Respiratory, Immunizations, and Infections

What are some signs of respiratory distress in children?

~ increased respiratory rate

~ coughing

~ retractions

~ labored breathing

What are some signs of a child with respiratory distress has been left untreated for too long?

~ labored breathing decreases

~ respiratory rate lowers

~ less coughing

~ less retractions

• THIS IS A SEVERE MEDICAL EMERGENCY

What are some respiratory illness managements?

~ give small amounts of fluids frequently

~ keep nasal passages clear

~ do warm or cool mist in front of child’s face so they can breathe in the mist

~ use vapor rub

~ teach parents to suction mouth then nose with a bulb suction

~ give nebulizer treatments when indicated and prescribed

~ give over the counter cough medications if child is 6 years or older

~ give honey for cough if child is 12 months or older

What is acute nasopharyngitis?

it is a common cold

What are the signs and symptoms of acute nasopharyngitis?

~ congested cough

~ runny nose

~ sore throat

~ fever

What are the signs and symptoms for day 0 of influenza?

~ usually no symptoms

~ most contagious 24 hours before symptoms appear

What are the signs and symptoms for days 1-3 of influenza?

~ exhaustion

~ muscle aches and pain

~ fever

~ cough

~ sore throat

What are the signs and symptoms for days 4-7 of influenza?

~ fever comes down

~ cough begins to improve

~ breathing becomes easier

~ less exhaustion

~ less fatigue

What is acute streptococcal pharyngitis?

it is strep throat

What are some signs and symptoms of acute streptococcal pharyngitis?

~ sore throat

~ headache

~ fever

~ abdominal pain

~ tonsils inflamed

~ edematous/red tongue

~ fine, red rash across chest

~ swollen glands in trunk of throat

How is streptococcal pharyngitis treated?

it is treated by antibiotics

What does tonsillitis occur with?

it occurs with pharyngitis

What are some signs and symptoms of tonsillitis?

~ swollen tonsils

~ difficulty swallowing

~ difficulty breathing

~ mouth breathing (if adenoids involved)

What is the management for viral tonsilitis?

~ treat signs and symptoms

~ provide comfort

What is the management for bacterial tonsilitis?

~ treat signs and symptoms

~ administer antibiotics

What is otitis media?

it is a common ear infection in children

What are some symptoms of otitis media?

~ ear aches

~ ear pain while laying down

~ fever

~ irritability

~ ear drainage

What are some managements for otitis media?

~ educate about care

~ comfort

~ administer antibiotics

~ inform postop care

What is infectious mononucleosis?

it is mono or “the kissing bug”

What are the signs and symptoms of infectious mononucleosis?

~ fever

~ puffy eyes

~ headache

~ malaise

~ fatigue

~ sore throat

~ lymphadenopathy

~ hepatosplenomegaly

What are some managements for infectious mononucleosis?

~ treat symptoms

~ rest

~ no contact sports

What are some signs and symptoms of croup?

~ barking cough

~ afebrile

~ worsens at night

~ mild respiratory distress

~ hoarseness

What are some managements for croup?

~ treat symptoms

~ warm humidified air

~ cool air

~ nebulizer treatments

What are the signs and symptoms of RSV and bronchitis?

~ rhinorrhea

~ coughing

~ wheezing

~ eye drainage

~ fever

What are some managements for RSV and bronchitis?

~ educate about treatments

~ teach suctioning

What are some signs and symptoms of asthma?

~ chronic coughing (night)

~ wheezing

~ tripod position

~ shortness of breath

What are some managements for asthma?

~ identifying triggers (exercise, allergens, emotions, infectious agents)

~ administer medications

~ humidifiers

~ hydration

~ peek expiratory flow meter (write down best effort out of the three attempts)

What are the signs and symptoms of status asthmaticus?

~ inability to speak

~ gasping for air

~ decreased/absent breath sounds

~ restlessness

What are the actions to be taken when a child is experiencing status asthmaticus?

~ call 911

~ maintain airway

~ administer rescue medications/ inhaler

What are the legal responsibilities for nurses with immunizations?

