Alterations in Immunity
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What is the most common transmission of disease in children?
Fecal-oral and respiratory route
What are ways to reduce the risk of transmission?
Use disposible tissues and discard after use
Wash hands with soap and water or gels after contact with diaper, runny nose, ect.
Teach children to cough/sneeze into their elbow rather than their hand
Do not allow sharing of dishes or utensils
Child needs to wash their hands after toileting and before eating
Use Lysol or bleach solution to wipe surfaces where food is prepared and where diapers are changed
Dispose diapers in closed containers
How do Immunizations work?
Child gets immunization (ex: varicella) ---> introduces an antigen--> triggers immune response---> the child produces antibodies--> immunity against the particular disease develops
Antibodies are protein that will respond to the antigen (varicella) introduced from another child infected with the disease (varicella) --> the child who is immunized has minimal chances of being susceptible to host.
Methods of transmission: Varicella
Methods of transmission: Diptheria
Contact or Droplet
Methods of transmission: Pertussis
Methods of transmission: Rota Virus
Methods of transmission: Measles
Airborne, Contact, Droplet
Methods of transmission: Mumps
Methods of transmission: Rubella
Droplet and contact
Methods of transmission: Strep Throat
Methods of transmission: Impetigo
contact with skin lesions
List the Major Nursing Considerations: Immunizations: DTAP
- Prior to immunization ask the previous reactions to immunizations
- In children with history of seizures give acetaminophen at time of vaccine then every 4 hours for 24 hours
- Tetanus booster given for contaminated wound or burn after 5-10 years
List the Major Nursing Considerations: Immunizations: IVP (Inactivated Polio Virus)
- Prior to administration ask about allergies to:
- Polymyxin B
- All doses must be separated by 4 weeks
- Clear colorless suspension
List the Major Nursing Considerations: Immunizations: MMR
Prior to administration ask if the child is allergic to neomycin or gelatin
Observe child with egg allergy for 90 minutes after vaccine
Check for immunoglobulin or blood products in the past year
Is recommended for HIV + unless severely immunocompromised
College students need to have the 2nd dose of MMR
Instruct adolescence to avoid pregnancy for 3 months after vaccine
List the Major Nursing Considerations: Immunizations: Hep B
- Check status of mothers Hepatitis B test
- If positive or unknown infant needs 1st dose within 12 hours
- 3 doses series can be started at any age
- Last dose for infants should not be given before 6 months of age
List the Major Nursing Considerations: Immunizations: HPV p.1198,1200 London
Administer the first dose to females ages 11-12 years. 6 months after the first dose (at least 24 weeks after the first dose)
Administer the series to females at age 13 to 18 years of age if not previously vaccinated.
Administer the second dose 1 to 2 months after the first dose and third dose
Side effects: Pain, swelling, erythema at injection site, pruritus, fever and fainting
Contraindications: Severe allergic reaction to prior dose or hypersensitivity to any vaccine components
Nursing considerations: Shake well before use. Solution is white cloudy liquid. No dilution or reconstitution
Causes: Irritant contact dermatitis that can be complicated by Candida albicans
Skin Manifestations: Glazed red plaques over skin in diaper area but the skin folds are spared; with Candida, rash is bright red scaly plaques with sharp margins
Treatment: Barrier such as zinc oxide
Nursing change diapers every 2-3 hours, no soap, or baby power, expose area to air
Streptococcus Group A: Impetigo (Pyrodermal)
Incubation period: 7-10 days
PPE: contact precautions; gloves, gown
Transmission: contact with skin lesions
Lesions are honey crusted at the site of open lesions
Teach client to wash skin, remove crusts, and apply antibiotic ointment
Cause: Fungal infection
PPE: gloves, gown
*****May fluoresce with an ultraviolet light
Nursing:All members of family should be assessed for fungal lesions
Teach children to avoid sharing items, complete entire prescriptions of medication even after lesions are gone " ID" reaction (itchy rash similar to eczema) should not be mistaken for allergic reaction
Cause: Unknown-immune system plays a role, 90% developed by age 5, often triggered by stress and allergens, risk factors for asthma and allergies, diagnosed through history and symptoms
Clinical Manifestations: Patches of inflammation with vesicles and crusts, intense pruritus, dry skin
Nursing: Hydrate and lubricate skin, reduce prurits and inflammation, identify triggers
Explain the pathophysiology that puts a child with asthma at risk for Thrush
Thrush is a fungal infection, usually caused by Candida albicans, that occurs as an acute condition in a child who regularly uses corticosteriod inhaler or has received antibiotics that disturbed the normal flora and allowed fungal growth
List three ways tick disease illness can be prevented
- 1. Wear protective clothing in areas that are heavily tick infested
- 2. Check for ticks after every outing
- 3. Remove tics as soon as possible
Seek medical attention if symptoms develop
These transmission based precautions need to be taken with a patient who has symptoms of measles?
Airborne, contact precautions, droplet
Bull neck with a Bluish white membrane covering tonsils?
In severe cases of diphtheria what 2 types of medications are used to treat this disease?
Antibiotics and Antitoxins
**Diphtheria puts off an endotoxin
How long should a child with egg allergy be monitored after an MMR vaccine?
Fever and Headache followed by progressing rash from macula to clear fluid filled vesicles, what disease?
Varicella (chicken pox)
Respiratory distress, facial laryngeal edema, wheezing, and hypotension are signs of this post injection complication?
The swelling of one or both of the parotid glands
A barking cough followed by a high pitched inhale breath
Pertussis ( whooping cough)
Streptococcus A will manifest as impetigo is transmitted this way
Prevention is key for most common vector born disease in North America
Treatment for this disease includes isolation until the 5th day of rash and interventions for photophobia
If a mothers test for this positive the infant needs the first dose of this immunization in 12 hours
Varicella is transmitted these two ways
Airborne and contact
All doses must be separated by 4 weeks
Epinephrine 1:1000 is given for this type of reaction
You want to teach children to do this when they cough or sneeze
cough or sneeze in their elbow
2 most common modes of transmission of disease in children
Fecal Oral and Respiratory route
The D in Dtap immunizes against the disease
Supportive care and Antipyretics are treatment for this itchy common childhood disease
Varicella ( Chicken pox)
Name 3 Nursing interventions that are important to remember when caring for a patient with common childhood disease
- 1. Be aware of isolation protocol
- 2. Promote skin integrity
- 3. Encourage fluids to promote hydration
- 4. Educate parents for home care of child including completing all antibiotics
- 5. WASH YOUR HANDS!!!!
Care of child after immunizations p. 1209, London
When a child receives an immunization, educate parents to observe for any reactions that might occur.
Local pain, redness and swelling are common. Use ice on the sites to help reduce swelling and pain. Acetaminophen or ibuprofen may be given to reduce fever and pain. The symptoms should disappear in a day or two
The child may have a fever, joint pain, muscle aches or fatigue within hours to days after the vaccine is given. Give Acetaminophen or ibuprofen for pain.
A few hives around the injection site may indicate a mild allergic reaction to the vaccine.
Call the childs HCP if there is concern about any above symptoms
A severe allergic reaction is indicated by flushed face; swelling of face, mouth, throat; wheezing or other difficulty breathing; shock (confusion, lack of movement or response, or unconsciousness) and abdominal cramping. Call 911 for emergency treatment. Have the child lie down and raise his or her legs until the ambulance arrives to promote blood return to the vital organs.
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