Communicable diseases

Question 1

Varicella precautions

Answer 1

Airborne - direct contact with contaminated objects and respiratory secretions(Droplets)
Contagious until all vesicles crust

Question 2

Varicella manifestations

Answer 2

Prodromal stage: fever, malaise, lymphadenopathy, anorexia
Pruritic rash: Centripetal (trunk), then extremities and face. Sparse on distal limbs
macule - vesicle- erupts- crust

Question 3

Varicella treatment

Answer 3

Supportive: Strict isolation, keep cool, NO aspirin, skincare (calamine, mittens, short nails).
Acyclovir/Zovirax: decreases # of lesions

Question 4

Varicella complications

Answer 4

Secondary infections (skin and pneumonia), encephalitis, thrombocytopenia

Question 5

Scarlet fever precautions and agent

Answer 5

Agent: Group A Beta-hemolytic streptococci
Droplet - direct contact from droplets or nose secretions, contaminated objects/food until 24 hrs after antibiotics
If no antibiotics- contagious for 10 days

Question 6

Scarlet fever manifestations

Answer 6

Prodromal stage: Abrupt high fever, halitosis
enanthema: red enlarged tonsil bed, edematous covered with exudate
Strawberry tongue
exanthema: sandpaper-like pink rash

Question 7

Scarlet fever treatment

Answer 7

Penicillin, erythromycin, cephalosporin, and supportive care
rest when febrile, increase fluids
Ok for school 24 hrs after antibiotics
Antipyretics, antipruritics, analgesics

Question 8

Scarlet fever teaching

Answer 8

Finish all meds
See HCP if persistent fever after antibiotics
Discard old toothbrush
Don’t share food/utensils/drinks

Question 9

Scarlet fever complications

Answer 9

Peritonsillar and retroperitoneal abscess

Sinusitis, otitis media, pneumonia, meningitis, glomerulonephritis, rheumatic fever, polyarthritis

Question 10

Pertussis precautions and communicability

Answer 10

Droplet

Most contagious during the catarrhal stage ( 1-2 weeks) and until 4 weeks

Question 11

Pertussis manifestations

Answer 11

Catarrhal (1-2 weeks): Mild cough, low temp (URI symptoms)
Paroxysmal (4-6 weeks): Short rapid cough followed by a whoop. Cyanosis may occur, cheeks flushed, eyes bulge, post tussive emesis.
Convalescent: Cough can continue for months Not as bad

Question 12

Pertussis Treatment and diagnosis

Answer 12

Erythromycin, clarithromycin, azithromycin, corticosteroids, albuterol
Suction, hydration, humidified oxygen, IV hydration/nutrition, VS, continuous pulse ox

Diagnosis: nasopharyngeal culture

Question 13

Measles precautions and communicability

Answer 13

(Rubeola) Airborne, Highly contagious 3-5 days before rash and 5 days after the rash

Question 14

Measles manifestation

Answer 14

Prodromal: fever, malaise, coryza, cough, conjunctivitis
Koplick spots on mucosa
Rash on day 3-4
Anorexia, lymphadenopathy, photophobia

Question 15

Measles complications

Answer 15

Secondary infection (bact. pneumonia), otitis media, obstructive laryngitis and laryngotracheitis, encephalitis, brain damage, hearing loss, subacute sclerosing panencephalitis

Question 16

Pertussis complications

Answer 16

Seizures, wtg loss, dehydration, hernias, rib fracture, otitis media, pneumonia.

Question 17

Measles nursing

Answer 17

Isolation- airborne
VS, analgesics, antipyretic (NO aspirin)
Tepid baths, bland foods, increase fluids
Cool mist, dim-lit room, bedrest, light clothing
Vitamin A supplements
Antibiotics to prevent sec. infection in high-risk child.

Question 18

Mumps cause/transmission

Answer 18

Cause: paramyxovirus infection of the parotids VIRAL
Transmission: Airborne, salivary secretions, urine
Most infectious 7 days before swelling to 9 days after

Question 19

Mumps manifestations

Answer 19

Prodromal: fever, malaise, muscle aches, earache worse when chewing, parotitis later

Question 20

Mumps complications

Answer 20

sensorineural deafness, encephalitis, myocarditis, arthritis, hepatitis, pancreatitis, sterility in adult males, meningitis
EPIDIDYMO ORCHITIS

Question 21

Mumps treatment

Answer 21

Rest, fluids, hot/cold compresses to neck, analgesia

SCROTAL ELEVATION FOR ORCHITIS

Question 22

Rubella precautions and communicability

Answer 22

Droplet- direct contact from droplets, stool, blood, urine, TRANSPLACENTAL
Congenital baby infectious up to 1 year
Contagious 7 days BEFORE rash and 5 days AFTER rash

Question 23

Rubella manifestations

Answer 23

RASH- begins in head/face, then spreads to chest tummy arms and legs.
Sore throat, malaise, low fever

Question 24

Rubella complications

Answer 24

Rare
encephalitis, arthritis
congenital rubella risk for damage > early gestation

Question 25

Conjunctivitis

Answer 25

Inflammation of conjunctiva Can be bacterial (H. flu, strep, pneumonia) Virus, allergy, trauma

Question 26

Meningitis (bacterial)

Answer 26

2-12 y.o. = Haemophilus influenza, Neisseria meningitis, strep pneumonia. NEISSERIA MENINGITIS TRANSMITTED BY DROPLET Neonatal = Group B strep, E Coli

Question 27

Viral meningitis

Answer 27

Mumps, ENTEROVIRUS (most common cause) | herpes virus, HIV

Question 28

Meningitis diagnosis

Answer 28

Lumbar puncture-- culture, gram stain, blood cell count, glucose and protein levels > CSF pressure Cloudy CSF=bacterial > protein

Question 29

Meningitis S/S (3M-2 YRS)

Answer 29

``` Fever or hypothermia Poor feeding Vomiting, restlessness Irritability, high pitched cry, lethargy BULGING ANTERIOR FONTANEL ```

Question 30

Meningitis S/S (child/adolescent)

Answer 30

SEVERE HEADACHE PHOTOPHOBIA NUCHAL RIGIDITY PETECHIAL/PRURITIC RASH LATER - seizures, altered LOC

Question 31

Meningitis treatment (bacterial)

Answer 31

CULTURE BEFORE GIVING ANTIBIOTICS ANTIBIOTICS STARTED BEFORE CULTURE RESULTS DROPLET PRECAUTIONS, BROAD SPECT. ANTIBIOTICS UNTIL BACTERIA IDENTIFIED

Question 32

Meningitis treatment (viral)

Answer 32

Treat symptoms and support | sometimes may use acyclovir for HSV

Question 33

Meningitis nursing

Answer 33

vs, NEURO, strict I+O, hydration and electrolytes, maintain ventilation, control temperature, quiet dim room, analgesics, fall prevention Side-lying if neck pain Treat complications- systemic shock, reduce ICP