Chapter 43: PEDIA : Infectious Disorders
You are the charge nurse on the pediatric unit when a pediatrician calls wanting to admit a child with rubeola (measles). Which of these factors is of most concern in determining whether to admit the child to your unit? A. There are several children receiving chemotherapy on the unit. B. The parents do not want to admit their child to the unit. C. The infection control nurse liaison is not on the unit today. D. No negative-airflow rooms are available on the unit.
No negative-airflow rooms are available on the unit. Clients with rubeola require implementation of airborne precautions, which include placement in a negative airflow room, this child cannot be admitted to the pediatric unit.The other circumstances may require actions such as staff reassignments but would not prevent the admission of a client with rubeola.
A child is diagnosed with infectious mononucleosis. The nurse reinforces homecare instructions to the parents about the care of the child. Which instruction should the nurse provide to the parents? A. Maintain the child on bed rest for 2 weeks. B. Maintain respiratory precautions for 1 week. C. Notify the pediatrician if the child develops a fever. D. Notify the pediatrician if the child develops abdominal or left shoulder pain.
Notify the pediatrician if the child develops abdominal or left shoulder pain. The parents need to be instructed to notify the pediatrician if abdominal pain (especially in the left upper quadrant) or left shoulder pain occurs, because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until the splenomegaly resolves. Bed rest is not necessary and children usually self-limit their activity. Respiratory precautions are not required, although transmission can occur via direct intimate contact or contact with infected blood. Fever is treated with acetaminophen
A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter? Reservoir Portal of exit Means of transmission Portal of entry
Portal of entry The chain of infection is the process by which organisms are spread. An infectious agent is any organism capable of causing an infection. It can be bacteria, viruses, or fungi. The reservoir is the place where these organisms thrive and reproduce. After reproduction, the organism must leave the reservoir. This area is the portal of exit. Pathogens can be transmitted via either direct or indirect methods. Direct method would be close contact with the infected person. Indirect transmission occurs with things like droplets in the air (e.g., sneeze, cough). The portal of entry is the way for a pathogen to enter the body. It can be through inhalation, ingestion, or breaks in the skin. Any person who cannot resist the pathogen is the susceptible host.
What information should be included in the teaching plan for a child with varicella? A. Administer aspirin for fever. B. Place the child in a warm bath for skin discomfort. C. Utilize salt solutions to assist in healing oral lesions. D. Remind the child not to scratch the lesions.
Remind the child not to scratch the lesions. Varicella lesions appear first on the scalp. They spread to the face, the trunk, and to the extremities. There may be various stages of the lesions present at any one time. The lesions are intensely pruritic. The teaching plan for varicella should include that the child not scratch the lesions. Opening the lesions gives access for secondary infection to occur and causes scarring. Acetaminophen, not aspirin, should be administered for fever due to the link with Reye syndrome. The best treatment for skin discomfort is a cool bath with soothing colloidal oatmeal every 3 to 4 hours for the first few days. Warm baths cause more itching and dry the skin.
The school nurse prepares a list of home care instructions for the parents of school children who have been diagnosed with pediculosis capitis (head lice). Which should be included in the list? Select all that apply. A. Siblings may also need treatment. B. Use antilice sprays on all bedding and furniture. C. Use a pediculicide shampoo and repeat treatment as necessary. D. Grooming items such as combs and brushes should not be shared. E. Launder all the bedding and clothing in hot water and dry on high heat. F. Vacuum floors, play areas, and furniture to remove any hairs that may carry live nits.
Siblings may also need treatment. Bedding and linens should be washed with hot water and dried on a hot setting. Thorough home cleaning is necessary to remove any remaining lice or nits. Siblings may need to be treated and combs and brushes may need to be discarded or soaked in boiling water for 10 minutes. Antilice sprays are unnecessary. Additionally, they should never be used on bedding, furniture, or a child. The pediculicide product needs to be used as prescribed, and the parents are instructed to follow package instructions for timing the application and for contraindications for their use in children.
A 6-year-old child is scheduled to have measles, mumps, and rubella (MMR) vaccine. Which of the following route will you expect the nurse to administer the vaccine? A. Intramuscularly in the vastus lateralis muscle. B. Intramuscularly in the deltoid muscle. C. Subcutaneously in the gluteal area. D. Subcutaneously in the outer aspect of the upper arm
Subcutaneously in the outer aspect of the upper arm . (MMR) the vaccine is administered subcutaneously in the outer aspect of the upper arm.
