MCI II FINALS: Other Bacterial, Other Infectious, Parasitic, Fungal, Candidiasis

Diphtheria

Pertussis

Tetanus

Bacterial Infections:

Rickettsial Diseases

Rocky Mountain Spotted Fever

Other Infectious Pathogens

1. Roundworms
2. Hookworms
3. Pinworms

Parasitic Infections

1. Tinea cruris (jock itch)
2. Tinea Pedis or (athlete’s foot)
3. Tinea Capitis - ringworm scalp
4. Tinea Corporis - ringworm body

Fungal infections

diphtheria, tetanus, and pertussis (DTaP) vaccine

Immunization for Diphtheria

Corynebacterium diphtheriae

What is the causative agent of Diphtheria

Diphtheria bacilli

invade and grow in the nasopharynx of children and produce an exotoxin (a potent protein poison) that causes __**massive cell necrosis and inflammation.**__

inflammation and necrosing cells

What are 2 happenings in Diphtheria

Respiratory System

what is the affected location in the body in Diphtheria

nasopharynx

which part of respiratory system, diphtheria bacilli invade and grow?

gray membrane on the nasopharynx

The inflammation and necrosing cells form a characteristic of __________

nose → major bronchi

Diphtheria bacilli extend up into ________ and down into -------

purulent nasal discharge and a brassy cough

once diphtheria bacilli extend up into the nose and down into the major bronchi, it would cause _________

__heart and nervous system.__

(Diphtheria) The toxin is absorbed from the __membrane surface__ and spreads systemically by the bloodstream to affect major organs, such as the ________________

severe __neuritis with paralysis__ of diaphragm, pharyngeal and laryngeal muscles

(In Diphtheria) if nervous system is affected → complications are _______

myocarditis with heart failure and conduction disturbances

(In Diphtheria) if cardio system is affected → complications are _______

clinical appearance

throat culture - reveals presence of diphtheria bacilli

diagnosis of diphtheria

1. IV administration of antitoxin in LARGE doses
2. IV penicillin or erythromycin
3. COMPLETE BED REST during acute stage
4. Droplet precautions

Treatment for Diphtheria

COMPLETE Bed Rest

In diphtheria, what is the crucial treatment during the acute stage of the illness?

close observation to prevent airway obstruction because of the build up of purulent discharges

What is the nursing observation that is need to be done to patient with diphtheria?

Endotracheal intubation

If obstruction occurs to patient with diphtheria, what is the management?

Bordetella pertussis

Causative agent of Pertussis

Pertussis vaccine given as part of DTaP vaccine

Immunization for Pertussis

Pertussis

also known as whooping cough

1. catarrhal stage
2. paroxysmal stage
3. convalescent stage

Pertussis manifests itself in __3 Steps CPC__

catarrhal stage

this stage begins with upper respiratory symptoms such as coryza, sneezing, lacrimation, cough, and a low-grade fever

common cold

symptoms of catarrhal stage of pertussis is may at first be mistaken for _________

1-2 weeks

catarrhal stage first period lasts for

paroxysmal stage

this stage involves symptoms of __**5 to 10 short, rapid coughs, followed by a rapid inspiration**__ which causes the “whoop” or high-pitched crowing sound of **whooping cough.**

1. Obvious distress while coughing
2. Cyanotic or red faced
3. Nose drain think, tenacious mucus
4. Vomits after paroxysm of coughing
5. Feel exhausted after

physical assessment for children in paroxysmal stage of pertussis

convalescent stage

this stage is the __gradual cessation of the coughing and vomiting__.

1. By its __striking symptoms “whooping cough”__
2. __Cultured B. pertussis bacillus__ from nasopharyngeal secretions during catarrhal and paroxysmal stages.

How is Pertussis diagnosed?

__**absent**__, making it more difficult to diagnose

in children younger than 6 months of age, the “whoop” of the cough may be _____

1. COMPLETE BED Rest
2. Keep from cigarette and dust that triggers coughing
3. Frequent small meals rather than larger meals
4. __**FULL 10-DAY COURSE**__ of Erythromycin/Azithromycin
5. Droplet precautions

Management of Pertussis (Whooping Cough)

\- alkalosis

\- dehydration

Complications of pertussis caused by include…

\- pneumonia

\- atelectasis

\- emphysema

Complications of pertussis caused by plugged bronchioles

1. little passive immunity transferred across placenta
2. @2 months old DTaP vaccine - one of the first immunizations scheduled.

prevention of pertussis

Tetanus

a __**highly fatal disease**__ if untreated, is caused by an __anaerobic, spore-forming bacillus__ found in *soil* and the excretions of animals.

Lockjaw

Tetanus also known as

Clostridium tetani

Causative agent of Tetanus disease

Tetanus toxoid contained in DTaP vaccine

Immunization for Tetanus

through an open wound

through a burn site

How does Tetanus bacilli enters and infect the body?

it creates an anaerobic environment, NO O2

What is the action of tetanus bacilli, how does it affect the body?

MOTOR Nuclei of CNS

What is the major system affected in Tetanus infection?

caused by infection of an entry point such as the umbilical cord at birth

in newborn care, tetanus is caused by

stiffness of the neck and jaw (lockjaw)

what is the hall mark symptom or first symptoms that are noticeable in children with Tetanus are __________

muscular rigidity of the trunk and extremities.

In children with Tetanus, within 24 to 48 hours, what symptoms develops?

opisthotonos, stiff and board-like,

Within 24 to 48 hours of occurrence of Tetanus disease, the back becomes arched called _____________,__ and the abdominal muscles become _____________

Sardonic grin sign

in children with Tetanus, his face assumes __an unusual appearance__, with __wrinkling of the forehead__ and __distortion of the corners of the mouth,__ a sign called ???

the child needs to be in a quiet, noise-free, and low light room, to avoid stimulation of painful, paroxysmal spasms.

