Infectious diseases Pediatrics

Which clinical manifestation would cause the nurse to suspect that the client is diagnosed with systemic lupus erythematosus?

Joint edema and tenderness Clinical features of systemic lupus erythematosus involve multiple body systems. When the musculoskeletal system is involved, the client exhibits joint tenderness, edema, and morning stiffness. Eyes that are red, burning, and tearing are commonly associated with allergic rhinitis (i.e., hay fever). Chest tightness and wheezing on expiration are associated with allergic asthma. Fever and night sweats are manifestations of acquired immunodeficiency syndrome

Measles

Koplick's spots Fever, cough, and conjunctivitis for 4-5 days Fever spikes up to 105 Red rash with white granules. Appears first on forehead and face, then spreads to trunk and extremities

Fifth Disease

Red rash on face progressing to trunk and extremities. Treat high fever and place in droplet precautions

H1N1 (swine flu)

S/S - Flu symptoms (cough, sore throat, fever, and myalgia). Severe pneumonia and acute respiratory distress. Dx - Symptoms, swab from nose or throat. Nrs care - antiviral (Tamiflu), supportive and symptomatic care.

Tetanus

S/S - Headache, restlessness, spasms of the mastication muscles, DIFFICULTY OPENING MOUTH, DYSPHAGIA, muscle spasms in the trunk, seizures. NRS care - prophylactic immunization of Tetanus, antibiotics, surgical debridement of the wound, diazepam for reduction of spasms.

scarlet fever

S/S - fever, sore throat, rhinitis, headache, enlarged cervical lymph nodes, SANDPAPER like rash appears 12-48 hours after onset of symptoms. Rash will begin to fade and fingers and toes can start to peel. STRAWBERRY TONGUE. NRS care - Antibiotic administration to treat Strep

Candida albicans

S/S white plaques on the surface of tongue and buccal membranes NRS care - Nystatin, educate parents about prevention, maintain nutrition

Cellulitis

Streak freak means it's in the blood

Fungal infections

Tinea capitis - Ringworm Tinea pedis - Athlete's foot Tinea cruris - Jock itch Tinea corporis - epidermal layer of skin Nrs care - anti-fungal medications

Mumps

UNILATERAL swelling of parotid glands S/S - Malaise, fever, anorexia, ear pain and pain with chewing, headache Control signs and symptoms, hydrate, good nutrition

HPV (human papilloma virus)

Warts - no shoe sharing, can be on inanament objects

West Nile Virus

spread to humans by the bite of an infected mosquito. S/S - Headache, malaise, anorexia, nausea, vomiting, myalgia, eye pain, lymphadenopathy, maculopapular rash. Rare cases can lead to encephalitis or meningitis. NRS care - Educate parents about the disease. Symptomatic care. Respond to parental concerns. Teach about insect repellents.

The nurse reviews measures to prevent tick bites with a parent of a child with Rocky Mountain spotted fever. Which statement by the parent indicates a need for further teaching?

"I will have my child wear long sleeves and long pants to keep covered up." 2."I will have my child stay on well-worn paths and not stray into tall grass." 3."I will check my child for ticks after being exposed to a high-risk tick-infected area." ***4."I will have my child wear dark colored clothing so the tick will not be attracted to the colors." Rationale: Protection from tick bites includes wearing light colored clothing to make the ticks more visible if they get on the child. Prevention of Rocky Mountain spotted fever includes measures to take to protect getting tick bites and includes wearing long-sleeved shirts, long pants tucked into socks, and a hat. Checking for ticks on children after they have been exposed to a high-risk area and using insect repellents containing diethyltoluamide and permethrins are also measures to take.

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement are true? (Select all that apply)

**1."It is extremely contagious. **2."It is most common in humid weather. 3."Lesions most often are located on the arms and chest. 4."It might show up in an area of broken skin, such as an insect bite." Rationale: Impetigo is a contagious bacterial infection of the skin caused by b-hemolytic streptococci or staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose, but may be present on the hands and extremities.

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin?

**1.Fine grayish red lines 2.Purple-colored lesions 3.Thick, honey-colored crusts 4.Clusters of fluid-filled vesicles Rationale: Scabies appears as burrows or fine, grayish red, threadlike lines. They may be difficult to see if they are obscured by excoriation and inflammation. Purple-colored lesions may indicate various disorders, including systemic conditions. Thick, honey-colored crusts are characteristic of impetigo or secondary infection in eczema. Clusters of fluid-filled vesicles are seen in herpesvirus infection.

The school nurse is conducting pediculosis capitus assessments. Which one indicates a positive head check?

1. Maculopapular lesions behind the ears 2. Lesions in the scalp that extend beyond the neck and hairline 3. White flaky particles throughout the scalp (Dandruff) 4. White sacs attached to the hair shaft in the occipital area Rationale: White sacs attached to the hair shafts in the occipital areaPediculosis capitis is an infestation of the hair and scalp with lice. The nits are visible and attached firmly to the hair shaft near the scalp. The occiput is an area in which nits can be seen. Maculopapular lesions behind the ears or lesions that extend to the hairline or neck are indicative of an infectious process, not pediculosis. White flaky particles are indicative of dandruff. → The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction?

