PEDS toddler/ preschool diseases

assess the victim

(initiate cardiorespiratory support if needed; assess mental status, reevaluate routinely; take vitals; evaluate for possible concomitant trauma or illness, treat prior to ingestion of gastric decontamination)

prevent poison absorption

(place child in a side-lying, sitting or kneeling position with the head below the chest to prevent aspiration)

identify the poison

(question victim & witness; observe circumstances surrounding the poisoning; look for environmental clues and save all evidence of potential poisoning in the absence of other evidence, including symptoms of ocular or dermal exposure; call the poison control center or other competent emergency facility for immediate advice regarding treatment)

s/s of giardiasis

***stinky bad diarrhea **abdominal cramping diarrhea vomiting anorexia FTT ** initial symptoms

communicablity of Varicella is

1-2 days befor ethe rash and until all lesions are crusted and scabbed over

Incubation period for measles

10-20 days takes some time before s/s show up

Chickenpox incubation period is communicability is

2-3 weeks 1-2 days before the rash and until all lesions are crusted.

incubation period for pinworms

2-3 weeks contaminating anything they contact

incubation period for scarlet fever is

2-4 days

pertusis incuabtion period

6-20 days

Characteristics of the child

: birth- 1 year highest risk; neonatal,unwanted, brain damaged, hyperactive, or physically disabled child

s/s of pertusis

: common cold s/s- runny nose/congestion, sneezing, mild fever & cough Severe coughing aka "whoop" starts 1-2 weeks coughing fits, violent & rapid coughing, loud whooping sound upon inspiration Highly contagious diseases that causes coughing attacks so severe they will induce vomitin

severe lead toxicity is

> 70mcg. This requires immediate inpatient treatment.

effect of lead in a cellular level

At a cellular level it competes with calcium interfering with the regulating actions of calcium; in the brain lead disrupts the biochemical processes and may have a direct effect on the release of neurotransmitters may cause alterations in the blood brain barrier and may interfere with the regulation of synaptic activity;

chicken pox/ varicella

Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV). It causes a blister-like rash, itching, tiredness, and fever. The rash appears first on the stomach, back and face and then spreads over the entire body causing between 250 and 500 itchy blisters...

type of precautions for Varicella/ chickenpox

Direct contact, droplet, (airborne) spread, and contaminated objects Maintain standard: Airborne and contact precautions IF hospitalized. until all lesions are crusted

giardiasis is transmitted

Fecal-oral route water food animals (esp puppies) dont let them play with puppy poop

S/S measles

Fever, malaise, PHOTOPHOBIA,cough, conjuctivitis Dry cough Runny nose Sore throat Inflamed eyes (conjunctivitis) Tiny white spots with bluish-white centers on a red background found inside the mouth on the inner lining of the cheek — also called Koplik's spots A skin rash made up of large, flat blotches that often flow into one another

Influenza

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent flu is by getting a flu vaccine each year.

Prevention of measles vaccine is

MMR

giardisis

MOST COMMON INTESTINAL PARASITE IN THE US INCRASED RISK FOR KD WHO ATTEND DAYCARE Giardia infection is an intestinal infection marked by abdominal cramps, bloating, nausea and bouts of watery diarrhea. Giardia infection is caused by a microscopic parasite that is found worldwide, especially in areas with poor sanitation and unsafe water. Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. The parasites are found in backcountry streams and lakes but also in municipal water supplies, swimming pools, whirlpool spas and wells. Giardia infection can be transmitted through food and person-to-person contact.

Measles

Measles is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine. Also called rubeola, measles can be serious and even fatal for small children.

Pertussis (whooping cough)

Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by the bacterium Bordetella pertussis. Pertussis is known for uncontrollable, violent coughing which often makes it hard to breathe. After cough fits, someone with pertussis often needs to take deep breaths, which result in a "whooping" sound. Pertussis can affect people of all ages, but can be very serious, even deadly, for babies less than a year old

Pinworms

Pinworm infection is the most common type of intestinal worm infection in the United States and one of the most common worldwide. Pinworms are thin and white, measuring about 1/4 to 1/2 inch (about 6 to 13 millimeters) in length. While the infected person sleeps, female pinworms lay thousands of eggs in the folds of skin surrounding the anus. Most people infected with pinworms have no symptoms, but some people experience anal itching and restless sleep.

Rotavirus

Rotavirus is a contagious virus that can cause gastroenteritis (inflammation of the stomach and intestines). Symptoms include severe watery diarrhea, vomiting, fever, and abdominal pain. Infants and young children are most likely to get rotavirus disease. They can become severely dehydrated and need to be hospitalized and can even die.

