Communicable Illnesses and Immunizations in Pediatric

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Communicable Illnesses and Immunizations in Pediatric
2014-10-11 15:31:07

the little children
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  1. Infectious and Comminicable diseases in childhood
    • Communicable diseases are prevented and treated with vaccinations, antibiotics, antiviral drugs and antitoxins
    • EARLY IDENTIFICATION is KEY to prevent spread

    • National, reportable/notiable diseases:
    • measels, mumps, rubella, menigococous, pertussis, polio, rabies, diptheria, tetanus, hep a & B, tb, STI, gonorrhea, syphillis and others, chamid. 

    prevention methods: wash hands, vaccination, educations, judious antibiotic use bacteria- precautions, virus, immunization to prevent
  2. Healthy People 2020
    • Increase immunization
    • decrease preventable disease
    • Immunize at every chance u get sick v well visit
  3. The infectious process
    • Infection occurs when organism enters the body and multiples
    •  inflammation- protect self
    •  increase fluid, blood, and nutrients area

    • Vascular and cellular reactions occur
    • Vascular
    •  - vasocontriction (wall off invaders) then vasodilation ( so all the different fluids that can help can get into that area)
  4. The infection Process (cellular response and phagocytosis)
    • Cellular response
    • - wbc (army of protectors body;s defense_
    • - different types- neutrophils, lymphocytes, basophils, eosinphils, monocytes

    • Phagocytosis- engulf foreign cells (pathogens). eat up invaders
    • - produce pus- if there is a cut in skin u will see pus- control invasion
    • - should the bacteria escape destruction 
    •     - sepsis or septicemia= serious condition (infection in blood)
  5. What else happens? Fever
    • Infection and inflammation
    • 100.4 is consider a fever
    • triggers release of endogenous pyrogens which then triggers prostagladin production - which triggers fever (not testing us)

    • PO > 99.5 (core)
    • Rectal > 100.4 (core)
    • Axillary > 99.1 
    • Tympanic > 100.4 (cores

    • Antipyretics 
    • - control fever and increase comfort (motrin/tylenol)
  6. Four stages of infectious
    • kids/people are contagious 
    • 1. Incubation period- time between invasion of an organism and onset of infection
    • 2. Prodomal period- time between beginning of non specific symptoms and disease specific ones (contagious) 
    • 3. Illness- pt demonstrates disease specific s/s (contagious) 
    • 4. convlescent period- symptoms begin to fade and child returns to wellness
  7. The infection process
    • Chain of infection (break that chain of infection)
    • 1. Infections agent- bacteria/virus/fungal
    • 2. reservoir- where the organism grows and multiple (could be in the human, animal, soil, food)
    • 3. Portal of exit- where it leaves and spreads to causing disease (URI- cough mouth portal of exit)
    • 4. modes of transmission- direct/indirect contact
    • 5. portal of entry- cut on body, mucous membranes/orfices in body
    • 5. susecptible host- immune system compromise, young, old, pt on antibiotics > 72 hr, hospital pt

    hand washing...
  8. Preventing Spread of infection
    • Health promotion and teaching 
    • Teach good nutrition practices (increase protein)
    • offer immunization at well and sick
    • hand washing most important act to prevent spread

    • Importance of preventing the spread of infection
    • - Noscomial infection acquired in the hospital
    • Increased risk for severe illness
    • - < 2 years old
    • - nutritional deficiences
    • - immunosuppressed
    • - indwelling vascular lines or catheters
    • - on antibiotics
    • - in hospital > 72 hours
    • - elders
  9. Preventing the spread of infection 2
    • disinfect the toys
    • use strict aspectic technique- sterile gloves and field (to keep bacteria out)
    • frequent hand washing and infection control practices- first line of defense. 
    • Nurses must protect themselves following standard precautions with patient- wearing gloves

