Pedi test 2: infections

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

penicillin

rubella - how to prevent?

MMR

Rubeola (measles) - how is it spread? also, where in the body is virus also present?

Highly contagious (airborne); virus present in blood and urine; MMR vaccine available

Trismus (lockjaw) - associated with what infection?

Inability to open the jaw due to pain associated with tetanus

pertussis prevention?

Tdap vaccine

The parents of a 3-year-old child report he was exposed to pertussis 2 days ago. They are concerned and ask the nurse how long it will take until he becomes ill if he indeed contracted the infection. What response by the nurse is indicated? "If your child had contracted the disease symptoms would have be noted by this time." "It normally takes about 3 weeks before symptoms begin." "If you child has contracted the illness he will become ill in about 2 weeks." "The signs of disease will be noted in 1 to 3 weeks."

"The signs of disease will be noted in 1 to 3 weeks."

scarlet fever caused by? transmission? dx?

cause: Group A Strep droplet transmission dx: throat culture, rapid strep test

Ibuprofen calculation: mg/kg/dose?

10 mg/kg/dose

The incubation period is ___ to ___ days for varicella zoster virus

10 to 21 days

Acetominophen calculation: what is the therapeutic range? (mg/kg/dose)

10-15mg/kg/dose

how many doses is the max in a day for ibuprofen?

4

what age must the child be to receive ibuprofen?

6 months and older

tetanus - how do symptoms progress (anatomically)?

descending fashion cephalocaudual

how to prevent diphtheria

DTaP vaccine

Mumps what should you tell the caregiver to do for the child?

MMR vaccine available; encourage fluids let them know its contagious (airborne)

Erythema Infectiosum (fifth disease) symptoms? how does the disease progress anatomically speaking?

Slapped-cheek appearing erythematous rash; rash spreads to trunk; moves peripherally, maculopapular rash w/ lace-like appearance

_______________ 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.

Varicella zoster virus

asses temp how often in a kid with infection? after how long do you check it when giving an antipyretic?

every 4-6 hours after 30-60mins

stages of infection: Illness

signs and symptoms of disease are clearly evident incubation, prodrome, illness, convalescence

stages of infection: convalescence

acute symptoms begin to disappear incubation, prodrome, illness, convalescence

what infection has highest incidence and greatest risk for death in infants < 1 yr old

pertussis

scarlet fever treatment?

Antibiotics No longer contagious 24 hrs after starting antibiotics

diphtheria treatment? monitor what main system? precautions when caring for?

Antibiotics as prescribed, monitor respiratory status droplet precautions

botulism cause?

Caused by Clostridium botulinum found in food (honey), environmental dust, wound not contagious must ingest

Spores found mostly in soil, dust, and feces - what is this and what does out cause?

Clostridium tetani causes tetanus

contact precaution diseases

MRSA VRE RSV C. diff Scabies Klebsiella pnemoniae carbapenemase (KPC) rotavirus conjunctivitis

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 Fifth disease Mononucleosis Mumps

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

PPE needed for airborne precautions

N95

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? Arms Stomach Legs Neck

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

first line of defense, phagocytic cells hint: granulocytes

Neutrophils including bands, segs (polymorphonuclear leukocytes or PMNs) Eosinophils, basophils

Mumps symptoms

Parotitis (inflammation of the parotid salivary gland) & fever

Parasitic infections: Pediculosis capitis? Pediculosis pubis? Scabies precaution?

