NCLEX/HESI Pediatric Immune Problems and Infectious Disease

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for FURTHER instruction?

"We need to maintain droplet precautions and a quiet environment for at least 2 weeks." *Incorrect because respiratory precautions are not required during the convalescent phase.

Mumps

Paramyxovirus, 14-21 days. From saliva and urine. Direct or droplet. Fever. Headache/Malaise. Anorexia. Jaw/ear pain. Orchitis. Deafness. Aseptic meningitis.

Rocky moutain spotted fever

Rickettsia rickettsii, 2-14 days. Tick bite. Fever. malaise. anorexia. vomiting. headache. myalgia. Maculopapular or petechial rash over ankles and writs.

The nurse is assessing a child admitted with a diagnosis of rheumatic fever. Which significant question would the nurse ask the child's parent during the assessment?

"Has any family member had a sore throat within the past few weeks?"

The nurse provides home care instructions to the parent of a child with acquired immunodeficiency syndrome (AIDS). Which statement by the parent indicates the need for FURTHER teaching?

"I can send my child to day care with a fever as long as it is a low-grade fever." *They should be kept at home.

A 6-year-old child with human immunodeficiency virus (HIV) infection has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse would make which best response to the child?

"I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."

The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus (HIV) infection. Which statement, if made by the parent, indicates the need for further instruction?

"I will clean up any spills from the diaper with diluted alcohol." *Alcohol would not kill the virus but bleach would.

A birthing parent with human immunodeficiency virus (HIV) infection brings a 10-month-old infant to the clinic for a routine checkup. The pediatrician has documented that the infant is asymptomatic for HIV infection. After the checkup the parent tells the nurse about being so pleased that the infant will not get HIV infection. The nurse would make which most appropriate response to the parent?

"Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old."

MRSA prevention

Frequent hand washing. Strict aseptic tech. Avoid sharing personal items. Regular cleaning of equitment. Clean wounds. Clean piercings and tatoos.

Rubella (German Measles)

14-21 days. From nasopharyngeal secretions, blood, stool and urine. Airborne, droplet and contact precautions Low fever. Malaise. Pink rash from face to body. Petechiae red spots.

scarlet fever

2-5 day incubation. Direct/droplet from nasopharyngeal secretions. High fever. Flushed cheeks. Vomiting. Headache. Enlarged lymph nodes. Malaise. Abd. pain. Sandpapper rash over body, not face. Pastias sign. Sheetlike sloughing of the skin. White furry strawberry tongue. Tonsils are red. Pharynx beefy red.

Pertussis (whooping cough)

7-10 days, up to 20. Direct/droplets from respiratory secretions. Loud cough. Cyanosis. Respiratory distress. Tongue protrusion. Listlessness. Irritability. Anorexia.

Rubeola (measles) interventions

Airborne and contact percautions. Quiet activities/rest. Cool mist vaporizer. Dim lights for photophobia. Antipyretics for fever. Vitamin A.

chicken pox (varicella)

Airborne, contact, droplet from respiratory secretions or skin lesions. 14-16 days. Slight fever. Malaise. Anorexia. Mascular rash. Lesion pustules. Crusting. *Isolate high risk children with immunosupression or communicable disease.

Rubeola (measles)

Airborne/Direct. paramyxovirus, 10-20 days incubation. From respiratory tract secretions, blood or urine. Fever/Mailiase. 3 C's- coryza, cough, conjuctivitis. Red rash and Erythematous maculopapular going from face to feet. Rash for 6-7 days. *Koplik's spots= 3 days of red spots with blue/white center.

The nurse is caring for a child diagnosed with erythema infectiosum (fifth disease). Which clinical manifestation would the nurse expect to note in the child?

An intense fiery red edematous rash on the cheeks

AIDS s/s

Candidal esophagitis. Cryptosporidosis. Cytomegalovirus. Herpes. HIV. Lymphoid pneumonitis. Mycobacterium infection. Pneumonia. Pulmonary candidiasis. Bacterial infection. Wasting syndrome.

