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    BB Childhood Diseases Fall12

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    phoenix180
    The document discusses common childhood diseases including fever, otitis media, streptococcal pharyngitis, meningitis, fifth disease, influenza, measles, mumps, rubella, varicella, and their symptoms, transmission, prevention, diagnosis and treatment. It also covers immunizations for various diseases, their purpose, types, scheduling, side effects and nursing considerations.

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    BB Childhood Diseases Fall12

    Uploaded by

    phoenix180
    23 views32 pages
    The document discusses common childhood diseases including fever, otitis media, streptococcal pharyngitis, meningitis, fifth disease, influenza, measles, mumps, rubella, varicella, and their symptoms, transmission, prevention, diagnosis and treatment. It also covers immunizations for various diseases, their purpose, types, scheduling, side effects and nursing considerations.

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    Childhood diseases; nursing

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    Bb Childhood Diseases Fall12(1)

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    The document discusses common childhood diseases including fever, otitis media, streptococcal pharyngitis, meningitis, fifth disease, influenza, measles, mumps, rubella, varicella, and their symptoms, transmission, prevention, diagnosis and treatment. It also covers immunizations for various diseases, their purpose, types, scheduling, side effects and nursing considerations.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    23 views32 pages

    BB Childhood Diseases Fall12

    Uploaded by

    phoenix180
    The document discusses common childhood diseases including fever, otitis media, streptococcal pharyngitis, meningitis, fifth disease, influenza, measles, mumps, rubella, varicella, and their symptoms, transmission, prevention, diagnosis and treatment. It also covers immunizations for various diseases, their purpose, types, scheduling, side effects and nursing considerations.

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    You are on page 1of 32

    Childhood Diseases

    Kimberly Ambruso, RN, MS

    Fever
    Why does it happen/what does it mean? What is considered febrile
    Oral Rectal Axilla or tympanic

    Consequences of fever?
    Brain damage
    >105

    Febrile seizures
    9 months-5 years

    Otitis Media
    S. pneumoniae, H. influenzae RSV, rhinovirus, influenza virus , adenovirus May include effusion

    Prevention
    Second Hand smoke Breastfeeding Upright feeding immunizations

    Symptoms Pain Irritability Pulling on ear Fever Difficulty with balance, hearing Treatment
    Antipyretics Analgesics Antibiotics (if bacterial)

    Perforated eardrum (tympanic Caused from pressure/fluid accumulation membrane)


    behind the membrane After rupture, pain
    decreases/subsides
    Ringing/buzzing Drainage Decreased Hearing/loss

    Stages of Infectious diseases


    Incubation period Prodromal period Illness phase Convalescent period

    Communicable Diseases
    Classifications and Symptoms Infectious in nature Bacterial vs. Viral vs. fungal
    Fever red, swollen throat Rash nasal congestion Oral lesions crusty lesions malaise

    Management Varies with causative agent Antibiotics Antivirals Supportive care Immune Globulins Prevention
    Immunizations

    Immunizations
    Purpose Types Attenuated Toxoid Active vs. Passive Immunity Gamma globulin/Immun o-globulin Who gets them? Controversy Religion Autism Personal preferences/Philosophical exemptions

    Scheduling of Immunizations
    Transplacental immunity Ability to make antibodies Ages 0-6 yrs: Ages 7-18 Catch-up schedule http://www.cdc.go v/vaccines/schedul es/downloads/chil d/0-18yrs-11x17fold-pr.pdf

    Acute Streptococcal Pharyngitis


    Group A -hemolytic streptococci With or without tonsillitis Untreated/mismanaged:
    Acute rheumatic fever Acute glomerulonephritis

    Occurrence
    Peak 4-7 years Winter months Crowded living conditions

    Diagnosis of pathogens
    Throat culture rapid strep test viral

    Mosby items and derived items 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

    Slide 9

    Mosby items and derived items 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

    Slide 10

    Pharyngitis/Tonsillitis
    Clinical manifestations
    Kissing tonsils Mouth

    Pharmacological management
    Penicillin Erythromycin Non-infectious after 24 hrs on Abx

    Therapeutic management
    Symptom management Antipyretics Analgesics Warm saline gargle

    Surgical Mangement
    Tonsillectomy and/or adenoidectomy

    10

    Bacterial Meningitis
    Description Transmission Droplet infection from nasopharyngeal secretions Appears as extension of other bacterial infection through vascular dissemination Organisms then spread through CSF Increased ICP / Hydrocephalus / cerebral edema
    Slide 12

    Acute inflammation of the CNS Decreased incidence following use of Hib vaccine caused by:
    meningococcus pneumococcus Group streptococci