The nurse caring for children with fungal infections most often administers which medication? benadryl acetaminophen prednisone ketoconazole
ketoconazole Ketoconazole, an oral antifungal, is the medication of choice for fungal infections. In some infections the treatment may be prolonged (3 months or more), and compliance must be reinforced.
A toddler is treated for pinworms. To prevent reinfection, what advice would you give the mother? Don't allow the child to play on the floor. Don't allow the child to play with the family dog. Help the child wash hands before eating. Urge the child to void as frequently as possible.
Help the child wash hands before eating. Pinworm infections are usually spread from the diaper area to the mouth by unwashed hands.
The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate? "A daily multi-vitamin will boost the immune system." "Handwashing is an effective way to prevent infection." "Remind your child to cover the mouth when coughing." "Clean your bathroom and kitchen when they look dirty."
"Handwashing is an effective way to prevent infection."
Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Incubation period Prodromal period Illness period Convalescent period
Incubation period Infection occurs when an organism invades the body and multiplies, causing damage to the tissue and cells. The infectious process goes through four stages. 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. The prodromal period is the time from the onset of nonspecific symptoms to specific symptoms, for example, cold/flu-like symptoms before Koplik spots occur in measles. The illness is the time during which symptoms of the specific illness occur. The convalescent stage is the time when the acute symptoms disappear.
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? Neck Arms Legs Stomach
Neck Tetanus progresses in a descending fashion to other muscle groups, causing spasms of the neck, arms, legs, and stomach.
A 5-month old infant with giardiasis was brought by his mother to the health center because of diarrhea occurring 4 to 5 times a day. His skin goes back slowly after a skin pinch and his eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category? No signs of dehydration Some dehydration Severe dehydration The data is insufficient
Some dehydration Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."
"I can't believe it. We're not unclean, poor people." Head lice is not an indication of poor hygiene or poverty. It occurs in all socioeconomic groups. Thus, the parents' statement about being unclean and poor reflects a lack of knowledge about the infection. A pediculicide is used to wash the hair to treat the infestation. Household contacts need to be examined and treated if affected. Extreme pruritus is the most common symptom, with nits or lice especially behind the ears or at the nape of the neck.
The nurse assists with providing an instructional session to parents regarding impetigo. Which statement by a parent indicates the need for further teaching? "It is extremely contagious." "It is most common during humid weather." "Lesions are most often located on the arms and chest." "It begins in an area of broken skin, such as an insect bite."
"Lesions are most often located on the arms and chest." Impetigo is most common during the hot and humid summer months. It begins in an area of broken skin, such as an insect bite. It may be caused by Staphylococcus aureus, group A β-hemolytic streptococci, or a combination of these bacteria. It is extremely contagious. Lesions are most often located around the mouth and nose, but they may be present on the extremities
Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the school children. Which statement, if made by a parent, indicates a need for further teaching regarding this communicable disease? "Small blue-white spots with a red base may appear in the mouth." "The rash usually begins centrally and spreads downward to the limbs." "Respiratory symptoms such as a very runny nose, cough, and fever occur before the development of a rash." "The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."
"The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."
The nurse reinforces instructions regarding the use of permethrin 1% to the parents of a child who has been diagnosed with pediculosis capitis. Which statements by the parents indicate they understand the instructions? Select all that apply. A. "We will need to apply another application in 48 hours." B. "The hair should not be shampooed for 24 hours after treatment." C. "The medication can be obtained over the counter in a local pharmacy." D. "The medication is applied repeatedly to the hair and left on for 24 hours." E. "The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out."
"The hair should not be shampooed for 24 hours after treatment." "The medication can be obtained over the counter in a local pharmacy." "The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out." Permethrin 1% is an over-the-counter, antilice product that kills lice and eggs with one application and that has residual activity for 10 days. It is applied to dried hair after shampooing and left for 5 to 10 minutes before it is rinsed (not shampooed) out. The hair should not be shampooed for 24 hours after the treatment to give it time to work. Using too much for too long can cause neurological damage.
