NURS 629 Peds Exam 3 Infectious Disease Questions And
Answers 2024/2025
Antbiotics
There is good bacteria within our bodies, such as the gut, that helps increase our
immune response. However, certain medications that are overused like _____ bypass
the immune system and are not recognized , causing spread and duplicatation within
the body. Educate you patients that should not receive this medication because of best
practice of
-What supportive things can be done to help with illness
-Offer handout on OTCs that will make feel better for specific illness.
-Say "You know what? The good thing is you don't need another medication that has
side effects and can make you even more sick."
history
A good _____ will help determine differentials and how to conduct the physical. We
want to know about
-What was the presenting symptom? (What started first; the rash [how fast did it
develop] or the fever[how high]?)
-How long did it last?
-OLD CARTS
-Comorbidities, Family hx, medications (like steroid use) allergies, immunizations,
recent travel
-Symptoms longer than 7-10 days usually bacterial infection but not always.
Hand-foot-mouth disease
Caused by Coxsackie Virus.
Most common in children (esp. with those that attend daycare) BUT can present in
adults also (symptoms usually worse).
3-6 day incubation
Outbreaks most often occur in late summer or early fall (when school starts)
24-48
Getting a CRP is controversal but if a CBC is obtained and the CRP is elevated you
want to get a second CRP in ____to____ hrs. to confirm diagnosis especially if it
continues to trend up (increase).
ESR
If this is elevated, showing that there is an inflammatory marker going on.
Hand-foot-mouth disease
Review of symptoms for this disease (What parents inform):
Low grade fever usually starts first possibly with some malaise, a little sore throat,
appeitite decreased noticed a few days before rash.
Feet hurt to walk (rash that becomes tender)
20% will also have lymphadenopathy present.
Hand-foot-mouth disease
Objective Findings for this disorder (Phsyical Exam):
Oral lesions typically appear first
, If you notice the oral lesions look at hands and feet. 24 hrs after symptom start lesions
(if they are going to) start which appear like a petechial rash (pinpoint, round spots
that form on the skin. They're caused by bleeding, which makes the spots look red,
brown or purple. The spots often form in groups and may look like a rash. The spots are
often 3-7 mm, flat to the touch [macular] and are nonblanchable [don't lose color when
you press on them]) and then blisters start.
Looks like caner sores with yellow ulcers and red halo but it can also be pale, white, and
oval with a red halo.
Rash usually resolves in 7 days.
Keep in mind depending on the strain of the coxsacie virus the lesions can be in
the genital area, on the upper and lower extremities and on the torso.
Non-blanchable
Erythema that means the skin does not turn white when touched with a finger.
Supportive (Tylenol, warm baths, Oragel)
What is the treatment for
Hand-foot-mouth disease?
Benadryl:Maalox
Oragel can be used for symptom managment of Hand-foot-mouth disease but as a
provider if you are concerned about choking hazards because of the child's age the
parents can use magic mouthwash which is a 1:1 combination of ____ and ____ which
you will provide as the the provider to swish around the child's mouth or rub on lesions
in the mouth. Both drugs are safe to drink.
Hydration
Why would we use magic mouth wash in hand-foot-mouth, even in young children,
besides the fact that we are trying to not have the child hurt too much? Hint related to
the pain.
very contagious
Education for hand-foot-mouth disease to the parents is that this disease is ___ ____
two days before symptoms start and two days after eruption.
The entire illness can last up to 1 week.
The child cannot return to School or day care until all of the lesions have crusted over to
prevent spreading to other children or adults.
Herpes Simplex Virus (HSV) 1
DNA virsus that causes acute infection (70-90% above the waist: face, oropharyngeal,
and ocular mucosa).
Spreads by:
Respiratory droplets
Contact with active lesions
Contact with fluid such as saliva.
Even without an outbreak can be spread b/c virus lives in the dermatome therefore
can be spread at anytime.
Herpes Simplex Virus (HSV) 1
ROS:
90% of primary infections are asymptomatic.
Symptoms usually occur 3-7 days after contact and recur often in the same location.
