Ch. 37 Nursing Care of Child with Infectious and Communicable Disorders

A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time? a. March 14 b. March 8 c. March 19 d. March 12

Ans A Children with mumps are no longer considered contagious 9 days following the onset of parotid swelling.

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

Ans D 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.

What is a true statement regarding measles? Peak outbreaks are in the summer. It is transmitted by the fecal-oral route. It is not contagious. The incubation period is 10 to 12 days.

Ans D Measles is a highly contagious disease spread via droplets from the nasopharyngeal secretions. The typical incubation period is 10 to 12 days. Outbreaks peak in the winter and spring. It is communicable 1 to 2 days before the onset of symptoms. The initial symptoms are fever, cough, coryza and conjunctivitis. These symptoms are followed by Koplik spots seen in the mouth. A rash develops on the head and spreads downward and outward.

The nurse is assessing a child with a varicella infection. The nurse would be alert for which possible complication(s)? Select all that apply. a. sScarlet fever Secondary bacterial infection Pneumonia Encephalitis Scarring

Ans B, C, D, E The most common complication of varicella is secondary bacterial infection caused by the child scratching the lesions. Other complications include pneumonia, scarring, and encephalitis. Scarlet fever is a complication associated with group A streptococcal infections.

The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply. a. The parents wear a respiratory mask when entering their child's room. b. The parents remove their personal protective equipment (PPE) at the door before exiting, then wash their hands. c. The parents state, "We will be sure to finish any antibiotic if our child is sent home with a prescription." d. The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." e. The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection."

Ans D, E All close contacts who are younger than 7 years of age and who are unimmunized or underimmunized should have pertussis immunization initiated or the series completed according to the recommended dosing schedule. Fluids should be increased in order to help thin secretions and prevent dehydration during the infection. The parents are correct in removing their PPE at the door and washing their hands when leaving the room, and wearing a mask. All antibiotics should be finished in order to treat the infection adequately and prevent immunity to antibiotics.

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? a. Tell the mother to seek medical help immediately. b. Explain how to care for the dog bite. c. Describe methods of managing a fever. d. Explain how to educate the child about animals.

Ans A 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.

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? a. "When did your symptoms begin?" b. "Have you traveled outside North America?" c. "Is anyone else in your household sick?" d. "Are there days your symptoms are worse?"

Ans B 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.

While assessing a child, the nurse notes a runny nose, temperature 100.4°F (38°C), and a whoop sound when the child coughs. On which diagnosis will the nurse anticipate providing education for this family? a. Tuberculosis b. Pertussis c. Influenza d. Nasopharyngitis

Ans B Pertussis, also known as whooping cough, begins as an upper respiratory illness and progresses to a persistent cough characterized by a whooping sound. Tuberculosis, influenza, and nasopharyngitis are not characterized by a whooping sound.

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation? a. If you suspect head lice, have the school nurse check the child. b. Discourage the child from going to sleepovers. c. Wash the bed linens in hot water to kill the lice. d. Head lice are becoming very resistant to treatment

Ans D The accurate advice is that head lice are becoming resistant to treatment. Children with head lice do not need to stay home, but parents should follow school policies regarding whether children are allowed in school until they are nit-free. Children should be allowed to participate in sleepovers, preferably bringing their own pillows. Head lice do not survive long once they have fallen off. Most children can be treated effectively without treating their bedding and clothing.

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. Rocky Mountain spotted fever Scabies Psittacosis Ascariasis Lyme disease

Ans A, E 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.

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of: a. impetigo. b. scarlet fever. c. osteomyelitis. d. pneumonia.

Ans B Group A streptococcal pharyngitis can progress to scarlet fever with the rash appearing in about 12 hours after the onset of the disease. Group A streptococcal pharyngitis is not associated with pneumonia. Impetigo is a group A strep infection involving the skin. Osteomyelitis can occur with an infection by group B streptococcus.

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

Ans B 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.

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? a Document that immunizations are up to date in the chart. b. Request parents follow WHO vaccine recommendations. c. Administer varicella and meningococcal vaccines. d. Ask parents which immunizations have been given.

Ans D 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.

The nurse is caring for a 10-year-old boy with diphtheria. What would the nurse institute as a tier 2 precaution? a. Use of a protective gown b. Use of a protective mask c. Negative air pressure ventilation d. Use of a protective face shield

Ans B Use of a protective mask if within 3 feet of the child is a tier 2 precaution with diphtheria, which is transmitted through contact with droplets. Use of a protective gown is a tier 2 precaution for contact transmission. Negative air pressure ventilation is a tier 2 precaution for airborne transmission. Face shields are part of tier 1 precautions against contaminated splashes.