HIV s/s

Chronic cough. Diarrhea. Developmental delay. FTT. Hepatosplenomegaly. Lymphadenopathy. Malaise/fatigue. Night swears. Oral candidiasis. Parotitis. Weight loss.

COVID-19

Contact, droplet and airborne. Fever. Cough. Sore throat. Fatigue. Diarrhea. Risk for pediatric inflammatory multisystem syndrome (PIMS). Having underlying conditions puts you at a higher risk.

Diphtheria

Corynebacterium 2-5 days. Direct contact with discharge from mucous membranes. Low fever/malaise. Foul smelling snot. Dense formation in the throat interfeers with eating, drinking, and breathing. *Bull neck edema.

Common tests for HIV

ELISA Western blot Polymerase chain reaction. P24 antigen. CD4 lymphocyte.

poliomyelitis (polio)

Enterovirus, 7-14 days. 1 week in feces. 4-6 weeks in throat. Direct contact with oropharyngeal secretions. Fever. Malaise. Anorexia. Nausea. Headache. Sore throat. Abd. pain. Sore neck. Limb paralysis.

Roseola (Exanthem Subitum)

HHV-6, 5-15 days. Sudden high fever followed by rash and febrile seizures.

HIV

HIV infects CD4+ T cells. Transmitted through blood, semen, vaginal secretions and human milk. Horizontal transmission is from contact. Vertical transmission is perinatal. *High risk for opportunistic infection.

Influenza S/S

Headache. Body aches. Fatigue. Chills. Cough. Congestion. Sore throat. Loss of appetite. Vomiting. Diarrhea. Symptoms usually last a week.

HIV/AIDS care instructions

High calorie, high protein diet. No fresh fruits and vegetables or raw meats. No contact with infected children,. No sharing utensils or sheets. Clean up body fluids with bleach 10:1

Erythema Infectiosum (Fifth Disease)

Human parvovirus. 4-14 days, up to 20. Mild fever/malaise. Runny nose. Slapped check rash. Skin is irritated by the sun, heat and cold. Antipyretics. Analgesics. Antiinflammatory.

Pertussis (whooping cough) interventions

Isolate during catarrhal stage. Antimicrobial therapy. Reduce environmental factors-dust, smoke, changes in temperature. Hydration. Nutrition. Suction and humidified oxygen. Cardiopulmonary status.

Protection against tick bites

Long sleeve shirts and pants. Hats. Light clothing. Stay on paths. Insect repellents. Trim yards. Remove tick fully.

Which home care instructions would the nurse provide to the parent of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

Monitor the child's weight. Frequent hand-washing is important. The child needs to avoid exposure to other illnesses. .Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).

Immunizations for an HIV child

Only inactivated influenza. Inactivated polio. NO measles. NO rotavirus. Varicella-zoster. Tetanus immunoglobulin.

mumps interventions

Private room. Droplet/contact. N95. Gown and gloves. Ensure rest. Soft food. Hot/cold compress.

The nurse caring for a child diagnosed with rubeola (measles) notes that the pediatrician has documented the presence of Koplik's spots. On the basis of this documentation, which observation is expected?

Small blue-white spots with a red base found on the buccal mucosa

The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse would provide which instruction to the parent?

The inactivated influenza vaccine will be given yearly.

The parent of a child with mumps calls the health care clinic to tell the nurse that the child has been lethargic and vomiting. What instruction would the nurse give to the parent?

To bring the child to the clinic to be seen by the pediatrician. *This could be a sign of septic meningitis.

An infant of a birth parent infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign?

cough

MRSA

methicillin resistant staph aureus. Hospital aquired, direct contact, open wounds and blood. Red/swollen. Warm. Pus. Fever/malaise. Chest pain. Cough. Fatigue. Chills. SOB.

A pediatrician prescribes laboratory studies for the infant of a birthing parent positive for human immunodeficiency virus (HIV). The nurse anticipates that which laboratory study will be prescribed for the infant?

p24 antigen assay