UWorld Pediatrics: Infectious Disease

The nurse plans care for a child admitted with measles. Which of the following interventions will the nurse include in the plan of care?

1) Advise measles vaccination to susceptible family members 2) Negative air flow room 3) Wear N95 respirator mask

The clinic nurse provides teaching for the parent of a child diagnosed with scabies. Which instructions should the nurse include in the teaching plan?

1) All people in close contact with the child need treatment 2) Apply permethrin cream to all skin surfaces 3) Wash the child's clothing and bedding in hot water or sealed in plastic bags for greater than 3 days

A nurse is caring for a school-age client who has fever, somnolence, and a skin rash from suspected meningococcal meningitis. Which interventions should be implemented for this client?

1) Allow patient to self position for comfort 2) keep NPO status 3) minimize environmental stimuli

The most recent laboratory results for a 12-month-old who is HIV-positive show a CD4 lymphocyte count of 500/mm3 and a CD4 lymphocyte percentage of 10%. The nurse anticipates administering which immunizations?

1) Hemophilus influenza type A 2) Hep A 3) Pneumococcal conjugate vaccine (PCV) - Children with severe immunosuppression as indicated by CD4 lymphocyte counts and/or percentages should not receive any live vaccines, including MMR and varicella.

Which discharge teaching instructions should the nurse provide to the parents of a 2-year-old with group A streptococcal pharyngitis?

1) replace toothbursh 24 hours after starting antibiotic 2) cool liquids and soft diet are recommended 3) complete all antiboitics even if child is feeling better 4) return to school or daycare after they have completed 24 hours of antibiotics and are afebrile.

The nurse is reviewing discharge teaching with the parent of a child with acute myelogenous leukemia who was admitted with varicella-zoster virus. The client has multiple lesions that have not crusted. Which of the following instructions should the nurse include?

Apply diphenhydramine cream sparingly to the lesions after bathing your child Keep giving your child acyclovir at home as prescribed You can give your child acetaminophen for fever and mild pain Your child will no longer be infectious after all the lesions have crusted over

The parent of an 11-month-old child calls the pediatric outpatient clinic and tells the nurse that the child was exposed to measles 2 days ago during a family trip to a theme park. What is the best response by the nurse?

Bring your baby to the clinic for an MMR vaccine - a child age <12 months can and should receive the MMR vaccine when there is an outbreak of measles and the child risks contracting the illness due to an exposure.

The parent of a 15-month-old calls the nurse and says that the child developed a rash and mild fever after receiving a routine measles, mumps, rubella, and varicella (MMRV) vaccine in the pediatric clinic 5 days ago. What is the best response by the nurse?

Does your child have a temperature? - Although rare, fever after MMRV vaccination can lead to febrile seizures. - The normal MMRV vaccine reactions that occur within 5-12 days after vaccination include mild fever and rash, irritability and restlessness, and swelling and erythema at the injection site.

An adolescent client with a sore throat is diagnosed with infectious mononucleosis. Which comment by the caregiver would alert the nurse that additional instruction is necessary?

I will need to pick up an antibiotic prescription at the pharmacy

A mother brings a child to the emergency department with itching and the rash shown in the exhibit. The child continues to scratch the lesions. What action should the nurse take first?

Place a mask on the child (has chickenpox) - The priority for a child with chicken pox is isolation (airborne, contact). Supportive care includes antihistamines for itching and acetaminophen (NOT aspirin) for fever. Fingernails should be cut short to prevent excoriation and secondary bacterial infection.

The clinic nurse assesses an 8-year-old client who reports a sore throat and has a bright red, pruritic rash on the chest that feels like fine bumps and looks like a sunburn. Which diagnostic tool does the nurse anticipate the health care provider will prescribe?

Rapid streptococcal skin test - Scarlet fever (ie, scarlatina), a complication of group A streptococcal infection (eg, streptococcal pharyngitis), is characterized by a distinctive red rash. Diagnosis is based on clinical presentation, rapid streptococcal antigen testing, and possible throat culture.

What are the symptoms of fifth disease?

Rash and joint pain 5-10 day incubation followed by severe rash on cheeks and then arms and legs, show influenza like symptoms, people with chronic anemia show malaise and joint pain there may be fetal infection in pregnant women, but no birth defects associated, in sever cases may cause Hydrops fetalis in babies, leading to death from heart failure Abnormal accumulation of fluid in 2 or more compartments (liver, heart) 10% mortality rate

What is Reye syndrome?

Reye syndrome often have had a recent viral infection, especially varicella (chicken pox) or influenza. Clinical manifestations include fever, lethargy, acute encephalopathy, and altered hepatic function.

A 15-month-old begins to seize during assessment for a high-grade fever. What is the most appropriate nursing action?

Stay with the client and monitor oxygen sat levels - Most clients experiencing a febrile seizure remain stable but still need continuous monitoring for hypoxia. They usually do not require anti-seizure medication. Ensuring client safety is important; therefore, the nurse should never leave a seizing client alone and stay to monitor oxygen saturation levels.

When do children need to be revaccinated for MMR?

The child will need to be revaccinated between age 12-15 months and between age 4-6 years.

What is fifth disease?

a viral illness caused by the human parvovirus and affects mainly school-age children. - Affected children typically recover quickly, within 7-10 days.

A nurse is giving instructions related to antibiotic eye drops to the parent of a 5-year-old with bacterial conjunctivitis. Which instruction is most important?

wash hands before giving the drops - also tissues used to wipe excess med from eye must be immediately discarded - keep towels and washcloths separate - child should not rub affected eye