    Bacterial Meningitis
    Diagnostics:
    Lumbar Puncture CBC Blood cultures

    Therapeutic management
    Antibiotics Isolation

    Manifestations:
    Fever Extreme irritability Poor feeding Vomiting Nuchal rigidity Opisthotonus

    Supportive care
    Corticosteroids Fluid replacement Monitoring neurological status
    Hearing loss ADD Learning disabilities

    Slide 13

    Meningitis Signs
    Kernigs Sign: http://youtu.be/rJ5AFuP3YA Brudzinskis Sign: http://youtu.be/jO 9PAPi-yus

    Nonbacterial Meningitis (Aseptic Meningitis)


    Causative agents are principally viruses Frequently associated with other diseases
    Measles, mumps, herpes, leukemia

    Onset abrupt or gradual Manifestations: headache, fever, malaise Diagnosis and treatment
    Mosby items and derived items 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
    Slide 16

    Fifth Disease
    Parvovirus Peak age: 5-14 yrs No vaccination Headache, fever, malaise Rash:
    After 1 week (face) extremities trunk

    Fifth Disease: transmission issues


    Nursing Management http://www.cdc.go v/ncidod/dvrd/revb /respiratory/b19&p reg.htm
    Standard and droplet precautions Antipyretics Antipruritcs Avoid exposure to sunlight Can go to school with rash

    H. Influenza
    Spring and summer months More common in daycare center population Droplet-based transmission URI symptoms meningitis, otitis, epiglottitis, pneumonia, septic arthritis, cellulitis

    Hib Vaccine
    Haemophilus influenzae type b Inactivated NOT the flu shot! Schedule
    2, 4 and 6 months Or 2,4 and 12-15 months

    Measles (Rubeola)
    Unimmunized persons Peak age: young adults/adults Winter and spring months Spread via droplet Symptoms High fever and malaise Lymphadenopathy Kopliks spots Respiratory symptoms Conjunctivitis Photophobia

    Measles
    Rash appears day 4
    Head trunk

    Management

    Red brown Very pruritic!!

    Supportive Care Dark environment/ sunglasses pneumonia, encephalitis Airborne precautions

    Mumps
    Adolescents Classic symptom is parotitis Fever, malaise, headache No rash

    Diet Droplet precautions Symptom management

    Rubella (German Measles)


    Peak age: pre-teen, adolescent Winter and Spring months Inhalation or nasopharyngeal secretions

    Symptoms Low grade fever Mild cough Sore throat Lymphadenopathy Arthritic pain Rash: face trunk extremities

    Rubella Management
    Relieve joint pain Control fever Tylenol / Motrin Standard and precautions birth defects

    Droplet

    Measles, Mumps, Rubella (MMR) Vaccine


    Live, attentuated 1st dose: 12-15 months 2nd dose: 4-6 yrs s/e rash fever (5-12 days after) Autism controversy

    May be combined with varicella (MMRV)

    Varicella
    Varicella-Zoster virus Peak age: older children young adults Incubation: 10-21 days When is it contagious?
    Symptoms Low grade fever, malaise Rash appears 24 hours after prodromal symptoms
    Stages: macule, papule, vesicle, crust Appear mostly on trunk

    Varicella Vaccine
    Only childhood disease epidemic that still exists After 1st birthday (12-15 months) Attenuated live virus s/e fever, rash Chicken pox pneumonia, encephalitis Cannot give to immunocompromised child or family member

    Other Immunizations
    Diphtheria, Tetanus, Pertussis IPV (Inactivated Polio) Rotavirus Hepatitis A,B Pneumococcal HPV (Human Papilloma Virus) Meningococcal (MCV4) Seasonal Flu (includes H1N1) Shingles

    Nursing care for Immunizations


    Indications for holding vaccine seriously ill Pregnancy (live viruses) Corticosteroids Chemotherapy Radiation
    Record all vaccine information Lot #, manufacturer, name of provider Side effects
    Fever, rash, malaise Give acetaminophen (Tylenol) anaphylaxis

    Educate on importance of keeping on schedule and continuing sequence

    Nursing management
    Scabs will not scar if you let them be! Antihistamines antipyretics Analgesics NO ASPIRIN!!! REYES SYNDROME!!

    Patient education
    Skin care for rashes
    Light cotton clothing Avoid perspiration Avoid wool clothing Increase fluids Keep fingernails short and clean (mittens) Press or rub on itchy areas Cold cloths Lukewarm baths with baking soda Dipenhydramine (Benadryl) Avoiding transmission of disease
    Avoid sick contacts Handwashing Keeping on schedule

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