    • Isolation precautions
    • - tier 1= standard precautions
    • - tier 2= transmission based precautions- contact, droplet, airborne p. 1262 table box
  10. Variation in pediatric anatomy and physiology
    • Normal immune function- protective response 
    • Some people of more susceptible due to:
    •  - immature immune response 
    •  - newborns display decreased inflammatory response - increase risk for infection
    • - cellular immunity functional at birth (because of mom IgG)
    • - humoral immunity occurs as child exposed to new diseases and develops immunity 
    •   - infant limited exposure to the disease
    •   - young children protection from immunization not complete
  11. Common medical treatments and drugs
    • Hydration- promotes fluid balance
    •  PO fluids
    •  IV fluids (really sick)
    •  maintain strict I/O

    • Fever reduction technique
    • - antipyretics- acetaminophen or ibuprofen
    • - no ASA for under 12 bc reyes disease
    • - non pharm
    •  light clothing, remove blankets, fan, tepid bath, cooling blankets

    assess temp q 4-6 hour and 30-60 after antipyretics
  12. Common medical treatments and drugs 2
    • Medications:
    • antibiotics - treat bacteria 
    • antiviral- treat virus
    • antipyretics- decrease temp (aceto/ibuprofen)
    • antipruritics - given PO or topically to relieve itching (hydrocodazone and antihistamine)
  13. Nursing Process: infectious disorder
    • Assessment
    • health hx- when did it start, what relieves it, anyone in the family, s/s, what have u been experiencing, N/V/D, rash, travel, what makes it worst, meds, how long have u been  going thru this, use of any new products

    • perform physical examination0 systemic and rashes
    • Monitor labs/dx testing- recognize when labs come back and report any abnormalities, get this info to the md
    • nx diagnosis, pain, impaired skin integrity, risk for infection, fever, impaired comfort

    Planning- family centered care (involve the whole fam), coping, prevention

    implementation- nurse responsible ie monitor I/O, hydation, vital signs, meds etc

    Evaluation- getting better or worst
  14. Physical Examination
    • Inspect
    •  - assess lesions, wounds,, rashes (exanthems- viral in nature)
    •  note color,, shape, distribution
    •  exudate
    •  scratching, restlessness, guarding

    • Observe
    •  affect (bouncy playing, listless), energy level, interactions with the world
    •  note lethergy
    •  nasal discharge, cough, respiratory problem (respiratory usually goes first on a child not heart)
    • check hydration
    •  mucosa, eyes, tears

    vital signs- T,P, R,BP, O2

    • Palate
    • temperature
    • moisture
    • turgor and texture
    • fontanels
    • rash
    • lymph nodes- anterior cervical, swollen hard and firm if they have an infection
  15. Lab and Dx testing
    • CBC- wbc most often- usually high with infection
    • erythrocytes sedimentation rate- inflammatory marker (could be high)
    • c-reactive protein
    • blood culture/sensitive- figure out bacteria and which antibiotic can kill it
    • stool culture/ O&P (ovum and parasite)
    • urine culture
    • wound culture
    • throat culture 
  16. Sepsis
    • sepsis or septicemia- presence of pathogenic organisms in the blood and tissues
    •  develops when bacteria avoid destruction and enter systemic circulation and lymphatics which transport the pathogens to other parts of the body

    • systemic inflammatory response syndrome (emergency)
    • can lead to septic shock (medical emergency)
    • prognosis variable and depends on age of child mortality rate 9-35%
  17. Sepsis neonate
    • most common in neonates and small infants because of their immature immune system. 
    • the don't have inflammatory response and not all have their vaccines yet. 

    • Common cause
    • neonate- e. coli, group b strep, herpes virus, enterovirus

    older children- neisseira, menigtudis, strep, salmonella, staph
  18. Sepsis s/s
    • s/s fever, chills, fatigue, malaise, nausea, vomiting, difficulty breathing, anxiety or confusion-
    • neonates maybe hypothermic- may not have a fever- low temp

    Therapeutic management- agressive med treatment ie IV and antibiotic

    nursing management- monitor closely, adminster meds as ordered

    infection prevention- hand washing, aseptic tech, cleaning equipment

    education- early recognition, fever < 3 months old, lethargy, poor response, lack of facial expression