Ch. 37: Child with a Communicable Disease

Symptoms of hepatitis Β in?

- Teens and adults are nausea, vomiting, abdominal pain, diarrhea, fatigue, fever, loss of appetite, joint pain, dark urine, clay-colored stools, and jaundice. - Symptom onset occurs within 90 days of exposure. - The clinical presentation of hepatitis Β for infants and children under 5 is quite different. - At this age, the virus can lie dormant in the body for many years, and patients can be asymptomatic

If a person has an allergy to eggs:

- That allergy might cause a reaction because most flu vaccines are produced in an egg product. - Current research suggests that each month after a flu shot, flu antibodies are reduced by approximately 7%

Nursing Considerations for Roseola:

- The greatest concern with a child who develops a roseola infection is the spike in temperatures. - Rapid high temperatures are associated with febrile seizures.

Diagnosing Varicella:

- The illness begins with fever, malaise, poor appetite, and lesions, often on the chest or back. - The lesions then spread to the body and extremities distally - At the point when all lesions crust over and the child is no longer febrile, he or she is considered to no longer be contagious. - Once someone recovers from a primary varicella infection, he or she usually has immunity for life.

Mild Cases of Measles:

- The illness produce self-limiting symptoms that can be treated at home supportively by reducing the fever, maintaining hydration, and getting rest. - In children, this illness is over within about a 2-week time period.

Nursing Considerations for Polio:

- The majority of children and adults infected with the polio virus may never show symptoms or develop the disease, but they may act as carriers and spread the virus. - Vaccination is recommended for children under the age of 5. - Two types of vaccines protect against polio: the inactivated polio vaccine (IPV) and the oral polio vaccine (OPV). - In the United States and other countries where the disease has been eradicated, IPV is given in a four-dose series.

A primary point of education with the Rotavirus vaccine is to teach the?

- The parents and caregivers that the live virus can be expelled in the diapers up to 15 days after the first dose. - It is unclear how contagious post-vaccine stools can be, but careful hand-washing and hygiene precautions are imperative to prevent transmission of the disease to other children and family members.

Nursing Considerations for Pneumococcus:

- The pneumococcus vaccine is limited in effectiveness because it does not cover all the dozens of strains of pneumococcus that exist—only the most common strains (typically 22 to 23 strains at a time). - Many emerging strains of pneumococcus are resistant to antibiotics and may not be covered by current vaccines.

If a health-care provider suspects that a child is having a reaction to an immunization:

- The provider must call for help while ensuring that the child is never left alone. - Allergic reactions, although rare, can be life-threatening because they can cause anaphylaxis (bronchial constriction, throat swelling, and hypotension).

In moderate to severe cases of diphtheria:

- The pseudomembranous coating on the tonsils or in the nose becomes so thick it becomes difficult for the child to breathe. - This can lead to swelling, swollen neck glands, and airway obstruction.

Nursing Considerations for Rotavirus:

- The rotavirus vaccine is a liquid given by mouth. - Depending on the brand, it can be given in a two- or three-dose series at 2, 4, and 6 months with at least 1 month between doses. - The vaccine contains whole, live viruses that multiply in the intestines and cause a mild case of the illness to stimulate the body's immune system.

There are no interventions or treatments for a child who has a measles infection:

- The viral infection will last about 4 to 5 days with a spreading rash and high fevers. - The child may require extra fluids and support for fevers and itching. - Postexposure vaccinations may help children who are not yet fully vaccinated against the measles, provided the immunization is administered within 72 hours of exposure to the measles virus. - The infection may still develop after the incubation period, but it is often milder with fewer symptoms and a shorter course of infection.

Polio (OPV) should not be used to immunize immunocompromised patients:***

- Their household contacts, or nursing personnel in close contact with such patients; eIPV is recommended for such persons. - Immunocompromised patients may be unable to limit replication of vaccine virus

Interventions for Roseola:

- There are no treatments for roseola. - Supportive care includes antipyretics such as acetaminophen (Tylenol) or ibuprofen (Motrin), rest, and hydration.

Interventions for Human Papillomavirus:

- There is no treatment for HPV. - There are ways to manage the complications and problems that arise from having an HPV infection, including treatment for genital or anal warts, treatment for abnormal Pap smears in teen girls, and surgery for warts that grow into the throat or airway structures

Interventions for Polio:

- There is no treatment for polio. - Once infected, the child will need to be supported through the paralysis. - Mechanical ventilation may be required if the paralysis extends to the trunk and compromises the child's ventilation. - Aggressive physical therapy may be ordered to improve the associated muscular hypotonia with the paralysis.

Interventions for Varicella:

- There is no treatment for varicella. - Children will need supportive care including fluids, rest, and isolation to prevent the spread to those not vaccinated, pregnant women, or young children who are not fully immunized. - Immunocompromised children, such as those receiving high-dose steroids or those being treated for cancer, may be given the varicella zoster-specific immunoglobulins known as VZIG.

Severe pneumococcal disease affects mainly infants and children under the age of 5 years:

- These young patients can present with symptoms of meningitis or sepsis and will require treatment with aggressive antibiotics; often they require pediatric intensive care unit (PICU) stays. - Infections of this type have a 20% to 30% mortality rate with complications that include brain damage and hearing loss in some children.

Parental Concerns About Childhood Vaccines and Immunizations:

- Thimerosal - Aluminum - Guillain-Barre Syndrome - Encephalitis/ Encephalopathy - Hypotonic/ Hyporespontsive Episodes (HHE) - Autism - Seizures - Autoimmune Reactions - Religious Objectionss

Live (attenuated) virus vaccine:

- This type of vaccine uses the whole virus, which has been manipulated in the laboratory in a number of ways to produce a weakened strain. - These viruses mimic the natural virus so closely that the body can produce antibodies to provide immunity to the actual disease. - The main benefit of a live virus vaccine is the strength of the immunity it produces. - It is often effective with just one dose. - The main deterrent to this type of vaccine is its ability, on rare occasions, to actually cause the disease because it is a live virus. - This is particularly important to note in immunocompromised patients.

Hepatitis B vaccinations:

- Three doses: Birth-2 months; 1-4 months; 6-18 months - Inactivated virus

A child who presents with symptoms of epiglottitis should never have any type of?

- Throat assessment such as a visual inspection with a tongue blade. - Touching the site can result in rapid swelling and total occlusion of the child's airway.

Diagnosing Haemophilus Influenzae Type B:

- Transmission occurs in children through nasopharyngeal droplets or respiratory droplets. - Mild cases often start with cold symptoms that sometimes progress to fever, ear infections, and respiratory infections such as bronchitis or pneumonia and often can be treated with antibiotics.

