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Communicable Diseases

By gbhetz5 Nov 05, 2012 723 Words
Communicable Disease
* Keep in mind all have fever, swollen LN, rash etc.
Scarlet Fever:
* Cause: Group A beta Hemolytic Streptococcus
* Spread via direct contact/droplet
* May lead to RF
* Uvula/pharynx beefy red; tonsils have white exudate, pinpoint lesions on palate * Sandpaper rash
* Pastina Sign: hyperpigmentation at joints
* TONGUE (white furry white strawberry strawberry )
* So throat culture if they have strept/sore throat
*** Anybody with a sore throat that comes down to school nurse- do not send them back to class, have them sent for throat culture *** Varicella:
* Infectious before rash and until vesicles crust * kid cant go back to school until vesicles are crusted * Strict isolation (from A. those who haven’t had varicella vaccine B. < 12months of age) * ACUTE PHASE: maculopapular rash turns to vesicle with erythematous base oozes and crusts * Itchy scratch spread/2nd infection

* @ Risk for Reye’s Syndrome
* Itchiness – give Benadryl
* PREVENTION vaccinate
Rubeola: (measles)
* Koplik spots ( white circumscribed in red in mouth)
* May have photophobia – wear sunglasses
* Fever is not marked
* Birth defects if mother exposed in first trimester
* **Tylenol for (fever, pain, H/A)
Roseola Infantum:
* HHV6
* Rash appears AFTER a DECLINE in fever
* At risk for febrile seizures-manage temperature
Erythema Enfectiosum:
- spread via droplet, no specific TX
-Stage I – “slap cheek” 1-120days may last; Stage III- RECURRENCE of rash (with exercise temperature change etc) Impetigo:
* Group A beta hemolytic STREPT, STAPH AUREUS
* Insect bite
* Contact isolation as long as vesicle present
* Lesion begin as honey color serum then yellow to brown crusts * Complication: postreptococcal glomerulonephritis (decrease urine, change color) * Culture vesicle
* Children should remain home from school and daycare fo 48 hours until on antibiotics or lesions r dry * PREVENTION: handwashing, child should not touch lesion, don’t share towel etc Pediculosis:

* Preschooler at increased risk
* All socioeconomic classes
* Pedicclosis vs. Dandruff (* can brush dandruff out; ped. Stays in hair when brushing) * Nit ( egg) louse (insect)
* DO NO JUMP FORM HEAD TO HEAD, spread via direct contact * Part hair, magnify to Dx
* Shampoo, disinfect sheets with HOT water, teach not to exchange combs, headgear Scabies:
* Happen to anyone
* Burrow – leaves debris under skin
* Cleanliness is NOT protection
* Scabacide Q12h- apply everywhere besides genitalia and face Parastic Infections
* Roundworm (GI); Hookworm (human feces); Pinworm (cecum) * PINWORMS: cause intense itching- child doesn’t wash hands- touches door knob etc. * PINWORMS: may be dosplayed as ADHD problem; so itchy

* PINWORM: Dx by anal scotch tape=lay eggs in anal tissue, examined then by microscope * PINWORM: Vermox; Tx all household members
Tinea Cruris: jock itch
Tinea Pedis: athlete foot
Tinea Capitus: ringworm
Tinea Corporis: skin
( to tx these use po griseofulvin or OTC fungal cream)
-inclusion (newborn), allergic (in response to allergn), gonorrheal (infant passing thru birth canal), bacterial (self limiting, HIGHLY contagious), or via foreign obj (metal) - TX Edema: cold compress; Tx crust: warm compress; don’t want to lay there with warm compress b/c bacterial growth, child don’t rub eyes

Immunologic Dysfunction
* *Incidence: most common hematologic D/O child
* *Etiology: decrease reticulocyte count and Hgb
* effects amount of Hgb available to carry O2
* activity intolerance: pallor, no energy, fatigue **Takes a while for H&H to decrease so this wouldn’t be first s/s * anemia develops slowly
* will have increased HR and cardiac output to compensate * cluster care, frequent rest periods, safety

* defective Hgb molecule that changes RBC shape to sickle cell * PAIN extremeeeeee
* CRISIS: Sickle cells destroyed by spleen – tangle- hypoxia – tissue eschemia – necrosis * Most common in African American
* Decreased life span
* Each person has different thing that causes crisis ( weather, temperature, elevation) * S/s develop after 6months because up to 6month fetal Hgb is in use * Crisis Long Term Complications: Heart, lung, kidney brain changes; blood becomes thicker each time * CVA # 1 cause death (complication) b/c cerebral occlusion * 4 crisis: 1. Vaso-occlusive = tangled cells; 2. Aplastic =decreased bone marrow, infection; 3. Acute Sequestration Crisis= massive entrapment of RBC in spleen, hypovolemic shock; 4. Hemolytic = combo glucose 6 and sickle cell * No labs are definitive

* No cure…treat s/s
* Pain control keep hydrated keep away from things that cause crisis * Dx: peripheral smear
* Assess all body parts
* Moniter I&O, weigh pt

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