Pediatric Nursing Study Guide -- Covering Communicable Diseases/ Blood Disorders/Childhood Cancers/Integumentary

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Concept Test Map/Study Guide
Test 2 will include chapters 36, 38, 49, 50, 53

To prepare for Test 2 please review the following:

Communicable diseases (CH38) April 2
a. Stages
* Invasion of organism
* Incubation period
* Prodromal period
* Clinical manifestations (S/S)
* Convalescent period
* Return to wellness
b. Immunities
* Active immunity naturally acquired – already exposed * Active immunity artificially acquired – vaccination * Passive immunity naturally acquired –
* Passive immunity artificially acquired --
c. Childhood communicable diseases
Viral Exanthems (w/ rashes)
* Roseola – (6mo – 3yr of age) from page 1061 and notes (Ch 38) * (Exanthem Subitum)
* Agent: Human herpesvirus 6
* Source: Unknown – possibly from saliva of healthy adult; entry via nasal, buccal or conjunctival mucosa * Incubation period: 5-15 days
* Communicable: Febrile period
* Transmission: Unknown – year round; no reported contact with infected individual in most cases. (peak age 6-15 mo of life) * Immunity: Active, naturally acquired (already exposed)
* Characteristics:
* High fever (104F/40C)/ 3-4 days
* Irritability and anorexia
* Appearance of rash when there is a sharp drop in fever * Rash discrete rose-pink macules or maculopapules appearing first on trunk, then spreading to neck, face and extremities; nonpruritic, fades on pressure, lasts 1-2 days * Associated signs and symptoms: Cervical/postauricular lymphadenopathy, inflamed pharynx, cough, coryza * Therapeutic Management:

* Antipyretics to control fever.
* Complications
* Recurrent febrile seizures (possibly from latent infection of CNS that is reactivated by fever) * Encephalitis (rare)
* Nursing Care Management
* Teach parents measures for lowering fever (antipyretic drugs); ensure adequate parental understanding of antipyretics to prevent accidental overdose * IF child is prone to seizures, discuss appropriate precaustions and possibility of recurrent febrile seizures * Rubella AKA German Measles p 1064-1065 (CH 38)

* Agent: Rubella virus
* Immunity: Active, naturally/ artificially acquired; Passive, naturally/ artificially acquired * Source: Primarily nasopharyngeal secretions of person with apparent or inapparent infection; virus also present in blood, stool and urine * Incubation period: 14-21 days

* Period of communicability: 7 days before to about 5 days after appearance of rash * Characteristics
* Low grade fever
* Swelling lymph nodes
* Mild rash: distinct pink-red maculopapular, first on face trunk extremities * Rash: Gone in 3d, disappears in same order ^
* First appears on face and rapidly spreads down to neck, arms, trunk and legs; by end of first day body is covered with discrete pinkish-red maculopapular exanthema * Constitutional S&S:

* Occasionally low-grade fever, headache, malaise and lymphadenopathy * Prodromal stage – Absent in children, present in adults and adolescents; consists of low grade feer, headache, malaise, anorexia, mild conjunctivitis, coryza, sore throat, cough and lymphadenopathy; lasts 1-5 days, subsides 1 day after appearance of rash * Therapeutic management

* No tx necessary other than antipyretics for low-grade fever and analgesics for discomfort * Complications
* Rare (arthritis, encephalitis, or purpura); most benign of all childhood communicable diseases; greatest danger is teratogenic effect on fetus. * Nursing Care Management
* Reassure parents of benign nature of illness in affected child * Use comfort measures as necessary
* Avoid contact with pregnant woman
* Monitor rubella titer in pregnant adolescent
* Do not give vaccine while...
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