Chapter 37: Nursing Care of the Child With an Infection

Tetanus Nursing Management

- observe for signs of resp distress - quiet envir to decrease spasms - pain management, nutrition, hydration - admin sedatives & muscle relaxants - standard precaution

sepsis patho

- systemic inflammatory response syndrome (SIRS) - cytokine release, occurring - cause an overproduction of proinflammatory cytokines - Impaired pulmonary, hepatic, or renal function may result from excessive cytokine release

Pertussis Nursing Management

-droplet precautions - providing high humidity envir. - frequent suctioning -assess for obstructive airway

Osteomyelitis risk factors

-open wound, especially compound fracture -skin infection and vascular insufficiency -other infection impetigo, infected varicella lesions, furunculosis, recent trauma, infected burns, and prolonged intravenous line use

DTaP immunization

2,4,6, 15 months, and 6 yrs old do not gave after 6 yrs old

14 to 28 days

A child is diagnosed with early disseminated Lyme disease. The nurse informs the parents the child will most likely receive antibiotic therapy for which length of time?

scarlet fever

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

penicillin v

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

What is rosacea?

A chronic inflammatory skin condition that causes redness to the face.

absence of rash

A nurse is assessing a child with a tick-borne disease. What finding would indicate to the nurse that the child has developed ehrlichiosis and not Rocky Mountain spotted fever? (there is rarely a rash with ehrlichiosis, which helps to differentiate it from Rocky Mountain spotted fever.)

Lyme, Rocky Mountain Spotted Fever

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.

Red strawberry tongue

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? *this is what is used to confirm the diagnosis

What is pityriasis rosea?

A self-limiting skin rash that starts with a large spot on the chest, abdomen, or back, followed by small lesions.

Rocky Mountain Spotted Fever symptoms

A week after tick bite: -High fever -N/V -Muscle aches -Insomnia -Rash = red macule/papules to petechiae on wrists/palms and ankles/soles, spreading centrally to trunk (Can be fatal if not treated) low leukocyte count, low or decreasing platelet count, and hyponatremia

viruses

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

What is erythema infectiosum?

Also known as fifth disease, it starts with fever, headache, and malaise.

sepsis symptoms

Fever, altered mental status (AMS), tachycardia, hypotension, current infectious symptoms

What is the progression of the rash in erythema infectiosum?

First on the face, then on the extensor surfaces of the extremities, and finally on the trunk and flexor surfaces of the extremities.

Airborne precautions

Gown, gloves and respirator mask used for patients known or suspected to be infected with pathogens transmitted by airborne droplet nuclei

Fifth disease (erythema infectiosum)

Human parvovirus B19 Mild flulike symptoms; "slapped-cheek" facial rash droplet precaution

Why should aspirin not be used in children as an antipyretic?

Increased risk of developing Reye syndrome.

What are nosocomial infections?

Infections contracted in a hospital or healthcare setting.

scabies symptoms

Intense pruritus (especially at night) with the presence of erythematous, papular rash with excoriations. The lesions are generally distributed but often are concentrated on the hands and feet and in body folds. May be found on head and neck In infants and young children the rash is often heavy on palms, soles and fingers, and it may include vesicles, pustules, or bullous lesions. CONTACT PRECAUTION

How can pityriasis rosea be treated?

It can be treated with steroid creams.

What are the symptoms of an enterovirus infection?

It can cause symptoms similar to the common cold or involve the respiratory system.

Erythema Infectiosum (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.

What are the signs of sepsis?

Lack of appetite, lethargy, hypotonia, temperature elevations.

Tetanus symptoms

Lockjaw; muscle spasms headache, spasms, crankiness, and cramping of the jaw (lockjaw), which are followed by difficulty swallowing and a stiff neck. Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach; seizures may result. fever along with an elevated blood pressure and tachycardia. spasms can cause fractures

How should a child be instructed to protect their skin from itching?

