Exam 12: Peds Communicable Diseases
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| Chickenpox (Varicella-zoster): viral (Source) | Primarily secretions of the respiratory tract of infected persons; to lesser degree skin lesions (scabs not infectious).
1)Direct contact.
2)Droplet (airborne) spread.
Contaminated objects.
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| Chickenpox (Varicella-zoster): viral (Signs & Symptoms) | (a)Begins with mild fever.
(b)Macules, papules, vesicles, and pustules filled with clear fluid 36 hours after the fever.
(c)Scabs form later.
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| Chickenpox (Varicella-zoster): viral (Contagious Period) | probably 1 day before eruption of lesions to 6 days after first crop of vesicles when crusts have formed
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| Chickenpox (Varicella-zoster): viral (Interventions) | (a)Trim fingernails to prevent scratching.
(b)Do not remove scabs prematurely, may cause scaring.
(c)Administer calamine lotion.
(d)Isolate from others.
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| Chickenpox (Varicella-zoster): viral (Prevention) | (a)Vaccine is now routinely administered.
(b)Acyclovir (Zovirax) or immune globulin (VZIG) is given to immunosuppressed children who are exposed.
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| Diphtheria (Corynebacterium diphtheriae): Source | Contact with patient or carrier.
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| Diphtheria (Corynebacterium diphtheriae): S/S | (a)Common cold with purulent nasal discharge.
(b)Malaise.
(c)Sore throat.
(d)White or gray membrane forms in the throat, causing respiratory distress.
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| Diphtheria (Corynebacterium diphtheriae): Incubation Period | 2-5 days
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| Diphtheria (Corynebacterium diphtheriae): Contagious period | usually 2 weeks
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| Diphtheria (Corynebacterium diphtheriae): Interventions | (a)Observe for respiratory, cardiac, and CNS involvement.
(b)Identify contacts for treatment.
(c)Intravenous antibiotics and antitoxin.
(d)Isolate.
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| Diphtheria (Corynebacterium diphtheriae): Prevention | (a) DPT vaccine to all infants.
(b) Intravenous antibiotics and antitoxin.
(c) Tracheotomy required.
(d) Provide oxygen and suction as needed
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| Fifth disease (erythema infectiosum): human parvovirus B19 (HPV) (Source) | : respiratory secretions and blood, blood products of infected persons, mainly school-aged children.
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| Fifth disease (erythema infectiosum): S/S | (a) Child has "slapped check" appearance.
(b) Generalized rash appears, and then subsides.
(c) Rash may reappear if skin is irritated by sun or heat.
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| Fifth disease (erythema infectiosum): Incubation period | 4-14 days
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| Fifth disease (erythema infectiosum): Contagious Period | during incubation period
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| Fifth disease (erythema infectiosum): Interventions | (a) This is a benign condition unless child is immuno-compromised.
(b) Isolation not required.
(c) May last 1-3 weeks.
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| Fifth disease (erythema infectiosum): Prevention | None.
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| Roseola (exanthema subitum): herpes virus 6 HSV-6 (sixth disease) Source | possibly acquired from saliva of healthy adult person; entry via nasal, bucca, or conjunctival mucosa
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| Roseola (exanthema subitum): S/S | (a)Persistent high (103-105 F) fever that drops rapidly as the rash appears.
(b)Macupapular rash is non-pruritic and blanches easily.
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| Roseola (exanthema subitum): Incubation Period | 5-15 days
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| Roseola (exanthema subitum): Contagious | unknown but probably until rash fades.
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| Roseola (exanthema subitum): Interventions | (a)Rest and quiet should be provided.
(b)Teach parents:
1)Temperature reducing techniques.
2)Prevention of seizures.
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| Roseola (exanthema subitum): Prevention | none; high fever may precipitate convulsions.
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| Measles (Rubeola): virus (Source) | respiratory tract secretions, blood, and urine of infected person.
(a)Direct contact.
(b)Droplet (airborne) spread.
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| Measles (Rubeola): S/S | may be mild or severe with serious complications.
(a)Fever.
(b)Cough.
(c)Conjunctivitis.
