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infect.dis.child
NP5. SFC. Test 3
| Question | Answer |
|---|---|
| At age 3 to 6 months infection rate | increases |
| Toddler and preschool ages have ahigh rate of ______ infections | viral |
| >5 years have an increase in what infections? | mycoplasma pneumonia and β-strep infections |
| Primary prevention of disease | Immunization |
| Otitis Media Common organisms include | Streptococcus pneumoniae, Haemophilus influenzae,and Moraxella catarrhalis |
| Otitis Media s/sx include | otalgia, fever, otorrhea, crying, fussy, tendency to pull or rub ear, rolls head from side to side, staggering gait |
| Otitis Media Patho | acute inflammation of middle ear with rapid onset of s/sx |
| Dx of OM | immobile, red or yellow bulging TM |
| For children < 3 y/o pull ears ______ & ______ to administer ear drops | down & back |
| For childern > 3 y/o pull ears ________ & ______ to administer ear drops | up & back |
| Therapeutic managament of OM | High dose amoxicillin (1st line therapy), Myringotomy (insertion of P.E tubes) if chronic OM |
| Chronic OM can lead to | vertigo, diff. hearing, hearing loss, tinnitis |
| Patho Meningitis | Acute inflammation of the meninges and CSF |
| Complications of Bacterial Meningitis include | hearing loss, brain damage, or learning disability |
| Clinical Manifestations of Meningitis in Children & adolescents include | Fever, Seizures, Alterations in sensorium, Photophobia, Nuchal ridity, Brudzinski sign, Kernig sign, Petechial rash(meningococcal) |
| Clinical Manifestations of Meningitis in Infant/young child include | Fever, Poor feeding, Bulging fontanel, Seizures, High-pitched cry, Vomiting |
| Clinical Manifestations of Meningitis in Neonate include | Poor sucking, Weak cry, Poor tone,Bulging fontanel |
| Therapeutic management for bacterial Meningitis | Isolation prec, antimicrobial therapy, hydration, control of seizures and temperture |
| Encephalitis patho | Inflammatory process of CNS with altered function of brain and spinal cord |
| Most frequent encephalitis causative organisms | viral |
| Encephalitis Vector reservoir in United States | mosquitoes |
| Clinical Manifestations of Encephalitis,Sudden or Gradual onset | Malaise,Fever, Headache/dizziness, Stiff neck, Nausea/vomiting, Ataxia, Speech difficulties |
| Clinical Manifestations Severe Encephalitis | High fever, Stupor/seizures, Disorientation/spasticity, Coma, Ocular palsies, Paralysis |
| Management of Encephalitis | Hospitalized for observation, Treatment is supportive, ICP monitoring may be required, Very young children may exhibit increased neurologic disability |
| Scarlet Fever Agent | group A beta-hemolytic streptococci |
| Scarlet Fever Transmission | droplet or direct contact.Nasopharangeal secretions. |
| Complications of Scarlet fever | carditis (Rheumatic Fever),peritonsillar abscess (emergency, can rupture),glomerulonephritis. |
| Scarlet fever Clinical Manifestations of Prodromal (1st)stage | high fever, vomitting, chills, abd pain, achy |
| Scarlet fever Clinical Manifestations of Enanthema (2nd) stage | rash on mucous membranes, tonsils red and enlarged, white strawberry tongue to red strawberry tongue |
| Scarlet fever clinical manifestations of Exanthema (3rd) stage | rash (fine sand papery), Pastia's lines (in creases, arm & groin area) |
| Treatment for Scarlet fever (abx) | Penicillin or Cephalosporin |
| dx of scarlet fever | thoart culture & characteristics of rash |
| When rash from scarlet fever disappears the ______ & _______ peel | hands & feet |
| Rheumatic Fever Occurs post what infection? | group A beta-hemolytic strep infection |
| Most significant complicationn of rheumatic fever is | cardiac valve damage. |
| Prevention of rheumatic fever includes | proper treatment of GABHS infection, take full dose of abx |
