MCN II FINALS: Viral Infections

Nosocomial or health care–associated infections (HAI)

infections that are contracted while in a hospital or other health care setting.

Viruses

are the smallest infectious agents known, and are so small that they cannot be seen through an ordinary microscope.Viruses

Viruses

They are not true cells because they contain either RNA or DNA, but not both.

viruses

Most of the childhood exanthems (rashes) are caused bu

Exanthem Subitum

Roseola Infantum also called as

Roseola

disease with severe symptoms, although the illness itself is mild

6 months to 3 years of age

Roseola generally occurs in children between

in the spring and fall

Roseola generally occurs at what season

a high fever (104° to 105°F \[40.0° to 40.6°C\])

The first symptom of Roseola

__fever falls abruptly__ and rashes appears

After 3 or 4 days of having Roseola, the child’s fever ___________

rose-pink macules

2 to 3 mm

flat with the skin surface

trunk, fade on pressure

What is the characteristics of Roseola rashes

1 to 2 days

Roseola rashes last for

__Rash is darker__

__No accompanying coryza, (upper respiratory symptoms), conjunctivitis, or cough.__

Difference of Roseola to Rubella or Measles

appearance of a rash appearing immediately after the sharp decline in fever

Hallmark symptom of Roseola

Acetaminophen or ibuprofen

Treatment of Roseola

Febrile seizure due to high fever

Complications of Roseola

German or 3-day measles

Rubella also known as

Rubella

Infectious disease that seen most during the __spring and mostly affects older school age and adolescent children__

1- to 5-day prodromal period

The symptoms of Rubella begin with a ---------

low-grade fever, headache, malaise, anorexia, mild conjunctivitis, possibly a sore throat, a mild cough, congestion, coryza, and swollen lymph nodes

1- to 5-day prodromal period of Rubella

Rash appears

After the 1 to 5 days of prodromal signs of Rubella, what happen?

discrete pink-red maculopapular rash

on the face, then spreads downward to the trunk and extremities

Characterize the rash of Rubella/ German measles

3rd day

At what day the rashes in Rubella disappears?

congenital malformation in the fetus

If a woman contracts rubella while pregnant, it can cause

before they reach childbearing age

It is so important that girls are immunized the MMR vaccine against rubella

follow droplet precautions for 7 days after the onset of the rash in addition to standard infection precautions

If a child develops rubella while in the hospital,

while pregnant

Because the vaccine contains a live virus, it is not recommended to obtain this immunization while _________

brown or black regular

7-day measles

Measles is also called

10- to 11-day prodromal period

The symptoms of Measles has ---------

postauricular, cervical, and occipital lymph nodes become enlarged

develops a high fever

malaise

coryza

conjunctivitis

__**photophobia**__

cough develop

prodromal symptoms of measles

measles has photophobic symptoms (sensitivity to light)

what is the only difference in prodromal symptoms of measles and rubella

Koplik spots

are __hallmark symptoms of Measles__ because they do not appear with any other exanthem.

Koplik spots

(small, irregular, brightened spots with a blue-white center point) appear on the buccal membrane

appear first on the buccal membrane (cheeks)

Koplik spots of Measles appear where ?

Rashes begins

By the fourth day of fever of child with Measles, what happen?

deep-red maculopapular rash

beings at hairline > behind the ears, back of the neck to face, neck, upper extremities, trunk, finally, the lower extremities

Characterize the rashes of Measles

red to brown

Rashes of Measles typically turns from ___________

Red - fades on pressure

Brown does not fade

Red rashes of Measles _______ while when it is brown _________

rash of scarlet fever, which always fades on pressure

scarlet fever desquamate hands and feet

differentiate rashes of measles and scarlet fever

1. loud cough and frequent
2. coryza is acute
3. fever is high
4. rash is pruritic

Symptoms of Measles

pneumonia

Fever that lasts beyond the third or fourth day of a rash or coughing that continues generally suggests one of the complications of measles ________

photophobia

Because children with measles have __________

otitis media (middle ear infection), croup, pneumonia, airway obstruction, and acute encephalitis

Children need to be seen by a health care provider because the complications of measles include

__**airborne precautions**__

If a child with Measles is hospitalized, follow

Chickenpox

The disease is marked by a low-grade fever, malaise, and, in 24 hours, the appearance of a distinctive rash

1. Macula
2. Papule within 6-8hrs
3. Vesicle
4. Crust

what are the 4 stages of rashes of Varicella

2 to 3 mm in diameter

erythematous area (namumula)

found trunk, although the face, scalp, palate, and neck

Characterize the lesion of Varicella or Chickenpox

extremely pruritic

Chickenpox rashes compare to others are ___________

antihistamine

treatment for Chickenpox pruritic rashes, reduce the itchiness to a bearable level

Acyclovir

an antiviral, may be prescribed to child with chickenpox that reduce the number of lesions and shorten the course of the illness

Reye syndrome

caution parents to __**avoid aspirin**__ because it is associated with the development of ______________ syndrome and instead use acetaminophen or ibuprofen to control fever.

follow airborne and contact precautions

If the child with __**Chickenpox**__ is hospitalized,

crusted

Children who had chicken pox may return to school as soon as all the lesions are ___________ because it is no longer infectious.