Varicella:

- Two doses, one at 12-15 months and one at 4-6 years - Live virus

Polysaccharide conjugate vaccine:

- Uses sugars from the bacteria and bonds them to portions of another germ. - This type of vaccine does not contain live viruses and does not contain the whole microbe, so it will not cause the infection or disease

Tetanus incubation period:

- Usually about 7 to 8 days with a range of 3 to 21 days. - Once tetanus binds to nerve cells and symptoms begin, there is no cure.

Serious reactions should be reported through the?

- Vaccine Adverse Event Reporting System (VAERS), a national vaccine safety surveillance program run by the CDC and the Food and Drug Administration (FDA). - Check with the local Public Health Department to find out which reactions are mandated to be reported.

Use appropriate PPE and infection-control measures when caring for a child with confirmed or suspected varicella infection. Initiate contact and airborne precautions:

- Wash hands before entering the child's room, again before care, after care, and again after removing PPE. - Wear a mask, gloves, and gown at all times when providing care. - Careful removal of the soiled PPE is warranted, and used items should be placed in a biological infectious waste container with a tight lid.

Children with communicable illnesses are at risk for spreading their infections to others:

- Young children do not have the knowledge, skill, and capacity to prevent the spread of infections by controlling body fluids such as mucus, saliva, and stool. - Infants easily transmit infections by placing their wet fingers into another's mouth, and toddlers do not have the capacity to learn infection-control measures without consistent teaching. - Preschool children share their items readily with their peers, transmitting infectious pathogens, and school-aged children do not always participate in good hand-washing techniques at school and after school.

Children with rubella will present with a?

- to 2-day history of not feeling well, mild fevers, and a sore throat. - The child may present with a maculopapular rash that typically begins on the child's forehead or face and progresses downward to the rest of the body - The primary risk of rubella, and therefore the primary reason for vaccination, is to women who contract this illness while pregnant.

Polio is spread by?

-By fecal/oral transmission but can be spread by direct contact with respiratory secretions or saliva. - Can be transmitted through poor hand washing, contaminated food and water, unsanitary food preparation and direct contact with infected person .virus can survive in water and sewer( spread in contaminated water sources).

Nonimmunizable Communicable Illnesses:

-Many infectious diseases and illness do not have immunizations -Particular concern because no way to prevent them with vaccines - Children are particularly vulnerable to the development of communicable illnesses.

Whole (inactive) virus vaccine:

-This type of vaccine contains the whole, killed organism, which retains the surface and internal structures that are strong stimulants to the immune system. - The virus is killed, or inactivated, by heat, phenol, formalin, or thimerosal. - This kind of vaccine is effective, but there is the possibility of an allergic reaction. - This type of vaccine requires multiple doses to be given initially to produce sufficient immunity, and it often requires booster doses to maintain immunity.

Although there is no treatment for an HPV infection, there are treatments for complications associated with HPV. What are some of the complications of HPV? (Select all that apply.)

1. Genital warts 2. Abnormal Pap smears

The two most important aspects of infection control are?

1. Hand washing 2. the use of personal protective equipment (PPE), which is equipment that is made available to health-care professionals to prevent the spread of infections or diseases. - PPE includes goggles, face shields, masks, gowns, and gloves.

Interventions for Tetanus:

1. Immediate cleansing of the wound with clean water and a disinfectant 2. Immediate medical attention to prevent the toxin from developing and spreading 3. Antibiotics to kill the bacteria 4. Tetanus immune globulin (TIG) shot to neutralize any toxin that is free-floating and not bound to nerve cells 5. Evaluation of previous immunizations: - A person who has received a series of tetanus vaccinations and has received a booster shot within 5 years will already have antibodies and should be protected from developing the disease.

Polio incubation period:

( Time between exposure and initial symptoms) is about 6-20 days ( range)

Strep infections have a rapid incubation period:

(24 to 72 hours) and are easily transmitted to other children in a classroom or childcare setting via respiratory secretions.

Kawasaki Disease:

(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms.

Mumps incubation period:

- 16 to 18 days; it is contagious from 7 days before to 5 days after salivary gland swelling begins. - The illness usually affects children 5 to 9 years old but can infect adolescents and adults.

Haemophilus influenzae Type B (Hib) side effects:

- 25% of children experience redness, swelling, and pain at injection site; 5% may experience a moderate to high fever. ***None known

Flu vaccine recommended anyone over?

- 6 months usually started in fall and contain 3 strains - Three strains of influenza viruses are common: influenza B viruses, influenza A H1N1 viruses, and influenza A H3N2 viruses. - The yearly flu vaccine is made by using one strain of flu virus from each type.

Hypotonic/Hyporesponsive Episodes (HHE):

- A RARE, sometimes serious, reaction, associated with pertussis-containing (DTaP) vaccinations. - This reaction causes a sudden onset of hypotonia. - The episode can last a few minutes to hours, and it occurs in children less than 2 years of age. - The reaction can sometimes require cardiopulmonary resuscitation (CPR). - Frequently, children are hospitalized after an episode for observation even if symptoms have subsided.

Pneumococcus, also known as Streptococcus pneumoniae:

- A bacterium that can cause a number of illnesses such as ear infections, serious respiratory infections such as pneumonia, and meningitis. - Blood tests are used to identify S. pneumoniae; then oral or IV antibiotics can be given.

Haemophilus influenzae type B (Hib):

- A bacterium that causes meningitis, blood infections, bone infections, epiglottitis, and pneumonia. - These illnesses can be life-threatening and require immediate medical intervention, hospitalization, and antibiotic treatment; intensive care can sometimes be required.

Varicella (chicken pox):

- A common childhood illness that is highly contagious. - An airborne virus that is spread through coughing, sneezing, and direct contact with infected lesions. - Once someone is infected with the varicella virus, the organism lies dormant and resides within the nerves of the body. - The infection can recur in adulthood in the form of shingles, which is an outbreak along nerve tracts that causes significant pain and discomfort.

Recombinant vaccine:

- A newer form of vaccine-recombinant technology, this vaccine produces a genetically altered organism. - It contains some manufactured proteins that match the germ's proteins closely, which stimulate the immune response in the body. - These vaccines do not contain any part of the original germ, so they do not have the risk of causing the disease.

Seizures:

- A rare reaction that some children have experienced after vaccination. - Generally, seizures are considered to be secondary to fever. - Febrile seizures are generally self-limiting and do not result in future health problems.

Diphtheria:

- A serious throat infection caused by Corynebacterium diphtheriae bacterium. - The bacterium secretes a toxin that irritates the respiratory tract, causing severe coughing and breathing difficulty. - Spread by respiratory droplets from coughing and sneezing and is contagious 2 weeks after the development of symptoms. ***The vaccine for diphtheria is part of the DTaP vaccination (diphtheria, tetanus, and acellular pertussis). - Vaccination does not provide lifetime immunity, and boosters are needed every 10 years to maintain immunity

Measles:

- A very contagious respiratory illness caused by the rubeola virus and spread by infected airborne droplets that are expelled when someone coughs or sneezes. - A person is contagious from 4 days before the rash starts until 4 days after the rash appears. - The virus is most often spread when one first gets ill before it is diagnosed.