Pediculosis capitis (head lice) Pediculosis pubis (pubic lice) Scabies contact precaution

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

a child with erythema infectiosum experiencing fatigue and confusion showing signs of decreased oxygenation, possibly related to aplasia of erythrocytes caused by the virus

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? malaise absence of rash fever headache

absence of rash

A chief danger of scarlet fever is that children may develop: respiratory obstruction. local areas of skin necrosis. acute glomerulonephritis. liver destruction.

acute glomerulonephritis. Because this is a streptococci-based infection, there is a chance the child will develop rheumatic fever or glomerulonephritis following the illness.

scarlet fever after how long will they no longer be contagious after taking antibiotics?

after 24 hrs

Rebeola (measles) precautions

airborne

what if you give honey to infant younger than 1 year old?

botulism can cause paralysis

Judicious antibiotic use mean what?

don't use antibiotics too much bc you can create resistant bacteria (do not need antibiotics for flu)

Rubella precautions

droplet

what precaution is child put on with diagnosis of pertussis?

droplet

acetaminophen: how often do you give it? max doses in a 24 hour period?

no more than every 4 hours max of 5 doses per day

lot of diseases you need antipyretics and antipruritics - what do you need to manage hand/foot/mouth disease and herpangina?

only analgesics

Herpangina what should you tell the caregiver to do for the child?

Hand hygiene, encourage fluids

droplet precaution diseases

Meningitis Flu Rubella Pertussis (whopping cough) Mumps

Hand, Foot, and Mouth Disease what should you tell the caregiver to do for the child?

Hand hygiene, encourage fluids

tetanus nurse management

Monitor respiratory status Decrease external stimuli Pain management Sedatives and muscle relaxants as prescribed

ZOONOTIC AND VECTOR-BORNE INFECTIONS?

Diseases caused by infectious agents that are transmitted directly or indirectly from animals or vectors, such as ticks, mosquitos, or other insect vectors to humans Rabies Cat-scratch fever Lyme disease Rocky Mountain spotted fever

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. The nurse would suspect the child has _______ disease and notify the health care provider for additional testing and potential antibiotic therapy

Lyme disease

Erythema Infectiosum (fifth disease) how would this impact a pregnant mother?

May cause fetal loss

septic arthritis? what location usually and what age?

Bacterial infection of the joint space Usually hip or knee & under age 3 Spread through blood or direct puncture

Rubeola (measles) symptoms?

Fever, cough, coryza, conjunctivitis, KOPLIK SPOTS

septic arthritis - 2 Nursing Considerations?

Pain/ fever control Joint assessment & ROM

PPE needed for Droplet precautions

mask

produce and maintain immune response hint: lymphocytes

B cell, T cell, and natural killer cells

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Prodromal period Incubation period Convalescent period Illness period

Incubation period The incubation period is the first stage of the infectious disease. It is the time between the invasion of an organism and the onset of symptoms of infection.

Osteomyelitis? treatment (how long)?

Bacteria in bloodstream invade the bone 4-6 weeks of antibiotics Pain managment

steps of fever?

Infection stimulates the release of endogenous pyrogens Pyrogens act on the hypothalamus and trigger prostaglandin production, which increases the body's set temperature This triggers the cold response (shivering, vasoconstriction, decrease in peripheral perfusion) This decreases heat loss and resets body temperature

erythema infectiosum (fifth disease) precautions

droplet

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? monocytes eosinophils neutrophils lymphocytes

eosinophils

Neonates and young infants with serious infections may NOT present with ____

fever may present with normal or low temps

Varicella Zoster symptoms?

fever, malaise, anorexia, H/A, mild abdominal pain followed by rash - pruritic erythematous macules that evolve to papules and then form clear, fluid-filled vesicles Highly contagious airborne

Systemic Inflammatory Response Syndrome (SIRS)

overwhelming inflammatory response in the presence of infection causing relative hypovolemia and decreased tissue perfusion (MSOF)

A child is brought to the clinic by the parents because the child had a high fever. Assessment reveals vesicles on the tongue and shallow ulcers on the oral mucosa. The child is diagnosed with hand, foot and mouth disease. When teaching the parents about this infection, which information would the nurse likely include? Select all that apply. "The infection can continue to spread to others for about 2 to 3 weeks." "This condition usually resolves in about 1 week." "Try offering cold items, like popsicles for fluids." "You need to make sure to wash your hands frequently."

