Communicable Diseases

Childhood communicable diseases

Childhood communicable diseases

-Most recover without difficulty -Declined due to immunizations -antibiotics has reduced serious secondary complications

general nursing care management for childhood communicable diseases

Prevent spread

Primary prevention -Immunizations -Control spread to others -reduce risk of cross-contamination -Good handwashing -Follow facility policies for infection control

Prevent complications -Children with immunodeficiency receiving steroids/immunosuppressive therapy/immunologic disorder

Provide Comfort -Most communicable diseases cause skin manifestations -Measures can include cool baths (usually without soap) and lotions (calamine)

primary prevention

preventing the development of disease ex: immunizations, hand washing

secondary prevention

Disease is detected and being treated early before it gets worse ex: screening programs mammography, antibiotics

tertiary prevention

an existing, usually chronic disease is MANAGED to prevent complications or further damage ex: a person who has had a stroke may involve taking aspirin to prevent a second stroke from occurring, diabetes, cancer patient and is getting rehabilitation

Measles is also known as

Rubeola virus

Measles (rubeola): transmission

droplet -Usually by direct contact with droplets of infected person by respiratory tract secretions, blood, and urine of an infected person

measles (rubeola): incubation period

10-20 days -Most contagious: 4 days before to 5 days after the rash appears but mainly during prodromal stage

incubation period

period of time between initial exposure/infection and first signs and symptoms

Measles (rubeola): clinical manifestations prodromal stage

-fever -malaise -coryza -cough -conjunctivitus -koplik spots

measles rash appears ____ to ____ days after onset of prodromal stage

3 to 4 -starts on face and spreads downward

Measles (Rubeola): complications

-encephalitis (inflammation of the brain that is rare but deadly) -pneumonia

Measels (Rubeola): treatment

-vitamin A -supportive bedrest -antipyretics during febrile period -maintain isolation until 5th day of the rash -keep child from rubbing eyes

mumps (paramyxovirus)

infection of the parotid gland

Mumps (paramyxovirus): transmission

direct contact or droplet spread of saliva

Mumps (paramyxovirus): incubation period

14-21 days

When is mumps most contagious?

immediately before and after swelling of glands

Mumps (paramyxovirus): clinical manifestations prodromal stage

-fever -headache -malaise -anorexia -earache aggravated by chewing

Mumps (paramyxovirus): clinical manifestations parotitis stage

by 3rd day unilateral or bilateral enlargement

Mumps (paramyxovirus): complications

-orchitis (male) -oophoritis (female)

Mumps (paramyxovirus): therapeutic management

-analgesics for pain -antipyretics for fever -encourage rest and fluids -cool compresses -maintain isolation when communicating (droplet and contact)

Rubella is also known as

German measles

Rubella (Rubella virus): transmission

direct/droplet -primarily spread by nasopharyngeal secretions, blood, stool, and urine

Rubella (Rubella virus): incubation period

14-21 days

when is rubella most contagious?

7 days before to 5 days after the appearance of rash

Rubella (Rubella virus): clinical manifestations

-low grade fever -headache -malaise -anorexia -mild conjunctivitis -coryza -sore throat -cough -lymphadenopathy for 1-5 days -rash

where does rubella rash 1st appear?

face then spreads downward -disappears the same way face down

when is rubella rash gone?

3rd day

Rubella (Rubella virus): complications

teratogenic effect on fetus during pregnancy

what to do if a mother doesn't have the rubella vaccine?

cocooning immunity -vaccinate everyone around her

Rubella (Rubella virus): therapeutic/nursing management

-avoid contact w pregnant women -antipyretics for fever -analgesics for discomfort -take droplet precautions

Chickenpox (Varicella) is caused by the

Varicella zoster virus

Chickenpox (Varicella): transmission

direct contact, droplet spread, contaminated objects -secretions of the respiratory tract -fluid filled skin lesions (lesser degree)

Chickenpox (Varicella): incubation period

2-3 weeks (usually 14-16 days)

when is Chickenpox (Varicella) most contagious?

1 day before skin lesions to 6 days after vesicular lesions crust over

Chickenpox (Varicella): clinical manifestations

-slight fever and anorexia for the 1st 24 hrs then highly pruritic rash develops

Chickenpox (Varicella): centripetal

rash starts on chest and back then moves to the entire body

Chickenpox (Varicella): 3 stages

1. papule

2. vesicle

3. crusting over

Chickenpox (Varicella): complications

pneumonia and encephalitis

Chickenpox (Varicella): treatment

1. antiviral- Acyclovir (Zovirax)

2. IV immunoglobulin (IVIG) after exposure to high risk immunocompromised children

Chickenpox (Varicella): supportive care

-give bath and change clothes/linen daily bc they ooze -calamine lotion -keep child's fingernails short -apply mittens -remove loose crusts -apply pressure to pruritic area rather than scratching -Avoid use of aspirin since it can trigger Reye's syndrome particularly in children with Varicella

Pertussis (whooping cough) is a _____________ disease

bacterial disease -bordetella pertussis

Pertussis (whooping cough): transmission

direct and indirect contact/droplet -spread by discharge from respiratory tract through direct contact or droplet spread -can be indirect with freshly contaminated articles -highly contagious

Pertussis (whooping cough): incubation period

6-20 days, usually 7-10 days

when is Pertussis (whooping cough) most contagious?

during catarrhal stage before onset of paroxyms

Pertussis (whooping cough): clinical manifestations catarrhal stage

-coryza -sneezing -lacrimation -cough -low grade fever

symptoms continue for 1-2 weeks and cough becomes worse

Pertussis (whooping cough): clinical manifestations paroxysmal stage

-cough most common at night -short, rapid, coughs followed by sudden inspiration associated w high pitch "whoop" -cheeks become flushed or cyanotic -eyes bulge and tounge protrudes during paroxysm -vomiting frequently follows the attack

generally lasts 4-6 weeks

whooping cough can last up to _____ to _____ weeks

6-10

Pertussis (whooping cough): complications

-pneumonia (usually cause of death in younger children) -weight loss -urinary incontinence -rib fractures

Pertussis (whooping cough): therapeutic/nursing management

-macrolides antibiotic therapy -those who are dehydrated and have complications may need hospitalization -lots of fluids -maintain isolation during catarrhal stage -encourage compliance and antibiotic therapy for household contacts

infectious mononucleosis (mono) is caused by

Epstein-Barr virus

infectious mononucleosis (mono): transmission

direct contact through bodily fluids -blood -semen -blood transfusion -organ transplantation -saliva

infectious mononucleosis (mono): incubation period

30 to 50 days

infectious mononucleosis (mono): clinical manifestations

-fever -exudative pharyngitis w petechia -lymphadenopathy -hepatosplenomegaly -increased atypical lymphocytes

symptoms can last from 10 days to 6 weeks

infectious mononucleosis (mono): complications

-meningitis -encephalitis -pneumonitis -ruptured speen

infectious mononucleosis (mono): therapeutic/nursing management

-short course of corticosteroids -rest -mild analgesic -antibiotics are only used if there is a secondary infection -may develop a nonallergic maculopapular rash -avoid strenuous activity and contact sports for 21 days after the onset of symptoms

hepatospleenomegaly

enlargement of the liver and spleen -risk for bleeding -no contact sports/strenuous activity after 21 days after symptoms