| Diagnosis of rheumatic fever includes | Jones Criteria, rising antistreptolysin O titer (ASO titer) |
| the drug of choice for rheumatic fever is | penicillin |
| Impetigo Contagiosa is caused by what organism? | Staphylococci |
| Impetigo contagiosa rash is identifed as | Easily ruptured vesicles that have honeycolored crusts |
| Treatment for impetigo includes | topical abx and/or oral |
| Impetigo is Common in | toddlers and preschoolers and thoose with broken, fragile skin |
| Diphtheria is caused by what Agent? | Corynebacterium diptheriae |
| Diptheria is Transmitted by | direct contact with infected person/article. Discharge from nasopharynx,skin, or lesions. |
| Diptheria is not communicalbe when | 3 nose, thoart, and skin cultures come back negative |
| Treatment for diptheria includes | equine antitoxin and antibiotics(penicillin G or erythromycin) |
| s/sx of diptheria includes | headache, swollen lymphnodes (bulls neck), diff swallowing, sore thoart, muscle weakness, grayish membrane in thoart, hoarseness, diff breathing |
| Nursing considerations for diptheria includes | monitoring for s/sx of obstruction |
| Pertussis (Whooping Cough) is caused by what Agent? | Bordetella pertussis |
| Pertusis is Transmitted by | droplet or direct contact,respiratory tract discharge. |
| Incubation period of pertusis is | 6 to 20 days. Most communicable during catarrhal stage |
| Pertusis cough is characterized as | Short, rapid coughs followed by crowing or “whoop” sound |
| pertusis is Suspected in a child with a cough > | 2 weeks |
| Catarrhal stage of pertusis is first 1-2 weeks that include s/sx of | upper resp cold, runny nose, sneezing, congestion etc. infants present with apnea and resp distress |
| paroxysmal stage of pertusis is the second stage that lasts 4-6 weeks and includes s/sx of | classic coughing and whooping spells (usually at night), post tusis vomiting |
| convalescent stage of pertusis is the third stage that is characterized by | a chronic cough that becomes less paroxysmal (fewer sudden outbursts of coughing) in nature |
| Treat Pertussis with a | macrolide, but does not completly get rid of cough. if given early will decrease severity |
| Diagnosis of pertussis consists of | s/sx and culture of nasopharyngeal |
| Complication of pertussis includes | pneumonia (usual cause of death) |
| If come in contact with pertussis treat with ______ abx to prevent | zythromycin |
| Tetanus "lock jaw" is caused by what agent? | Clostridium tetani |
| Tetanus is characterized by | Painful muscular rigidity, trismus |
| Tetanus is transmitted by | Entering body via wounds |
| Tetanus is treated with Aggressive supportive therapy with attention to | airway and respiratory support |
| Prevention of tetanus includes | Tetanus immunizations every 10 years Dtap or Tdap vaccine |
| S/Sx of rhematic fever include | Fever, Painful and tender joints. Small, painless nodules beneath the skin, CP, palpitations, Fatigue, SOB,painless rash with a ragged edge. Jerky, uncontrollable body movts(hands, feet and face),unusual behavior(crying or inappropriate laughing) |
| Chickenpox (Varicella)Agent | Varicella-zoster virus |
| Transmission of chickenpox (varicella) | direct contact, airborne.Respiratory tract secretions and lesions. |
| Chicken pox (varicella) is Communicable | 1 day before eruption and 6 days after eruption or when lesions crust up |
| Chickenpox (varicella) Occurs primarily in children under | 15 years of age |
| Clinical Manifestation of chickenpox (varicella) in Prodromal stage (1st) includes | slight fever, tiredness |
| Clinical manifestation of chickenpox (varicella) in Eruptions stage (2nd) includes | emacule rash to papules to vesicles which ruptures and eventually crusts over |
| Chickenpox rash starts in center then spreads outwards, it is not common on (parts of body) | distal extremities (hands, feet) |