Herpes Zoster

is caused by the varicella-zoster virus, the same virus that causes chickenpox

Shingles

Herpes Zoster also known as

symptoms of chickenpox.

In Herpes Zoster, the first time the virus invades, children demonstrate the

__pruritus and cutaneous vesicular lesions__ on erythematous bases

@trunk face and upper back

> causes deep, nagging pain

The first manifestations of Herpes Zoster are

analgesia for pain and measures to reduce pruritus.

VZIG may minimize symptoms

Acyclovir limits the disease

Treatment for herpes zoster includes

Erythema infectiosum

the fifth important childhood exanthem after measles, rubella, varicella, and scarlet fever

Erythema infectiosum

this infection occurs most often in __children 2 to 12 years of age__

fever, headache, and malaise

The first phase of the Erythema infectiosum

Rashes

A week later of Erythema infectiosum, what happen?

intensely red maculopapular rash appears on the face called

__**“slapped face” appearance**__

In the first stage of Erythema infectiosum

rash spreads to the extensor surfaces of the extremities

2nd day of Erythema infectiosum

it appears on the flexor surfaces and the trunk

3rd day of Erythema infectiosum

1 week or more

face rash up to 3 months

Lesions/rashes of Erythema infectiosum lasts for

center outward, like a lacelike appearance.

Unique appearance of Erythema infectiosum is when lesions fade, they fade from the ______________

droplet precautions in a hospital

If child is in the hospital with erythema infectiosum, follow

the rash disappears

Children with erythema infectiosum can return to school as soon as the _____________ because they are no longer infectious after this point

Poliomyelitis (Infantile Paralysis)

this condition is caused by poliovirus

gastrointestinal tract

The poliovirus enters the child’s ___________ where it multiplies and produces symptoms

fever, headache, nausea, vomiting, abdominal pain, and mild stiffness of the neck, back, and legs.

Symptoms of child infected by Poliovirus

intense pain > tremors > paralysis

As the poliovirus invades the central nervous system, these initial symptoms change to __________________

bed rest with analgesia and moist hot packs to relieve pain

Treatment for poliomyelitis is ___________

2 to 6 weeks, possibly as long as 12 months

Intubation period of rabies

malaise, fever, anorexia, nausea, sore throat, drowsiness, irritability, and restlessness

prodromal signs of rabies

hydrophobia (“water fear”)

When children with rabies try to drink, they experience __violent contractions of the muscles of the mouth leading to drooling of saliva.__

This phenomena gives the disease its former name:

numbness or hyperesthesia

Children with rabies may notice ___________ at the area of the bite

comatose, with possible total body paralysis.

As rabies progress, children will become :((

sutured and closed

If puncture wounds from bite are present, the wound must not be ___________

Because tetanus can develop

Why is puncture wounds not closed?

It is an organism that are anaerobic, grows in deep, closed wounds where O2 does not reach

rabies vaccine and an antirabies serum (RIG)

If the animal is found to be rabid, children receive both the _________

wound site and the remainder is given intramuscularly.

A portion of the RIG dose is injected into where?

immediately (day 0) and then again on days 3, 7, and 14

Anti-rabies is given in what frequency?

(2 to 6 weeks after the bite)

Administering the rabies vaccine allows the child to begin additional antibody formation so that by the time the rabies virus from the bite begins to have an effect __(how many weeks after the bite?__), the child has developed sufficient antibodies to combat it and prevent the illness

Mumps Virus

What is the causative agent of mumps?

chewing and an earache

Within 24 hours children with mumps, she will feel pain on?

Parotid Gland

What is the gland site of pain in mumps? Located along the jawline just in front of the earlobe?

testicular pain and swelling (orchitis)

If boys have mumps, they are most likely to develop?

submaxillary adenitis (or swelling of lymph nodes)

Mumps is difficult to differentiate from?

Place hand along the child’s Jawline.

what is the best method of differentiation of mumps and submaxillary adenitis?

mumps

If the major amount of swelling is above the hand, it is probably _____

adenitis

If the largest amount of swelling is below the handline, _____

Epidemic Parotitis

Mumps also known as

about 6 days

How many days until the swelling of mumps recedes?

soft, bland or liquid foods

Since children with mumps would have painful chewing, what foods is recommended?

excluded from school

Since mumps is an infectious disease, child should be?

droplet precautions

Precautions of Mumps when at hospital?

meningoencephalitis

severe permanent hearing impairment

what are serious complications of mumps?

FALSE; only a single testis is involved

TRUE OR FALSE: If mumps orchitis develops, both of the testis are affected. Both swells, painful and tender.