Roseola/ Exanthem subitum/ Human herpesvirus type 6b (HHV-6b):

- A viral infection caused by the HHV-6 pathogen. - The transmission of the virus is by saliva of an infected person. - Presents with low-grade fevers and fussiness for 1 to 2 days, then a sudden elevated fever. - The classic roseola rash starts after the last fever (sometimes the day of the last fever) and begins on the child's face and then progresses downward

Hepatitis A:

- A virus that affects the liver, causing temporary inflammation.

Mumps/ Viral parotitis:

- A virus that only affects humans and causes illness that can last from several days to several weeks. - Any child who has neither had mumps nor received a vaccination is susceptible. - Spread by respiratory droplets, frequently through the coughing and sneezing of an infected person.

Thimerosal:

- A water-soluble, crystalline powder used as an antiseptic that was used as a preservative in immunizations. - No longer used with the exception of some influenza vaccines. - Concerns emerged because thimerosal is mercury-based and has been connected to minor reactions. - Current science has not found a link between thimerosal and autism or any other serious harm. - Families can ask for influenza shots that do not contain thimerosal. - A mercury-containing preservative in some vaccines can cause toxicity

Influenza: The "Flu"

- A yearly occurring viral infection that occurs in the winter and has significant mortality and morbidity worldwide, particularly in the very young, the elderly, and immunocompromised patients. - There are several strains of the virus with a different strain dominating each year. - This makes developing the yearly vaccine challenging. Each year the flu shot is developed based on research that indicates which strains will be most prevalent during the upcoming year.

Moderate cases of hepatitis A in children can involve?

- Abdominal pain, vomiting, diarrhea, and dehydration for several days. - Approximately 4 weeks after exposure, an exposed person starts to feel ill. - The severity of the disease varies depending on the age of the infected person.

Nursing Considerations for Hepatitis B:

- About 25% of infants infected with hepatitis B develop liver cancer or liver failure later in childhood and sometimes require a liver transplant. - Children who acquire hepatitis B later in childhood, during toddler or preschool years, often become chronically infected.

Aluminum:

- Added to many vaccines to improve their effectiveness. - Combination vaccines may increase the amount of aluminum in a vaccine to make it optimally effective. - It is unclear and insufficiently studied to determine how much aluminum may be toxic to infants and children and what effect it may have.

Rubella: German Measles

- An airborne virus spread by coughing and sneezing or by contact with nasopharyngeal secretions, urine, blood, or stool of those infected - Causes a fever and rash for 2 to 3 days. - Considered a highly infectious viral disease among children who are not immunized. - Children can be infectious up to 10 days before the appearance of the rubella rash.

Acyclovir:

- An antiviral medication, is sometimes used in older children and adults within 72 hours of developing a rash to help control the severity of the illness and prevent fever. - Can limit the outbreak of lesions and the accompanying uncomfortable itching, thus reducing the likelihood of secondary infections.

Guillain-Barré Syndrome:

- An autoimmune reaction in which the immune system attacks the nervous system, causing temporary paralysis that usually lasts a few weeks and can require intensive care. - The most common vaccines that Guillain-Barré has been associated with are tetanus-containing vaccines and meningococcal vaccine, although it has been associated with other vaccines, including influenza. - Parents need to understand that this is a rare complication and having a tetanus, meningococcal, or severe flu infection has much greater and more common risks.

The stages of Varicella lesions:

- An individual with varicella begins to be contagious 1 to 2 days before the rash appears. - On the second day of illness, the rash lesions turn to blisters and begin to itch; new lesions will continue to develop. - By the third day of illness, the blisters crust over. - The cycle of new lesions, blisters, and crusting affects the entire body, including the face and extremities, and continues throughout the course of the illness, about 5 days.

Rotavirus:

- An intestinal virus that is extremely contagious and transmitted through stool, saliva, and poor hand-washing and hygiene practices. - Most common in the fall and winter seasons and are a frequent cause of illness and hospitalization in young infants and children. *** Resistant to disinfectant solutions and antibacterial hand soaps.

The child with a diagnosis of diphtheria must be treated immediately with both?

- Antibiotics and an antitoxin that will neutralize the diphtheria toxin spreading in the child's body. - The toxin can cause heart arrhythmias or heart failure and can lead to nerve damage and paralysis. - This illness can be fatal for as many as one in five children under the age of 5.

It is not uncommon to hear people say, "I don't get the flu shot—it gives me the flu." The standard flu vaccine or "flu shot" is an inactivated influenza vaccine that contains only killed viruses, so it cannot give someone the flu:

- Antibodies that protect against the illness are produced at about 2 weeks after the vaccination. - During this time, someone who received the flu shot can be exposed to the flu virus and become infected. - Some people experience aches and pains after an injection, but these symptoms are mild in comparison to the actual flu symptoms and usually subside in 1 to 2 days.

Nurses have the responsibility to provide parents with information on infection-control measures so that other members of the child's family and community do not acquire infections:

- Anticipatory guidance is a means to share information with parents concerning when and how to teach secretion control (sneezing into sleeve, using tissues, washing hands frequently and independently). - The concept of infection control includes measures implemented by health-care institutions and behaviors performed by health-care team members, parents, and children.

Rotavirus Treatment:

- Antinausea medication, rehydration, and sometimes treatment with probiotic powder to decrease diarrhea by increasing the number of "good" intestinal bacteria.

Although many cases of pertussis can be treated at home, hospitalization is often required when an infant demonstrates?

- Apnea, respiratory compromise, and neurological impairment secondary to anoxic episodes. - Airway maintenance and adequate hydration and nutrition are priorities in treatment. - Infants with pertussis can be very ill and sometimes require extended periods of hospitalization.

Serious complications can occur in pregnant women who are infected with varicella in the first 20 weeks of pregnancy:

- Approximately 2% of women infected in this period of gestation will have children born with congenital varicella syndrome. - This can result in scarring of the skin; abnormalities in the limbs, brain, and eyes; and low birth weight. - If a woman develops a varicella rash from 5 days before to 2 days after delivery, the newborn will be at risk for neonatal varicella. - Without immediate antiviral treatment, up to 30% of such newborns may develop severe neonatal varicella infection, which can be life-threatening

Zinc deficiency:

- Associated with immune system impairment and greater severity of serious infectious childhood diseases. - In childhood communicable or infectious diseases that have associated diarrhea, zinc supplementation has shown to greatly shorten the duration.

To make the toxoid vaccine:

- Bacteria are grown in large amounts. - The toxin they produce is inactivated by chemical, heat, or other treatments, producing a toxoid that can be given as a vaccination. - After vaccination, the body produces antibodies that will inactivate the bacterial toxin in the case of future exposure. ***This is the type of immunization used for diphtheria and tetanus.

