Health problems of Toddlers and Preschoolers

1 to 3 years of age

What ages are the toddler period?

Autonomy vs. Shame and Doubt

Delayed gratification
Independence
Self-Control
Negativism

What is the developmental stage for Toddlers?

3 to 5 years of age

What ages are the Pre-School period?

Initiative vs Guilt

Initiate activities with others
Inquisitive
Enthusiastic learners
Feel remorseful for wrong behavior
Explore new things/activities

What is the developmental stage for preschoolers?

8.5-10.2

Calcium levels

135-145

Sodium levels

96-106

Chloride levels

70-110

Glucose levels

3.5-5.5

Potassium levels

1.5-2.3

Magnesium Levels

11.5-13.5

Hemoglobin levels for 2-6 year olds

12.5-14.5

Hemoglobin levels for 6-12 year olds

14.5

Hemoglobin levels for 12-18 year old boys

14

Hemoglobin levels for 12-18 year old girls

Direct contact: blisters, saliva, mucous, contaminated objects and surfaces

How is Chickenpox (Varicella Zoster VZV) transmitted?

Airborne: N95 mask

What type of precautions is needed for Chickenpox?

2-3 weeks, average 14-16 days

What is the incubation period of Chickenpox?

5 to 10 days

What is the duration of Chickenpox?

1 day

How long is the prodromal stage for Chickenpox?

1-2 days before eruption of lesions until all have crusted (and every last lesion has to be crusted over until its deemed safe)

What is the period of communicability for chickenpox?

Pyrexia
Crust
Headache
Papules/vesicles
Pruritus

What are clinical manifestations of chickenpox?

Airborne and contact precautions
Bath/linen change daily
Calamine lotion
Antihistamines and Antipyretics
Keep fingernails short and clean
Avoid heat

How do you care for chicken pox?

Secondary bacterial infection and encephalopathy

What can be the complications for chicken pox?

Corynebacterium Diphtheria

Diphtheria is also known as?

Droplet: secretions from mucous membranes (nose, nasopharynx, skin, lesions)
Direct contact

How is diphtheria transmitted

2 to 4 weeks. Must have 3 negative cultures before you are clear of it.

What is the period of communicability for diphtheria?

2 to 5 days

What is the incubation period for diphtheria?

common cold/localized symptoms
Serosanguineous mucopurulent drainage
Epistaxis

What are the nasal clinical manifestations for diphtheria?

Pyrexia, hoarseness, cough
Retractions, dyspnea, cyanosis
Airway obstruction

What are the laryngeal clinical manifestations for diphtheria?

Malaise, anorexia, sore throat, pyrexia
Tachycardia
Lymphadenitis (bull's neck)
White/gray thick exudate covering mucous membranes
Toxemia, septic, shock, death

What are the tonsillar/pharyngeal clinical manifestations for diphtheria?

Antipyretics

Antibiotics: Penicillin G or Erythromycin

Complete Bed Rest: Prevent myocarditis

Tracheostomy for airway obstruction

Requires treatment of contacts (especially those not immunized) and carries of the disease

Can be re-infected if not vaccinated

What is the treatment and nursing care for diphtheria?

Cardiomyopathy
Heart Failure
Toxic Neuropathy
Paralysis and Death

What are complications for diphtheria?

Fifth Disease or slapped cheek disease

Erythema Infectiosum is also known as

Droplet

How is Fifth Disease transmitted?

4 to 14 days, may be up to 21 days

What is the incubation period for fifth disease?

Contagious before symptoms are present

What is the period of communicability for fifth disease?

a Teratogen

Fifth disease is considered as what to pregnant women?

Erythema on face that disappears within 1-4 days

What is stage one of Erythema Infectiosum?

Maculopapular red spots - 1 day after rash on face

Appears symmetrically

Progresses proximal to distal

May last a week or longer

What is stage two of Erythema Infectiosum?

Rash subsides but recur (heat/cold/friction)

What is stage three of Erythema Infectiosum?

Analgesics
Antipyretics
Anti-inflammatory
Ibuprofen

What are supportive/treatment measures for Erythema Infectiosum?

Arthritis/Arthralgia
Usually, self limiting

What are complications of Erythema Infectiosum?

Standard and droplet precautions

What type of precautions are taken for Erythema Infectiosum?

Roseola

Exanthem Subitum is also known as

5 to 15 days

What is the incubation period for roseola?

Year round
Saliva from healthy adults

How is Roseola transmitted?

Standard precautions

What type of precautions are needed for Roseola?

Unkown

What is the period of communicability for Roseola?

Persistent high fever 3-7 days in child who appears well

Fever disappears as rash appears

Nonpruritic rash that lasts 1-2 days

Discrete rosy pink macular/macropapular

Appears on trunk

Neck, face, extremities

Blanches with pressure

What are some defining characteristics of Roseola?

Antipyretics
Hydration
Seizure precautions

How is Roseola treated?

Measles

Rubeola is also known as what?

Respiratory tract secretions
Blood and urine

What is the source of the Measles?

Airborne

How are the Measles Transmitted?

10-20 days

What is the incubation period of the Measles?

4 days before until 5 days after rash appears

Mainly during prodromal stage

Winter months

What is the period of communicability for the Measles?

Malaise (tiredness) and pyrexia

Cold-like symptoms and cough within 24 hours

Koplik spots 2 days prior to rash-occur first in buccal mucosa

Symptoms diminish 2 days after rash appears

What does the prodromal stage of the Measles look like?

