PEDS Chapter 15: Nursing Care of the Child with an Infection

A child has been diagnosed with hand, foot and mouth disease. The child's mother wants to know how long it will take for her child to feel better. What information should be provided to the child's parent? "Your child will likely feel better within a week." "It can take about 2 weeks for your child to feel better." "Within 10 days of starting the antibiotic therapy your child will start to feel better." "Once your child completes the antiviral therapy he will feel better."

"Your child will likely feel better within a week." Hand, foot, and mouth disease is a self-limiting virus. The condition normally self-resolves in a week. Antibiotic and antiviral therapies are not normally needed for treatment.

The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next? Place the child on bed rest. Begin physical therapy. Administer an antipyretic. Auscultate the child's lungs.

Auscultate the child's lungs. Because poliomyelitis can cause motor paralysis of the respiratory muscles, assessing respiratory status is priority. Once the nurse has ensured respiratory function is intact, the nurse can place the child on bed rest, administer an antipyretic, and begin physical therapy.

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? Encourage rest and relaxation. Antibiotic therapy may be initiated. Antiviral medications can be prescribed. Range of motion to prevent contractures.

Encourage rest and relaxation. Rubella infection is usually mild and self-limited. The care given is normally supportive. Rest is encouraged. Medications administered are normally limited to antipyretics and analgesics. Antibiotic and antiviral therapies are not normally included in the plan of treatment. Range of motion is not needed as mobility of the client is not limited.

The nurse is preparing to administer acetaminophen to a 4-year-old child to provide comfort. Which precaution is specific to antipyretics? Check for medicine allergies. Take the entire course of medication. Ensure proper dose and interval. Warn of possible drowsiness.

Ensure proper dose and interval. It is very important to ensure that the proper dose is given at the proper interval because an overdose can be toxic to the child. Concerns with allergies and taking the entire, prescribed dose are precautions when administering antibiotics and all medications. Drowsiness is not a side effect of antipyretics.

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? Notify the primary health care provider. Place the child on contact precautions. Obtain an electrocardiography (ECG). Clean the rash with rubbing alcohol.

Notify the primary health care provider. The nurse would suspect the child has Lyme disease and notify the health care provider for additional testing and potential antibiotic therapy. Precautions are not indicated for clients with Lyme disease. An ECG would only be needed if cardiac symptoms were noted. It is recommended to clean the site of the tick bite with rubbing alcohol when the tick is removed, not at a later time.

The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first? Obtain blood cultures. Initiate antibiotic therapy. Obtain urine specimen for analysis. Initiate intravenous therapy.

Obtain blood cultures. When treating a child suspected of having an infection, the blood cultures must be obtained first. The administration of antibiotics may impact the culture's results. A urine specimen may be obtained but is not the priority action. Intravenous fluids will likely be included in the plan of care but are not the priority action.

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? Severity of the sore throat An enanthematous rash Red, strawberry tongue White exudate on the tonsils

Red, strawberry tongue The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis.

What is a true statement regarding varicella zoster virus infection? Secondary bacterial infections of the skin can occur. The incubation period is 7 days. It is transmitted by fecal-oral route. It tends to be more severe in children.

Secondary bacterial infections of the skin can occur. Varicella zoster virus infection carries with it the complication of a secondary bacterial infection of the skin. The lesions are intensely pruritic, making the child want to scratch the lesions and opening them to a variety of organisms to invade. The incubation period is 10 to 21 days. It is transmitted by direct contact with the vesicles and by airborne route. It tends to be more severe in adolescents and adults.

The nurse is caring for a 5-year-old girl with scarlet fever. Which intervention will most likely be part of her care? Exercising both standard and droplet precautions. Palpating for and noting enlarged lymph nodes. Monitoring for changes in respiratory status. Teaching proper administration of penicillin V.

Teaching proper administration of penicillin V. Penicillin V or erythromycin is the preferred antibiotic for treatment of scarlet fever. Scarlet fever transmission is airborne, not via droplet. Lymphadenopathy occurs with cat scratch disease and diphtheria. Close monitoring of airway status is critical with diphtheria because the upper airway becomes swollen.

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply. a. Lyme disease b. Rocky Mountain spotted fever c. Psittacosis d. Ascariasis e. Scabies

a, b Infectious diseases caused by tick bites include Lyme disease and Rocky Mountain spotted fever. Psittacosis is transmitted to children by birds. Ascariasis is a roundworm infection. Scabies is a parasitic infection caused by a female mite.

Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? a 1-year-old receiving oral amoxicillin for otitis media an 18-month-old child receiving chemotherapy over 5 days a 2-year-old child with HIV being discharged later that day a 3-year-old child with malnutrition and poor weight gain

an 18-month-old child receiving chemotherapy over 5 days The children at highest risk for contracting a hospital-acquired infection include children younger than 2 years of age, children with a nutritional deficit, those who are immunosuppressed, those who have indwelling vascular lines or catheters, are receiving multiple antibiotic therapy, or who remain in the hospital for longer than 72 hours. To determine the child at greatest risk, count risk factors and determine which child has the most risk factors.

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? "Your child must have been exposed to someone with herpes zoster." "Herpes zoster is a reactivation of a previous varicella zoster infection." "Children who are immunocompromised are more likely to contract shingles." "Handwashing is an effective way to prevent the spread of infectious disorders."

"Herpes zoster is a reactivation of a previous varicella zoster infection." Herpes zoster (shingles) is reactivation of the latent varicella zoster (chickenpox) infection that occurs during times of immunosuppression and aging. Although it is possible to contract the varicella zoster virus from a person with herpes zoster or varicella zoster, a child diagnosed with herpes zoster has already been exposed to varicella zoster. Handwashing will not directly prevent herpes zoster.

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: herpes virus. enterovirus. protozoa. bacteria.

bacteria. Neonatal sepsis can be caused by viruses such as herpes simplex or enteroviruses and by protozoa (e.g., oxoplasma gondii). However, bacteria are typically the culprits.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as: enterovirus. fifth disease. rosacea. pityriasis rosea.

fifth disease. Erythema infectiosum is also known as "fifth disease." It starts with a fever, headache, and malaise. One week later, a rash appears on the face. A day later, the rash appears on the extensor surfaces of the extremities. One more day later, the rash appears on the trunk and flexor surfaces of the extremities. Pityriasis rosea is a skin rash that begins with a large spot on the chest, abdomen, or back that is followed by a pattern of small lesions. It is self-limiting and can be treated with steroid creams. Rosacea is a chronic inflammatory skin condition that causes redness to the face. An enterovirus infection can many times cause the same symptoms as the common cold or it can include the respiratory system. It is contagious.

The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is: griseofluvin ceftriaxone acyclovir penicillin

penicillin Syphilis responds to one intramuscular injection of penicillin G benzathine; if the child is sensitive to penicillin, oral doxycycline, tetracycline, or erythromycin can be administered as alternative treatment.

A 6-year-old child is being treated for a parasitic infection. When reviewing results from the child's white blood cell count, which finding would be anticipated? elevated monocytes reduced basophil levels increased eosinophil levels reduced neutrophil levels

increased eosinophil levels Eosinophils are the first line of defense against parasitic infections and allergic reactions and will be elevated. Monocytes are a second line of defense and will be elevated in response to leukemias, lymphomas, and chronic inflammation. Basophils respond to allergic disorders and hypersensitivity reactions. Neutrophils are the first line of defense upon invasion of bacteria, fungus, cell debris, and other foreign substances.

The most common complication of varicella is: pneumonia. secondary bacterial infections. scarring. encephalitis.

secondary bacterial infections. Varicella starts with lesions that appear first on the scalp, face, trunk, and then extremities. The lesions begin as macules then develop into papules and finally clear, fluid-filled vesicles. These lesions are intensely pruritic. The most common complication of varicella is secondary bacterial infection caused by the child scratching the lesions. Other complications include pneumonia, scarring, and encephalitis.

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning? oral temperature 102.3°F (39°C) white blood cell count 18,000/mm3 urine output of 10 ml over 3 hours apical heart rate 120 beats per minute

urine output of 10 ml over 3 hours Children with sepsis will show alteration in temperature, heart rate, respiratory rate, and white blood cell count. Septic shock with organ dysfunction is more serious and can be manifested by decreased urine output.

After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause? Bacteria Viruses Parasites Fungi

Viruses Most childhood exanthems are caused by viruses.

The nurse is caring for a child newly diagnosed with diphtheria. Which nursing interventions would the nurse include in the child's plan of care? Select all that apply. a. Administering antitoxin intravenously b. Instituting airborne precautions c. Monitoring for airway obstruction d. Adhering to droplet precautions e. Ensuring complete bed rest

a, c, d, e Treatment of diphtheria involves intravenous administration of antitoxin in large doses. In addition, children are given penicillin or erythromycin intravenously. Complete bed rest is crucial during the acute stage of the illness. Droplet precautions must be followed until cultures are negative. Children need careful observation at all times to prevent airway obstruction. If obstruction occurs, endotracheal intubation may be necessary.