What is the priority nursing consideration to patient with Tetanus?

1. __**Lock jaw**__
2. __**Muscular Rigidity**__
3. Opisthotonos
4. Sardonic sign
5. Difficulty breathing
6. __**Body Spams**__

Symptoms of Tetanus

respiratory obstruction

death by asphyxiation

In tetanus, as these __spasms begin to include the larynx__, it can lead to complications of ______________

1. __Child is cared at a quiet, stimulation-free room__ with total parenteral nutrition, sedation, and a muscle relaxant
2. __Tetanus immune globulin (human__) to supply passive antitoxins
3. __Parenteral penicillin G or erythromycin__ to reduce growing forms of bacillus
4. Child need to be __intubated__ and have __mechanical ventilation__ to maintain oxygen

Management of Tetanus

Rickettsiae

these are organisms that __resemble viruses__ both in size and in their __inability to reproduce except inside the cells of a host organism__

fission

Rickettsia reproduce by _________

ticks, lice, mites, or fleas (arthropods)

Rickettsiae multiply inside __________ without causing disease.

Rickettsiae

They are transmitted to humans through the __bite or feces of the infected arthropod.__

Q fever

What is an exception in Rickettsial Disease which is spread by droplet infection?

Rocky Mountain spotted fever

the second most common Rickettsial disease seen in the Western US, and is transmitted by tick bites.

during the spring and early summer

At what season ticks are most plentiful, and most often occurrence of Rocky mountain spotted fever?

typical rash

persistent headache

high fever

mental confusion

In 2 to 8 days, Rocky Mountain spotted fever symptoms begin → includes ________

wrists and ankles → arms and legs → trunk

Rocky Mountain Spotted Fever rashes begin on the _________

palms and soles

Unlike most rashes, Rocky Mountain Spotted Fever can cover the _________

doxycycline for 7-10 days ; initiated first 5 days symptoms

First line therapy for Rocky Mountain Spotted Fever ____________.__ It should be initiated within the first __________ days of the appearance of symptoms

administer the drug for the full course of therapy to ensure disease eradication and to prevent the risk of complications

Important to note in administering antibiotics!

Parasites

organisms that live on and obtain their food supply from other organisms.

Helminths

pathogenic or parasitic worms.

1. roundworms - nematodes
2. flukes - trematodes
3. tapeworms - cestodes

Helminths includes

Helminths

begin life when the eggs or larvae are eliminated in the feces or urine of humans.

Helminths

They are then transmitted to the oral cavity by __contaminated foods or hands__.

Ascariasis

type of roundworm infection

intestinal tract

roundworm parasite lives in the

ingested eggs → penetrate intestinal wall → enter circulation → migrate to body tissues

Route of roundworm parasite into the body

1. loss of appetite
2. nausea and vomiting

Symptoms of Ascariasis

Intestinal obstruction

this may occur from a mass of roundworms in the intestine

Ascariasis

this roundworm infection can be prevented by the sanitary disposal of feces to prevent contamination of the soil.

single dose of anthelmintic → __**pyrantel pamoate (Antiminth)**__

Ascariasis medication treatment?

through skin → migrate to intestinal tract → intestinal villi

How does hookworms enter the body?

Hookworms

what helminthic parasite attach themselves onto the intestinal villi and suck blood from the intestinal wall to sustain themselves.

severe anemia

If a great number of hookworms are present, _______ may result.

Pinworms

are small, white, threadlike worms that __**live in the cecum**__**.**

Pinworms

pinworm migrates down the intestinal tract and out of the anus to deposit eggs on the skin in the __**anal and**__ __**perianal region**__

Anal area to itch → child awaken at night crying and scratching

movement of pin worms causes ______________

from the child’s fingernails to the mouth

When the child scratch their anal because it is itchy, some eggs are carried from ______________, then the child ingested, cycle repeated.

Pinworms

These worms are large enough that they __**can be seen if the child’s buttocks**__ are separated

single dose of mebendazole (Vermox) or pyrantel pamoate (Antiminth)

Treatment for pinworms

pin worm infestation

easily transmitted from person to person

Mycoses

a disease caused by infection with a fungus

__internal__ organs.

Deep mycoses invade ________

skin, __subcutaneous__ tissue, and bone

Subcutaneous mycoses invade the _____________

hair, skin, or nails.

Superficial mycoses invade only the _________

1. tinea cruris
2. tinea pedis
3. tinea capitis
4. tinea corporis

Four superficial fungal infections seen frequently in children are

Tinea __cru__ris (jock itch)

fungal infection that occurs on the inner thighs and s__cro__tum

Tinea cruris (jock itch)

Fungal infection that where the area appears reddened and is very pruritic

clotrimazole (Lotrimin) or econazole (Spectazole) liquid or powder

treatment for Tinea cruris (jock itch)

Tinea __Pedis__ or (athlete’s foot)

fungal infection that occurs between the __toes__ and on the plantar __surface of the__ __**foot**__

Tinea Pedis or (athlete’s foot)

Fungal infection that produces pruritic, pinpoint vesicles with fissuring

liquid preparations of an antifungal agent such as __clotrimazole (Lotrimin)__

Treatment for Tinea Pedis

Tinea __Cap__itis

ringworm of the s__**calp**__ ; infection of a single hair follicle then spread rapidly in a circular pattern to produce a lesion approx. 1in. in diameter

becomes filled with dirty-appearing scales.

In __**Tinea Capitis**__, the hairs involved in the lesion __generally break off__ and the circle becomes ______________