(d)Koplik's spots: small red spots with white centers which appear on the inner cheeks.
(e)Maculopapular rash erupts.
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| Measles (Rubeola): Incubation Period | 2-3 weeks (10-20 days)
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| Measles (Rubeola): Contagious period | from 4 days before to 5 days after rash appears.
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| Measles (Rubeola): Interventions | (a)Symptomatic care.
(b)Isolate and provide quiet activities.
(c)Utilize measures to reduce eyestrain caused by photophobia.
(d)Detailed oral care.
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| Measles (Rubeola): Preventions | (a)Vaccine at 15 months.
(b)If exposed without vaccine, gamma globulin may be given after exposure.
(c)Vitamin A is recommended to reduce morbidity.
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| Mumps (parotitis): paramyxovirus (Source) | saliva of infected persons.
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| Mumps (parotitis): S/S | (a)Fever.
(b)Headache.
(c)Vomiting.
(d)Painful swelling of glands near ear and jaw line.
(e)Enlarged parotid gland.
(f)May be bilateral.
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| Mumps (parotitis): Incubation period | 14-21 days (18 days average)
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| Mumps (parotitis): Contagious period | : most communicable immediately before and after swelling begins.
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| Mumps (parotitis): Interventions | (a)Encourage fluids.
(b)Isolate.
(c)Ice compresses to neck for comfort.
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| Mumps (parotitis): Prevention | vaccine after 15 months of age (MMR).
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| German Measles, three-day measles (Rubella): rubella virus (Source) | (a)Primarily nasopharyngeal secretions of infected person; also present in blood, urine, and stool.
(b)Indirect contact with contaminated objects.
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| German Measles, three-day measles (Rubella): S/S | (a)Occasionally mild fever, headache, malaise and sore throat; cold symptoms may precede rash.
(b)Maculopapular rash: tiny, rose-colored rash.
(c)Enlarged glands at back of neck.
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| German Measles, three-day measles (Rubella): Incubation period | 2-3 Weeks (usually 18 days)
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| German Measles, three-day measles (Rubella): Contagious period | 7 days before to about 5 days after the rash appears.
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| German Measles, three-day measles (Rubella): Interventions | (a)Avoid exposing women in early months of pregnancy.
(b) Give plenty of rest and employ comfort measures:
1)Antipyretics.
2)Analgesics.
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| German Measles, three-day measles (Rubella): Prevention | (a)All infants should receive vaccine.
(b)Boosters at preschool age.
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| Polio (infantile paralysis for poliomyelitis): enteroviruses, three types (Source) | feces and oropharyngeal secretions of infected persons, especially young children.
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| Polio (infantile paralysis for poliomyelitis): S/S | (a)Headache.
(b)Fever.
(c)Stiff neck.
(d)Stiff back.
(e)Paralysis.
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| Polio (infantile paralysis for poliomyelitis): Incubation period | usually 7 – 14 days with range of 5 – 35 days average.
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| Polio (infantile paralysis for poliomyelitis): Contagious Period | (a)1 week for throat secretions.
(b)4 weeks for feces.
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| Polio (infantile paralysis for poliomyelitis): Interventions | (a)Isolate.
(b)Bed rest.
(c)Observe for respiratory distress.
(d)Position; physiotherapy.
(e)Range of movement exercises.
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| Polio (infantile paralysis for poliomyelitis): Prevention | (a)Start complete series of polio vaccines in infancy.
(b)May require respirator care.
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| Scarlet Fever: Group A beta-hemolytic Streptococcus bacteria (Source) | usually nasopharyngeal secretions of infected persons and carriers; direct contact or droplet ; indirectly by contact with contaminated articles or ingestion of contaminated milk or other food.
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| Scarlet Fever: S/S | (a)Tachycardia.
(b)Strawberry tongue.
(c)Pinpoint rash.
(d)Circumoral pallor.
(e)Desquamation.
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| Scarlet Fever: Incubation Period | 2-5 days with range of 1-7 days.
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| Scarlet Fever: Contagious period | (a)During incubation and clinical illness, approximately 10 days.
(b)During the first two weeks of carrier phase.
