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