Transcript Infectious and Communicable Diseases

Infectious and Communicable
Diseases
Ball & Bindler
Donna Hills APN EdD
Clinical Considerations
Etiology: bacterial, fungal, viral, or
protozoan
Cluster of symptoms are disease
specific
fever secondary to the release of
prostaglandins, triggered by the
invading organism
may be a beneficial physiologic
response. Fevers < 101-101.5 may not
be treated right away.
Clinical Management
Fevers > 101.5 are only treated with
Acetominophen or Ibuprophen;not
Aspirin due to association with Reye’s
syndrome
Symptomatic relief with viruses
Antibiotics with bacterial infection; (antifungal or protozoan as applicable)
Prevention of transmission/Isolation of
infected child.
Good handwashing/ bacteriostatic
hand gel
The Toxic Child
exhibits more severe symptomatology
of illness
high fever, lethargy, poor ability to focus
or give eye contact, decreased tone,
poor perfusion (delayed cap refill),
hypoventilation or hyperventilation,
cyanosis, saturation less than 95% on
room air, significantly low temperature
in a premie or child with neurologic
impairment.
Evaluating Child with
Fever/illness
Body’s natural defense against
infection
Low grade fever may be beneficial to fight off
organisms or enhance the effect of antibiotics.
Antipyretics are usually given for temps
>100 or 101 Ax (per Dr.’s order).
Fevers >102 should be treated
Some children experience febrile seizures
so may treat more rapidly in this case.
Acetominophen or Ibuprophen are
preferred in children: no ASA d/t assoc
with Reyes Syndr.
Case Study: 1 month old with a
fever
Mrs. Carole calls the pediatric office
to report that her 1 mo old has an
axillary temp of 101. She is eating a
little less than usual but otherwise
seems fine.
What is your response to Mrs. Carole
and what is your rationale?
Otitis Media
Used to be a common cause for fever
Incidence is now decreased with the use of
the HIB and PCV vaccines.
Some children are still anatomically prone
to OM due to poor eustachian tube
dysfunction with or without a URI
Treatment with antibiotics: Amoxicillin,
Azithromycin, Augmentin, Cefuroxime.
Persistent fluid (SOM) can lead to hearing
loss over time.
Infectious Skin Infestations
Lice (Pediculosis Capitis)
Common among children of all socioeconomic
levels; ages 3-10yr most common.
Nits found on hair shaft
Incub for eggs 8-10 days
Presents with itching and “flaking”
Rx with Permethrin (Nix) shampoo
Lindane is last resort: neurotoxic
No-nit policy can be diffic for parents; not
recommended by AAP.
Scabies
Mite infestation: Sarcoptes scabei
Skin to skin contact; household
transmission common
Most common in kids <2yrs
Presents with intense puritis and
characteristic linear rash (on hands or
fingers) or diffuse trunkal rash.
Rx with scabicide lotion (Permethrin
5%).
Impetigo
Bacterial infection caused by staph or
streptococcus.
Common sites: face, around mouth, hands,
neck, and extremities, intertriginous areas.
Irritation or break in the skin serves as an
entry
Presentation as pustule surrounded by
erythema/edema, erupts with honey
colored crust.
Bullous impetigo: vesicles enlarge, stim by
release of endotoxin: coalesce
Spread to face or extr: self innoculation.
Infectious and Communicable
Diseases
Review and study table 12-5 pgs 620635.
Complete the worksheet/handout for
infectious diseases.