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? a. "My child can play outside bare footed when treatment is done." b. "I should have my other children tested." c. "The medications should be taken for 2 weeks." d. "I should have my child eat more foods with iron."

Ans A 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 is caring for multiple clients on the pediatric unit. Which child will the nurse see first? a. a child with erythema infectiosum experiencing fatigue and confusion b. a child diagnosed with chicken pox reporting nausea and malaise c. a child diagnosed with measles experiencing photophobia and coryza d. a child with herpes simplex who is reporting mouth pain and pruritis

Ans A Rationale: A child with erythema infectiosum experiencing fatigue and confusion is showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus. A child with signs and symptoms of decreased oxygenation should be seen first. Nausea and malaise are symptoms of chicken pox. A child with herpes simplex will most likely report pain an pruritis. Signs and symptoms of measles include photophobia and coryza.

The nurse is preparing to provide education on the prevention of infection to parents of children. Which intervention(s) will the nurse include? Select all that apply. a. Limiting exposure to sick persons b. Proper handling and preparation of foods c. Judicious antibiotic use d. Vaccination administration e. Proper handwashing

Ans A, B, C, D, E Interventions to limit the spread of infections and diseases include: proper handwashing, appropriate antibiotic use (take prescribed amount), follow the recommended vaccination schedule, limiting exposure to known sick persons, and proper handling and consumption of foods. The nurse would include all choices in the teaching.

A nurse is preparing a presentation for a local mothers' group about common viral infections associated with a rash during childhood. When describing rubella, what information would the nurse include? Select all that apply. a. Any itching with the rash is usually mild. b. The disease most often occurs during late summer and early fall. c. The infection is communicable for a week before to a week after the rash appears. d. The rash typically begins on the trunk and spreads to the face. e. Incubation period usually ranges from 16 to 18 days

Ans A, C, E Rubella has an incubation period ranging from 12 to 23 days, but usually 14 days. It is communicable for 7 days before the rash to 7 days after the onset of the rash. Itching is usually mild. It occurs most commonly during late winter and early spring and the rash typically begins on the face and spreads down the neck, trunk, and extremities.

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? a. "It can take about 2 weeks for your child to feel better." b. "Your child will likely feel better within a week." c. "Once your child completes the antiviral therapy he will feel better." d. "Within 10 days of starting the antibiotic therapy your child will start to feel better."

Ans B

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? a. There have been no other reported instances in the area b. The dog was unprovoked when he bit the girl c. The dog belonged to a neighbor d. The dog was properly immunized for rabies

Ans B 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

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? a. trimethoprim-sulfamethoxazole b. penicillin V c. clarithromycin d. erythromycin

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

The rash in roseola is pruritic. Which measure would you teach the parent to provide comfort? Dress the child warmly to bring out the rash so that it fades quickly. Apply cool compresses to the skin to stop local itching. Administer infant aspirin every 4 hours as necessary for comfort. Discuss with the child the importance of not scratching lesions.

Ans B Rashes can be uncomfortable and irritating. Parents need to be educated on ways to relieve discomfort and to protect and maintain skin integrity. Cool compresses or cool baths will help to relieve the itching associated with the rash. Antipruritics may be necessary to help with itching. To protect the skin, the child should be instructed not to scratch the skin to alleviate itching. The child's fingernails should be kept short. Keeping the child dressed warmly will not bring out the rash any sooner. Being warm will, however, cause increased body temperature and intensify the itching. Aspirin should not be used in children as an antipyretic. There is an increased risk of developing Reye syndrome.

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

Ans B 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.

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

Ans B The child with varicella needs to wash his 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 at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? a. Accessing an indwelling venous access device. b. Puncturing a vein on the dorsal side of the hand. c. Using an automatic lancet device on the heel. d. Administering sucrose prior to beginning.

Ans B The usual sites for obtaining blood specimens are veins on the dorsal side of the hand or the antecubital fossa. Administration of sucrose prior to beginning helps control pain for young infants. Accessing an indwelling venous access device may be appropriate if the child is in an acute care setting. An automatic lancet device is used for capillary puncture of an infant's heel.

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 free of any lesions." "Your child may return to school when all of the lesions have crusted over." "Your child may return to school when there has been no fever for 48 hours." "Your child may return to school when a health care provider has given written permission."