Not to scratch the skin and keep fingernails short.

wash hands

The nurse is providing education to the parents of a child diagnosed with pinworms. Which statement is most important for the nurse to include in the teaching? (The most effective measure to prevent pinworms or a recurrence is good hand hygiene, especially after using the bathroom and before eating.)

irritable

The nurse is reviewing the assessment data from a 4-year-old child admitted to the hospital for management of early onset sepsis. Which finding supports the diagnosis? (Sepsis may be associated with lethargy, irritability, or changes in level of consciousness. The septic child will likely not desire a high activity level and would prefer to remain in bed.)

cool compress

The rash in roseola is pruritic. Which measure would you teach the parent to provide comfort?

atraumatic care of capillary puncture

The young infant will benefit from the use of oral sucrose and nonnutritive sucking before and during

What can be the cause of nosocomial infections?

Viral, bacterial, or fungal infections.

What can cause neonatal sepsis?

Viruses such as herpes simplex or enteroviruses, and protozoa like oxoplasma gondii.

incubation period 10-12 days

What is a true statement regarding measles?

secondary bacterial infections

What is a true statement regarding varicella zoster virus infection? (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.)

group b strep

What is the leading cause of neonatal sepsis and death? (In infants under the 3 months of age the most causative agents are group B streptococcus, Escherichia coli, Staphylococcus aureus, enteroviruses, and the herpes simplex virus.)

rosacea

a chronic inflammatory skin condition that causes redness to the face

cryogen

a natural antipyretic that produces lower temperatures

septic arthritis symptoms

fever, reports of pain, refusal to bear weight or straighten the joint, and limited range of motion (the child usually maintains the joint in flexion and will not allow the leg to be straightened). Any attempt at passive range of motion will reveal pain. Palpate the affected joint for warmth and swelling.

Botulism symptoms

for infants: Constipation Poor feeding Listlessness Generalized weakness Weak cry For older kids: Double vision Blurred vision Drooping eyelids Difficulty swallowing Slurred speech Muscle weakness both - diminished gag reflex

contact precautions

gloves and gown required for individuals coming in contact with a patient Methods of infection control that must be used for patients known or suspected to be infected with epidemiological microorganisms that can be transmitted by either direct or indirect contact.

mumps immunizations

immunization between 12 and 15 months of age, followed by a second vaccine between 4 and 6 years

infectious process

incubation period, prodromal stage, illness stage, convalescence

sepsis

infection resulting from bacteria and viruses, which are the most common, fungi, viruses, rickettsia, or parasites

antibiotics

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? (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.)

droplet precaution

***Ex: Flu, Purtusis (whooping cough), RSV, Mumps, Pneumonia, Diptheria, Menigitis, Strep, -found in secretions (mucus, coughing, etc). ***Wear: gloves, mask, and goggles (if within 3 FT of the patient). -Pt. is usually in a private room, however; if needed cohort with the SAME EXACT ILLNESS -If pt. leaves the room they need to wear a mask.

indwelling venous cath blood draws

- initial blood will be discarded to prevent contamination with intravenous fluids or medications - After aspirating the specimen, flush the venous access device with normal saline to prevent clogging

Lymphocytes

B cells, T cells, natural killer cells Main source of producing an immune response; respond to viral infections (measles, rubella, chickenpox, infectious mononucleosis); tumors

What is typically the cause of neonatal sepsis?

Bacteria.

Rocky Mountain Spotted Fever

Caused by Rickettsia rickettsii Sx: rash on palms and soles (migrating to wrists, ankles, then trunk), HA, fever. Endemic to East Coast (in spite of its name). peak incidence in children greater than 5 years of age tx; Doxycycline

Who is at highest risk for nosocomial infections?

Children younger than 2 years, those with a nutritional deficit, immunosuppressed individuals, those with indwelling vascular lines or catheters, those receiving multiple antibiotic therapy, those in the hospital for longer than 72 hours.

CAMRSA

Community Acquired MRSA. A infection spread by a community member and hasn't necessarily been to the hospital. Transmission occurs through direct person-to-person contact, respiratory droplets, blood, or sharing personal items, such as hair brushes, towels, and sports equipment, and touching surfaces or items contaminated with MRSA. Clusters of MRSA have been found in day care centers and among athletic teams. Staphylococci are resistant to heat and drying and can be found on environmental surfaces months after contamination

How can itching associated with a rash be relieved?

Cool compresses or cool baths.

What are the symptoms of pertussis?

