32 terms

Infectious and communicable disease

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Communicable Disease
Illness that is directly or indirectly transmitted from one person or animal to another by contact with body fluids, with contaminated objects, or by vectors (e.g., ticks, mosquitoes)
Risk Factors for Infectious and Communicable Diseases in Newborns and Infants
Immature immune system

Passively acquired maternal antibodies provide limited protection

Disease protection through immunization is incomplete
Risk Factors for Infectious and Communicable Diseases in Children
Limited prior exposure to communicable diseases

Poor health

Immunodeficiency
Common Routes of Infection Transmission in Children
Behaviors that lead to the spread of infection
Traits of children- diapers, sharing toys, poor hand hygiene
Nurse's Role in Infection Control
Promote infection control strategies

Report infectious and communicable diseases to state health officials
Diseases of childhood and adolescence
Measles, mumps, rubella, polio, pertussis, diphtheria, tetanus, Haemophilus influenza type B, hepatitis B, hepatitis A, pneumococcus, varicella, rotovirus, meningococcal diseases, human papillomavirus
Active immunity
An antigen is introduced into the body in a vaccine, which stimulates antibody production without causing clinical disease
Passive immunity
Antibodies produced in another human or animal host is given.
Provides immediate protection
Does not provide lasting immunity
Example: Tetanus immune globulin
Immunization Type
Inactivated
DTaP, IPV, Hep B, Hib, PCV, Hep A, Influenza
Live attenuated (weakened)
MMR, Varicella, Influenza (nasal spray)
*Contraindicated in immunocompromised individuals
Vaccine Side Effects
Local reactions
Erythema, swelling, pain, and induration
Vaccine Side Effects
Systemic reactions
Fever, irritability, malaise, anorexia (e.g., DTaP)
Vaccine Side Effects
Allergic reactions
(local and systemic - 0.012%))
Wheal, urticaria
Severe local
Anaphylaxis
Vaccine Side Effects
Other serious reactions
not the vaccine, but products in the vaccine
Vaccine Side Effects
Unique reactions
MMR- rash and fever (normal)
Varicella- pox that break out for 30 days
Misinformation about vaccines
Vaccine-preventable diseases have been eliminated.

Immunization weakens the immune system. Multiple vaccines overload the immune system and cause harmful effects.-
doesn't weaken immune system- vaccines not as strong as used to be

It would be better to let the child get the disease than get immunized.

Vaccines do not work. Children still get the disease.

Belief that they can control their child's susceptibility to disease and the outcomes
Steps in Administering Immunization
Identify needed immunizations
Review the vaccine screening questions
Review the Vaccine Information Statement (VIS)
Fever Benefits
Rid of organisms that thrive in lower body temperatures
Mobilizes immune response
↓ plasma iron concentration - limits microorganism growth
Fever Risk
When body temp reaches 41° C (105.9)
Febrile seizure
Sepsis
Definition: Overwhelming infection in the bloodstream

Causes from infectious diseases:
Infected pox

Can lead to septic shock
septic shock
systematic response to pathogenic organisms in the blood resulting in circulatory dysfunction
Signs of Sepsis
Hypothermia or hyperthermia
Abdominal distention
Anorexia
Respiratory distress
Vomiting
Cool extremities
Mottling
Lethargy
Varicella (Chicken Pox)
Transmission: Airborne and lesion contact
Direct contact with mucous membranes or conjunctiva
Incubation: 14 - 21 days
Communicable -5 days before rash and until it crusts
Clinical manifestations:
mild fever, malaise, headache, itching with rash
Potential complications:
Secondary infection, cellulitis, encephalitis
Prevention:
Vaccine after age 12m
Nursing Management of Chicken Pox
*Airborne and contact precautions

Hx of immunization and exposure

Change linen frequently

Observe for signs of complications - drowsiness, meningeal sign

Monitor for acyclovir side effects - nausea, vomiting, diarrhea, h/a, allergic reactions
Management of Lesions
Use cool wet compresses or giving baths in cool or lukewarm water (Oatmeal bath, e.g., Aveeno)

Keep fingernails short and clean.

Put calamine lotion on itchy areas

Give child foods that are cold, soft, and bland.

Acetaminophen regularly to help relieve pain if there are mouth blisters.

Medication for itching.
Hand, Foot and Mouth Disease (Coxsackievirus)
Transmission: fecal-oral and respiratory routes
Incubation : 3-6 days
Clinical manifestations:
Lesions cheeks, gums, and tongue.
Papulovesicular lesions on hand and feet
Irritable, fever, anorexia, dysphagia
Treatment: supportive care
Prevention: avoid contact with infected person early in the disease
Hand, Foot and Mouth Disease (Coxsackievirus)
Nursing Management
Standard and contact precautions
Topical lotions and systemic meds for pain
Cool drinks; soft, bland food
Warm saline mouth rinses
Observe for dehydration
Reassurance and support to parents
Nonaspirin antipyretics
Erythema Infectiosum (Fifth's Disease)
Transmission: Respiratory and blood
Incubation: 6-14 days
Clinical manifestations:
Flu-like illness for 2-3 days
1 week later - fiery-red rash on cheeks (*slapped face), lacelike symmetric, erythematous, maculopapular rash on trunk and limbs
Treatment: Supportive
Prevention: avoid contact with infected persons
Meningococcus
Transmission: respiratory droplets
Highest rates < 5 years of age.
Incubation: 1-10 days
Communicable until 24 hours after start of antibiotics
Clinical manifestations -onset is rapid and life-threatening
Onset - flu-like symptoms with prostration
Neuro signs
Meningococcemia - urticarial, maculopapular
Shock, hypotension, DIC, coma
Meningococcus (cont)
Complications
Loss of limbs d/t necrosis; hearing loss, arthritis, seizures, pericarditis, hemiparesis
Up to 15% with invasive type die

Prevention
Vaccine for children > 2 years for persons at high-risk
Close contact - prophylaxis treatment

Treatment
Penicillin G (cefotaxime, ceftriaxone - alternatives)
In ICU
DIC treated with plasma, blood, or platelets
Meningococcus
Nursing management
Standard and droplet precautions

Monitor for shock and respiratory compromise

Monitor for fluid overload and ↑ ICP -watch fluids

Help identify close contacts that need prophylaxis

Help family identify and connect with supports

Surviving child will likely need rehab
Roseola
Transmission: likely to be respiratory

Incubation : 5-15 days

Clinical manifestations:
Sudden, high fever for 3-8 days; normal behavior and appetite
Fever followed by pale, pink, discrete, maculopapular rash

Treatment: Supportive