Alterations in Immunity

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  1. What is the most common transmission of disease in children?
    Fecal-oral and respiratory route
  2. 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
  3. 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.
  4. Methods of transmission: Varicella
  5. Methods of transmission: Diptheria
    Contact or Droplet
  6. Methods of transmission: Pertussis
  7. Methods of transmission:  Rota Virus
    Fecal-Oral Route
  8. Methods of transmission: Measles
    Airborne, Contact, Droplet
  9. Methods of transmission: Mumps
  10. Methods of transmission:  Rubella
    Droplet and contact
  11. Methods of transmission: Strep Throat
  12. Methods of transmission:  Impetigo
    contact with skin lesions
  13. 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
  14. List the Major Nursing Considerations: Immunizations: IVP (Inactivated Polio Virus)
    • Prior to administration ask about allergies to:
    • Neomycin
    • Streptomycin
    • Polymyxin B 

    • All doses must be separated by 4 weeks 
    • Clear colorless suspension
  15. 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 
  16. 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 
  17. 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
  18. Diaper Dermititis
    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
  19. 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
  20. Ringworm
    Cause: Fungal infection 

    Transmission: contact 

    PPE: gloves, gown 

    *****May fluoresce with an ultraviolet light

    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
  21. Atopic Eczema 
    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
  22. 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
  23. 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
  24. These transmission based precautions need to be taken with a patient who has symptoms of measles?
    Airborne, contact precautions, droplet
  25. Bull neck with a Bluish white membrane covering tonsils?
  26. In severe cases  of diphtheria what 2 types of medications are used to treat this disease?
    Antibiotics and Antitoxins

    **Diphtheria puts off an endotoxin
  27. How long should a child with egg allergy be monitored after an MMR vaccine?
    90 minutes
  28. Fever and Headache followed by progressing rash from macula to clear fluid filled vesicles, what disease?
    Varicella (chicken pox)
  29. Respiratory distress, facial laryngeal edema, wheezing, and hypotension are signs of this post injection complication?
  30. The swelling of one or both of the parotid glands
  31. A barking cough followed by a high pitched inhale breath
    Pertussis ( whooping cough)
  32. Streptococcus A will manifest as impetigo is transmitted this way
  33. Prevention is key for most common vector born disease in North America
    Lyme Disease
  34. Treatment for this disease includes isolation until the 5th day  of rash and interventions for photophobia 
  35. If a mothers test for this positive the infant needs the first dose of this immunization in 12 hours
    Hep B
  36. Varicella is transmitted these two ways
    Airborne and contact
  37. All doses must be separated by 4 weeks
  38. Epinephrine 1:1000 is given for this type of reaction
  39. You want to teach children to do this when they cough or sneeze
    cough or sneeze in their elbow
  40. 2 most common modes of transmission of disease in children
    Fecal Oral and Respiratory route
  41. The D in Dtap immunizes against the disease
  42. Supportive care and Antipyretics are treatment for this itchy common childhood disease
    Varicella ( Chicken pox)
  43. 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!!!!
  44. 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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Alterations in Immunity
2013-11-08 22:39:01

Alterations in Immunity--Based off Homework and Slide give by instructor
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