When the health care provider looks in a child's mouth during a sick-visit examination, the parent exclaims: "The tongue is bright strawberry red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis? Steroids to decrease the inflammation Acetaminophen to decrease the throat pain Penicillin to prevent acute glomerulonephritis Erythromycin to prevent the spread to siblings

Penicillin to prevent acute glomerulonephritis A "strawberry tongue" is a classic sign of scarlet fever. Penicillin is prescribed to treat the beta-hemolytic group A streptococcal infection and to prevent the complication of developing acute glomerulonephritis and rheumatic fever. Erythromycin can be used to treat the disease if the child is allergic to penicillin. Antibiotics are not given prophylactically to siblings. The disease is spread via droplets, so keeping the siblings away from the infected child and handwashing are the best preventive measures. Acetaminophen can be administered for fever control. It works systemically and has very little, if any, affect locally. Antibiotics are the mainstay of treatment. Steroids are used infrequently.

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients? Airborne precautions Droplet precautions Contact precautions Standard precautions

Contact precautions Contact precautions means placing the client in an isolation room with limited access, wearing gloves during contact with the client and all body fluids, wearing two layers of protective clothing, limiting movement of the client from the room, and avoiding sharing equipment between clients. Standard precautions are used with every client. They involve good handwashing and the use of gloves for client contact. Airborne precautions are used for diseases where small particles are dispersed in the air. They require that the client be in a negative-pressure room and, in addition to standard personal protective equipment, the mask should be N95 or higher. Varicella would need airborne precautions. Droplet precautions are used for diseases such as pertussis, which produce large droplets. They require standard precautions plus a surgical mask, preferably with a face shield.

An adolescent comes to the clinic and is diagnosed with syphilis. The nurse discusses the treatment plan with the adolescent. In addition to medication, what instruction will the nurse give the adolescent? The sexual partners need to be tested. Limit the number of sexual partners. Syphilis is a reportable disease. How the infection will progress if not treated.

The sexual partners need to be tested. Syphilis is a sexually transmitted infection. It can be experienced by both men and women. The primary infection is treated with benzathine penicillin G injection. This will cure the infection. If not treated, the infection can develop into secondary, later, or tertiary stages. At the tertiary stage, the disease cannot be treated or reversed. The most important thing for the adolescent to understand besides the treatment is that all sexual partners need to be evaluated and treated. Otherwise, the disease will just continue to spread among all the partners. Additional teaching for this adolescent includes condom use and limiting the number of sexual partners.

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? Measles Mumps Mononucleosis Fifth disease

Mumps Mumps begins with a fever, headache, anorexia, and malaise. Within 24 hours an earache occurs. When pointing to the site of pain, however, the child points to the jawline just in front of the earlobe. Mumps is contagious 1 to 7 days prior to the onset of symptoms and 4 to 9 days after the parotid swelling begins. Fifth disease is also known as the "slapping disease," as the rash on the cheeks look like someone slapped the child's face. Measles does not involve parotid swelling or earaches. Mononucleosis does involve swollen lymph nodes but they are in the neck and the axillary area.

A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client? The dog was unprovoked when he bit the girl The dog was properly immunized for rabies There have been no other reported instances in the area The dog belonged to a neighbor

The dog was unprovoked when he bit the girl An unprovoked attack is much more suggestive that the animal is rabid, rather than if the bite happens during a provoked attack. The dog being immunized for rabies and there being no other reported instances of rabies in the area would indicate a lower risk that the dog was rabid. The fact that the dog belonged to a neighbor does not necessarily indicate a lower risk for rabies infection.

The nurse is providing teaching to the parents of a child with varicella. Which statement by the parents indicate the teaching was successful? "We should apply alcohol to the lesions every 4 hours." "If our child has a fever, we can give them some aspirin." "The lesions should eventually form soft crusts that drain." "We need to make sure that our child washes their hands frequently."

"We need to make sure that our child washes their hands frequently." The child with varicella needs to wash their hands frequently with antibacterial soap to reduce bacterial colonization. A cool bath with soothing colloidal oatmeal may help the skin discomfort. Alcohol would be too drying to the skin. Acetaminophen, not aspirin, should be used to reduce fever. The lesions should eventually crust over. Soft crusts with drainage may suggest an infection.

