Pediatric Exam 1

Hand Hygiene (Hand Washing)

what is the most important way to stop the spread of Infection?

EBV (Epstein-Barr Virus) (mononucleosis)

Virus causing fatigue, sore throat, swollen lymph nodes, increased WBC, splenomegaly & hepatic involvement?

If his knees hurt

A 6-year-old boy is suspected of having late-stage Lyme disease. Which assessment should the nurse use to produce findings supporting this concern?

"Hand gels are actually very effective in preventing the spread of infection."

A mother voices concern to the nurse that her child should not be using alcohol-based hand gels to help prevent the spread of infection. How should the nurse respond?

Standard Precautions

Conjunctivitis requires what type of isolation precautions?

Sepsis

Fever, Tachycardia, Tachypnea and Low Blood Pressure are signs of what

Sepsis

Infants younger than 3 months of age with a rectal temp of 39C(102.2 F)or higher need to see a physician because they are at risk for what?

Sepsis

Intensive Care Unit Stay, Intravenous Lines, and Immunocompromised are all risk factors for what in children?

Incubation Period, Prodrome, Illness, Convalescence

List stages of infection in order

Low-grade fever Macular rash Papular rash Vesicle formation Crusting

List the order of the formation of Varicella Rash infection?

Penicillin If pen allergy - erythomycin

Medications prescribed for Scarlet Fever

Doxycycline (<8 is not because of discoloration of teeth)

The 12-year-old child has been diagnosed with Lyme disease. She is allergic to penicillin. Which medication will most likely be ordered for this client?

Cefuroxime

The 6-year-old child has been diagnosed with Lyme disease. She is allergic to penicillin. Which medication will most likely be ordered for this client?

Koplik spots

The appearance of which hallmark clinical manifestation occurs in measles?

Press the pruritic 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?

HYDRATION (drink non-irritating fluids)

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?

administer oxygen

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child?

auscultate lungs (because can cause respiratory paralysis)

The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next?

Hydration Fever reduction

Two major/most common medical treament's in children?

Susceptible host (chain of infection)

a person who can get sick when they are exposed to a disease causing pathogen?

portal of exit

mucus membranes, urinary & respiratory tract, gastro & reproductive tract are examples of what part of the chain of infection?

Droplet & Contact (blood) precautions

5th disease requires what kind of isolation precautions?

Mumps

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition?

nosocomial (health care-associated) infection.

A 3-year-old girl was in the hospital for a week following open heart surgery. By the end of the week, she had contracted an infection. The nurse recognizes this type of infection as a:

(Sneeze) Upper Respiratory Secretion

A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl subsequently played with. In this case, what is the portal of exit in the chain of infection?

Increased eosinophils

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?

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?

scarlett fever or acute glomerulonephritis

A chief danger of scarlet fever is that children may develop:

1)Dorsal aspect of the hand Antecubital fossa (2) Jugular & Femoral Vein

A child admitted to the pediatric unit is to have blood specimens obtained for testing. When preparing to obtain the specimens via venipuncture, which sites would the nurse likely use? (1) (2) Which locations can be used by physician?

Scarlet Fever

A child presents to hospital with fever, erythematous rash all over their body except soles of feet and palms, the rash is flaking and their tongue has a strawberry appearance what can the nurse assume the child has?

varicella (chicken pox)

A child presents with a fever and within 24 hours has a lesion that begins as a macule becomes a papule in 6-8 hours and becomes umbilicated and forms a crust..We could assume the child is infected with what virus?

Rubella (German Measles)

A child presents with low grade fever, Ha, malaise, cough and a rash that started on the face and is spreading to the rest of the body, what could you assume they were infected with?

immunization

Healthy People 2020 focuses on what for children?

1-3 weeks

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. About how long until signs could be noted?

Conjunctivitis

Viral, Bacterial or Allergic infection causing pink sclera of the eye, yellow-green purulent discharge, crusting of eyelids.

Fifth's Disease (Erythema Infectiosum)

Virus causing fever, running nose, HA then rash at about 7-21 days ("slapped cheek" look on day 4 on face)

Resevoir

What chain of infection involves a place the pathogen can thrive?

immunizations/vaccines

What is the main way to prevent of communicable disease?

secondary bacterial infection

What is the most common complication of Varicella?

Measles (Rubeola)

What negative sense RNA virus is associated with cough, coryza, and conjunctivitis with photophobia?

mode of transmission

What part of the chain of infection could be controlled by handwashing & proper PPE?

infectious agent

What part of the chain of infection involves bacteria, parasite, virus, etc.

neutrophil, eosinophil, basophil

What type of WBC are in first line of defense?

Lymphocytes (B & T) (NKC natural killer cells)

What type of WBC are the main source of stimulating an immune response to viral infections (measels, rubella, chx pox, EBV)(tumors)

Monocytes

What type of WBC respond to larger infections such as chronic inflammation, leukemias & Lymphomas?

Standard Precautions

What type of isolation precautions is EBV?

airborne/contact precautions

What type of precautions does measles virus require?

Droplet precautions

What type of precautions is Pertussis?

Measels (Rubeola)

Which Virus is presented with Koplik spots (white-blue centerpoint) on Buccal & Conjunctivitis?

Neutrophils

Which WBC would be elevated in bacterial, fungal infections?

Basophils

Which WBC would be elevated in hypersensitivity reactions?

erythrocyte sedimentation rate (ESR)

Which diagnostic tool is used to identify children who may have an infection or inflammatory process?

Aspirin

Which medication are forbidden to give children to reduce fever due to the chance of Reyes Syndrome?

Pertussis (whooping cough)

Which viral infection presents with runny nose/congestions, whooping cough upon inspiration starting at 1-2 weeks?

Mumps

What viral infection causes swelling of parotid glands, fever, earache worse by chewing?