Do not administer the following vaccines if patient is allergic to?

- Baker's yeast: avoid recombinant hepatitis B vaccine - Eggs: avoid influenza vaccine, MMR - Neomycin: avoid IPV, MMR, and varicella vaccine

Interventions for Haemophilus Influenzae Type B:

- Because Hib is caused by bacteria, the child will be treated with antibiotic therapy. - A child may be admitted to the hospital for hydration, antibiotics, and monitoring.

Nursing Considerations for Hepatitis A:

- Because the virus is transmitted easily via stool, blood, contaminated objects, food, and water, it is important to teach and reinforce learning about hand hygiene - Parents should be aware of community breakouts of hepatitis A and should perform strict hand hygiene when taking children to visit family in long-term care facilities, hospitals, or other health-care settings where stool and blood are handled.

Pertussis is spread by?

- Being in close contact with someone coughing and sneezing and can be spread by parents, siblings, and caregivers. - Children at greatest risk for serious illness from pertussis are infants less than 6 months.

Hepatitis B:

- Blood/body fluid-borne virus transmitted through sexual activity; use of contaminated IV drug needles, tattoo needles, health-care-related needle sticks; or at birth when a baby is exposed to contaminated blood and body fluids. - HBV is virulent and can survive outside a person on a razor or toothbrush for up to 1 week*** - There is a two-injection vaccine series for Hep B.

Moderate Cases of Measles:

- Can involve secondary ear infections, pneumonia, and high fevers. - These cases will require antibiotics and possibly hospitalization, depending on the severity. - The child usually recovers without complications.

Diagnosing the Measles:

- Cause fever, a generalized red rash, red eyes (conjunctivitis), runny nose, cough, and general malaise. - The development of bluish spots on the buccal mucosa (Koplik's spots) is unique to this disease

Varicella outbreaks in settings such as?

- Childcare centers, schools, and hospitals can last as long as 4 to 5 months. - Outbreaks are monitored by Public Health Departments and the CDC. - In hospital settings, varicella identification is a major focus of Infectious Disease Departments because of the vulnerability of hospitalized patients who are immunocompromised.

Tetanus Interventions:

- Cleanse wound, immediate medical attn to prevent spread of toxin, ABO to kill bacteria, TIG shot to neutralize any toxin, evaluation of previous immunization.

Most HPV infections?

- Clear on their own but when they do not, health problems such as genital warts and various cancers can develop - Associated not only with cervical cancer, but also with anal, head, and neck cancer in males; genital warts across the life span; and, rarely, the presence of warts in the airway of infants and children

Interventions for Hepatitis B:

- Close monitoring of a child with chronic HBV is important to evaluate for liver damage and possible liver cancer. - Postexposure HBV vaccine given within 12 hours of exposure can help prevent HBV infection

The main assessments for polio are the onset of abrupt symptoms of a?

- Cold followed by low-grade fevers. - Paralysis can present within 3 days, but this depends on the degree of nerve tissue involvement

It's the job of the pedi nurse and health-care team to recognize common childhood communicable diseases to prevent the?

- Containment, prevention of spread, rapid treatment, and prevention of complications can take place. - Observation, recognition, and prompt treatment can make the difference in length and severity of a childhood illness.

Interventions for Influenza:

- Currently approved for treating influenza is oseltamivir phosphate (Tamiflu). - This medication can be administered to children as young as 2 years old. - The medication should be started within 48 hours of symptom onset. - After 48 hours, the medication has not been found to be as effective

Children with Communicable diseases often present with secondary conditions such as?

- Dehydration from prolonged poor oral intake or a lengthy bout of diarrhea. - Sometimes the child will present in a critical state of sepsis and require immediate life-saving interventions.

Influenza Complications:

- Dehydration is a major complication of the illness, resulting from high fevers, nausea, vomiting, and diarrhea. - Severe muscle aches and pains are common with influenza.

Pneumococcal Conjugate side effects:

- Drowsiness, loss of appetite, redness or tenderness at the injection site - Life-threatening allergic reactions (very rare)

Diagnosing Human Papillomavirus:

- During birth, an infant can be exposed to HPV infection from a mother with cervical HPV. - Newborns can become ill very quickly with high fever and seizures and may become lethargic. - HPV infection in newborns can be very severe (CDC, 2019) and can lead to infant death.

How to reduce pain if possible from reactions from immunizations?

- Elma cram and vapocoolant sprays - Epi pen on hand at all times

Allergies and Toxicities:

- Epinephrine should be available in unit where immunizations are given - Child should be observed for 20 minutes after immunization - Varicella must be given same day as MMR or no less than one month later - A tuberculin skin test (PPD) should not be given within 6 weeks of MMR or varicella - Some vaccines can be given on the same day but must be in different syringes and administered in different sites -Serious adverse events must be reported to the national VAERS program

Mumps typically starts with a few days of?

- Fever, headache, muscle aches, tiredness, and loss of appetite and is followed by swelling of salivary glands. - Diagnosis is usually made after observation of symptoms or a known mumps exposure.

Varicella side effects:

- Fever, mild rash, and swelling of injection site - Seizures, lowered consciousness, permanent brain damage

MMR: Measles, Mumps, and Rubella side effects:

- Fever, mild rash, swelling of the neck or cheeks, temporary stiffness and pain in joints, temporary low platelets - Seizures, serious allergic reactions, deafness, permanent brain damage

Nurses have the opportunity to teach preteens and teens how to keep from getting or to stop the spread of HPV infections:

- First, all girls and boys at age 11 or 12 should get the HPV vaccine (CDC, 2017). - The vaccine is a three-shot series. - The second dose is given 2 months after the first, and the third dose is given 6 months after the first dose. - The HPV vaccine does not protect against all strains of HPV, only the most common ones. - Sexually active girls need to understand that a regular Pap test can detect if the cervix has precancerous lesions due to HPV

DTaP: Diphtheria (C. diphtheriae), Tetanus (Clostridium tetani), and Acellular Pertussis:

- Five doses: 2 months; 4 months; 6 months; 15-18 months; booster 4-6 years Inactivated virus

Initial symptoms of rotavirus are similar to?

- Gastroenteritis and involve fever, vomiting, and diarrhea. - The diarrhea can last more than a few days, up to a few weeks in some cases, and can be more frequent and foul smelling.

Common flu symptoms include the following:

- Generalized symptoms - Respiratory symptoms - Gastrointestinal symptoms - Central nervous system symptoms

Expanded Contact precautions:

- Hand washing only, no alcohol-based hand gels; gown and gloves - C diff and Roto virus

Standard Precautions:

- Hand washing, gloves, gowns, masks, eye protection, and facial shields as needed - For everyone at all times ( gloves, wash hands, handle laundry) for cdiff and roto virus must wash hands no hand sanitizer.