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed? "Our child is contagious for 1 week after the rash appeared." "Acetaminophen or ibuprofen can be given to help with pain." "Antibiotics are needed to help our child recover from rubella." "Family members should wear a mask when coming to visit us."

"Antibiotics are needed to help our child recover from rubella." Rubella (German measles) is caused by the rubella virus. Children will be contagious for 1 week before to approximately 1 week after the rash appears. Acetaminophen or ibuprofen can be given to help with pain or fever, and the child will be on droplet precautions (mask) while in the hospital.

The nurse is preparing an education plan for a pregnant woman who has venereal warts. What should the nurse include as teaching points for this client? "During a vaginal birth, your newborn may develop warts in the throat." "Your newborn is at high risk for being large-for-gestational-age if you deliver vaginally." "If delivered vaginally your newborn is at high risk for developing sepsis." "The teeth, bones, and brain of your newborn can be affected if you deliver vaginally."

"During a vaginal birth, your newborn may develop warts in the throat." There is a high risk of the newborn developing warts in the throat, especially if the mother has large vaginal warts. Low birth weight and blindness are common with several sexually transmitted infections. Syphilis in the mother often leads to problems with the teeth, bones, and brain of the newborn.

The nurse is caring for a child whose family recently emigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate? Administer varicella and meningococcal vaccines. Ask parents which immunizations have been given. Document that immunizations are up to date in the chart. Request parents follow WHO vaccine recommendations.

Ask parents which immunizations have been given. When caring for a child recently emigrated from a developing country, the nurse should be aware that WHO recommended vaccinations and U.S. recommended vaccinations may be different. The most appropriate action is for the nurse to determine which vaccinations have been given to decide if additional immunizations may be needed.

A 10-year-old child has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important? Ensure that the specimen is obtained from proper area. Collect three specimens on three different days. Use aseptic technique when getting the specimen. Obtain specimen before antibiotics are given.

Obtain specimen before antibiotics are given. In order to ensure a successful culture, the nurse must determine if the child is taking antibiotics. Throat cultures require specimens taken from the pharyngeal or tonsillar area. Stool cultures may require three specimens, each on a different day. The nurse would use aseptic technique when getting a blood specimen as well as the urine, but antibiotics cannot be received by the child prior to the test being done.

The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention? reservoir portal of exit mode of transmission susceptible host

reservoir The reservoir is the place where a microorganism grows and reproduces. Dressings left unchanged leave a dark, warm, moist environment for microorganisms to thrive. Covering the mouth and using personal protective equipment are ways to control portals of exit. Modes of transmission can be controlled with handwashing and personal protective equipment. The susceptible host is the person who is susceptible to developing an infection. Promotion of natural defenses is a good way to prevent infection.

An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first? "Have you traveled outside North America?" "Are there days your symptoms are worse?" "When did your symptoms begin?" "Is anyone else in your household sick?"

"Have you traveled outside North America?" Malaria comes from a bite of Anopheles species of mosquito. The infection produces high fevers, chills, rigors, sweats, headaches and arthralgia. If the disease is suspected, it would be most important for the nurse to know if the adolescent had traveled to any areas in Africa, Asia or South America, where the type of mosquitoes are found that produce malaria. All of the other questions are appropriate, but they are not as important as the travel, which could help lead to a definitive diagnosis.

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? measles mumps whooping cough scabies

mumps Mumps is an infectious disease with a primary symptom of a swollen parotid gland. It is a contagious disease spread by droplets. The child is contagious 1 to 7 days prior to the onset of the swelling and 4 to 9 days after the onset of the swelling. Pertussis (whooping cough) is a respiratory disorder that causes severe paroxysmal coughing, which produces a whooping sound. Measles is recognized by Koplik spots in the mouth and the classic maculopapular rash that starts on the head and spreads downward. Scabies is a skin condition where lice lay eggs under the skin. The rash is very pruritic and is seen on the hands, feet, and folds of the skin.

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable: pinworm gonorrhea Lyme disease pertussis

pinworm Pinworm infections are not required to be reported. Gonorrhea, Lyme disease, and pertussis are all reportable infectious diseases.

The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101°F (38.3°C). Which statement by a parent indicates an understanding of fevers and their management in the ill child? "We've been giving him a little extra acetaminophen to help bring his fever down." "We've had to wake him up in the night to give him more medicine to reduce his temperature." "My wife and I have been using cold water and washcloths on him because of the fever." "Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection."

"Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection." Fevers can be protective and can help the body fight the infection. Fevers slow down bacterial or viral growth. Mismanaging fevers include inappropriate dosing of antipyretics, awakening a child at night to administer antipyretics, and using cold water or sponging the child with alcohol to reduce the temperature.

A child has been diagnosed with hookworm. The nurse is teaching the parent about the treatment for the condition. Which statement made by the parent confirms that further education is needed? "My child can play outside bare footed when treatment is done." "The medications should be taken for 2 weeks." "I should have my child eat more foods with iron." "I should have my other children tested."

"My child can play outside bare footed when treatment is done." Hookworms are found in soil, especially in areas with warmer climates. They enter the body through the skin, pores and hair follicles. The treatment is with the drug albendazole. The duration is from 7 to 14 days of treatment. Most importantly, besides medication, good handwashing and sanitation practices are needed. Children should wear shoes and not go barefoot outside since the worms can enter through the soles of the feet. The worms attach themselves to the walls of the small intestine where they feed and reproduce. This can cause anemia. The child's diet should include foods high in iron or iron supplements. All children who are suspected or at high risk should be evaluated for hookworms.

The nurse at the pediatrician's office receives a call from the mother of a child who has just been bitten by the neighbor's dog. What action would be the priority? Tell the mother to seek medical help immediately. Explain how to educate the child about animals. Describe methods of managing a fever. Explain how to care for the dog bite.

Tell the mother to seek medical help immediately. The mother should seek medical help for her child immediately. Once the child has been seen by a physician, it can be determined whether immunoprophylaxis is necessary. Education about animals is important to prevent any recurrent bites, but this is appropriate only after the child has been seen and a plan has been determined. Flu-like symptoms such as fever occur early in rabies infection. However, the child must be seen first. Explaining how to care for the bite would be done only after the child is seen and an appropriate plan is determined.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? The child has had 7 wet diapers in the past 24 hours. The child cries when his mother is not in sight. The child has had 8 ounces of formula in the past 24 hours. The child's birth history indicates he was born at 42 weeks' gestation.

The child has had 8 ounces of formula in the past 24 hours. Sepsis is a systemic overresponse to infection resulting from bacteria and viruses, which are the most common fungi, viruses, rickettsia, or parasites. It can lead to septic shock, which results in hypotension, low blood flow, and multisystem organ failure. Signs of sepsis include a lack of appetite, lethargy, hypotonia, and temperature elevations.

The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella? This disease can reactivate years later and cause shingles. Vitamin A is indicated for children younger than 2 years. Dehydration is caused by mouth lesions. Children with this disease need to avoid pregnant women.

This disease can reactivate years later and cause shingles. Varicella zoster results in a lifelong latent infection. It can reactivate later in life resulting in shingles. The American Academy of Pediatrics recommends consideration of vitamin A supplementation in children 6 months to 2 years hospitalized for measles. Dehydration caused by mouth lesions is a concern with foot and mouth disease. Avoiding exposure to pregnant women is a concern with rubella, rubeola, and erythema infectiosum.

A parent calls the nurse triage line at the clinic. The parent is concerned and believes the preschool-aged child may have contracted rubeola. Which question(s) should the nurse ask the parent to aid in making this diagnosis? Select all that apply. a. "How long has your child had the cough and runny nose?" b. "Has your child been around any other children with measles?" c. "When you look in your child's mouth can you see any spots or anything unusual?" d. "Can you describe what your child's rash looks like?" e. "Has your child completed the measles vaccine series?"

a, b, c, d Rubeola is caused by the rubeola virus and is spread through droplet transmission. Symptoms generally start with a cough, coryza, conjunctivitis and fever. This stage can last 2 to 4 days. A classic sign is Koplik spots. These are bright red spots with blue-white centers on the buccal mucosa. The rash begins to appear 3 to 4 days after the prodromal symptoms. It is erythematous and maculopapular in nature. The rash starts on the head and expands downward and outward. If the preschool-aged child received a measles vaccine, it should have been administered between 12 to 15 months of age. The second dose would not be due until 4 to 6 years of age, so this preschooler may be too young for the second dose. It would be important to know if the child had been around anyone else with measles. The virus could have been via another child's coughing and sneezing, and the preschool-aged child may not be thoroughly protected with only one dose of the vaccine.

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders? eosinophils neutrophils lymphocytes monocytes

eosinophils Eosinophils function to combat allergic disorders and parasitic infestations. Neutrophils function to combat bacterial infections. Lymphocytes function to combat viral infections. Monocytes function to combat severe infections.