~ obtaining informed consent

~ proper documentation (more than commentary)

~ document date and time of administration

~ document site of administration

~ document any adverse reactions post-vaccination

~ monitor for immediate reactions

~ HIPAA

~ ensuring vaccines are stored and handled according to guidelines- legally responsible for improper handling

~ legal obligation to report adverse reactions -Vaccine Adverse Event Reporting System (VAERS)

~ emergency preparedness

~ vaccination education

~ vaccination advocacy

What are live/active vaccines?

~ they contain a weaken form of the pathogen that causes the disease

~ they stimulate a strong immune response and often provide long term immunity after two doses

What are inactivated vaccines?

~ they contain viruses or bacteria that have been inactivated so they cannot cause the disease

~ they stimulate an immune response but to maintain immunity requires multiple doses and boosters

What are toxoid vaccines?

~ they are immunizations created using inactivated toxins

~ they stimulate immunity against toxins rather than the bacteria themselves

What are subunit/conjugate vaccines?

they contain only pieces of the pathogens they protect against

What are some examples of live vaccines?

~ measles

~ mumps

~ rubella (MMR)

~ varicella

~ influenza (nasal spray)

~ rotavirus

~ zoster

~ yellow fever

~ oral polio

What are some examples of inactivated vaccines?

~ polio (injected)

~ hepatitis A

~ rabies

~ influenza

What are some examples of toxoid vaccines?

~ diphtheria

~ tetanus (part of DTaP combines immunization)

What are some examples of subunit/conjugate vaccines?

~hepatitis A

~haemophiles influenza type B (Hib)

~pertussis (part of DTaP combined immunization)

~ pneumococcal

~ meningococcal

~ human papillomavirus

When can hepatitis B be administered?

~ 1st dose given at birth

~ if mom is Hep B+, baby must receive vaccine within 12 hours after delivery

When is hepatitis A administered?

2 dose series that begins at 12-18 months old

When is polio vaccine administered?

4 dose series, begin at 2 months

When is rotavirus vaccine administered?

it must be completed by 8 months old

When is MMR vaccine administered?

it is administered at 12 months and 4 years old

What is hepatitis B?

~ contagious viral infection of the liver

~ spread through contact with infected body fluids such as blood or semen

What is HIB?

~ contagious bacterial infection of the lungs, brain, and spinal cord (URI’s, ear infections, and meningitis)

~ primarily affects children under 5 years old

What is hepatitis B?

it is a contagious viral infection of the liver spread by contaminated food, drink, or close contact with an infected person

What is polio?

it is a contagious viral infection of nerves and brain spread through the mouth from stool on contained hands, food or liquid, air and direct contact

What is pertussis?

~ highly contagious respiratory disease

~ begins with common cold symptoms, progresses to more serious symptoms (whooping cough, profuse mucous with eye and nasal drainage, fever, dehydration)

~ treat with antibiotics if diagnosed early

What is tetanus?

it is a bacterial infection of brain and nerves cause by spores found in soil, dust, fecal matter; spores enter the body through wounds or broken skin

~ sign is lockjaw

What is pneumococcal?

~ strep pneumoniae bacteria

~ causes bacterial ear infections, sinusitis, meningitis, pneumonia

~ treat symptoms with antibiotics

What is measles?

~ viral infection spread by respiratory secretions

~ signs & symptoms: rash (Koplik spots), fever, malaise, cough

~ can result in secondary bacterial infections

What is rubella?

~ viral infection spread by respiratory secretions'

~ signs & symptoms: fever, malaise, rash

~ harmful for pregnant women, cause congenital abnormalities

What is mumps?

~ viral infection spread by respiratory droplets

~ signs & symptoms: fever, malaise, earache, swelling of parotid glands, chipmunk cheeks

~ treat with rest, analgesics, bland foods, compresses to neck

~ can cause infertility

What is roseola?

~ viral

~ high fever and rash

What is fifth disease?

~ viral

~ slapped face appearance

~ hand and mouth disease

What is scarlet fever?

~ bacterial

~ sign & symptoms: strawberry tongue, fever, vomiting, red rash'

~ recent strep throat