infection ch 43

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

"We need to make sure that he washes his hands frequently." Explanation: The child with varicella needs to wash his hands frequently with antibacterial soap to reduce bacterial colonization. A cool bath with soothing colloidal oatmeal may help the skin discomfort. Alcohol would be too drying to the skin. Acetaminophen, not aspirin, should be used to reduce fever. The lesions should eventually crust over. Soft crusts with drainage may suggest an infection.

A child is diagnosed with an enterovirus infection. Which type of infection control precaution would be most important for the nurse to use?

Contact Explanation: For the child with an enterovirus infection, contact precautions are used during the illness. Standard precautions are followed at all times and are appropriate for any child. Droplet precautions would be used for a child infected with pertussis. Airborne precautions would be indicated for the child with varicella.

The nurse caring for children with fungal infections most often administers which of the following medications?

Griseofulvin Explanation: Griseofulvin, an oral antifungal, is the medication of choice for fungal infections. In some infections the treatment may be prolonged (three months or more), and compliance must be reinforced.

Put the following stages of infectious disease in correct order:

Incubation period Prodromal period Illness Convalescent period

A nurse is instructing the parents of a child who is suspected of having pinworms how to check the child. Which of the following instructions would be most appropriate?

Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep. Explanation: Diagnosis is confirmed by direct visualization of worms by the parents or by microscopy. Tell parents to view the child's anus with a flashlight 2 to 3 hours after the child is asleep. The worm is white, thin, and about 1/2 inch long, and it moves. Pinworms are not identified as black dots on bed linens. Specimens are best obtained as the child awakens before toileting or bathing. Checking the washcloth would be of no benefit. Pinworms do not change the appearance of the stool.

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections?

Neutrophils Explanation: Elevations in certain portions of the white blood cell count reflect different processes occurring in the body. Neutrophils function to combat bacterial infection. Eosinophils function in allergic disorders and parasitic infections. Basophils combat parasitic infections and some allergic disorders. Lymphocytes function in viral infections.

The nurse is discussing medications to be given to a child who has been diagnosed with Candidiasis. Which of the following medications would most likely be prescribed for the child?

Nystatin Explanation: Application of nystatin (mycostatin, nilstat) to the oral lesions every 6 hours is an effective treatment for candidiasis. Treatment for diaper rash caused by candida albicans is the application of nystatin ointment or cream to the affected area.

A nursing instructor is teaching students about childhood infectious diseases. Which of the following would the instructor identify as the cause of warts in children?

Papilloma virus Explanation: Warts, one of the most common dermatologic diseases in children, are caused by the papillomavirus.

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child?

Penicillin V Explanation: Penicillin V is the antibiotic of choice for the treatment of scarlet fever. Ibuprofen is used to treat fever. Acyclovir is used to treat viral infections. Doxycycline, a tetracycline, is the drug of choice for treating Rocky Mountain spotted fever.

What condition begins as an upper respiratory illness and progresses to a persistent cough characterized by an inspiratory whoop?

Pertussis Explanation: Pertussis, also known as whooping cough, begins as an upper respiratory illness and progresses to a persistent cough characterized by an inspiratory whoop. TB is not characterized by an inspiratory whoop. Sepsis and HIV are not associated with an inspiratory whoop.

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease?

Playing in the woods about a week ago Explanation: Lyme disease is caused by the bite of an infected tick, with a rash appearing 7 to 14 days after the tick bite. Ticks are commonly found in wooded areas. Therefore, reports of the child playing in the woods about 7 days ago would support the diagnosis of Lyme disease. A papular and vesicular rash is commonly associated with varicella (chickenpox). A high fever for 3 to 5 days before a rash suggests roseola. Extreme pruritus with visible nits would suggest pediculosis.

One method of preventing communicable diseases in children is to administer vaccines to stimulate the development of antibodies. Which of the following best describes what occurs in the child when vaccines are given?

The child develops an active immunity. Explanation: When a vaccine is given, active immunity occurs which then stimulates the development of antibodies to destroy infective agents without causing the disease.

Which of the following is the drug of choice for multidrug-resistant strains of infection?

Vancomycin Explanation: Vancomycin is the drug of choice for serious infections involving multiple drug-resistant strains. Sensitive strains respond to most antibiotics including erythromycin and clindamycin. Most community-acquired MRSA infections can be treated on an outpatient basis with trimethoprim-sulfoxazole or clindamycin.

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

scarlet fever. Explanation: Group A streptococcal pharyngitis can progress to scarlet fever with the rash appearing in about 12 hours after the onset of the disease. Group A streptococcal pharyngitis is not associated with pneumonia. Impetigo is a group A strep infection involving the skin. Osteomyelitis can occur with an infection by group B streptococcus.