Cough and cold symptoms that progress to paroxysmal coughing spells with copious secretions.

monocytes

Second line of defense; respond to larger and more severe infections than neutrophils by phagocytosis; leukemias and lymphomas; chronic inflammation

What can sepsis lead to?

Septic shock, hypotension, low blood flow, and multisystem organ failure.

What does CAMRSA typically cause?

Skin and tissue infections.

What are the symptoms of diphtheria?

Sore throat, difficulty swallowing, and airway obstruction.

What are the symptoms of scarlet fever?

Sore throat, fever, and a characteristic rash on the face, trunk, and extremities.

Lyme disease symptoms

Stage 1 - Erythema migrans ("central bullseye"), flu-like illness Stage 2 - Cardiac problems (arrythmia, pericarditis) or Neuro problems (aseptic meningitis, facial palsy) Stage 3 - arthralgia in knee, Neuro problems (encephalitis) *complaints of fever, malaise, mild neck stiffness, headache, fatigue, myalgia, and arthralgia or pain in the joints - ring-like rash at the site of the tick bite (erythema migrans)

What is sepsis?

Systemic overresponse to infection resulting from bacteria and viruses.

septic shock symptoms

Tachycardia, fever, HYPOtension (SYSTOLIC lower then 90), pallor, fatigued, cold, reduced urine output, SOB, Decreased LOC,N/V, sweating,

managing skin rashes

Teach parents to keep their child's fingernails short and hands clean. Explain the importance of discouraging scratching, and discuss distraction techniques they can use with the child. Cool compresses or cool baths can relieve itching. Encourage the child to press on rather than scratch the itchy area; this can relieve discomfort while maintaining skin integrity.

Infant Bolulism

when the infant ingests the spores of Clostridium botulinum. These multiply in the intestinal track and produce toxins. The disease is caused by the ingestion of spores from dust, improperly preserved home-canned foods and feeding an infant under 1 year of age raw honey. The infant has poor feeding, is listless, has a weak cry, and has a poor gag reflex—a distinguishing symptom. The nurse would ask about the water supply and unpasteurized milk if food poisonings or parasites were suspected. Asking about the date of the infant's illness is important, but this information does not take priority over the question about honey.

fifth disease

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: (also known as the "slapping disease," as the rash on the cheeks look like someone slapped the child's face)

botulism

a disease characterized by severe, potentially fatal paralysis of skeletal muscles, resulting from the consumption of a bacterial toxin. ingested through improperly preserved home-canned foods., raw honey in infants,

Scarlet fever

a group A streptococci infection. the bacteria produce a toxin that causes a rash. children 5 to 15 years. Transmission is through droplets and follows contact with respiratory tract secretions. Transmission is facilitated by the type of close contact that occurs in schools and child care centers. incubation period is 2 to 5 days

what is scabies?

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.

Pityriasis Rosea

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

rubella

a viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash

diphteria

acute infection of the throat and upper respiratory tract caused by the diphtheria bacterium. may affect the nose, larynx, tonsils, or pharynx. Tonsillar and pharyngeal infections are the most common. pseudomembrane causes airway obstruction and suffocation.

pertussis

aka whooping cough a respiratory disorder that causes severe paroxysmal coughing, which produces a whooping sound

tetanus

an acute, often fatal neurologic disease caused by the toxins produced by Clostridium tetani. haracterized by increased muscle tone and spasm. found most commonly in soil, dust, and feces from humans or animals. spores can enter the body through a wound that is contaminated, through a burn, or by injecting contaminated street drugs. Once it enters the body, an anaerobic environment allows it to multiply and a poisonous toxin is released.

fever management

antipyretics NO aspirin or pepto (Reye Syndrome) cool clothes decrease room temp frequent temp check febrile seizure precautions

CAMRSA Symptoms

bump or skin area that is red, swollen, painful, and warm to touch. It may also include fever, fluctuance, and purulent drainage. The lesion may have appeared suddenly and be red and raised, resembling an insect bite. Necrotic areas may develop. Abscesses, especially abscessed hair follicles, and pimples are common presentations

Mumps

caused by Paramyxovirus, is characterized by fever and parotitis (inflammation and swelling of the parotid gland). spread via airborne droplets or contact with infected droplets. The incubation period is 12 to 25 days. * ice packs to the testicles and gentle testicular support may be helpful.

