Chapter 6 - Childhood Communicable & Infectious Disease

Airborne Infection Isolation Room (AIIR)

New term for (-) pressure isolation room

Airborne Diseases

• TB

• Disseminated zoster

Droplet Diseases

• Flu type b

• Meningitis

• Pneumonia

• Epiglottitis

• Sepsis

• Scarlet fever

• Pertussis

• Adenovirus

• Rubella

Contact Disease

• Wound infections

• c diff

• hep A

• e.coli

• rotavirus

• cellulitis

• impetigo

• lice

• ebola

During feedings, what should the nurse wear if child is likely to spit or vomit

A gown

Recommended age for primary vaccines

At birth or within 2 weeks of birth

Attenuate

Reducing the virulence

Cocooning

Protecting infants from vaccinating those who come in close contact

What happens if a child received primary immunization but failed to receive all doses?

They only receive the missed ones

HBV Vaccine

• given if mom is hepB antigen negative

• Response is not optimum in those < 4.4lbs

• IM vaccine

• Avoid dorsogluteal site

HAV vaccine is recommended

Beginning at age 1

DTap Vaccine can cause

Respiratory manifestations

DTaP vax is given every

10 yrs

How often are Td (tetanus) boosters recommended?

Every 10 years

What ages is the pertussis vaccines recommended for?

• 6 weeks to 6 yrs of age

  • Given: 2, 4, 6 mos

Why is the acellular pertussis vaccine preferred?

• Has fewer local and systemic reactions

When should children received the polio vaccines?

2mos → 4mos → 6 to 18 mos → 4 to 6yrs

Pediarix (Combination Vaccine)

Contains DTaP, HepB, & Polio vax

When is the measles vax given?

At 12 to 15 mos of age

Why should individuals born b4 1956 excluded from measles vaccine?

They are thought to be immune from exposure to natural measles virus

Postexposure prophylaxis protocol?

• 1 MMR dose within 72hrs

When is MMRV vax given?

• 12mos to 15mos

• 4 to 6 yrs of age

Who should NOT receive the MMRV vaccine?

Children with HIV

What type of supplementation helps decrease morbidity due to measles?

Vitamin A supplementation

Although rubella is a mild infection in children, why is it serious in pregnant women?

It crosses the placenta!!

When are rubella vaccines recommended?

• 12 to 15 mos

• Age of school entry

• 4 to 6 yrs of age

What should women that get rubella vaccine be cautioned against?

To NOT get pregnant for 28 days after receiving rubella vaccine

When should Hib vax be given?

• Children older than 15 mos

• IM injection

When is the varicella vax recommended?

• 12 to 15 mos

• 4 to 6 yrs

  • 3 mos btwn first and second doses

Administration of Varicella Vaccine

• keep frozen

• use within 30mins of reconstitution

When is the PCV13(pneumococcal) vax recommended?

• 6 weeks to 24 mos

• 2 → 4 → 6 mos → 12 to 15mos

When is the flu vax recommended?

Annually (as early as 6mos)

T/F: those with egg allergy cannot get the flu vaccine

False! (they can received the INACTIVATED)

When is meningitis vax recommended

• 11 to 12 yrs olf

• Booster - 16 to 18 yrs

Contraindication to meningitis vaccine

• hypersensitivity

• latex allergy

Rotavirus

• Dr. H mentioned it “smells horrible”

• Severe diarrhea

When is the rotavirus vax recommended?

• 2 → 4 → 6 mos

When is HPV vax recommended?

• 11 to 12 yrs

• 2nd dose: 1 to 2 mos after

• 3rd dose: 6mos after

HPV vax ranges?

Minimum of age 9 to 26 yrs of age

General vaccine contraindications?

• Yeast hypersensitivity (hepb vax)

• Neomycin allergy (MMR vax)

• pregnancy (MMR)

Thimerosal

• Vaccine preservative

• Contains ethyl mercury, prompts many to not get the vax

**many manufacturers have stopped including this preservative in vaccines

Studies have shown there’s no link between

Thimerosal and autism

Why is the dorsogluteal site not recommended?

• Risk for sciatic nerve damage

Why is aspiration for blood not recommended for IM injections?

• Unnecessarily painful

• Large vessels aren’t at injection site

What should nurses avoid doing to the injection site?

They should avoid manually stimulating/rubbing

Interventions that can minimize injection pain

• Lidocaine with occlusive dressing for 30mins

• Vapocoolant spray (use cotton ball1st)

• Breastfeeding

• Distractions

What is a general contraindication for ALL vaccines?

Severe febrile illness

Who wouldn’t get live vaccines?

• Anyone that is immunocompromised

• Recent acquired passive immunity

  • Blood transfusions

  • Immunoglobulin

  • Maternal antibodies

MMR contraindications?

• Neomycin allergy

• Pregnancy

• Gelatin allergy

If a vax requires to be refrigerated

Store in shelves NOT in the door

What can protect the vax from light?

Wrapping vial with aluminum

NA: Be cautious applying anti-itch cream on children

Who are simultaneously receiving an oral antihistamine

What type of bacterial infections can bed bugs cause?

Folliculitis/cellulitis

What should be told to a mother of a child with measles?

AVOID pregnant women at all costs

• can cause congenital heart defects

Augmentin (used to treat bacterial infections) is usually prescribed with a probiotic because…

Augmentin tends to tear the gut up

Hydrogen peroxide can help relieve the itch for what disease?

Chickenpox itch

T/F: zika virus is transplacental

True

Cellulitis occurs from bed bugs if the bite reaches

A joint/bone

Bed bug symptomatic care consists of

Antihistamines & topical steroids

Apthous Stomatitis (Canker Sore)

• Onset: mild traumatic injury, allergy, stress

• Small/white ulcers with red border

• NOT contaigous

• No fever/systemic signs

• INSIDE MOUTH!!

Herpetic Gingivostomatitis (HGS)

• Onset: HSV1

• Fever, edema, erythematous, vesicles erupt

• Inside/outside mouth