Nursing Care of the Child With an Infectious or Communicable Disorder

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?

"Antibiotics are needed to help our child recover from rubella."

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?

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

An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first?

"Have you traveled outside North America?"

The father of a child with mononucleosis is concerned with his child's fever and cough. The father asks when antibiotic therapy will begin. What is the best response by the nurse?

"Mononucleosis is a viral infection so an antibiotic isn't used. We address the symptoms with appropriate therapy."

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

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?

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

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent?

"Your child may return to school when all of the lesions have crusted over."

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?

14 to 28 days

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38°C (100.4°F)? Record your answer using one decimal place.

7.5

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

Apply cool compresses to the skin to stop local itching.

Which collaborative interventions will the nurse implement for a child with acute herpetic gingivostomatitis? Select all that apply.

Assess intake and output. Provide popsicles and ice. Administer acetaminophen. Initiate contact precautions. Give an oral dose of acyclovir.

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

Auscultate the child's lungs.

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.

What is the leading cause of neonatal sepsis and death?

Group B streptococcus

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

Incubation Prodrome Illness Convalescence

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.

Lyme disease Rocky Mountain spotted fever

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?

Mumps

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

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?

Penicillin to prevent acute glomerulonephritis

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:

Pinworm

What information should be included in the teaching plan for a child with varicella?

Remind the child not to scratch the lesions.

The nurse is assessing a child with a varicella infection. The nurse would be alert for which possible complication(s)? Select all that apply.

Secondary bacterial infection Encephalitis Scarring Pneumonia

What is a true statement regarding varicella zoster virus infection?

Secondary bacterial infections of the skin can occur.

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

The child has had 8 ounces of formula in the past 24 hours.

The nurse is taking a health history for an 8-year-old boy who is hospitalized. Which is a risk factor for sepsis in a hospitalized child?

Use of immunosuppression drugs

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.

Wearing protective clothing when playing in wooded areas. Inspecting the skin closely for ticks after the child plays in wooded areas. Contacting the health care provider if there is any area of inflammation that might be a bite.

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:

fifth disease.

A child has been diagnosed with hookworm. The nurse is teaching the parent about the treatment for the condition. Which statement made by the parent confirms that further education is needed?

"My child can play outside bare footed when treatment is done."

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?

Contact precautions

The nurse is preparing to administer acetaminophen to a 4-year-old child to provide comfort. Which precaution is specific to antipyretics?

Ensure proper dose and interval.

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

Incubation period

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?

Obtain specimen before antibiotics are given.

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.

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?

The dog was unprovoked when he bit the girl

The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply.

The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection." The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing."

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

Viruses

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

a child with erythema infectiosum experiencing fatigue and confusion

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?

absence of rash

The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention?

reservoir

Which child will the nurse identify as at greatest risk for developing a urinary tract infection?

an 8-month-old bottle-fed female with HIV

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?

asking the child if his knees hurt

A 3-week-old infant is diagnosed with pertussis. Which antimicrobial agent would the nurse expect the physician to prescribe?

azithromycin

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves:

bacteria.

What is one of the most commonly reported communicable diseases in the United States?

gonorrhea

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

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

scarlet fever.

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule?

small elevation of epidermis filled with a viscous fluid

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

urine output of 10 ml over 3 hours

The nurse is caring for a 10-year-old boy with diphtheria. What would the nurse institute as a tier 2 precaution?

use of a protective mask