Contact Precaution:

- Hand washing, gown, and gloves; may also be called enteric contact precautions when the microbe is present in the stool - When contamination likely to occur skin to skin or contact with contaminated formite. direct or indirect contact with pts environment ( rsv, cdiff, roto virus, hep A, staph,ch pox) gown and glove all times, prior to pts room, remove upon leaving.

Autoimmune Reactions:

- Have been reported with some vaccines; these are an overreaction of the immune system to some component of the vaccine. - Reported vaccine-associated autoimmune diseases have been rheumatoid arthritis, thyroid disease, diabetes, and multiple sclerosis.

Health-care personnel who work with children are at risk for contracting communicable diseases simply because?

- Having close contact with body secretions is part of caring for children. - Therefore, using PPE is mandatory when caring for a child with a communicable disease.

Interventions for Pertussis:

- Hydration and nutrition are important considerations in treating these patients and are particularly important because children, particularly infants, are highly susceptible to dehydration. - Post-coughing emesis is common with pertussis infections, and oral intake is often difficult because of coughing episodes and difficulty breathing.

Diagnosis of viral roseola is based on the?

- Identification of the classic rash. - The roseola rash is red, pink, and papular in nature. - Assessing for a recent history of fevers will also assist in the diagnosis.

Interventions for Hepatitis A:

- In cases characterized by abdominal pain, diarrhea, and dehydration, hospitalization for antinausea and antidiarrhea medication, as well as IV rehydration, may be needed. - Both children and adults can be given an infusion of IV immunoglobulin (IVIG) within 2 weeks of exposure; this has an 85% chance of preventing the development of the disease.

Tetanus:

- Infection is caused by a toxin secreted by the bacterium Clostridium tetani. - Tetanus enters the body through punctures from rusty metal, dirty needles, open wounds, or a break in the skin exposed to contaminated surfaces.

Encephalitis/Encephalopathy:

- Inflammation and swelling of the brain. In rare cases, infants will develop this condition postimmunization and have a high fever and intense screaming alternating with lethargy. - The symptoms can last up to a few days. - In a small number of cases, encephalitis can progress to encephalopathy, a form of brain injury that causes permanent damage. - This is associated with the old DTaP vaccine, the MMR vaccine, and tetanus-containing vaccines.

Nursing Considerations for the Mumps:

- Inflammation of the testicles (epididymitis) in males who have reached puberty is the most common complication. - Fertility issues are often a concern but are rare. - Females may experience inflammation of the ovaries and/or the breast. - Other rare complications that have been reported are meningitis and encephalitis. - At one time, when mumps was more prevalent, deafness was a significant complication but is now rarely reported

The severity of the coughing spells makes it difficult to?

- Inhale, and inhalation only occurs when the respiratory tract has been emptied of air. - The characteristic "whooping" sound is the result of trying to inhale through the glottis, which is irritated from the coughing spells and narrowed by spasm and secretions.

The bacteria that cause pertussis secrete a toxin that severely irritates and damages the lining of the throat and lungs:

- Initially, the symptoms resemble those of a cold, including runny nose, congestion, and sneezing. - After 1 to 2 weeks, the patient has repeated, violent, prolonged coughing fits that can last up to 30 to 60 seconds.

DTaP: Diphtheria (C. diphtheriae), Tetanus (Clostridium tetani), and Acellular Pertussis side effects:

- Injection site reactions, nonstop crying for longer than 3 hours, tiredness, vomiting, low-grade fever - Seizure, fever greater than 40.6°C (105°F); any tetanus-containing vaccine can, in very rare instances, cause Guillain-Barré syndrome.

If an allergic reaction occurs:

- It does not necessarily prevent the child from receiving other vaccines. - Once the substance in the vaccine that caused the reaction is identified, a vaccine that does not contain that substance will be administered.

Children's immunizations or vaccines are scheduled to protect them from infections they may be exposed to:

- Its important to understand what the side effects are and provide education to the parents and care givers - ( if they have an allergic reaction it does not mean they cant get vaccine in future, just need it to be identified, such as allergic to eggs can have a vaccine that does not contain that allergen)

Tetanus is often called [lockjaw] because the stiffness usually starts with the?

- Jaw muscles and spreads to the neck, causing swallowing difficulty. - Within 24 to 48 hours, rigidity and spasms may develop and spread to the trunk and extremities. - The child's neck and back become stiff and arched, the abdominal wall becomes rigid, and the severity of the muscle contractions can cause fractures of the spine and long bones

Nursing Considerations for Haemophilus Influenzae Type B:

- Long-term, meningitis can cause hearing loss, learning disorders, and/or nerve injury. - Epiglottitis can rapidly occlude the child's airway. - The classic presentation of epiglottitis includes drooling, dystonia, and dysphagia with the child appearing quite toxic and in a tripod position to maximize ventilation. - The child needs immediate emergency care, airway support, and rapid antibiotics to avoid death.

Hep B side effects:

- Low-grade fever, soreness at site of injection (administered in the vastus lateralis muscle) - Serious allergic reactions, high fevers

Pertussis symptoms:

- May be mild with dry cough, within 2 weeks the cough often progresses to the coughing spells characteristic of the disease, which then continue to increase in severity and frequency. - With the severe coughing episodes, cyanosis can occur, the eyes can roll back, and the level of consciousness can change. - Seizures and, in rare cases, encephalopathy, have been associated with the illness.

Interventions for Pneumococcus:

- Mild cases are treated on an outpatient basis with antibiotics. - In more severe cases, the child may appear lethargic and have increased respiratory distress. - Severe cases should be treated in the hospital with IV antibiotics, monitoring, and nursing care.

Acquiring a rubella infection during pregnancy can also cause a?

- Miscarriage or premature delivery. - The vaccine for rubella is usually given with measles and mumps in the form of the MMR vaccine

Who are at risk of Hep A?

- Most children under the age of 6 often do not show symptoms; of those who do, the symptoms resemble mild intestinal flu symptoms. - Children 6 to 12 years often feel ill but have what are considered mild symptoms. - Older children and adults can have severe symptoms that resemble food poisoning or gastroenteritis, lasting up to a few weeks.

Measles incubation period:

- Once exposed, a person displays symptoms within 8 to 12 days. - Once a person contracts the illness and recovers, he or she is considered to have lifelong immunity.

Pertussis Teaching:

- Parents and siblings may feel guilty for causing the child's distress. - The family will require teaching about the importance of childhood immunizations, but during the course of the acute illness and hospitalization, the parents need support. - It is important to be supportive and therapeutic in all interactions with the family

Whenever a child is seen by the health-care team, immunizations should be discussed because adherence to the recommended schedule is important:

- Parents must be encouraged to keep track of each child's immunization document because this is needed for entrance into school. - Be aware that immunization schedules may change.