Can get swollen glands, fever, and malaise
Answers 2024/2025
Antbiotics
There is good bacteria within our bodies, such as the gut, that helps increase our
immune response. However, certain medications that are overused like _____ bypass
the immune system and are not recognized , causing spread and duplicatation within
the body. Educate you patients that should not receive this medication because of best
practice of
-What supportive things can be done to help with illness
-Offer handout on OTCs that will make feel better for specific illness.
-Say "You know what? The good thing is you don't need another medication that has
side effects and can make you even more sick."
history
A good _____ will help determine differentials and how to conduct the physical. We
want to know about
-What was the presenting symptom? (What started first; the rash [how fast did it
develop] or the fever[how high]?)
-How long did it last?
-OLD CARTS
-Comorbidities, Family hx, medications (like steroid use) allergies, immunizations,
recent travel
-Symptoms longer than 7-10 days usually bacterial infection but not always.
Hand-foot-mouth disease
Caused by Coxsackie Virus.
Most common in children (esp. with those that attend daycare) BUT can present in
adults also (symptoms usually worse).
3-6 day incubation
Outbreaks most often occur in late summer or early fall (when school starts)
24-48
Getting a CRP is controversal but if a CBC is obtained and the CRP is elevated you
want to get a second CRP in ____to____ hrs. to confirm diagnosis especially if it
continues to trend up (increase).
ESR
If this is elevated, showing that there is an inflammatory marker going on.
Hand-foot-mouth disease
Review of symptoms for this disease (What parents inform):
Low grade fever usually starts first possibly with some malaise, a little sore throat,
appeitite decreased noticed a few days before rash.
Feet hurt to walk (rash that becomes tender)
20% will also have lymphadenopathy present.
Hand-foot-mouth disease
Objective Findings for this disorder (Phsyical Exam):
Oral lesions typically appear first
, If you notice the oral lesions look at hands and feet. 24 hrs after symptom start lesions
(if they are going to) start which appear like a petechial rash (pinpoint, round spots
that form on the skin. They're caused by bleeding, which makes the spots look red,
brown or purple. The spots often form in groups and may look like a rash. The spots are
often 3-7 mm, flat to the touch [macular] and are nonblanchable [don't lose color when
you press on them]) and then blisters start.
Looks like caner sores with yellow ulcers and red halo but it can also be pale, white, and
oval with a red halo.
Rash usually resolves in 7 days.
Keep in mind depending on the strain of the coxsacie virus the lesions can be in
the genital area, on the upper and lower extremities and on the torso.
Non-blanchable
Erythema that means the skin does not turn white when touched with a finger.
Supportive (Tylenol, warm baths, Oragel)
What is the treatment for
Hand-foot-mouth disease?
Benadryl:Maalox
Oragel can be used for symptom managment of Hand-foot-mouth disease but as a
provider if you are concerned about choking hazards because of the child's age the
parents can use magic mouthwash which is a 1:1 combination of ____ and ____ which
you will provide as the the provider to swish around the child's mouth or rub on lesions
in the mouth. Both drugs are safe to drink.
Hydration
Why would we use magic mouth wash in hand-foot-mouth, even in young children,
besides the fact that we are trying to not have the child hurt too much? Hint related to
the pain.
very contagious
Education for hand-foot-mouth disease to the parents is that this disease is ___ ____
two days before symptoms start and two days after eruption.
The entire illness can last up to 1 week.
The child cannot return to School or day care until all of the lesions have crusted over to
prevent spreading to other children or adults.
Herpes Simplex Virus (HSV) 1
DNA virsus that causes acute infection (70-90% above the waist: face, oropharyngeal,
and ocular mucosa).
Spreads by:
Respiratory droplets
Contact with active lesions
Contact with fluid such as saliva.
Even without an outbreak can be spread b/c virus lives in the dermatome therefore
can be spread at anytime.
Herpes Simplex Virus (HSV) 1
ROS:
90% of primary infections are asymptomatic.
Symptoms usually occur 3-7 days after contact and recur often in the same location.
Can get swollen glands, fever, and malaise