A child is diagnosed with infectious mononucleosis. The nurse reinforces priority homecare instructions to the parents about the care of the child. Which instruction should the nurse provide to the parents?

1.Maintain the child on bed rest for 2 weeks. 2.Maintain respiratory precautions for 1 week. 3.Notify the pediatrician if the child develops a fever. ***4.Notify the pediatrician if the child develops abdominal or left shoulder pain. Rationale: Notify the pediatrician if the child develops abdominal or left shoulder pain. The parents need to be instructed to notify the pediatrician if abdominal pain (especially in the left upper quadrant) or left shoulder pain occurs, because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until the splenomegaly resolves. Bed rest is not necessary and children usually self-limit their activity. Respiratory precautions are not required, although transmission can occur via direct intimate contact or contact with infected blood. Fever is treated with acetaminophen

Cytomegalovirus (CMV)

A herpesvirus that can produce the symptoms of prolonged high fever, chills, headache, malaise, extreme fatigue, and an enlarged spleen. Give antiviral.

pertusis (whooping cough)

A highly contagious acute upper respiratory infection caused by the bacterium Bordetella pertussis. S/S - Whooping cough - high pitched inspiratory - persistent and has coughing paroxysms that lead to vomiting. Fever. NRS care - Antibiotic administration. Airway and oxygen monitoring. Possible hospitalization

After the first injection of an immunotherapy program, the nurse notices a large, red wheal on the client's arm, coughing, and expiratory wheezing. Which intervention should the nurse implement first?

Administering IM epinephrine per protocol Immediately on noticing the client's sign and symptoms, the nurse would determine that the client is experiencing anaphylaxis to the injection. The first action is to give 0.2 to 0.5 ml of 1:1,000 epinephrine I.M. Notifying the health care provider, beginning oxygen administration, and starting an I.V. line follow after the initial injection of epinephrine is administered

Haemophilus influenzae type B

Begins as upper respiratory infection Symptoms of infection are dependent on site - otitis media, upper and lower respiratory infections, septic arthritis, cellulitis. NRS care - ANTIBIOTIC ADMINISTRATION Supportive care

April is diagnosed with systemic lupus erythematosus. Which instruction would be included in the teaching plan for the client?

Wear large-brimmed hats when exposed to the sun. The client diagnosed with systemic lupus erythematosus needs to modify his lifestyle. This includes avoiding sun and ultraviolet light exposure, especially between the hours of 10 a.m. and 4 p.m. The client also should wear tightly woven clothing. Regardless of of the source, exposure to ultraviolet light, even by means of tanning beds, should be strictly avoided. Removing all dust-collecting items in the home is appropriate for client diagnosed with asthma. Carrying injectable epinephrine is appropriate for a client who is allergic to insect stings or certain foods.

systemic lupus erythematosus signs and symptoms

Weight loss, fatigue, fever; "butterfly rash" on face, neck and scalp; photosensitivity of skin, joint and muscle pain, joint deformities, nausea, vomiting and diarrhea

Rabies

an acute viral infection that is most commonly transmitted to humans by the bite or saliva of an infected animal. S/S - flu symptoms, malaise, fever, sore throat, headache. Alterations in mental status - confusion, hallucinations. Seizures, hyper-excitability, hyper-salivation, respiratory arrest. Dx - saliva samples, serum, spinal fluid, skin biopsies. NRS care - clean wound, rabies vaccine, rabies immune globulin, animal isolated and tested.

juvenile rheumatoid arthritis

an autoimmune disorder that affects children aged 16 years or less with symptoms that include stiffness, pain, joint swelling, skin rash, fever, slowed growth, and fatigue

Allergic reaction

angioedema, facial edema, anxiety, n/v, hypotension, cyanosis, altered LOC, tachycardia, can present with upper and lower obstruction

Roseola

any rose-colored rash marked by maculae or red spots on the skin S/S - sudden high fever >101 - 103

infectious mononucleosis (mono)

characterized by fever, a sore throat, and enlarged lymph nodes, caused by the epstein-barr virus Bedrest, hydration, fever control, isolation - even when at home

Varicella Zoster Virus

chicken pox and shingles Fever, malaise, rash, URI symptoms. H and P Decrease itching - clamine lotion Decrease pain - Acetaminophen Acyclovir and oatmeal baths

systemic lupus erythematosus

chronic autoimmune inflammatory disease of collagen in skin, joints, and internal organs

systemic lupus erythematosus nursing care

manage pain and inflammation, prevent exposure to triggers, treat symptoms, prevent complications, give corticosteroids (never withdraw), antimalarials, or immunosuppressives, maintain good nutrition, rest and exercise