| Treatment/nursing care for chickenpox (varicella) includes supportive care and _______ or _________ or ________ if immunocompromised | VariZig or Acyclovir or IGIV |
| Complications of chickenpox (varicella) includes | Secondary bacterial infection from scratching,encephalitis, pneumo, & hemorratic varicella if immuno comprimised |
| Measles (Rubeola) Agent | virus |
| Measles (Rubeola)Source | respiratory, blood, urine secretions. droplet transmission |
| Measles (rubeola)Incubation period is | 10 to 20 days |
| Measles (rubeola) is communicability from | 4 days before to 5 days after appearance of rash |
| In Measles (rubeola)what spots appear 2 days before rash? | Koplik’s, sm. irrg. red spots with bluish white center, in mouth next to molars |
| measles (rubeola) rash starts at hair line and moves | down to toes over a 3 day period |
| Measles Catarrhal (prodrome) phase is characterized by | fever, runny nose, sneezing, URI symptoms |
| Measles (rubeola) Rash phase appears day | 3-4 of illness |
| Treatment/Nursing Care of measles (rubeola) includes | Supportive, Dim lights if photophobia present, Antipyretics for fever, monitor for febrile seizures |
| Rubella (German Measles)Agent | rubella virus |
| Rubella (German measles) Transmission | direct contact or indirect contact with article freshly contaminated with nasopharyngeal secretions, blood, stool, or urine |
| Rubella (German measles) Incubation & communicable period | 14 to 21 days.Communicable 7 days before and 5 days after. |
| Rubella (German measles)Complications | rare greatest danger is teratogenic effect on fetus. Rubella is the most benign communicable childhood disease |
| Measles (Rubeola) rash involves the ______ & ______ of feet and hands | palms and soles |
| Rubella's (German Measles) Prodromal stage s/sx consists of | fever, headache, not feeling well |
| Rubella's (German Measles) Rash first appears on | face, then spreads down. Disappears from face down |
| Rubella's (German Measles) treatment consists of | No treatment necessary |
| Mumps Agent | paramyxovirus |
| Mumps Transmitted via | droplet or direct contact,saliva |
| Mumps Incubation & communicable period | 14 to 21 days,communicable right before and after swelling begins |
| Mumps s/sx | Fever, headache, malaise, followed by parotitis |
| Mumps May cause | orchitis and meningoencephalitis |
| Poliomyelitis Agent | enterovirus |
| Poliomyelitis Transmission | feces, oropharyngeal secretions. Direct contact. Fecal-oral. |
| Poliomyelitis communicable & Incubation period | 7-38 dyas. Not sure how long communicable for. 4-6weeks in feces. |
| Poliomyelitis has 3 forms | Abortive or inapparent- feel sick, fever, headache, n/v/d, lasts few hours to few days. Nonparalytic- more severe s/sx of abortive but including neck, back & muscle stiffness and aches. Paralytic- s/sx same as above but including paralysis. |
| Tx for Poliomyelitis includes | Supportive treatment |
| pt with poliomyelitis will be on what contact precautions? | enteric prec |
| Infectious Mononucleosis Agent | Epstein-Barr virus |
| Infectious Mononucleosis Transmission | saliva. Not sure how long communicable for. |
| Infectious Mononucleosis Incubation | 4-6 weeks. |
| Infectious Mononucleosis s/sx | Fever, fatigue (severe), sore throat, enlarged tonsils, macular rash, may cause Lymphadenopathy and hepatosplenomegaly |
| Education for Infectious Mononucleosis with complications of hepatosplenomegaly to a patient includes | for up to 4-6 weeks no contact sports |
| Dx of Infectious Mononucleosis includes | EBV titers, Monospot (can only be done in first few days) |
| Infectious Mononucleosis Most significant complication is | splenic rupture |
| Reyes Syndrome is defined as | Toxic encephalopathy with Cerebral edema and fatty liver changes. |
| Reyes Syndrome Starts with profuse | vomiting and varying degrees of neurologic impairment. |
| Definitive diagnosis of Reyes syndrome includes | Liver biopsy and neurological signs (lethargy to coma). |
