Nursing Care of the Child with Infection

What are the five types of infections?

•Bacterial (septic)

•Viral

•Zoonotic & Vector-Borne

•Parasitic & helminthic

•Sexually transmitted

Infection prevention

What is the most effective method?

Hand washing

Infection prevention

What are the different methods?

•Handwashing

•Immunizations

•Proper food handling and preparation

•Judicious antibiotic use

Immunizations are an effective method for infection prevention in children. What needs to be promoted?

Ensure parents are properly educated regarding vaccine -schedule and boosters

What is judicious antibiotic use?

Ensuring the whole course of antibiotics is completed

Chain of infection

Infectious agent -> Reservoir -> Portal of Exit -> Modes of Transmission -> Portal of Entry -> Susceptible Host

Any agent capable of causing infection

Infectious agent

A place where the pathogen can thrive and reproduce

Reservoir

A way for the pathogen to exit the reservoir

Portal of exit

Two types of transmission

Direct and indirect

A way for the pathogen to enter the host

Portal of entry

Any person who cannot resist the pathogen

Susceptible host

Portal of exit/entry

What are examples?

•Skin and mucous membranes

•Respiratory tract

•Urinary tract

•GI tract

Infectious agent

How do you control or eliminate them?

•Handwashing

•Wearing gloves

•Cleaning, disinfecting, or sterilizing equipment

Reservoir

How do we break the chain?

•Control or eliminate reservoirs

•Control sources of body fluids that may harbor pathogens

•Provide provide proper wound care by changing soiled dressings

•Keep linens clean and dry

Provide provide proper wound care by changing soiled dressing

Which chain of infection are we breaking?

Reservoir

Portal of exit

How do we break the chain?

•Cover mouth and nose when sneezing

•Avoid talking over open wounds or sterile fields

•Use PPE

Avoid talking over open wounds or sterile fields

Which chain of infection are we breaking?

Portal of exit

Modes of Transmission

How do we break the chain?

•Wash hands before and after invasive procedures

•Use PPE

•Urge children and family to wash hands frequently, before eating, after eliminating, and touching infectious material

Urging children and family to wash hands frequently before eating is an example of breaking what chain?

Modes of Transmission

Portal of Entry

How do we break the chain?

•Use proper sterile technique during procedures

•Provide appropriate wound care

•Dispose of needles and sharps in containers

•Provide children with their own personal care items

Provide children with their own personal care items

Which chain of infection are we breaking?

Portal of Entry

Susceptible host

How do we break the chain?

•Protect susceptible host by promoting normal body defenses against infection

•Maintain integrity of child's skin and mucous membranes

Susceptible host

How do you protect normal defenses?

•Regular bathing and oral care

•Adequate fluid & food intake

•Proper immunizations

What are the reasons why infants can't fight off organisms naturally?

•Decreased inflammatory response

•Immature immune response

•Limited exposure to disease

•Loss of passive immunity from mothers antibodies

What is cellular immunity?

Immunity that we are born with

When does humoral immunity occur?

When the body encounters new disease and develop antibodies

Infants have humoral immunity T/F

False.

Common laboratory tests for infectious disease

•Complete Blood Count (CBC)

•Erythrocyte Sedimentation Rate (ESR)

•C-reactive protein (CRP)

•Blood Culture and Sensitivity

•Stool, urine, wound, throat, nasal cultures

What two laboratory tests will identify inflammatory markers?

•Erythrocyte Sedimentation Rate (ESR)

•C-reactive protein (CRP)

When should you take cultures?

Before giving antibiotics

What are the treatments for Infectious Disorders?

•Hydration

•Fever reduction

•Medications

Course of treatments for Infectious Disorders

What medications are used?

•Antibiotics (bacteria)

•Antivirals (viruses)

•Antipyretics (fever)

•Antipruritics (itching)

How will an infection cause a fever?

It will stimulate the release of endogenous pyrogens, these pyrogens act on the hypothalamus, releasing prostaglandins which increase body temperature, this triggers the cold response (shivering) in order to decrease heat loss and reset the body temperature

Fever with a stiff neck is a sign of what?

A more emergent illness (meningitis, lyme, tetanus)

Lyme disease

Tick-borne disease

What will educate parents about when their child has a fever?

If it's a low grade fever, let it ride out because it will help fight the infection

If it becomes a high grade fever, it must be treated immediately with antipyretics

Bacterial infections

What are the common symptoms?

•High fever

•Green/yellow nasal discharge

What are the different types of bacterial infections?

•Community acquired MRSA

•Pertussis

•Tetanus

•Botulism

•Osteomyelitis

•Septic arthritis

Pertussis

Tetanus

Botulism

Osteomyelitis

Septic arthritis

Identify each one

Pertussis - Whooping cough

Tetanus - Rusty nails

Botulism - Food borne illness (most common)

Osteomyelitis - Bone infection (hard to treat)

Septic arthritis - Fluid around joints (post-injury)

What type of infections are children at high risk for?

Bacterial infections

What type of infections cannot be treated with medications and must run their course naturally?

Viral infections

Vaccines prevent what type of illnesses?

Viral infections

Symptoms of Viral Exanthem

Rashes that starts in the face or trunk and continue to spread

Characteristic rashes that emerge from viral illnesses

What is this called?

Viral exanthems

Rubella vs. Rubeola

Rubella (German measles) and Rubeola (Measles)

Parvovirus (fifth disease)

"Slapped cheeks" rash

Parvovirus (fifth disease)

What should you be cautious about with this infection?

It can easily be mistaken for child abuse

What are the viral infections?

•Rubella (german measle)

•Rubeola (measles)

•Varicella

•Shingles

•Roseola infantum

Varicella zoster

This virus is contagious until when?

Until all lesions are gone

Roseola infantum

Rash starts on the trunk and goes to the extremities

Disease caused by infectious agents that are transmitted directly or indirectly from animals or vectors

Zoonotic and Vector-Borne Illnesses

Examples of vectors

Ticks, mosquitos, or other insects

What illnesses are derived from mosquito bites?

•West Nile virus

•Dengue fever

•Zika

What illnesses are derived from tick bites?

•Anaplasmosis

•Ehrlichiosis

•Lyme disease

What illness is derived from anopheles mosquitoes?

Malaria

What illness is derived from mammals?

Rabies

Parasitic and Helminthic Infections

How do they spread?

Through direct and indirect contact

Name the parasitic infections

•Pediculosis capitis (head lice)

•Pediculosis pubis (pubic lice)

•Scabies (most common)

Name the helminthic infections

•Ascariasis (round worm)

•Hook worm

•Pin worm

How can a new born or infant become infected with STIs?

If the mother is untreated during pregnancy and delivery

Why are adolescents commonly infected with STIs?

Lack of education and resources

Nursing interventions to promote comfort

•Assess pain and response to interventions frequently

•Administer analgesics and antipruritics

•Apply cool compresses or bathe areas with itching

•Provide fluids frequently

•Cool mist humidification

•Dress child in light clothing if febrile

•Use diversion and distraction