Q

Measles

A

Grows in cells that line lungs and back of throat

Spread via coughing, sneezing, and other close contact

Prevention with routine MMR vaccine

79
Q

Complications of Measles

A

Pneumonia bronchitis
Deafness
Brain inflammation ( Encephalitis)
Corneal Ulceration ( Blindness )
Death

  • Leading cause of vaccine preventable deaths worldwide
80
Q

Rash appears on the hairline and spreads cephalocaudally over 3 days
Kolpik spots on oral mucosa

Conjunctivitis cough
coryza
Fever

A

Rubeola Ordinary Measles

81
Q

Headache
Low grade fever
Sore throat
Coryza
Lymphadenopathy

Rash begins on face and spreads cephalocaudally

Forehammer spots on soft palate

A

Rubella German Measles

82
Q

Varicella

A

Cause varicella zoster virus in nerve fibers

83
Q

Symptoms of Varicella

A

Rash
Burning pain
itchy blisters
high fever
tiredness
loss of appetite
headache

Prevent with varicella vaccine at 12 months and 4 years

84
Q

Complications of Varicella

A

Dehydration
Permanent scarring
Pneumonia
Brain inflammation
Skin bone, joint and infections
Death

85
Q

Spread via coughing, sneezing, and physical contact and highly contagious

A

Varicella

Remains in nervous system and likely to lead to shingles outbreaks later in life

86
Q

5th Disease Rash

A

Erythema infectious is sometimes called “ slapped cheek disease”

2-3 distinct phases

  1. Bright red rash occurs on the side of the face and sometimes on the forehead and chin. Gone in 5 days.
  2. Then appears on the neck, trunk, forearms, upper legs, and buttocks. Rash starts as round red spots and begins to take on lacy look. Itchy and older children.
  3. Body rash fades. It may come back if the person is out in the sun, gets too warm, or is under stress. 1-3 weeks. Even though a rash comes back does not illness is worse.
87
Q

Virus that grows in parotid glands

A

Mumps

Prevention MMR Vaccine at 12 months and 4 years

88
Q

Symptoms and Complications of Mumps

A

Low fever
Headache
Malaise
Dry mouth
Swollen salivary
Sore face
Earache

Complications
Testicular Swelling
Meningitis Encephalitis
Pancreatitis
Hearing loss
Death ( rare in US)

89
Q

Many childhood diseases both viral and bacterial can be prevented with adequate

A

Immunization

90
Q

Many vaccinations require multiple doses

A

True

91
Q

Immunizations can prevent

A

DTP
MMR
Varicella
Poliomyelitis
Others

92
Q

Diseases caused by infectious agents that are transmitted directly or indirectly from animals or vectors, such as ticks, mosquitos, or other insect vectors to humans

A

Zoonotic and Vector Borne Infections

93
Q

Types of Zoonotic and Vector Borne Infections

A

Rabies
- 4 doses rabies vaccine, rabies immune globulin

Cat Scratch Disease- Cats carry bacteria in their saliva
- Lymphadenopathy- antibiotics

Lyme Disease- Bite from deer tick
- Less than 8 years amoxicillin
- More than 8 years doxycycline

Rocky Mountain Spotted Fever- dog and wood tick

94
Q

Teaching guidelines for Tick Removal

A

Use fine tipped tweezers
Protect fingers with tissues, paper towel, or latex
Grasp as close to skin as possible and pull upward with steady, even pressure
Do not twist and jerk
Once removed, clean site with soap and water and wash your hands
Save the tick for identification in case the child becomes sick. Note date of tock bite

95
Q

Parasitic and Helminthic Infections

A

Parasitic Infections
- Pediculosis capitis- Pediculicide
- Pediculosis pubis
Scabies- Peremetherin

Heleminthic
Pinworm- anal itching- mebendazole
Hookworm- Cats and dogs; albendazole
Acariasis- Unsanitary conditions; mebendazole

96
Q

Key Teaching Points for a Child with an Infectious Disease

A

Assess child’s and family willingness to learn

Provide time for family to adjust
Repeat information
Teach in short sessions
Gear teaching to level of understanding to child
Provide rewards and reinforcement
Use multiple modes of learning involving many cases

ADN005 Pediatrics (21 decks)

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