Pediatric Infectious and Communicable Diseases

The home care nurse provides instructions regarding basic infection control to the parent of an infant with HIV infection. Which statement, if made by the parent, indicates the need for further instruction? 1. "i will clean up any spills from the diaper with diluted alcohol" 2. "i will wash baby bottles, nipples, and pacifiers in the dishwasher" 3. "i will be sure to prepare foods that are high in calories and high in protein" 4. "i will be sure to wash my hands carefully before and after caring for my infant"

1. "i will clean up any spills from the diaper with diluted alcohol"

An infant of a mother infected with 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? 1. cough 2. liver failure 3. watery stool 4. nuchal rigidity

1. cough

Which home care instructions should the nurse provide to the parent of a child with AIDS? Select all that apply. 1. monitor the child's weight 2. frequent hand washing is important 3. the child should avoid exposure to other illnesses 4. the child's immunization schedule will need revision 5. clean up body fluid spills with bleach solution (10:1 ratio of water to bleach) 6. fever, malaise, fatigue, weight loss, vomiting, and diarrhea are expected to occur and do not require special intervention

1. monitor the child's weight 2. frequent hand washing is important 3. the child should avoid exposure to other illnesses 5. clean up body fluid spills with bleach solution (10:1 ratio of water to bleach)

The nurse is caring for a 4 yo child with HIV infection. The nurse should expect which statement that is aligned with the psychosocial expectations of this age? 1. "being sick is scary" 2. "i know it hurts to die" 3. "i know i will be healthy soon" 4. "i know i am different than other kids"

2. "i know it hurts to die"

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1. the child has symptoms of a cold 2. the child had a previous anaphylactic reaction to the vaccine 3. the mother reports that the child is having intermittent episodes of diarrhea 4. the mother reports that the child has not had an appetite and has been fussy 5. the child has a disorder that caused a severely deficient immune system 6. the mother reports that the child has recently been exposed to an infectious disease

2. the child had a previous anaphylactic reaction to the vaccine 5. the child has a disorder that caused a severely deficient immune system

A child is receiving a series of the hepatitis B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parent about a history of a severe allergy to which substance? 1. eggs 2. penicillin 3. sulfonamides 4. a previous dose of hepatitis B vaccine or component

4. a previous dose of hepatitis B vaccine or component

The clinic nurse is instructing the parent of a child with HIV infection regarding immunizations. The nurse should provide which instruction to the parent? 1. the hepatitis B vaccine will note be given to the child 2. the inactivated influenza vaccine will be given yearly 3. the varicella vaccine will be given before 6 months of age 4. a western blot test needs to be performed and the results evaluated before immunizations

2. the inactivated influenza vaccine will be given yearly

A 6 yo child with 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 should make which best response to the child? 1. "the pain will go away if you lie still and let the medicine work" 2. "try not to think about it. The more you think it hurts, the more it will hurt" 3. "i know it must hurt, but if you tell me when it does, i will try to make it hurt a little less" 4. "every time it hurts, press on the call button and i will give you something to make the pain go all away"

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

The nurse provides home care instructions to the parent of a child with AIDS. Which statement by the parent indicates the need for further teaching? 1. "i will wash my hands frequently" 2. "i will keep my child's immunizations up to date" 3. "i will avoid direct unprotected contact with my child's body fluids" 4. "i can send my child to day care if he has a fever, as long as it is a low-grade fever"

4. "i can send my child to day care if he has a fever, as long as it is a low-grade fever"

The mother with HIV infection brings her 10 month old infant to the clinic for routine checkup. The HCP has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response to the mother? 1. "i am so pleased also that everything has turned out fine" 2. "because symptoms have not developed, it is unlikely that your infant will develop HIV infection" 3. "everything looks great, but be sure to return with your infant next month for the scheduled visit" 4. "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"

4. "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"

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? 1. "we need to encourage our child to drink fluids" 2. "coughing spells may be triggered by dust or smoke" 3. "vomiting may occur when our child has coughing episodes" 4. "we need to maintain droplet precautions and a quiet environment for at least 2 weeks"

4. "we need to maintain droplet precautions and a quiet environment for at least 2 weeks"

A parent brings her 4 month old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? 1. varicella, hepatitis B vaccine 2. diphtheria, tetanus, acellular pertussis (DTaP); measles, mumps, rubella (MMR); inactivated poliovirus vaccine (IPV) 3. MMR, Haemophilus influenzae type b (Hib), DTaP 4. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)

4. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1. monitor the infant for a fever 2. bring the infant back to the clinic 3. apply a hot pack to the injection site 4. apply a cold pack to the injection site

4. apply a cold pack to the injection site

A HCP prescribes laboratory studies for an infant of a woman positive for HIV. The nurse anticipates that which laboratory study will be prescribed for the infant? 1. chest xray 2. western blot 3. CD4+ cell count 4. p24 antigen assay

4. p24 antigen assay