sepsis cause

common causative organisms in infants and children include Escherichia coli, group B Streptococcus, Staphylococcus aureus, and Neisseria meningitidis

osteomyelitis symptoms

constant bone pain increased ESR (shows infection) positive would cultures warmth, swelling, redness in extremity leukocytosis irritability, lethargy, possible fever, and onset of pain or change in activity level. The child usually refuses to walk and demonstrates decreased range of motion in the affected extremity. Inspect the affected extremity for swelling. Palpate for local warmth and tenderness. Note point tenderness over affected bone.

lyme disease

disorder marked by arthritis, myalgia, and malaise; cause is a bacterium carried by a tick *Doxycycline is the drug of choice: can cause permanent discoloration of the teeth. can give amoxicillin or cefuroxime (if allergic)

measles

ecognized by Koplik spots in the mouth and the classic maculopapular rash that starts on the head and spreads downward.

pertussis tx

erythromycin, clarithromycin, and azithromycin, are the drugs of choice. younger infants, azithromycin should be used and erythromycin and clarithromycin avoided * azithromycin may cause potentially fatal heart rhythm in some patients because it can lead to abnormal changes in the electrical activity of the heart

(Exanthem Subitum/ 6th disease) Roseola

fever and faint maculopapular rash from the trunk to the extremities - standard precautions

Scarlet fever symptoms

fever greater than 101°F, chills, body aches, loss of appetite, nausea, and vomiting. pharynx, which is usually very red and swollen. The tonsils may have yellow or white specks of pus, and cervical lymph nodes may be swollen. an erythematous rash appearing on the face, trunk, and extremities. The rash is typically absent from the palms and soles of the feet. It looks like a sunburn but feels like sandpaper. tongue develops a thick coat with a strawberry appearance

scabies

infestation of parasitic mites that tunnel under the skin and produce vesicles that are itchy - Appear as grayish brown, threadlike burrows on the skin contagious skin disease transmitted by the itch mite

enterovirus

many times cause the same symptoms as the common cold or it can include the respiratory system. It is contagious.

neck

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

septic arthritis risk factors

respiratory infection or otitis media, skin or soft tissue infections, or, in the neonate, traumatic puncture wounds and femoral venipunctures. The history is usually significant for sudden onset of fever and moderate to severe pain.

tetanus management

-supporting respiratory and cardiovascular function, -stopping toxin production, -neutralizing unbound toxins, -controlling muscle spasms. -Tetanus immunoglobulin may be given - Removal of offending organism, by debridement of wound, -IV antibiotics such as metronidazole - intensive nursing care with mechanical ventilation. (severe)

Fever pathogenesis

1) Endogenous pyrogens reach anterior hypothalamus. where they trigger prostaglandin production and increase the body's temp - can slow the growth of bacteria and viruses and increase neutrophil production and T-cell proliferation

Obtain specimen before antibiotics

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?

increased eosinophil levels

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? (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.)

Mumps

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? (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.)

8 oz formula

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? (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.)

acute glomerulonephritis.

A chief danger of scarlet fever is that children may develop: (Scarlet fever infection is the result of group A streptococci. It generally starts with a throat infection (strep throat). The bacteria produce a toxin that causes the rash over the body. Because this is a streptococci-based infection, the child will need to be monitored for the development of rheumatic fever or glomerulonephritis following the illness.)

mumps

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? (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)

An airborne bacterial infection that affects mostly children younger than 6 years. Patients will be feverish and exhibit a "whoop" sound on inspiration after a coughing attack; highly contagious through droplet infection. - incubation period= 6 to 21 days, usually 7 to 10 days. cough lasts 1-4 wks

scarlet fever complications

rheumatic fever, glomerulonephritis, skin infections, abscesses of the throat, pneumonia, and arthritis can still occur therefore prompt recognition and proper treatment are important

What may be necessary to help with itching?

