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NP5. SFC. Test 3

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