Infectious Diseases and Skin Infections - PEDS Exam 1

Infectious Diseases and Skin Infections

Cellulitis

• Skin infection that requires antibiotics

• If untreated → leads to skin abscess

• Redness and swelling of infected area

think: “Cell” → “Swell”

Impetigo

• Itchy red sores, rash, fluid-filled blisters

• Do not scratch

• clean with soap and water

think: Impetigo —> Itchy

Scarlet Fever

• airborne droplets or contact transmission

• follows strep throat or impetigo

think: strep throat and impetigo cause redness → “scarlet”

Nursing care for a child with a communicable (contagious) disease

• always ask questions!

• stabilize before discussing immunizations

• educate with facts only

Immunizations PRECAUTIONS (different from contraindications)

• moderate to severe illness

• personal or family history of seizures for MMRV vaccine

• it is okay to administer if patient had a one-time low grade fever

Immunizations CONTRAINDICATIONS

• severe fever - ex. 101ºF for past 5 days

• cancer patients → they are immunocompromised

• live, attenuated vaccines for pregnant women/planning to become pregnant

• anaphylactic reaction to vaccine previously

What is Hepatitis B?

Chronic, viral infection that damages the liver. Can lead to cirrhosis or liver cancer

How is Hepatitis B transmitted?

blood, semen, other bodily fluids

What are some s/sx of Hep B?

• may be asymptomatic

• jaundice

• dark urine

• clay-colored stool

What is the route for the Hep B vaccine?

IM

What is the schedule for Hep B administration?

0 months, 1 month, and 6 months (3 doses)

What is Rotavirus?

disease that causes severe, watery diarrhea dn vomiting

Who can you not give the Rotavirus vaccine to?

Pregnant women → it is a live, attenuated vaccine (oral)

What route is the DTaP vaccine given? When do you give it?

IM. Give at 2 mo, 4 mo, 6 mo, 15 mo, and 4-6 years

What is Measles?

highly contagious respiratory virus

Describe the rash and symptoms that occur with Measles

• starts at hairline and spreads downward

• maculopapular → no bumps/fluid-filled blisters

• Koplik spots: white spots in mouth with red rings

When does measles become contagious?

4 days before or after rash appears

What is Mumps?

Virus that causes puffy cheeks and swollen jaw

What is Rubella?

virus that causes a maculopapular rash that starts at the face and spreads to the rest of the body

Why is the MMR vaccine given? What is the dose schedule? What is the contraindication? What is the route?

• MMR vaccine is given to cover immunization for Measles, Mumps, and Rubella

• Give at 12-15 months and at 4-6 years

• Contraindicated for pregnant women/planning to become pregnant b/c it is a live, attenuated vaccine

• IM route

What is varicella?

aka chickenpox, a virus that causes a rash with fluid-filled blisters, which contain fluid that contains the virus. Rash starts at trunk and then spreads to the body

Why is it important to get the vaccine for MMR and Varicella?

You can be contagious before the rash appears, so you can spread it without knowing

When do you give the varicella vaccine? What is the route? Who is it contraindicated for?

• Give the vaccine at 12-15 months and 4-6 years

• SUBQ route

• contraindicated for pregnant women or planning to become pregnant b/c it is a live, attenuated vaccine

What is HPV?

• Human Papillovirus, can lead to cervix, penis, anus, and throat cancer (more).

• It is the most common sexually transmitted infection

When do you give the HPV vaccine?

• 11-12 years and 6-12 months after only first dose

• If given after age 15, give another dose at 1-2 months, and another dose at 6 months

• Main idea: give before sex occurs

What are the advantages of pediatric skin?

• fetal skin can undergo scarless wound repair

• neonatal skin is adaptive, protective functions

What are pediatric skin weaknesses?

• infants and children need delicate products bc they are more sensitive and prone to injury

What are the different types of pediatric skin conditions?

• rash

• hives

• warts

• acne

• birthmark

What is Dermatitis?

Any condition that causes skin inflammation. Causes red rash, itchiness, and dry skin

What skin infections are considered dermatitis?

• diaper rash

• cradle cap

• eczema

• contact dermatitis

What is diaper rash?

• aka diaper dermatitis

• most common baby skin infection

• moisture in diaper causes excessive growth of bacteria/fungi in diaper area

How do you treat diaper rash?

• keep diaper area clean and dry

• cream/ointment that contains zinc oxide or petroleum jelly

What is cradle cap?

• aka seborrheic dermatitis

• yellow scaly patches surrounded by red rash on infant scalp

• caused by sebaceous glands overproducing oil

How do you treat cradle cap?

Mild baby shampoo, gently rub off scaly patches

What is eczema?

• aka atopic dermatitis

• itchy, red, dry skin spots that are extra sensitive and prone to infection

How do you treat eczema?

• avoid allergic triggers

• bathe in warm water

• moisturize regularly and after water exposure. Ex. moisturize after shower

What is contact dermatitis?

• itchy painful rash as a reaction to any allergen or irritant

• allergen/irritants can be poison ivy, perfume, paint, cleaners, soaps

How do you treat contact dermatitis?

• moisturizers

• anti-itch creams

• topical or oral steroids

What is Lice?

• aka pediculosis captitis

• eggs laid on hair shaft close to skin

• itching

What do you need to educate a patient on if they have lice?

• do not share personal items

• clean personal items

• lice do not jump or fly

• help them feel unashamed

How do you treat lice?

• Pediculocides-permethrin 1% cream rinse - apply on scalp

• removing nits and combing

What is scabies?

• scabies mite burrows underneath skin and deposits its eggs and feces

• intense itching

• maculopapular LESIONS

• linear threadlike burrows

How is scabies transmitted?

with prolonged contact → it takes about 45 minutes for mite to burrow under skin

How do you treat scabies?

• permethrin 5% cream - apply everywhere

What do you educate a patient on if they have scabies?

do not scare personal items, clean them