Types of Vaccines:

- Polysaccharide conjugate vaccine - Live (attenuated) virus vaccine - Whole (inactive) virus vaccine - Recombinant vaccine

When a child is hospitalized for complications associated with a communicable disease?

- Post a sign on the patient's door to alert team members, family members, and visitors of the necessary precautions to take. - Never post the child's diagnosis because that would breech patient confidentiality and privacy rules (Health Insurance Portability and Accountability Act [HIPAA]).

Pneumococcal Conjugate:

- Prevnar: Four doses at 2 months, 4 months, 6 months, and 15 months. - One catch-up dose can be given through age 5 if any doses were missed. - Polysaccharide conjugate vaccine

Droplet Precautions:

- Private room or room with patient with same organism, hand washing, mask if within 3 feet of patient, gown, gloves, and eye shielding as needed - Droplet-enters thru eyes, nose, mouth, mucous membrane (thru talking ,sneezing, coughing ), droplets are larger than airborne so do not stay suspended in air they fall on what is near and contaminate it. - Travels less than 3 feet( Diphtheria, flu, mumps, meningitis, meningococcemia, pneumonia, 5th disease whooping cough) - Gown and gloves for RSV (roto virus)

Airborne Precautions:

- Private room with door closed, hand washing, masks, gowns, gloves, eye protection, and facial shields as needed - Less 5 micrones transmitted thru inhalation, pt sneezes and particles survive and floats in air for several hours (chicken pox/varicella, shingles, measles, TB) - If pt leaves room they wear a mask with measles TB varicella need neg pressure room and special N95 mask( allows no air to leave room) N95 tight mask

An infant or child with a moderate case of Hib infection can present:

- Quite ill. - Common presentations include respiratory symptoms in addition to secondary infections. - The child may appear lethargic and ill, show signs of increased work of breathing and labored respiration, and have signs of mild to moderate dehydration from fever and poor oral intake.

Severe complications from chicken pox for healthy individuals are?

- RARE, but chicken pox can be life-threatening to patients who are immunocompromised or who have HIV/AIDS.

Serious Cases of Measles:

- Rare but can involve complications in the brain tissue called encephalitis or encephalopathy. - Pneumonia and respiratory infection can be serious and require hospitalization and intensive care. - Very rarely (1 to 2 per 1,000 cases), measles can cause death.

What does Vitamin A do for Measles?

- Reduce the symptoms and severity of the infection for those who have low vitamin A levels, especially for children who are malnourished or for those children who are at higher risk for complications.

The characteristic symptom of mumps

- Salivary gland inflammation (also known as parotitis), causes swelling of the glands, cheeks, and jaw. - The swelling can be unilateral or bilateral, and it can last for 1 to 10 days - The fever that accompanies the acute phase of the illness can range up to 40°C (104°F) for 1 to 6 days.

Severe Reactions of Rotavirus vacccine:

- Seizure - Kawasaki disease - Intussusception

Vaccinations:

- Some give lifelong immunity, others are seasonal and require yearly immunizations. Vaccines that are not live are often given in multiple doses each one builds your immunity up a little bit more each time given ( 1st 50%. 2nd 75% 3rd 90%) so what if you only get the 1st one?? The type of immunizations can also determine is a particular vaccine is appropriate for certain populations ( live virus not recommended for immunocompromised patients because o their inability to launch antibodies)

Symptoms of diphtheria start as a?

- Sore throat and develop into a visible white coating on the tonsils or in the nose. ***This coating is referred to as a pseudomembranous coating. - Serious infection

Influenza side effects:

- Soreness, swelling and redness at injection site, fever, body aches, fatigue, headache - Severe allergic reactions, Guillain-Barré syndrome (rare)

Human Papillomavirus (HPV):

- Spread through unprotected sex. - There are 40 strains of the virus, and it often goes undetected because there are often no visible signs. - Both women and men can carry the virus and without immunization, most sexually active women and men will have come into contact with the virus by their 20s and can act as carriers.

The level of protection is dependent on how an infectious organism is transmitted and the anticipated contact and exposure of staff:

- Standard precautions - Airborne precautions - Droplet precautions - Contact precautions - Expanded contact precautions - Protective precautions

Hep A is transmitted by?

- Stool or blood and is often the result of contaminated objects put in the mouth, poor hand hygiene and food handling, and contaminated water. - The infection can easily be transmitted in restaurants and homes if there are poor hand-washing and hygiene practices.

Toxoids:

- Substances that are chemically modified to retain their antigen properties but are no longer considered poisonous - Instead of producing antibodies against the organism itself, toxoids produce antibodies against toxins secreted by the organism.

Treatment of mumps:

- Supportive and includes analgesics/antipyretics, fluids, rest, scrotal elevation, and ice packs, all focusing on symptom relief. - Complicated cases may require hospitalization. - Respiratory isolation precautions should be implemented, and the child should be kept from school or day care until all manifestations of the symptoms have subsided, about 9 days after parotid swelling.

Nursing Considerations for Influenza:

- Supportive treatment for influenza is geared toward maintaining adequate hydration and controlling fever. - Young children are at risk for febrile seizures because the flu can cause rapid increases in body temperature. - Therefore, temperature control is particularly important in this patient population

A nurse is preparing to give a flu shot to a toddler. When the nurse asks the parents if their child has any allergies, they tell her that he is allergic to eggs. What action should the nurse take next?

Ask the health-care provider if the child can receive the intranasal flu vaccine.

Children who have viral infections such as varicella should not be given?

Aspirin; there is an association with viral syndromes, the consumption of aspirin, and the development of Reye syndrome

What is one difference between enteric contact precautions and contact precautions?

Contact precautions are used when there is a likelihood of infection transmission through direct or indirect contact with a patient or his or her care items.

The tetanus toxin then spreads and begins to bind to the neurons of the CNS:

Gradually causing paralysis throughout the body. Left untreated, the illness can be fatal.

CNS symptoms of the common flu:

Headache and dizziness can occur with the flu, requiring pain medications and bedrest.

A nurse is reviewing the immunization record of a 9-month-old with the parents. Which immunizations would the nurse expect to see listed?

Hepatitis B; diphtheria, tetanus, and pertussis (DTaP); Hib; IPV; and PCV

A 2-month-old baby has been given the rotovirus vaccine. What should the nurse emphasize to the parents?

Live virus can be expelled through the stool

Attending kindergarten is an important milestone for a young child. Which immunizations, if all prior immunizations are complete, would be needed for a 5-year-old attending kindergarten?

MMR, IPV, and DTP

Acquired Immunity:

Obtained by either exposure to a bacterium, virus, or toxin sufficient to stimulate an immune response by the body, or stimulating the body's immune response through vaccination or immunization.

What can prevent infection control?