Ans B 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 performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease? a. Cranial nerve palsies b. Multiple erythema migrans on the skin c. Bull's-eye rash around the bite d. Recurrent arthritis in the large joints

Ans C A bull's-eye rash (ring-like rash) around the bite is typical of early localized Lyme disease. Multiple erythema migrans on the skin occurs during early disseminated disease. Cranial nerve palsies are indicative of early disseminated disease. Recurrent arthritis in the large joints occurs in the late stage of the disease.

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? Standard precautions Droplet precautions Contact precautions Airborne precautions

Ans C 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.

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? a. neutrophils b. monocytes c. eosinophils d. lymphocytes

Ans C 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 has been brought to the pediatric clinic. The assessment reveals the child has a temperature of 100.9°F (38.3°C), as well as a rash that is pink and has raised areas. When the area is palpated, the skin blanches. Which disease is most associated with these findings? a. rubeola b. varicella zoster c. exanthem subitum d. rubella

Ans C Exanthem subitum or sixth disease is a member of the herpes viruses. It presents with a pinkish rash that may be flat or raised. The rash area blanches when palpated. A maculopapular rash that begins on the face and spreads head to foot is consistent with rubella. Rubeola presents with bright red spots with blue-white centers on mucous membranes, mainly on the buccal mucosa. It looks like tiny grains of white sand surrounded by a red ring. Varicella zoster presents with erythematous macules that evolve to papules and then form clear, fluid-filled vesicles.

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next? a. Arms b. Stomach c. Legs d. Neck

Ans D Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach.

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? a. "My wife and I have been using cold water and washcloths on him because of the fever." b. "We've had to wake him up in the night to give him more medicine to reduce his temperature." c. "Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection." d. "We've been giving him a little extra acetaminophen to help bring his fever down."

Ans C 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.

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? a. "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection." b. "The pathophysiology of sepsis is complex." c. "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys." d. "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are responsible for the clinically observable effects of the sepsis."

Ans C Keeping the answer to what sepsis is will help the parents understand the pathophysiology. While all answers are correct, the response: "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys" provides the most understandable explanation and addresses the parent's question.

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings? a. Nits b. Slapped cheek appearance c. Koplik spots d. Lymphadenopathy

Ans C Koplik spots are bright red spots with blue-white centers appearing primarily on the buccal mucosa and indicate rubeola (measles). They are often described as tiny grains of white sand surrounded by red rings. Lymphadenopathy is used to document enlargement of the lymph nodes. Slapped cheek appearance refers to the erythematous flushing associated with fifth disease. Nits refer to the adult eggs of pediculosis.

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? a. Mononucleosis b. Fifth disease c. Mumps d. Measles

Ans C 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.

The mother brings her neonate to the emergency department and states, "My baby just doesn't look right. I know something is wrong." Based on an assessment, the nurse suspects the neonate is experiencing sepsis. Which finding in the client's medical record will help to confirm this diagnosis? a. White blood cell count is 9,000/μL (9x109/L) b. Client's current heart rate is 155 beats per minute. c. Maternal membranes ruptured 20 hours before birth. d. Client born at 41-weeks gestation

Ans C Prolonged or premature rupture of membranes increases a neonate's risk for sepsis and would support the nurse's suspicion of sepsis. A heart rate of 110-160 beats per minute is within normal range for a neonate. Tachycardia, tachypnea or difficulty breathing, and hypotension are expected symptoms of sepsis. The client's gestation age at birth is not related to the development of sepsis. A white blood cell (WBC) count of 9,000/μL (9x109/L) is within normal range for a neonate. Neonates can have higher WBC count, up to 30,000/μL (30x109/L) initially following birth. The neonate's count will decrease to the expected adult range of 5,000/μL (5x109/L) to 10,000/μL (10x109/L) about 2 weeks after birth.

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 lack of juvenile immunizations use of immunosuppression drugs resuscitation or invasive procedures

Ans C 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? a. Place client on fall precautions. b. every 4 to 6 hours PRN fever c. amoxicillin 40 mg/kg/day orally every 8 hours d. Monitor the client's cardiac status.

Ans C 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.

A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence. a. Prodrome b. Illness c. Incubation d. Convalescence

Ans C, A, B, then D An infectious disease begins with incubation, then progresses to the prodrome stage, then to illness, and finally to convalescence.

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: a. gonorrhea b. Lyme disease c. pertussis d. pinworm

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

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? susceptible host portal of exit mode of transmission reservoir

Ans D 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.

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? a. Initiate intravenous therapy. b. Obtain urine specimen for analysis. c.Initiate antibiotic therapy. d. Obtain blood cultures.

Ans D 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.