NR 340 Peds Study Guide LATEST GUIDE (100%)

NR 340 Peds Study Guide

Infectious and Immune Disorders

Function of immune system
 1st line of defense
o Skin/mucous membranes
o Passive immunity from mom
o Maternal circulation/breast milk
 Cannot produce immunoglobulins (antibodies)
 Until approx. 2 mos. of age
 Immune system not fully functional until 6 years of age
 Those babies that are breast fed, usually have less ear infections
 Stimulates production of antibodies against a specific foreign substance (antigen)
 Contraindications
o Anaphylaxis
o High doses of steroids (<14 days)
o Acute febrile illness – greater than 39
o Common cold/minor illness NOT contraindicated
o Chronic illness (cancer)
o Taking immunosuppressive drugs
o Egg allergy – flu shots
o Most up to date schedules on CDC.gov
Purpose of vaccines, misconceptions
 Misconceptions
o Causes autism
o Rotovirus vaccine is dangerous
o Vaccines have toxic ingredients – led and mercury
o Vaccines can fail
o Vaccines can cause the actual illness
o Parents can refuse vaccines
 Types
o Live (attenuated) – vaccines made from virus made from live virus
o Killed (inactivated viruses)
o Toxoids – diphtheria, tenus, - one type of vaccine – based on the toxin made
from the bacteria
o Human immune globulin – Igg Ige – weakened immune system and this helps
them bring up their immune system
o Herd immunity – vaccinate many to protect the few
Communicability periods of disease
 Incubation period – common cold = 1-5 days
o Time of exposure to the time the time symptoms arrive

, o Chicken pox = 21 days
 Period of communicability – time it takes to transfer a disease from me to you
 Prodromal period – beginings off an illness – feeling eh, scratchy throat
 Sometimes difficult to tell the difference
 Virus
o Increased lymphocytes
 Bacteria
o Increased neutrophils
o Left shift – some of the white blood cells shift to make it look bacterial infection
Common viral and bacterial infections, treatment, and nursing care
viral
 Gastroenteritis
o Vomiting/diarrhea
 Volume depletion
 Intravascular space
o Degree of dehydration
 Determined by physical exam
 Signs of dehydration – clammy – dry mucus membranes, dry skins
o Treatment
 Mild/moderate
 Zofran (ondansetron)
 Oral hydration
 Severe
 IV 20cc/kg isotonic solution
 Coxsackie disease (infants and young children)
o Hand/foot/ and mount disease
 Fever
 Sore throat
 Malaise
 Poor appetite
 Rash and mouth sores occur 1-2 days after the above symptoms
 Lasts about 1 week
 Conjunctivitis – pink eye – last 7-10 days
 Thrush
o Yeast infection
 Oral (infants)
 Urogenital (infants/toddlers; diaper dermatitis)
 “Yeast infection” (adolescent girls)
 Intertrigo (skin folds of groin, armpits, torso)
o Treatment
 Hygiene (limit moisture diaper area)
 Topical/systemic antifungals (nystatin)

,  5th disease
o Fever
o Runny nose
o Headache
o Rash (slapped cheek) then spreads (comes and goes)
o May last 2-39 days
 Chicken pox
 Measles, mumps, rubella
 Roseola (6-18 months)
o Sudden high fever (39.4-41.1) 3-5 days
o Rash several hours to 2 days after fever is gone
 Blanches with pressure
 Neck and trunk, may have whitish ring, lasts 24-48 hrs
 Monomucleosis (Epstein- Barr virus)
o Causes
 Fever
 Fatiguge
 Sore throat
 Swlooen glands
 Many have a rash (exanthem)
 Most have fever
 Most are accompanied by cold or flulike symptoms
 Most transmitted by direct contact with droplets or airborne particles
 Most can be prevented by immunization
 Treatment is mostly symptomatic
 Encephalitis is rare but can occur as a complication of most childhood viral infections
 Febrile seizures (most common from 3 months-5 yrs)
Bacterial
 Strep throat /scarlet fever
 Lyme disease (most common tic-borne disease)
o Affects skin, musculoskeletal, CV, neuro systems
 Early: Vague flu-like symptoms/”bulls-eye” rash
 Neuro: Headaches, bell’s palsy, ataxia
 Musculoskeletal: Large joint arthritis (knee), joint/muscle pain
 Pertussis (Whooping cough)
o Catarrhal stage
 1-2 weeks
 URI symptoms
 Paroxysmal
 2-4 weeks or longer
 Increased severity of cough (whoop sound). Cyanosis, distention of neck
veins, salivation, tongue protrusion

, o Convalescent
 1-2 weeks
 Symptoms lessen, cough may persist for months
 Helminths (Worms)
o Transmission
 Oral-fecal
 Ingestion contaminated host
 Skin penetration
 Bite of blood-sucking insect
o Treatment
 Entire family
 Prevention
 Anti-worm meds po
 Bacterial meningitis
o Acute inflammation of meninges
 Bacteria enters subarachnoid space
 Inflammation response triggered
 Causes obstruction of blood flow
 Increased ICP
 Seizures
 Hernation
 Death
o Infants <32 weeks gestation most at risk
 Temp instability
 Bulging anterior fontanel
 Shrill cry/irritability
 Gaze deviation
 Posturing/seizures
 NO nuchal rigidity
o Older child
 Fever
 Headache
 Meningeal signs
 Brudzinski sign
 Kernig’s sign
 Nuchal rigidity
 Most reliable
 Bacterial infections
o Older child
 Photophobia
 Vomiting
 Behavior changes