PPE

Generalized symptoms of the common flu:

Rapid onset of fever, chills, conjunctivitis, headache, malaise, muscle pain (myalgia), and sudden onset of rigor.

Immunity:

Refers to the body's ability to develop antibodies against specific bacteria, viruses, and toxins that can prevent future illness from exposure to the same antigen. - Active - Passive - Acquired

Active immunity:

Results from the development of antibodies or sensitized T lymphocytes after being exposed to an invading organism.

Moderate cases of varicella can involve a?

Secondary bacterial infection of the lesions and be more painful, sometimes leaving a scar

Exposure to rubella, particularly during the first 12 weeks of pregnancy, can cause?

Serious birth defects such as heart problems, hearing and vision loss, brain damage, and liver or spleen damage.

Religious Objections:

Some religious faiths teach that medical procedures and treatments must be refused, limited, or delayed until prayer or clergy are consulted.

What are complicating factors that can compromise patients further and require antibiotics and hospitalization?

Superimposed bacterial infections, such as pneumonia

Transmission of influenza is?

Aerosol, requiring airborne precautions

What are examples of Live (attenuated) virus vaccine?

measles, mumps, rubella (MMR); varicella; rotavirus; oral polio; and the nasal flu vaccines.

The incubation period of the flu:

which is the time interval between exposure to a communicable disease or infection and the presentation of the first symptoms, is between 24 and 72 hours.

How Immunizations Work to Fight Infections During Childhood:

• A weakened form of the germ that causes disease is injected into a child's body via a needle and syringe. Sometimes the vaccine is made up of just part of the germ but enough to activate the child's immune response. • The child's body then produces antibodies in large numbers that can fight off the infection. • Antibodies are a type of protein that are a part of the child's immune system. When the immune system recognizes germs have entered the body, these small proteins attach themselves to the germ and kill it. • If a fully immunized child is exposed to the germ that causes disease, he or she will have sufficient antibodies to fight off the germ so that the disease does not occur. • Not all childhood vaccines provide lifetime protection against disease. Some need to be given again in adulthood. • Virtually all childhood diseases can be prevented by the completion of an immunization schedule

Strep Throat Treatment:

• Antibiotics will be prescribed after a rapid strep test or throat culture comes back positive for Streptococcus A. • The child must finish the entire course of oral antibiotics to prevent the development of resistant strains of bacteria and to make sure that the infection is completely treated.

Caring for a Child Whose Communicable Disease Causes a Rash:

• Dress the child in only cotton clothing, no synthetics. • Dress the child in loose-fitting, lightweight clothing. • Keep the rash covered from the sun. • Keep the skin cool and dry. • Provide cool baths or cool compresses on the rash; try oatmeal baths. • Do not allow the child to scratch the rash lesions; cover the hands of infants or young toddlers; apply infant mittens if needed. • Use mild soaps when bathing the child. • Prevent the child from becoming sweaty. • Change the child's bed linens daily. • Administer oral antihistamines if needed to prevent scratching. • Apply calamine lotion for topical relief.

When a child presents with flu-like symptoms (cough, fever, body aches) in any clinical setting:

The child and family should be placed away from others, and a mask should be placed on the child.

Pertussis incubation period:

The incubation period for pertussis is 7 to 10 days, and onset usually occurs 6 to 20 days after exposure.

The father of a child who has been admitted for IV antibiotics for methicillin-resistant Staphylococcus aureus (MRSA)-positive pneumonia asks the nurse what the term incubation period means. What is the best response by the nurse?

The incubation period is the time between exposure to the infection and the first symptoms.

Protective Precautions (aka reverse precautions or neutropenic precautions):

The patient is protected from communicable diseases by a positive-pressure room. - Here as the door opens, air is pushed out toward the hallway to prevent airborne or droplet-transmitted microbes from entering the child's room. - Patient protective in negative pressure room. - Used for kids with decreased immune systems or corticosteroids or HIV.

Passive Immunity:

The temporary immunity acquired by transfusing immune globulins or antitoxins either artificially from another human or from an animal that has been actively immunized against an antigen, or naturally from the mother to the fetus via the placenta.

A nurse is explaining to new parents how vaccines increase a child's antibodies to protect him or her from infection if the child is exposed to a communicable disease. How should the nurse describe the effectiveness of childhood vaccines?

They are useful in the prevention of childhood communicable diseases, but they are not always 100% effective.

The patient has an impaired ability to clear secretions because of damage to the cilia of the lungs:

Thick, tenacious secretions obstruct the bronchi and bronchioles of the lungs, often leading to atelectasis and pneumonia.

Many childhood diseases no longer around ( polio, smallpox) because of?

Vaccines, but its becoming more popular to not vaccinate so we are seeing and increase in some diseases such as measles.

A 6-month-old infant is due for the last dose of hepatitis B vaccine. Which site should the nurse select for administering the injection?

Vastus lateralis

GI symptoms of the common flu:

Vomiting, abdominal pain, and diarrhea with secondary dehydration can occur with the flu and require fluid replacement therapy.

Roseola incubation period:

he approximate incubation period for roseola is 10 days.

Why should the child be monitored for 20 minutes post-administration?

iPV inactivated poliovirus

Rotavirus is easily spread in?

Day-care centers, where frequent diaper changes occur and children share toys and food.

The parents of 1-year-old DeShawn bring him to the clinic for a well-child visit. When it is time for their son to receive his scheduled immunizations, the parents refuse, stating, "We don't want him exposed to any more thimerosal." Which response by the nurse is most appropriate?

"In fact, studies show that thimerosal is safe at low levels, but we do have thimerosal-free vaccines that we can give your child."

A child is in droplet precautions. For which distance would wearing a mask not be required?

3 Feet

Pertussis: Whooping Cough

A common, serious, and very contagious bacterial infection of the upper respiratory tract, which is especially concerning in infants.

Endemic:

A disease that occurs continuously or in expected cycles in a population with a certain number of cases expected for a given period.

Polio:

A highly contagious infectious disease of the spinal cord caused by a filterable virus.

__________ __________ is obtained in two ways: (1) by exposure to a bacterium, virus, or toxin sufficient to stimulate an immune response by the body, or (2) by stimulating the body's immune response through vaccination or immunization.

Active Immunity

Epidemic:

An infectious disease or condition that attacks many people at the same time in the same geographical area.

Influenza:

Annually from infancy through old age Inactivated virus

Communicable Disease:

Capable of being transmitted from one individual to another.

Rotavirus in Infants and young children are at risk for?

Dehydration because of fluid loss from vomiting and severe, prolonged diarrhea.

Most signage is now standardized to list what PPE is required and has pictures or illustrations of what is required:

Gloves, masks, and gowns should be available for staff, family, and visitors to use, and precautions should be enforced.

The vaccine for tetanus is part of the?