A student is assisting the healthcare provider in the care of a patient diagnosed with poliomyelitis. Which statement made by the student correctly describes how the poliovirus affects neuromuscular function? "When the poliovirus infects the central nervous system it inhibits acetylcholine." "Nerve inflammation and demyelination results in muscle weakness." "The poliovirus destroys lower motor neurons in the spinal cord." "The poliovirus causes an autoimmune destruction of the motor nerves."
"The poliovirus destroys lower motor neurons in the spinal cord." Poliomyelitis, the disease caused by the poliovirus, affects the anterior horn (gray matter) in the spinal cord. As the poliovirus replicates in the motor neurons of the anterior horn, cell destruction and paralysis occurs.
The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate? "State-required vaccinations are needed for your child to attend school." "There are no side effects from vaccinations that you need to worry about." "Vaccinations are very effective at preventing serious disease and infection." Your child will probably not acquire the disease because other children are vaccinated."
"Vaccinations are very effective at preventing serious disease and infection." Nurses should provide education about the effectiveness of vaccines to prevent serious diseases at every visit. Although state-required vaccinations are needed for the child to attend school (some states allow medical, religious, and philosophical exemptions), this statement does not address the parents' concern. The child may not acquire the disease because others are vaccinated, but this statement could give the parents a false sense of security. Although most vaccinations do not have serious side effects, the nurse cannot ensure the child will not have a serious reaction to the vaccine.
The nurse obtains a health history from a mother of a 15-month-old child before administering a measles, mumps, and rubella (MMR) vaccine. Which is essential information to obtain before the administration of this vaccine? A recent cold Allergy to eggs The presence of diarrhea Any recent ear infections
Allergy to eggs Before the administration of a measles, mumps, and rubella vaccine, a thorough health history needs to be obtained. The MMR vaccine is used with caution in a child with a history of allergy to gelatin or eggs because the live measles vaccine is produced by chick embryo cell culture. The MMR vaccine also contains a small amount of the antibiotic neomycin. Options 1, 3, and 4 are not contraindications to administering this immunization.
After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? A. After day 5 of the rash B. the rash is completely healed C. Once the rash appears D. After the lesions have crusted
After the lesions have crusted Children with chickenpox (varicella zoster) can return to school once the lesions have crusted.
A 6-month-old infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at the well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which instruction by the nurse is appropriate? A. Monitor the infant for a fever. B. Bring the infant back to the clinic. C. Apply an ice pack to the injection site. D. Leave the injection site alone, because this always occurs.
Apply an ice pack to the injection site. Occasionally tenderness, redness, or swelling may occur at the site of the injection. This can be relieved with cool packs for the first 24 hours and followed by warm or cool compresses if the inflammation persists. It is not necessary to bring the infant back to the clinic. Option 1 may be an appropriate intervention, but it is not specific to the question.
A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? Select all that apply. Enteric Contact Airborne Protective Neutropenic
Contact Airborne Rubeola is transmitted via airborne particles or direct contact with infectious droplets. Airborne precautions and contact precautions are required; a mask and gloves are worn by those who come in contact with the child. Gowns and gloves are not indicated. Articles that are contaminated should be bagged and labeled. Options 1, 4, and 5 are not indicated for rubeola
Infectious mononucleosis ("mono") is caused by which of the following? Treponema pallidum Epstein-Barr virus Microsporum canis Streptococcal bacterium
Epstein-Barr virus Infectious mononucleosis ("mono") is caused by the Epstein-Barr virus, one of the herpes virus groups. The organism is transmitted through saliva.
The nurse provides instructions to the mother of a child with impetigo regarding the application of antibiotic ointment. The mother asks the nurse when the child can return to school. Which response by the nurse is appropriate? A. Ten days after using the antibiotic ointment B. One week after using the antibiotic ointment C. As soon as the antibiotic ointment is started D. Forty-eight hours after using the antibiotic ointment
Forty-eight hours after using the antibiotic ointment The child should not attend school for 24 to 48 hours after the initiation of systemic antibiotics or for 48 hours after the use of the antibiotic ointment to make sure they're no longer contagious. Without treatment, impetigo can remain contagious for several weeks. The school should be notified of the diagnosis. Therefore, the remaining options are incorrect.
A child seen in the clinic is found to have rubeola (measles) and the mother asks the nurse how to care for the child. Which instruction should the nurse provide to the mother? A. Keep the child in a room with dim lights. B. Give the child warm baths to help prevent itching. C. Allow the child to play outdoors because sunlight will help the rash. D. Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.