(c)May persist for months.
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| Scarlet Fever: Interventions | (a)Respiratory precautions.
(b)Bed rest; quiet activity.
(c)Teach regarding prevention of streptococcal infections.
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| Scarlet Fever: Prevention | (a)Penicillin therapy is given for 10 days.
(b)Culture/treat streptococcal infection.
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| Infectious Mononucleosis: Epstein-Barr virus (EBV) (Source) | : oral secretions, spread by direct contact only; evidence of spread through sexual contact, especially when multiple partners are involved.
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| Infectious Mononucleosis: S/S | (a)Low grade fever.
(b)Malaise.
(c)Jaundice.
(d)Enlarged spleen.
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| Infectious Mononucleosis: Incubation Period | approximately 30 – 50 days (4 - 6 weeks)
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| Infectious Mononucleosis: Contagious Period | unknown; spread by direct intimate contact with oral secretions.
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| Infectious Mononucleosis: Interventions | (a)Rest and supportive treatment; isolation if required.
(b)Provide school tutoring to maintain grade level.
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| Infectious Mononucleosis: Prevention | (a)Limit contact with saliva.
(b)Do not share eating utensils.
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| Whooping Cough (pertussis): Bordetella pertussis (bacteria) (Source) | (a)Direct contact.
(b)Droplet (airborne) spread.
(c)Indirect contact with freshly contaminated objects.
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| Whooping Cough (pertussis): S/S | (a)Begins with cold-like symptoms: fever, cold, cough.
(b)Spells of coughing, accompanied by a noisy gasp for air that creates "whoop".
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| Whooping Cough (pertussis): Contagious Period | 5-21 days (10 days average)
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| Whooping Cough (pertussis): Infectious period | several weeks
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| Whooping Cough (pertussis): Interventions | (a)Isolate.
(b)Bed rest.
(c)Provide abdominal support during coughing spell.
(d)Re-feed child if he/she vomits.
(e)Observe for airway obstruction.
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| Whooping Cough (pertussis): Prevention | vaccine in infancy (DPT)
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| Tuberculosis (mycobacterium tuberculosis): bacteria (Source) | (a)Airborne.
(b)Contact with an infected person (lung is usual portal of entry, but may also be ingested).
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| Tuberculosis (mycobacterium tuberculosis): S/S | children often asymptomatic.
(a)Low grade fever.
(b)Malaise.
(c)Anorexia.
(d)Weight loss.
(e)Cough.
(f)Night sweats.
(g)Positive tuberculin skin test.
(h)Immunocompromised patients, such as with AIDS, are at increased risk.
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| Tuberculosis (mycobacterium tuberculosis): Intervention Period | 2-10 weeks; spread by droplet infection, airborne.
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| Tuberculosis (mycobacterium tuberculosis): Contagious Period | after treatment when cough subsides
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| Tuberculosis (mycobacterium tuberculosis): interventions | (a)Isolate newborn from infected mother.
(b)Identify contacts.
(c)Isolate using a special mask
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| Tuberculosis (mycobacterium tuberculosis): Prevention | early detection by tuberculin skin test (PPD)
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| Hepatitis (Type A, HAV): virus (Source) | fecal-oral route, usually from contaminated food or water.
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| Hepatitis (Type A, HAV): S/S | (a)Fever.
(b)Anorexia.
(c)Headache.
(d)Abdominal pain.
(e)Malaise.
(f)Jaundice.
(g)Dark urine.
(h)Chalk-like bowel movements.
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| Hepatitis (Type A, HAV): Incubation Period | 15 - 50 days, average 25 – 30 days.
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| Hepatitis (Type A, HAV): Contagious Period | uncertain, virus may be shielded for 6 months in neonates.
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| Hepatitis (Type A, HAV): Interventions | (a)Avoid ingestion of fecal-contaminated water; swimming in contaminated water or shellfish from such water.
(b)Proper hand washing.
(c)Standard precautions essential.
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| Hepatitis (Type A, HAV): prevention | (a)Hepatitis A vaccine is recommended for children traveling to endemic areas.