A child is diagnosed with scarlet fever. History reveals that the child has no known drug allergies. When preparing the child's plan of care, the nurse would anticipate administering which agent as the drug of choice? penicillin V erythromycin trimethoprim-sulfamethoxazole clarithromycin

penicillin V Penicillin V is the antibiotic of choice. In those sensitive to penicillin, erythromycin may be used. Trimethoprim-sulfamethoxazole and clarithromycin are not used.

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? "Your child may return to school when all of the lesions have crusted over." "Your child may return to school when a health care provider has given written permission." "Your child may return to school when free of any lesions." "Your child may return to school when there has been no fever for 48 hours."

"Your child may return to school when all of the lesions have crusted over." Varicella is a highly communicable disease. It is spread via airborne transmission or by direct contact with the nasopharyngeal secretions of an infected person. Varicella is communicable from 1 to 2 days before the rash occurs until all the vesicles have crusted over. The nurse would be correct in telling the parent the child cannot return to school, even though the child is feeling better, until all the vesicles have crusted over. The child does not have to be free of lesions. Being free of fever does not make the child less communicable. The child would not need a permission slip from the health care provider unless this is a specific requirement by the child's school district.

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? The nurse will administer oxygen. The nurse will encourage bed rest. The nurse will administer antibiotics. The nurse will monitor caloric intake.

The nurse will administer oxygen. The major complication of pertussis (whooping cough) is pneumonia and respiratory complications. Oxygen, bed rest, and monitoring for airway obstruction are nursing interventions. The highest priority is administering oxygen to maintain adequate oxygenation of cells.

The nurse is caring for a child diagnosed with hand-foot-mouth disease. When educating the family about this disease, which education by the nurse is most important? "Make sure your child drinks plenty of nonirritating fluid." "Hand-foot-mouth disease is associated with a high fever." "You can give acetaminophen every 4 to 6 hours for pain." "The lesions should disappear in a few days without scarring."

"Make sure your child drinks plenty of nonirritating fluid." Children with hand-foot-mouth disease can experience dehydration related to the high fever, anorexia, and painful mouth lesions. The nurse should educate the family to provide nonirritating fluids to encourage the child to drink to avoid dehydration. Hand-foot-mouth disease is associated with a high fever, and parents can provide acetaminophen. The lesions should disappear in a few days; however, the most important education is aimed at prevention of dehydration.

A 15-year-old child visits their health care provider's office reporting fever, headache, malaise, and pain with chewing and along the jawline just in front of the ear lobe. After asking their parent to leave the room, the child then tells the nurse that they are also experiencing testicular pain and swelling. Which condition does the nurse suspect this client is most likely experiencing? mumps infectious mononucleosis poliomyelitis herpes zoster

mumps Initial symptoms of mumps include fever, headache, anorexia, and malaise. Within 24 hours, pain on chewing and an "earache" occurs. When the child points to the site of the earache, however, the child points to the jawline just in front of the ear lobe, the site of the parotid gland. By the next day, the gland appears swollen and feels tender; the ear becomes displaced upward and backward. Boys may also develop testicular pain and swelling (orchitis). None of the other conditions listed matches the symptoms indicated.

The nurse is taking a health history for an 8-year-old boy who is hospitalized. Which is a risk factor for sepsis in a hospitalized child? maternal infection or fever use of immunosuppression drugs lack of juvenile immunizations resuscitation or invasive procedures

use of immunosuppression drugs The use of immunosuppression drugs is a risk factor for the hospitalized child. Maternal infection or fever and resuscitation or invasive procedures are sepsis risk factors related to pregnancy and labor. Lack of juvenile immunizations is a risk factor affecting the overall health of the child but does not impact the chance of sepsis.

When caring for a child diagnosed with West Nile virus, the nurse will question which prescription from the primary health care provider? amoxicillin 40 mg/kg/day orally every 8 hours acetaminophen every 4 to 6 hours PRN fever Place client on fall precautions. Monitor the client's cardiac status.

amoxicillin 40 mg/kg/day orally every 8 hours West Nile virus is transmitted to humans primarily through the bite of infected mosquitoes and manifestations include: fever, weakness, fatigue, balance problems, memory impairment, headache, myocarditis, hepatitis, myositis and orchitis, and rhabdomyolysis. Treatment is symptomatic. Since this is a viral illness, antibiotics would not be given and the nurse would question such prescriptions. It is appropriate to give acetaminophen for the fever or pain; place on fall precautions due to fatigue, balance problems, and weakness; and monitor the cardiac status for the development of myocarditis.