Keep the child in a room with dim lights. A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest that the parent keep the child out of brightly lit areas. Children with viral infections are not to be given aspirin because of the risk of Reye's syndrome. Warm baths and the sun will aggravate itching. In addition, the child needs to rest
A school-age child is placed in contact precautions for a communicable disease. Which observation indicates that teaching about these precautions has been effective? A. Family members are sitting on the client's bed. B. Father applies a face mask before entering the child's room. C. Mother applies a gown and gloves before entering the child's room. D. Younger brother applies a face mask, gown, gloves, and face shield before entering the room.
Mother applies a gown and gloves before entering the child's room. For contact precautions, a disposable gown and gloves are required to prevent the transmission of infection. Family members should not be sitting on the client's bed. A face mask and face shield are not required for contact precautions.
The nurse assigned to care for a child with mumps is monitoring the child for the signs and symptoms associated with the common complication of mumps. The nurse monitors for which sign/symptom that is indicative of this common complication? ain Deafness Nuchal rigidity A red, swollen testicle
Nuchal rigidity The most common complication of mumps is aseptic meningitis, with the virus being identified in the cerebrospinal fluid. Aseptic meningitis means that is caused other than bacteria (septic meningitis). Common signs include nuchal rigidity, lethargy, and vomiting. A red, swollen testicle may be indicative of orchitis.Although this complication appears to cause most concern among parents, it is not the most common complication. Although mumps is one of the leading causes of unilateral nerve deafness, it does not occur frequently. Muscular pain, parotid pain, or testicular pain may occur, but pain does not indicate a sign of a common complication
A school-aged child with an infectious disease is placed on transmission-based precautions. If the child is not dehydrated or otherwise in distress, which nursing diagnosis would be the priority? Impaired skin integrity related to trauma secondary to pruritus and scratching Fluid volume deficit related to increased metabolic demands and insensible losses Social isolation related to infectivity and inability to go to the playroom Deficient knowledge related to how infection is transmitted
Social isolation related to infectivity and inability to go to the playroom Children who are placed on transmission-based precautions are not allowed to leave their rooms and are not allowed to go to common areas such as the playroom or schoolroom. Thus, they are at risk for social isolation. Impaired skin integrity, fluid volume deficit, and deficient knowledge may be appropriate but would depend on the infectious disease diagnosed.
The nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. How should the nurse plan to administer the vaccine? A. Intramuscularly in the deltoid muscle B. Subcutaneously in the gluteal muscle C. Subcutaneously in the outer aspect of the upper arm D. Intramuscularly in the anterolateral aspect of the thigh
Subcutaneously in the outer aspect of the upper arm MMR is administered subcutaneously in the outer aspect of the upper arm. Each child should receive two vaccinations, the first between 12 and 15 months of age and the second between 4 and 6 years or 11 and 12 years.
Based on the assessment, you classified a 3-month old infant with the chief complaint of diarrhea in the category of SOME DEHYDRATION. Based on the IMCI management guidelines, which of the following will you do? A. Give the infant's mother instructions on home management. B. Keep the infant in your health center for close observation. C. Bring the infant to the nearest facility where IV fluids can be given. D. Supervise the mother by giving 200 to 400 ml of Oresol in 4 hours.
Supervise the mother by giving 200 to 400 ml of Oresol in 4 hours. In the IMCI management guidelines, SOME DEHYDRATION is treated with the administration of Oresol within a period of 4 hours. The amount of Oresol is best computed on the basis of the child's weight (75 ml/kg body weight). If the weight is unknown, the amount of Oresol is based on the child's age.
A child is brought to a clinic after developing a rash on the trunk and on the scalp. The parents report that the child has had a low-grade fever, has not felt like eating, and has been generally tired. The child is diagnosed with chickenpox. Which statement by the nurse is accurate regarding chickenpox? A. The communicable period is unknown. B. The communicable period ranges from 2 weeks or less up to several months. C. The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. D. The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions.
The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. The communicable period for chickenpox is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. In roseola the communicable period is unknown. Option 2 describes diphtheria. Option 3 describes rubella.
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. The dog was unprovoked when he bit the girl B. The dog was properly immunized for rabies C. There have been no other reported instances in the area D. 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.