(b)Injection of gamma globulin gives temporary immunity when exposed.
(c)Vaccine is required for all children in some states.
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| Hepatitis (Type B, HBV): virus (Source) | (a)Blood or blood products contaminated with HBV.
(b)Exchange of blood or any body secretion.
(c)Intimate physical contact.
(d)Mother to infant.
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| Hepatitis (Type B, HBV): S/S | (a)Patient may lack symptoms with initial onset, or may be more insidious.
(b)Symptoms same as type A, but more serious.
(c)Can manifest liver pathology.
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| Hepatitis (Type B, HBV): Incubation Period | 30-180 days, average 50 days
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| Hepatitis (Type B, HBV): Contagious Period | uncertain, may persist in carrier state for years to lifetime.
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| Hepatitis (Type B, HBV): Intervention | (a)Avoid direct contact with blood or blood products (health workers at increased risk of exposure).
(b)Identify high-risk mothers and newborns.
(c) Educate concerning need for vaccination. Vaccine is required in some states.
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| Hepatitis (Type B, HBV): prevention | (a)Immunize with HBV vaccine during newborn period.
(b)Interferon or reverse transcriptase inhibitors may be an effective treatment.
(c)Immune globulin may be indicated for exposed, susceptible children.
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| Lyme Disease: Borrelia burgdorferi.- most common tick-borne disorder in US (source) | Deer tick
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| Lyme Disease: S/S | (a)Skin lesions at site of tick bite.
(b)Macule with raised border and clear center.
(c)May "burn".
(d)Fever.
(e)Arthralgia: joint pain.
(f)May lead to heart and neurologic involvement
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| Lyme Disease: Incubation Period | 3-31 days
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| Lyme Disease: Contagious Period | only spread by infectious ticks.
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| Lyme Disease: Interventions | educate concerning prevention of exposure.
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| Lyme Disease: Prevention | (a)Wear protective clothing in wooded area.
(b)Inspect for ticks following play when camping.
(c)Light colored clothing makes tick more noticeable.
(d)Remove tick with tweezers.
(e)Inspect pets.
(f)Treat infections with:
1) Amoxicillin.
2) Doxy
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| Erythema | a diffused reddened area on the skin.
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| Macule | a flat, nonpalpable, circular area on the skin (< 1cm dia); may be brown, red, purple, white, or tan. Ex: freckles, flat moles
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| Papule | an elevated, palpable, circular area on the skin (< 1cm dia); may be brown, red, pink, tan or bluish red in color. Ex: warts, pigmented nevi
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| Vesicle | a circular area on the skin (< 1cm) that is elevated and contains serous fluid Ex: blister, varicella.
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| Pustule | a circular area on the skin that is elevated and contains pus; Ex: acne, variola.
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| Scab | a dried pustule that is covered with a crust
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| Pathognomonic | a term used to describe a lesion or symptom that is characteristic of a specific illness.
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| Pediatric AIDS | acquired immunodeficiency syndrome caused by the human immunodeficiency virus (HIV).
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| AIDS is transmitted by | Oral, anal, or vaginal sex.
Sharing drug needles.
Transfusion with blood.
In utero from an infected mother.
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| AIDS: Pathophysiology | (1)HIV attacks lymphocytes.
(2)Imbalance between the helper T cells (that support the immune system) and the suppressor T cells that shut it down.
(3)Over time, the number of helper cells drops.
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| AIDS: Manifestations | Failure to thrive.
Repeated respiratory infectious (Pneumocystis carinii).
Chronic Ear infections & Sinusitis.
Chronic Diarrhea.
Recurrent Fever.
Anemia.
Hepatosplenomegaly.
Thrush.
Lymphadenomegaly.
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| AIDS: Diagnostic Evaluations | (1)ELISA and Western Blot not as reliable in diagnosing infants and young children.
(2)Based on clinical signs and symptoms defined by the CDC.
(3)Presence of risk factors associated with AIDS in the mother.
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| AIDS: Treatment and Nursing Care | supportive, no cure.
(a)Didanosine (DDI).
(b)Nevirapine.
(c)Invirase.
(d)Ritonavir.
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