| Reyes Syndrome is Associated with the use of what medication in children? | aspirin therapy for treatment of fever in children with varicella and influenza. |
| Reyes syndrome Goal of therapy is to | maintain cerebral perfusion |
| Ingestions of Injurious Agents is Major cause of death in children (age) | <5years |
| Most common reason ingestion occurs | Improper storage! |
| In what age group does infectious mononucleosis affect the most severe? | adolescents |
| Most important principle of dealing with poisoning to treat the _____ first, then the ______. | child, poison |
| Activated charcoal is used for ingestion of injurious agents because it acts by? use of increases risk for? | binding to substances, odorless, tasteless. Risk for constipation, aspiration, or bowel obstruction |
| Tx for Lead & Iron poisoning | Chelation therapy (binds to heavy metals) |
| Lead poisioning Screen all children at age | 1 and 2 years |
| The signs and symptoms of lead poisoning in children may include | Irritability, Loss of appetite, Weight loss, Sluggishness and fatigue, Abdominal pain, Vomiting, Constipation, Learning difficulties. |
| The signs and symptoms of lead poisoning in newborns who are exposed to lead before birth may experience | Learning difficulties & Slowed growth |
| Indigestion of Tylenol damages the | liver |
| Antidote for tylenol indigestion includes | N-Acetylcysteine (Mucomyst) |
| may remain symptom free for up to 24 hours after taking a toxic overdose of acetaminophen (tylenol). After this period, the following symptoms are common in Tylenol poisoning | Nausea, Vomiting,Not feeling well, Not able to eat or poor appetite, Abdominal pain |
| Symptoms of acute overdose for Aspirin may include | Upset stomach and stomach pain, Nausea,Vomiting -- may cause an ulcer or gastritis |
| Symptoms of chronic Aspirin overdose may include | Fatigue, Slight fever, Confusion, Collapse, Rapid heart beat, Uncontrollable rapid breathing |
| Large overdoses of aspirin may also cause | Ringing in the ears, Tempoary deafness, Hyperactivity, Dizziness, Drowsiness, Hyperactivity Seizures, Coma |
| Clinical manifestations of Iron overdose includes | Black &/or bloody stools, Diarrhea, Metallic taste in mouth, Nausea, Vomiting blood, Dehydration, Low bp, Rapid & weak pulse, Shock, Chills, Coma,Convulsions, Dizziness, Drowsiness, Fever, H/A, fatigue, cyanotic lips & nails, Flushing, pallor. |
| Hepatitis B immunization route | IM |
| Hepatitis B immunization starts at what age? | birth to 1 month |
| Contraindications for Hepatitis B vaccine includes | severe reaction to previous dose, allergy to bakers yeast, moderately or severely ill |
| S/Sx Adverse reaction to hepatitis B vaccine includes | soreness at site, temp of 99.9f or higher, anaphylaxis (severe, uncommon) |
| Rotavirus immunization route | oral |
| Contraindications for Rotavirus vaccine includes | weakened immune sys, severe combined immunodeficiency, mod to severe illness |
| Adverse reactions to rotavirus vaccine includes | mild temp diarrhea, irritable |
| Dtap (kids) or Tdap (>11 years) route | IM |
| Dtap (kids) or Tdap (>11 years) starts at | 2 months |
| Dtap (kids) or Tdap (>11 years) contraindications | brain or nervous sys dz w/in 7 days of previous dose, seizure or callapsed, cried nonstop for 3 hrs, fever > 105 after a dose |
| Dtap (kids) or Tdap (>11 years) adverse reactions | redness fussiness, vomiting, non-stop crying for 3 hrs, fever >105f, perm brain damage (rare) |
| Haemophilus influenza type b (HIB) vaccine route | IM |
| Haemophilus influenza type b (HIB) vaccine is given to prevent | OM, meningitis/encephalitis |
| Is Haemophilus influenza type b (HIB) vaccine required? | yesss!!! |
| contraindications of Haemophilus influenza type b (HIB) vaccine | severe reaction to previous dose, mod to severely ill |