Rash appears 3-4 days after prodromal symptoms

Erythematous maculopapular (flat) appearing on face

Cephalocaudal (head to toe direction)

Brownish appearance 3-4 days later

Skin peels over most extensive area of involvement

What are characteristics of the Measles after the rash appears?

Supportive
Bedrest
Antipyretics
Antibiotics-prevent secondary infection
Vitamin A 50,000-200,000 IU

How are the measles treated?

Bacterial pneumonia

Obstructive laryngitis/laryngotracheitis

Encephalitis and otitis media

What are complications of the Measles?

Avoid chilling (increases shivering, shivering increases body temp, and increase body temp with exacerbate the fever and increase the risk of seizures)

Dim lighting

Avoid rubbing eyes

Remove secretions/crust from eyes

Increase fluids/Bland diet

Keep skin clean

How do you care for someone with the Measles?

Mumps

Paramyxovirus is also known as what?

Direct contact with saliva
Droplet spread

How are the Mumps transmitted?

14-21 days

What is the incubation period for the Mumps?

Immediately before and after swelling

What is the period of communicability for the Mumps?

Fever
Headache
Malaise for 24 hours

What does the prodromal stage of the Mumps look like?

Parotitis:

enlarged parotid glands

unilateral/bilateral

painful and swollen

difficulty swallowing (a lot of drooling=aspiration risk)

Submandibular swelling

Earache/pyrexia

What are clinical manifestations of the Mumps?

At higher risk for malnutrition and dehydration

Hearing loss

Encephalitis/Meningitis

Myocarditis

Hepatitis/Pancreatitis

Arthritis

Orchitis (inflammation of the testicles)

Oophoritis (inflammation of the ovaries)

Male sterility

Thyroiditis

What are complications of the Mumps?

Isolation

Rest and limited activity

Analgesics and antipyretics: Tablets and elixers

Soft/bland easy to chew foods

Compresses: hot/cold

Maintain hydration

How do you treat the mumps?

Whooping cough

Pertussis is also known as what?

Droplet

How is Pertussis transmitted?

7 to 10 days can range 6 to 20 days

What is the incubation period of pertussis?

most infectious during catarrhal stage and first two weeks after onset of cough

What is the period of communicability for pertussis?

URI symptoms for 1-2 weeks
Dry hacking cough becomes more severe

What does the catarrhal stage look like for pertussis?

2-6 weeks

Nocturnal coughing

Short rapid cough with high pitched crowing sound

Flushed/cyanotic cheeks

Bulging eyes with protruding tongue

Mucous plug with vomiting

What does the paroxysmal stage look like for pertussis?

Cough lessens over 2-3 weeks

if secondary infection occurs, symptoms may worsen

What does the convalescent stage look like for pertussis?

Antibiotics-preventative measure

Erythromycin, clarithromycin (Biaxin), azithromycin (Zithromax)

Supportive therapy-may require hospitalization

Hydration

Oxygenation

Mechanical ventilation

How is Pertussis treated?

Atelectasis

Hernia

Otitis Media

Prolapsed rectum

Seizures

Pneumonia

Encephalopathy

Hemorrhage

What are complications of Pertussis?

Polio

Enterovirus is also known as what?

3

How many types of polio are there?

1 and 3

What types of polio are most frequently associated with paralytic form?

Direct contact with feces/urine
Oropharyngeal

How is Polio transmitted?

5-35 days
Average is 7 to 14 days

What is the incubation period for Polio?

Unknown

What is the period of communicability for polio?

Fever, sore throat, headache, anorexia, vomiting, abdominal pain

May last a few hours to a few days

Clinical Manifestations of Abortive/Inapparent Polio ?

Same symptoms as abortive but more severe

pain in legs, back, and neck

More troubling than paralytic

Clinical Manifestations of non-paralytic Polio ?

Initially same course as non-paralytic

recovery period

CNS paralysis

Clinical Manifestations of paralytic Polio ?

German measles

Rubella is also known as what?

German measles

What is the most benign of childhood diseases?

Droplet

Bood, urine, feces

How is Rubella transmitted?

14-21 days

What is the incubation period for Rubella?

7 days prior to 5 days after appearance of rash

What is the period of communicability for Rubella?

Low grade fever, headache, malaise, and lymphadenopathy

What are the constitutional clinical manifestations for Rubella?

Absent in children

Present in adults and adolescents

Low grade fever, malaise, anorexia, mild conjunctivitis, sore throat, cough lymphadenopathy

Last 1 to 5 days

Generally disappears 1 day after rash develops

What are the prodromal clinical manifestations for Rubella?

1. Miscarriage
2. Congenital Heart defects
3. Fetal death may occur

What can happen to a pregnant women if she contracts rubella during the first or second trimester?

Appears on face

Rapidly spreads to neck, arm, legs, and trunk

by end of day 1, body is covered with red/pink maculopapular exanthema

*disappears by third day in same order as it began*

What are the characteristics of the Rubella Rash?

Antipyretics
Analgesics

How do you treat Rubella?

Scarlet Fever

Streptococcal Pharyngitis is also known as what?

Droplet-nasopharyngeal secretions

Indirect contact-contaminated objects (toothbrush, etc)

How is Scarlet Fever transmitted?

1-7 days

What is the incubation period for Scarlet Fever?

10 days to 2 weeks

May persist for months in carrier state
(can pass this even though no symptoms shown)

Considered contagious until 24 hours after initiation of antibiotics

can become re-infected

What is the period of communicability for Scarlet Fever?