Antipruritics.

transmission-based precautions

measures taken to prevent the spread of diseases from people suspected to be infected or colonized with highly transmissible pathogens that require measures beyond standard precautions to interrupt transmission, specifically, airborne, droplet, and contact precautions

child signs of dehydration

missing: pink and moist oral mucosa, elastic skin turgor, and adequate urine output * at least 1 to 2 mL/kg/hr output

granulocytes

neutrophils, eosinophils, basophils ingest and destroy the pathogen.

complications of lyme disease

Arthritis, heart block, meningitis, Bells Palsy

topical permethrin

Assessment of a child reveals black burrows of about 1-inch long between the fingers and toes and in the axilla. A diagnosis of scabies is made. When planning this child's care, the nurse anticipates which medication being prescribed?

incubation period

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? (he time between the invasion of an organism and the onset of symptoms of infection.)

protective clothes, inspection, contact HCP

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply.

varicella zoster

Red macules, papules, vesicles, pustles then scabs; different stages at teh same time, HHV 3 disease: chickenpox, shingles transmission: airborne, droplet, contact with blister fluid. Air-borne and contact precautions

auscultate lungs

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. (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.)

standard precaution

represent basic infection prevention measures used during every patient interaction whether a known or suspected infection is present 1. hand hygiene 2. use of personal protective equipment - gowns gloves facemarks 3. cough etiquette

secondary bacterial infection

The most common complication of varicella is:

rest and relax

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?

Puncturing a vein on the dorsal side of the hand.

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used?

given honey?

The nurse is assessing a 8-month-old infant who has symptoms of poor feeding, a poor gag reflex, listlessness and a weak cry. What is the most important question the nurse should ask the parent about these symptoms? (due to infant botulism)

press the area

The nurse is caring for a 10-year-old child with a skin rash. The nurse should include which intervention to manage the associated pruritis?

urine output of 10 ml

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning? (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.)

urine output

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning? (Septic shock with organ dysfunction is more serious and can be manifested by decreased urine output.)

admin o2

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? (The major complication of pertussis (whooping cough) is pneumonia and respiratory complications.)

erythema Infectiosum (Fifth Disease)

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first? (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.)

Is enterovirus infection contagious?

Yes, it is contagious.

convalescent stage

the stage during which acute signs and symptoms of a disease fade and a person is no longer contagious

diphtheria risk factors

unimmunized or underimmunized, living in crowded or unsanitary living conditions, having a compromised immune system, and traveling to developing countries where diphtheria remains endemic (Doerr, 2019). Routine infant immunization can prevent the disease. Therapeutic management involves administration of antibiotics and antitoxin, as well as airway management.

blood draws in kids

venipuncture are the superficial veins of the dorsal surface of the hand or the antecubital fossa - Capillary puncture of the child's fingertip, the great toe, or the infant's heel may also be used *Use a topical anesthetic cream or gel (preferred), refrigerant spray, or iontophoresis before venipuncture.

osteomyelitis

a bacterial infection of the bone and soft tissue surrounding the bone. S. aureus , invading bacteria trigger an inflammatory response, formation of pus and edema, and vascular congestion spread through blood. resulting in death of the bone tissues. tx antibiotics 4-6 wks

septic arthritis

a condition in which S. aureus bacteria invade the joint space, most often the hip or knee. children <3. **considered a medical emergency, as destruction of the joint cartilage may occur within just a few days

rubeola

contagious disease characterized by fever, inflammation of the mucous membranes, and rose-colored spots on the skin; also called measles - Immune serum globulin (IG) given within 6 days - Cool mist humidification to alleviate coryza and cough • Airborne precautions until 4 days after the onset of rash

prodromal period

short period after incubation; early, mild symptoms

Scarlet Fever: Nursing Management

• Droplet precautions • Full course of penicillin • Bed rest, quiet activity. • Treat sore throat: cool mist humidifier - Penicillin and amoxicillin are the antibiotics of choice -

trimmed nails, distractions, pressure on skin, clean hands

What would the nurse include in the teaching plan for parents and their child with a pruritic rash? Select all that apply.

penicillin

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? (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.)

HIV baby

Which child will the nurse identify as at greatest risk for developing a urinary tract infection? (Factors that make an individual more prone to a urinary tract infection include young age, female gender, and immunosuppression. Infants who are formula-fed are at greater risk than infants who are breastfed.)

maculopapular rash, fever, upper resp infection

The nurse is obtaining a health history and assessment for a child being admitted who is suspected of having measles. What signs and symptoms does the nurse expect to find during the assessment? Select all that apply.