Scarlet Fever

Scarlet fever is a bacterial illness that develops in some people who have strep throat. (Group A Beta hemolytic streptococci) scarlet fever features a bright red rash that covers most of the body. Scarlet fever is almost always accompanied by a sore throat and a high fever. sandpaper skin

Chelation

TERM used for removing lead from circulating blood and theoretically some lead from organs and tissues. It is unclear whether chelation affects lead stores in bones. does not counteract any effects of the lead multiple treatments may be needed. **adequate hydration is essential during therapy because the chelates are ecreted via the kidneys potential toxic side effects. renal hepatic and hematologic parameters should be monitored ex: BAL

nursing intervetntions for pinworms

Teach them how to do the tape test: before the child wakes up treatment usually requires 2nd treatments in 2 weeks prevention: HANDWASHING

S/S of chicken pox/ varicella

The classic symptom of chickenpox is a rash that turns into itchy, fluid-filled blisters that eventually turn into scabs. The rash may first show up on the face, chest, and back then spread to the rest of the body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all the blisters to become scabs.***spread to face and proxima extremties, RASH MAY EFFECT MUCOUS MEMBRANES Other typical symptoms that may begin to appear 1-2 days before rash include: fever tiredness loss of appetite headache

what medication should you give high risk chickenpox pts

administer acylovir

nursing Tx for scarlet fever

administer full course of antibiotiic therapy, analgesics, and antipyretics IM penicillin G Respiratory precautions for the 1st 24hours after ABX antibiotic therapy encourage fluids= fever no vaccine is present still

when can the child return to school after chicken pox?

after 1 week (end of communicability) until all lesions are crusted

there is a relationship between ______ and lead poisoning

anemia. children who are iron deficient absorb lead more readily than those with sufficient iron stores. lead can interfere with the binding or iron onto the heme molecule. kids have symptoms of anemia

lead poisoning affects

any part of the body, including the renal hematologic, and neurologic system. Of the most ocncern for young childrn is the developing brain and nervous system

Emergency steps in case of poison ingestion

assess the victim terminate exposure identify the poison prevent poison absorption

Children from ___ to ___ are at highest risk for being abused

children from birth to 1 year old are at highest risk for being abused

environmental characteristics

chronic stress, poverty, unemployment, divorce, poor housing, frequent relocation, alcoholism, drug addiction, increased exposure between parents & kids (over crowding)

Environmental characteristics

chronic stress, poverty, unemployment, divorce, poor housing, frequent relocation, alcoholism, drug addiction, increased exposure between parents & kids (over crowding)

pinworm is transmitted by

classrooms daycare centes

type of cough of pertusis

cough- short rapid coughs followed by crowing or "whoop" sound

long term neurocognitive signs of lead poisoning include

developmental delays, lowered intelligence reading skill deficits, visual spatial problems visual motor problems learning disabilites an lower academic success. chronic lead toxiicity may also affect physical growth and repoductive efficiency

Measles contact

direct contact with droplets

precaution for chicken pox

direct contact, droplet, contaminated object

Pertusis transmission

droplet or direct contact

Therapuetic treatment for lead poisoning

education, reassess/rescreen, chelation therapy (removing lead from circulating blood and theoretically some lead from organs & tissue

mode of transmission of pinworms

eggs are ingested or inhaled causes intense itching around the anus eggs are deposited under the fingernails continual re-infection

terminate the exposure

exposure (empty mouth of pills, plant parts, or other material; flush any body surfaces including eyes exposed to toxins with large amounts of moderately warm water or saline; remove contaminated clothing, including socks, shoes, and jewelry; ensure protection of rescuers & health care workers from exposure; bring victim of inhalation poisoning into fresh air)

s/s of rotavirus

fever,nausea, vomiting, WAtch out for dehydration for your patients

Pinworms s/s

intense perianal itching general irritablity restlessness poor sleep bed-wetting poor sleep bed wetting distractablity short attention span

With immunized child with mild breathrough varicella what precautions?

