Transcript NURSING CARE OF THE CHILD WITH AN

Chapter 40
Infectious Disorders
Stages of infectious disease
• Incubation period
– Time between the invasion of an organism & the onset of
S/S
– 7-10 days (maybe longer depending upon pathogen)
• Prodromal period
– Time between the beginning of nonspecific symptoms &
specific symptoms
– Hours to a few days
• Illness
– Specific symptoms are evident
• Convalescent period
– Time between when the S/S begin to fade and a return to
full wellness
Chain of infection
• Reservoir
– Place in which organisms grow & reproduce
• Portal of exit
– Method by which organisms leave an infected person’s body to be spread
to another individual
– Table 43-1 (blood, respiratory secretions, feces, & exudate from lesions)
• Means of transmission
– Direct contact, indirect contact, fomites (inanimate objects, ex. food,
bedding, towels, combs, drinking glasses, etc), insects, or vermin
• Portal of entry
– Means by which a pathogen can enter an individual’s body
– Inhalation, ingestions, breaks in the skin (ex. bites, abrasions,
burns)
• Susceptible host
VIRAL INFECTIONS
• Viral exanthems (rashes)
– Exanthem subitum (Roseola Infantum)
• Rash following a high fever
– Rubella (German measles)
• Rarely seen because of MMR
• Important because it can cause serious birth defects
– Measles (Rubeola)
• Rarely seen because of MMR
• Occurs with Coryza (rhinitis and sore throat), cough, and
conjunctiva
• Koplik’s spots-whitish spots on the buccal membranes
• Viral exanthems (rashes)
– Chickenpox (Varicella zoster)
• Will become rare because of mandatory immunization
• Fluid filled vesicles that crust over, occur in different stages
• Highly contagious, spread by respiratory droplets as well as contact
– Herpes zoster
• Same virus as chicken pox but usually occurs in older children/adults
• Causes painful vesicles along a dermatome
• May be treated with acyclovir
– Erythema infectiosum (Fifth disease)
• “slapped cheeks” appearance and a lacy rash
• Important because it can cause birth defects
– Smallpox (Variola)
• Important because of bioterrorism
• People with this are really sick with fever, chills, vomiting, then rash
• Rash progresses from macule to papule to vesicle to pustule.
VIRAL INFECTIONS
• Enteroviruses
– Coxsackievirus infections
• Herpangina
– Poliovirus infections: Poliomyelitis
• Occurs in other parts of the world
• IPV used now instead of OPV because of
immunocompromised people contracting disease shed in
stool
Cytomegalovirus
• Common cause of congenital infection in infants
• Some children are asymptomatic for years and then
manifest with
– Mental retardation/learning disabilities
– Hearing loss/blindness
• Symptoms evident at birth can include
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Jaundice
Seizures
Respiratory distress
microcephaly
• Therapy is experimental
• Viruses causing central nervous system diseases
– Rabies
• Other viral infections
– Mumps
• Rarely seen because of MMR
• Mumps in a teenage or adult man can lead to sterility
– Infectious mononucleosis
• S/S similar to tonsillitis with sore throat, lymphadenopathy, and fever
• Spleen is enlarged and fatigue can last ~6 weeks
• Treat symptoms only
OTHER INFECTIONS
• Scarlet fever
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Group A beta-hemolytic strept
Often seen with Strept throat
Usually not seen with “cold” symptoms
Treated for 10-14 days with antibiotics
• Eye infections/inflammations
– Conjunctivitis (viral or bacterial)
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Starts in one eye and moves to the other
Bacterial…purulent discharge
Viral…watery discharge
Schools or day care will only believe it is bacterial so treat
with antibiotic ointment
• Highly contagious, can be spread by gnats
• Anthrax
OTHER BACTERIAL
INFECTIONS
– Important because of bioterrorism
– Three types, inhalation, cutaneous, & gastro
– Inhalation
• Most serious, >90% mortality
• Begins with flu like symptoms
– Cutaneous
• Begins as a papule and progresses to a painless depressed black eschar
• Mortality 1% with antibiotic therapy
– Gastrointestinal
• Acquired by eating undercooked meat infected with anthrax
• Develops abd. pain, diarrhea; mortality is 25%
– Management
• Cipro for >18 years, Doxycycline for <18.
• Diphtheria
– S/S
• Foul nasal discharge, low-grade fever
• Gray membranes on tonsils and pharynx
• Neck edema
– Therapeutic management
• DTaP…rarely seen due to immunization
• Pertussis
– S/S
• See Box 40-1 pg. 1034
– Therapeutic management
• DTaP…rarely seen due to immunization
OTHER BACTERIAL
INFECTIONS
• Lyme disease
– Transmitted by the deer tick
– S/S
• Papule at the site of the tick progressing to a large
swollen ring
• Systemic involvement
– Therapeutic Management
• Amoxicillin or PCN V or doxycycline
• Prevention is the most important tool
OTHER INFECTIOUS
PATHOGENS
• Rickettsial diseases
– Rocky mountain spotted fever
• Transmitted by the wood, dog, or rabbit tick
• S/S
– A reddened area develops at the site of the tick bite
– Afterwards, rash, headache, fever, and mental confusion
– CNS involvement
• Management
– Tetracycline for 7-10 days
– Prevention
OTHER INFECTIOUS
PATHOGENS
• Helminthic infections
– Roundworms
(Ascariasis)
– Hookworms
– Pinworms