DTaP vaccination (diphtheria, tetanus, and acellular pertussis). Vaccination does not provide lifetime immunity, and boosters are needed every 10 years to maintain immunity ***2,4,6, 15-18 mos and 4-6 yrs

Preventing the spread of influenza to vulnerable sick children is a nursing imperative:

Droplet and contact precautions should be implemented right away. For H1N1 (very serious) strains of the flu, an N95 mask is required.

Assessments of Pneumococcus:

Early symptoms of pneumococcus are similar to cold symptoms and may progress to ear infections, bronchitis, or pneumonia.

What are examples of Recombinant vaccine?

Examples of this type of vaccine are pneumococcal pneumonia and Haemophilus influenzae.

Tetanus symptoms:

Fever, tachycardia, high blood pressure, sweating, and cardiac arrhythmias. *** NO CURE

What are the common side effects of the Rotavirus?

Fever, vomiting, and diarrhea in 10% of children and poor feeding in 25% of children.

Antigen:

Foreign substance such as bacteria, viruses, toxins, and foreign proteins that stimulates the formation of antibodies and therefore provides immunity.

Haemophilus influenzae Type B (Hib):

Four doses: 2 months; 4 months; 6 months; and 15 months Polysaccharide conjugate vaccine

Respiratory Symptoms of the common flue:

Inflammation of the larynx and trachea, cough, sore throat, nasal congestion, and retrosternal pain are associated with the flu. Children often develop croup, pneumonia, and bronchitis as secondary conditions.

Common side effects from the HPV vaccine include?

Injection site reactions, headache, fatigue, muscle aches, and joint pain.

When a patient is diagnosed with hepatitis B, antiviral medications such as?

Interferon alfa-2b (Intron A) or lamivudine (Epivir-HBV) may be administered

What is one challenge we see in pediatric nursing?

Is that the very young kids cant tell us what is wrong, so we have to be observant.

Although serological tests are available for definitive diagnosis, the mumps virus can be?

Isolated from throat washings, urine, cerebrospinal fluid (CSF), and other body fluids.

Community outbreaks of hepatitis A can be common because it is?

Most contagious 1 week before symptoms begin. A vaccine for Hep A is available.

Only a few childhood communicable diseases, such as?

Pertussis, tuberculosis (TB), and measles, are followed for epidemic and endemic patterns.

Zinc supplementation has also been shown to prevent?

Pneumonia in children between 2 months and 5 years of age.

Pneumococcus severe reactions:

Pneumonia, chest cold, and gastroenteritis have been reported during vaccine trials; however, these may have been unrelated to the vaccine

Rare but serious complications of varicella can include?

Pneumonia, septicemia, toxic shock syndrome, septic arthritis, encephalitis, hemorrhagic conditions, and death.

Who are high risk for Measles?

Pregnant women or children with immune dysfunction diseases may require IV immunoglobulins (antibodies) to prevent serious complications.

An important aspect of childhood communicable disease is the Child's immune systems ability to respond( leukemia).

True

If anaphylactic shock place child flat with legs slightly elevated.

True

If reaction occurs it can be reported thru VAERS and if reported in time it is listed on the product insert.

True

School-aged children have the highest flu infection rate in the population and may be hospitalized because of the complications of this virus.

True

There is no link between the immunizations and autism.

True

Those who survive Hib meningitis have long-term neurological problems including permanent hearing loss.

True

You don't give oral polio or varicella vaccines to immunosuppressed kids.

True

MMR: Measles, Mumps, and Rubella:

Two doses: 12-15 months; 4-6 years Live virus

Intranasal spray:

Uses a live attenuated influenza virus) can give kids adverse reactions ( fever, malaise, muscle pain, and other general symptom)

Treatment for rubella:

Usually symptomatic for an individual who has the disease and includes medication for fever and aches, fluids, and rest.

What are the examples of Whole (active) virus vaccine?

anthrax, cholera, whooping cough, rabies, inactivated polio, and typhoid.

The CDC recommends two doses of chicken pox vaccine for children:

the first dose at 12 to 15 months and a second dose at 4 to 6 years.

If the parents of a child hospitalized with a communicable illness express concerns about immunizations, or if they have refused or delayed their child's immunizations, the health-care team must provide additional teaching to both parents before discharge:

• Educating the family about the importance of a complete immunization program for all children to prevent childhood diseases such as the one that the child is being treated for • Providing written information on the immunization schedule and on each immunization being administered • Teaching them that there are catch-up schedules that can start right away • Educating them about each of the diseases/infections and their complications • Scheduling a follow-up appointment for after discharge so that they can be seen right away by a pediatrician who will implement a catch-up immunization schedule

Symptoms of Strep Throat:

• Severe sore throat, often with rapid onset • Red, raw, swollen throat tissue with white spots • High fever • Low energy • Swollen lymph nodes in the neck • Not wanting to swallow; pain with swallowing

If preventing a tick bite is not successful, the following measures are recommended to remove the tick:

• Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible. • Pull upward with steady, even pressure. Do not twist or jerk the tick; this can cause the mouthparts to break off and remain in the skin. If this happens, remove the mouthparts with clean tweezers.

Several protective measures are recommended to prevent being bitten and infected by ticks. These measures should be used in areas where grass, trees, or brush grow:

• Wear long pants. • Tuck pant legs into socks so that ticks cannot get inside pant legs. • Wear a long-sleeved shirt and tuck it inside the pants. • Spray insecticide containing permethrin on boots and clothing. • Apply insect repellent containing DEET on your skin and reapply every few hours. • Inspect for ticks, particularly in hair and on creased areas of the body where ticks may hide.

Proper storage and handling will ensure potency of vaccine:

•Do not store in refrigerator or freezer door •Store in center of shelves, away from vents •Store at 35° to 46° F (1.6° to 7.7° C) •Vaccines cannot be refrozen after they have been thawed

Contraindications to Immunizations:

•Immunocompromised state •Pregnancy (with certain vaccines) •Bacteremia or meningitis •Immunocompromised caregiver in the home •Requires individual evaluation by the health care provider •Corticosteroid therapy •Requires individual evaluation •History of high fever or other reaction after previous immunization

Vaccines:

•Multiple doses at predetermined intervals may be needed to achieve an immunity •Used to prevent disease, cannot be used to treat disease •Correct route of administration: Important to achieve optimum immunization

Reporting Mandates:

•Severe reactions can occur with childhood immunizations •Serious reactions: voluntarily reported through the Vaccine Adverse Events Reporting System (VAERS) •If reported enough: listed as a post-licensing-reported reaction in the vaccine information or product insert (PI) •Check with local public health department to learn reactions or childhood diseases that are mandated to be reported

Nursing Responsibilities for Immunizations:

•When/at what age vaccines are due. •Childs immunization history. •Vaccines that can be given together. •Contraindications. •Route of administration. •Proper equipment/supplies needed. •Any emergency meds/equipment needed. •To observe infant for at least 20 minutes after.