isolate until no new lesions are seen

Pathophysiology of lead

lead can affect may parts of the body including renal, hematologic & neurological systems for young kids brain & nervous system is the most concerning- lead moves through out the body but settles in the teeth and bones where it remains inert & in storage. kids who are iron deficient absorb lead more readily; lead can interfere with binding of iron on heme molecules creating picture of anemia even if kid is not iron deficient; lead can damage the proximal tubules of renal system; increase membrane permeability-increasing ICP-creating tissue ischemia and atrophy

what multi STAGES of the rash is included for chicken pox

maculas, papules, vesicles, pustules, and crusts

Nursing care for chickenpox

maintain standard,ariborne, and contact precautions until all lesion are crusted. keep child in home away from susceptible individuals until vesicles have dried adminster skin care:, provide cool aveeno baths and loose clothing. reach child to apply pressure instead of scratching it. administer antypyretics (NO ASPIRIN) and antihistamines

giardisis s/s incuabtion time

most infections resolve within 4-6 weeks chronic infection may last for years

s/s of lead poisoning

nausea, vomiting, constipation, anorexia and abdominal pain; hypophosphatemia, glycosuria, & aminoaciduria

pinworm is caused by

nematode: Enerbius vermicularis universally present in termperate climates

Risk factors for lead poinsoning

nonintact lead-based paint pottery or dishes containing lead living in poverty being younger than 6 years old dwelling in urban areas and living in older rental homes where lead decontamination may not be a priority

Rotavirus is caused by

nosocomial pathogens

3 risks factors that are commonly identified in child abuse

parental characterics characteristics of the child environmental characteristics

complications of pertusis

pneumonia (usual cause of death)

complications of measles

pneumonia, otis media, encephalitis

BAL-chelation

potential toxic side effects. renal hepatic and hematologic parameters should be monitored contrainidcited in children with peanut allergies or hepatic insufficenecy nor should it be given in conjuction with iron. must be given only at a deep intramuscular site in repeated doses over several days.

nursing interventions for Giardiasis

prevention -education of daycare staff -sanitary practices Famlly education

prevention of disease

primary prevention; vaccine HANDWASHING instruct the child to practicegood hand washing technique after toileting and before eating. Use a tissue to cough or sneeze

stages of Varicella

prodromal stage- low grade fever, malaise, and anorexia distribution stage- spreading of rash to face and proximal extremities but sparse on distal limbs and less on area not exposed to heat Constitution Stage- elevated temp irritability of pruitus

DX of lead poinsoning

rarely have symptoms lead testing of a venous blood speciment from a venipuncture. the collection process is important. blood must be collected carefully, to avoid contaminiation by lead on the skin. The acceptable BLL is now 10mcg

dont give aspirin to children why

risk for Ryes syndrome BUT helps treat inflammaiton/fever in Kawinski Disease

the most common cause of infectious diarrhea is caused by what

rotavirus can causes gastroenteritis in children under 5 may be viral, bacterial or funcal NOSOCOMIAL (get at hospital)

scarley fever precautions

standard and droplet precautions until 24 hours after initiation of treatment

s/s of scarlet fever

sudden high fever, pulse increased out of proportion to fever, h/a vomiting, general malaise, abdominal pain and chills Red rash. The rash looks like a sunburn and feels like sandpaper. It typically begins on the face or neck and spreads to the trunk, arms and legs. If pressure is applied to the reddened skin, it will turn pale. Red lines. The folds of skin around the groin, armpits, elbows, knees and neck usually become a deeper red than the surrounding rash. Flushed face. The face may appear flushed with a pale ring around the mouth. Strawberry tongue. The tongue generally looks red and bumpy, and it's often covered with a white coating early in the disease. The rash and the redness in the face and tongue usually last about a week. After these signs and symptoms have subsided, the skin affected by the rash often peels. Other signs and symptoms associated with scarlet fever include: Fever of 101 F (38.3 C) or higher, often with chills Very sore and red throat, sometimes with white or yellowish patches Difficulty swallowing Enlarged glands in the neck (lymph nodes) that are tender to the touch Nausea or vomiting Headache

Nursing Tx: Measles

teach parents supportive management for fever and discomfort use a dimly lit room or sunglasses for photophobia

what causes girardis

the giradisia parasite

Parental characterics that can cause a child to injury

young parents, single parent families,, socially isolated family with few supportive relationships, low self esteem of parent or little knowledge of appropriate parenting skills Substance abuse parents / abuseive families poor parental role models

plan for teaching parents the prevention of intestinal parasitic disease in their family

• Always wash hands & fingernails with soap & water before eating, handling food and after toileting; avoid placing fingers in mouth & biting nails; discourage kids from scratching bare anal area; use superabsorbent disposable diapers to prevent leakage; change diapers as soon as soiled & dispose of diapers in closed receptacle out of child's reach; do not rinse cloth or disposable diapers in toilet; disinfect toilet seats & diaper changing areas; use dilute household bleach or ammonia and wipe clean with paper towels; drink only treated water or bottled water, especially when camping; wash all raw fruits and vegetables and food that has fallen on the floor; avoid growing foods in soil fertilized with human or untreated animal poop; teach kids to poop only in toilet not on ground; keep dogs & cats away from playgrounds and sandboxes; avoid swimming in pools frequented by diapered kids; wear shoes outside