| Adverse reactions to Haemophilus influenza type b (HIB) vaccine | redness, warmth at site, fever over 101f, anaphylaxis (severe, uncommon) |
| Pneummococcal (prevnar) immunization is required in what setting? | daycares |
| Pneummococcal (prevnar) immunization starts | 2 months |
| Pneummococcal (prevnar) immunization route | IM |
| Contraindications for Pneummococcal (prevnar) immunization | allergy to vaccine containing diptheria toxoid, mod to severe illness |
| Adverse reactions to Pneummococcal (prevnar) immunization | swelling, fussiness, mild fever as high as 102.2f |
| Inactivated Polio vaccine starts | 2 months |
| Inactivated Polio vaccine route | IM or SC |
| Is Inactivated Polio vaccine required? | yess |
| Contraindications for Inactivated Polio vaccine | allergic to neomycin, streptomycin or polymyxin B, mod to severe illness |
| Adverse reactions of Inactivated Polio vaccine | soreness at site, high fever or unusual behavior(not known to cause serious s/e) |
| Measles, Mumps, Rubella (MMR) vaccine route | SC |
| Measles, Mumps, Rubella (MMR) vaccine starts | 1 year |
| Contraindications for Measles, Mumps, Rubella (MMR) vaccine | allergy to gelatin, neomycin, steroids, HIV, low platelet count, recent blood transfusion |
| Adverse reactions to Measles, Mumps, Rubella (MMR) vaccine | fever, rash, seizures, temp joint pain (severe very rare: deafness, brain damage, coma) |
| Varicella (chickenpox) vaccine route | SC |
| Varicella (chickenpox) vaccine starts | 1 year |
| Contraindications for Varicella (chickenpox) vaccine | allergy to gelatin, neomycin, steroids, HIV, cancer, pregnant, low platelet count, recent blood transfusion |
| Adverse reactions to Varicella (chickenpox) vaccine | fever, rash, seizures, pneumonia(rare) |
| Hepatitis A vaccine starts | from 1 year |
| Hepatitis A vaccine route | IM |
| Contraindications/Precautions for Hepatitis A vaccine | pregnant, severe reaction to prev dose, mod or severely ill, latex allergy |
| Adverse reaction to Hepatitis A vaccine | mild h/a, soreness, tiredness, loss of appetite, anaphylaxis (severe, uncommon) |
| Meningcoccal vaccine starts | from 11 years |
| Meningcoccal vaccine route | IM |
| Contraindications for Meningcoccal vaccine | prev. severe reaction |
| Adverse reactions to Meningcoccal vaccine | redness, pain at site, mild fever |
| Influenza (inactivated) vaccine starts | from 6 mo |
| Influenza (inactivated) vaccine route | IM |
| Contraindications for Influenza (inactivated) vaccine | egg allergy, guillain-barre symptoms, guillian-barre syndrome |
| Adverse reactions to Influenza (inactivated) vaccine | soreness, fever, febrile seizure, flu like symptoms, guillain-barre syndrome |
| Influenza (live) vaccine starts | from 2 years |
| Influenza (live) vaccine(live) route | intranasally |
| Contraindications for Influenza (live) vaccine | under 2 y/o, pregnant, weakened immune system, children <5 yrs w/ asthma or episodes of wheezing w/in past yr, aspirin therapy, egg allergy, guillain-barre, mod or severe illness |
| Adverse reactions for Influenza (live) vaccine | soreness, fever, flu like symtoms |
| Human papillomavirus (gardasil & cervarix) vaccine starts | from 9 years |
| Human papillomavirus (gardasil & cervarix) vaccine route | IM |
| Contraindications for Human papillomavirus (gardasil & cervarix) vaccine | pregnant, yeast allergy(gardasil), latex allergy (cervarix), mod to severe illness |
| Adverse reactions to Human papillomavirus (gardasil & cervarix) vaccine | pain, redness, swelling, h/a, fainting. req to sit for 15 min after shot to prevent fainting |
| AAP reccomends the use of ________ in boys to prevent genital warts | gardasil |
| Scarlet fever incubation & communicable period | Incubation period: 1 to 7 days. infectious during incubation & illness. carriers can be infectious for months |
Created by:
stilsl
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