Metronidazole (Flagyl) is given to treat a patient's giardia lamblia infection. which of the following is appropriate to teach the patient/caregivers? A. The urine may turn reddish. B. This should be taken before meals. C. There is a metallic taste in the mouth upon ingestion. D. Current sexual partners may need treatment for this kind of infection.
There is a metallic taste in the mouth upon ingestion. Metronidazole leaves a metallic taste in the mouth.The urine may turn dark amber brown, not reddish.Metronidazole should be taken with a meal to avoid GI upset.Current sexual partners do not require treatment for this infection.
The immune system works to destroy pathogens by helping the body get rid of or resist the invasion of foreign materials The blood cells that surround, ingest, and neutralize the pathogens are: erythrocytes. macrophages. platelets. lymphocytes.
macrophages When a pathogen enters the body, the immune system works to destroy the pathogen. This occurs when white blood cells known as macrophages surround, ingest, or neutralize the pathogen.
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: nosocomial infection. viral infection. bacterial infection. fungal infection.
nosocomial infection. Nosocomial (health care-associated) infections are contracted while in a hospital or other health care setting. Children younger than 2 years, children with a nutritional deficit, those who are immunosuppressed, those who have indwelling vascular lines or catheters, those who are receiving multiple antibiotic therapy, or those who remain in the hospital for longer than 72 hours are at highest risk for contracting such an infection. The infection could be viral, bacterial, or fungal, but not enough information is provided in the scenario to determine this.
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? pertussis tuberculosis influenza nasopharyngitis
pertussis 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 doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? redness of the skin produced by congestion of the capillaries small, circumscribed, solid elevation of the skin discolored skin spot not elevated at the surface small elevation of epidermis filled with a viscous fluid
redness of the skin produced by congestion of the capillaries Erythema is redness of the skin produced by congestion of the capillaries.
The nurse reviews the home care instructions with a parent of a 3-year-old with pertussis. Which statement by the parent indicates a need for further teaching? A. "I know that my child will make a loud whooping sound." B. "I understand this whooping cough is viral and I have to let it run its course." C. "I understand that I need to watch for respiratory distress signs with pertussis." D. "I can reduce the environmental factors that can trigger coughing, like dust and smoke."
"I understand this whooping cough is viral and I have to let it run its course." Pertussis is caused by the bacteria Bordetella pertussis and treatment requires antimicrobial therapy. Symptoms of pertussis consist of a respiratory infection followed by increased severity of cough with a loud whooping on inspiration. The child may experience respiratory distress, and the parents should be instructed on reducing environmental factors that cause coughing spasms, such as dust, smoke, and sudden changes in temperature.
The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further teaching? "We need to encourage adequate fluid intake." "Coughing spells may be triggered by dust or smoke." "We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." "Good hand-washing techniques need to be instituted to prevent spreading the disease to others."
"We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase. Options 1, 2, and 4 are components of home care instructions
How is the poliomyelitis virus spread? Select all that apply. By infected mucous By a mosquito bite By infected stool All of the above
By infected mucous By infected stool Poliovirus is spread through direct contact or contamination of food or water by the feces of an infected person.
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.
The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease? A. Skin rash caused by a virus B. Skin rash caused by a bacteria C. Respiratory disease caused by virus involving the lymph nodes D. Respiratory disease caused by a virus involving the parotid gland
D. Respiratory disease caused by a virus involving the parotid gland Mumps is caused by a paramyxovirus that causes swelling from the parotid gland, causing jaw and ear pain. It is transmitted via direct contact or droplets spread from an infected person, salive from infected saliva, and possibly by contact with urine. Airborne and contact precautions are indicated during the period of communicability. Options 1, 2, and 3 are incorrect.
How is Rubella transmitted? A. It is spread through contact with upper respiratory secretions of infected persons. B. contact with personal belongings of the infected individual. C. It is transmitted by the blood and semen of the infected person. D. Direct contact with contaminated surfaces and food.
It is spread through contact with upper respiratory secretions of infected persons. Rubella is spread by direct contact with nasal or throat secretions of infected individuals. Rubella can also be transmitted by breathing in droplets that are sprayed into the air when an infected person sneezes, coughs or talks.
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? Koplik spots Lymphadenopathy Slapped cheek appearance Nits
Koplik spots 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.
Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)? A. a 1-year-old receiving oral amoxicillin for otitis media B. an 18-month-old child receiving chemotherapy over 5 days C. a 2-year-old child with HIV being discharged later that day D. 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.
During a routine assessment, the nurse determines that a school-age child has head lice. What did the nurse assess in this child? A. macular rash on the arms B. white flecks on hair shafts C. red raised rash on the neck D. pustule formation on the trunk
white flecks on hair shafts Pediculosis capitis or head lice are characterized by small, white flecks on hair shaft, which are nits or the eggs of lice, and extreme pruritus. Head lice are not associated with a macular rash, a red raised rash, or pustule formation.
A child is admitted to the pediatric unit with a sudden onset of one-sided flaccid paralysis. Which of these diagnostic tests will be most useful in supporting a diagnosis of poliomyelitis? Stool culture Blood culture Muscle biopsy Chest radiograph
Stool culture Poliovirus can be detected in specimens from the throat, feces (stool), and occasionally cerebrospinal fluid (CSF).
A mother is using Oresol' in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. You will tell her to: A. Let the child rest for 10 minutes then continue giving Oresol more slowly. B. Bring the child to the health center for assessment by the physician. C. Bring the child to the health center for IV therapy. D. Bring the child to the nearest hospital for further assessment.
Let the child rest for 10 minutes then continue giving Oresol more slowly. Vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol more slowly.The child can be brought to the health if he cannot be managed at home.IV therapy is not yet necessary.If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital.
The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis (thrush). Which medication would most likely be prescribed for the child? acetaminophen ampicillin aspirin nystatin
nystatin Application of nystatin to the oral lesions every 6 hours is an effective treatment for oral candidiasis (thrush). Treatment for diaper rash caused by Candida albicans is nystatin ointment or cream applied to the affected area.
The nurse is caring for a newborn who was delivered vaginally. The infant has a white coating in the mouth that looks like milk curds. The nurse suspects that the infant has: A. oral candidiasis (thrush) caused by Candida albicans. B. tinea capitis caused by Microsporum audouinii. C. pediculosis. D. atopic dermatitis.
oral candidiasis (thrush) caused by Candida albicans. Newborns can be exposed to a candidiasis vaginal infection in the mother during delivery. Oral candidiasis (thrush) appears in the child's mouth as a white coating that looks like milk curds.
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 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.
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? A. "Your child must have been exposed to someone with herpes zoster." B. "Herpes zoster is a reactivation of a previous varicella zoster infection." C. "Children who are immunocompromised are more likely to contract shingles." D. "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 toddler is being treated for pinworms. What advice should the nurse give to the mother to prevent reinfection? A. Everyone in the family will need to be treated. B. Don't allow the child to play on the floor. C. Urge the child to urinate every 2 hours as possible. D. Keep the child away from playing with the family cat.
Everyone in the family will need to be treated. Pinworms are small, white, threadlike worms that live in the cecum and are transmitted to the mouth. Children should be taught to wash the hands before eating to prevent the transmission of the worms back into the digestive tract. In addition,all family members need to be treated for pinworm infestation because the worms are easily transmitted from person to person. Playing on the floor, frequent voiding, and playing with the cat will not help prevent reinfection with pinworms.
A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox? A. Macular rash on the trunk and scalp B. Pseudomembrane formation in the throat C. Maculopapular or petechial rash on the extremities D. Small, red spots with a bluish-white center and red base
Macular rash on the trunk and scalp A macular rash that first appears on the trunk and scalp and then moves to the face and the extremities is a characteristic of chicken pox. Pseudomembrane formation in the throat is characteristic of diphtheria. A maculopapular or petechial rash primarily on the extremities is characteristic of Rocky Mountain spotted fever. Small red spots with a bluish-white center and red base are known as Koplik spots and are characteristic of measles
The nurse is caring for a hospitalized child with a diagnosis of rubella (German measles). The nurse reviews the primary health care provider's progress notes and reads that the child has developed Forchheimer sign. Based on this documentation, which should the nurse expect to note in the child? A. Swelling of the parotid gland B. Petechiae spots located on the palate C. A fiery red edematous rash on the cheeks D. Small blue-white spots noted on the buccal mucosa
Petechiae spots located on the palate