"This condition usually resolves in about 1 week." "Try offering cold items, like popsicles for fluids." "You need to make sure to wash your hands frequently."

Hand, Foot, and Mouth Disease symptoms?

High fever; vesicles on tongue, oral mucosa; vesicles on hands and feet that are football shaped

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? Droplet precautions Contact precautions Airborne precautions Standard precautions

Contact precautions

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. Range of motion to prevent contractures. Antibiotic therapy may be initiated. Antiviral medications can be prescribed.

Encourage rest and relaxation. Rubella infection is usually mild and self-limited.

Exanthem Subitum (sixth disease) symptoms?

High fever (101-106 F) for 3-5 days; 12-24 hrs after fever resolves, a pinkish red, flat or raised rash that blanches when touched appears and lasts 1-3 days

Rubella manifestations? disease spreads in what direction?

Maculopapular rash begins on face and spreads head to foot. Polyarthralgia (joint pain in multiple joints) in adolescents

why is rubella dangerous for pregnant lady?

can result in miscarriage, fetal death, or congenital malformations. MMR vaccine available.

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? Acetaminophen to decrease the throat pain Penicillin to prevent acute glomerulonephritis Steroids to decrease the inflammation 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 strococcal infection and to prevent the complication of developing acute glomerulonephritis and rheumatic fever.

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? Press the pruritic area. Apply hot compresses. Encourage warm baths. Rub powder on the pruritic area.

Press the pruritic area. Pruritus may be managed by pressing on the area instead of scratching. Increases in temperature will result in vasodilation and increase the pruritus. Warm baths and hot compresses should be avoided. Rubbing may result in increased itching.

The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? Puncturing a vein on the dorsal side of the hand. Using an automatic lancet device on the heel. Accessing an indwelling venous access device. Administering sucrose prior to beginning.

Puncturing a vein on the dorsal side of the hand.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the mostsupport 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. 8 oz is not a lot Signs of sepsis include a lack of appetite, letheragy, hypotonia, and temperature elevations.

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

The incubation period is 10 to 12 days.

Varicella Zoster precautions

airborne

mumps precautions

airborne

What should you know about MMR diseases? in terms of spreading.

airborne precautions on all three

diphtheria

an acute bacterial infection (Corynebacterium diphtheriae) of the throat and upper respiratory tract

Exanthem Subitum (roseola infantum) (sixth disease) what should you tell the caregiver to do for the child?

give fluids

What can scarlet fever progress to?

glomerulonephritis

PPE needed for contact precautions

gown and gloves

Herpangina symptoms?

high fever; vesicles on tongue and oral mucosa

parotitis? common in what disease?

inflammation of the parotid salivary gland mumps

Airborne precaution diseases

measles(Rubeola) chickenpox (varicella) Herpes zoster/shingles TB

second line of defense, responds to larger and more severe infections hint: type of WBC

monocyte

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? trimethoprim-sulfamethoxazole penicillin V clarithromycin erythromycin

penicillin V

diphtheria develops a Pseudomembrane in throat area, what does this put child at risk for?

respiratory issues so monitor

It is recommended to clean the site of the tick bite (Lyme disease) with ____________ when the tick is removed

rubbing alcohol

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

secondary bacterial infections.

Exanthema Subitum (Roseola) Sixth Disease precautions

standard

hand, foot, and mouth disease precautions

standard

herpangina precautions

standard

pertussis treatment? precautions?

suction, antibiotics, monitor respiratory droplet precautions

stages of infection: prodrome

time from appearance of nonspecific symptoms (fatigue, malaise) to more specific symptoms of the disease incubation, prodrome, illness, convalescence

Precautions are not indicated for clients with Lyme disease true or false?

true

Is mononucleosis a virus or bacteria?

virus

Reservoir of infectious agents

where the pathogen can thrive (human body)

pertussis? cause?

whooping cough (paroxysmal cough, copious secretions); highly contagious bacterial infection of the pharynx, larynx, and trachea caused by Bordetella pertussis