Childhood Communicable Diseases & Immunizations

Question 1

Varicella (Chickenpox)
Transmission

Answer 1

Direct contact of mucous membranes and lesions. Also airborne.

Question 2

Varicella (Chickenpox)

Clinical Manifestations

Answer 2

flu like symptoms, pruitic macules that progress to a fluid filled vesicle that open and crust over.

Question 3

Varicella (Chickenpox)

Nursing intervention

Answer 3

supportive- fluids, analgesic, antipyretic. Oatmeal bath, keep fingernails short.

Question 4

Coxsackievirus (Hand, Foot, Mouth disease)

Transmission

Answer 4

Fecal-oral and respiratory (coughing)

Question 5

Coxsackievirus (Hand, Foot, Mouth disease)

Clinical Manifestations

Answer 5

lesions on buccal surface of cheeks, gums and tongue, hands and feet.

Question 6

Coxsackievirus (Hand, Foot, Mouth disease)

Nursing intervention

Answer 6

Supportive: popsicle, Tylenol, contact precautions.

Question 7

Erythmea Infectiosum (Fifth Disease)

Transmission

Answer 7

respiratory secretions and blood

Question 8

Erythmea Infectiosum (Fifth Disease)

Clinical Manifestations

Answer 8

• Stage 1- flu like illness for 2-3 days, then symptom free for 1-7 days
• Stage 2- fiery red rash on cheeks “slapped face”, circomoral pallor, lacy rash on body
• Stage 3- lasts 1-3 weeks as the rash fades.
• 5th disease: think 5 finger slap to face

Question 9

Erythmea Infectiosum (Fifth Disease)

Nursing intervention

Answer 9

supportive, droplet precautions

Question 10

Haemophilus Influenzae

Transmission

Answer 10

Contact or Droplet

Question 11

Haemophilus Influenzae

Clinical Manifestations

Answer 11

Viral URI, may lead to meningitis, epiglottitis, pneumonia, sepsis.

Question 12

Haemophilus Influenzae

Nursing intervention

Answer 12

blood and CSF culture, antibiotics, droplet isolation until 24 hrs after initiation of antibiotics, supportive.
HIB vaccine

Question 13

Measles (Rubeola)

Transmission

Answer 13

contact and airborne

Question 14

Measles (Rubeola)

Clinical Manifestations

Answer 14

high fever, coryza (clear runny nose) , cough, *Koplik’s spots (white bumps) on buccal mucosa, red, blotchy maculopapular rash that begins on the face.

Question 15

Measles (Rubeola)

Nursing intervention

Answer 15

supportive

Question 16

Rubella (German Measles)

Transmission

Answer 16

droplet, contact

Question 17

Rubella (German Measles)

Clinical Manifestations

Answer 17

Pink, maculopapular rash that starts on the face. Low grade fever, URI symptoms, lymphadenopathy, Forschheimer spots (erythmatous red pinpoint, or larger, lesions on soft palate)

Question 18

Rubella (German Measles)

Nursing intervention

Answer 18

supportive, droplet & contact isolation.

Question 19

Meningococcus

Transmission

Answer 19

contact & Droplet

Question 20

Meningococcus
Clinical Manifestations

Answer 20

flu like symptoms, prostration, may develop a petechial rash that turns into purpura if child becomes septic.

Question 21

Meningococcus

Nursing intervention

Answer 21

Penicillin, fluids, maintain airway, droplet precautions until 24 hours after start of antibiotics.
HIB vaccine

Question 22

Mumps

Transmission

Answer 22

contact & droplet

Question 23

Mumps

Clinical Manifestations

Answer 23

malaise, low grade fever, pain with swallowing, parotid swelling. May cause orchitis which can lead to sterility in boys.

Question 24

Mumps

Nursing intervention

Answer 24

supportive, droplet isolation.

Question 25

Pertussis (Whooping cough) Transmission

Answer 25

Droplet and contact

Question 26

Pertussis (Whooping cough) Clinical Manifestations

Answer 26

- Catarrhal stage: URI symptoms for 1-2 weeks - Paroxysmal stage: whooping cough- 1-6 weeks - Convalescent stage: up to 6 weeks, until coughing subsides.

Question 27

Pertussis (Whooping cough) Nursing intervention

Answer 27

macrolide antibiotic: erythromycin (also treat close contacts prophylactically), corticosteroid, supportive treatment, droplet isolation until 7 days after antibiotics initiated

Question 28

Roseola Transmission

Answer 28

respiratory secretions of healthy individuals

Question 29

Roseola Clinical Manifestations

Answer 29

sudden high fever (>103 F)for 3-8 days. When the fever subsides, a pale pink, maculopapular rash starts on the trunk and spreads to the face, neck, and extremities.

Question 30

Roseola Nursing intervention

Answer 30

supportive

Question 31

Rotavirus Transmission

Answer 31

Fecal-oral Incubation: 2-4 days

Question 32

Rotavirus Clinical Manifestations

Answer 32

low grade fever, vomiting, watery diarrhea.

Question 33

Rotavirus Nursing intervention

Answer 33

fluid and electrolyte replacement, contact isolation

Question 34

Contraindications to Immunization

Answer 34

- Fever, moderate illness - Allergies to medications, food, or any vaccine (eggs, preservatives) - Any previous adverse reactions to a vaccine in the past - Does the child have cancer, leukemia, AIDS? Any immunocompromised - Has the child taken prednisone, steroids, anticancer medications or radiograph tx in past 3 months - Mild illness: can still get the vaccine - Moderate: should not get vaccine/ delayed

Question 35

Adverse Reactions

Answer 35

- erythema, tenderness, swelling at the injection site, low grade fever, irritability. - Anaphylaxis (tachycardia, hypertension, irritability, headache, nausea, tremors, rash, SOB) Treat with Epinephrine. Often caused by additives (egg, yeast)

Question 36

vaccine given at birth

Answer 36

Hep B: It’s a series

Question 37

Live vaccines

Answer 37

MMR Varicella - given at 12 months of age; because of stronger immune system

Question 38

Kindergarten required vaccines:

Answer 38

- DTap: booster/ at least first dose - IPV: Polio - MMR - Varicella

Question 39

Covid 19/ Flu

Answer 39

recommended yearly

Question 40

11-12 yo vaccines

Answer 40

- Tdap: If received last dTap 10 years prior - HPV: genital warts (can start at 9 yo- recommend at 11 yo check up) - Meningicoccal