Childhood_Illnesses_and_Disorders-student copy LPN

Health Promotion

Childhood Diseases and Immunizations

Overview

  • Topics covered include childhood diseases, particularly infectious diseases and their immunization.

Infectious Childhood Diseases

General Characteristics

  • Classification of childhood illnesses includes:
    • Infectious in Nature
    • Types: Bacterial, Viral, and Fungal
  • Common Symptoms:
    • Fever
    • Redness
    • Swollen throat
    • Blisters
    • Oral lesions
    • Crusty lesions
    • Malaise
    • Itching

Nursing Assessment in Infection Identification

Factors to Consider:

  • Recent exposure to infectious agents
  • Prodromal Symptoms:
    • Early signs before full onset of the disease
  • Immunization History
  • Previous history of having the disease

Stages of Infectious Diseases

  • Incubation Period
    • Time between exposure and onset of signs/symptoms.
  • Prodromal Period
    • Early signs (like fever) to clinical syndrome (like rash).
  • Illness Phase
    • Time when symptoms are prevalent.
  • Convalescent Period
    • Time when symptoms fade and recovery begins.

Preventing Spread of Disease

Components of Prevention:

  • Primary Prevention
    • Focused on immunization against diseases.
  • Control of Disease Spread
    • Techniques to lower risk of transmission:
    • Infection control policies
    • Hand washing

Special Considerations for Compromised Children

At Risk Groups:

  • Children with immunodeficiency:
    • Receiving steroid therapy
    • Undergoing other immunosuppressive therapies
    • Those with generalized malignancies
    • Children with immunologic disorders

Complications from Viral Diseases

  • Common Viral Diseases: Chicken Pox and Fifth Disease
    • Fifth Disease: Caused by Human Parovirus (HPV)
    • Can lead to thrombocytopenia (low platelet count) and neutropenia (low white blood cell count).
  • Children with Immunodeficiency are most susceptible to complications:
    • Examples include leukemia/lymphoma patients and children at risk for varicella-zoster virus (VZV) replication.
  • Varicella (Chicken Pox) leads to:
    • Primary manifestation before age 15
    • Potential for secondary herpes zoster (shingles), which is painful and localized.
  • Sickle-Cell Disease
    • At risk for aplastic anemia due to Fifth Disease.

Specific Viral Diseases

Roseola

  • Agent: Herpes Virus
  • Characteristics:
    • Limited to children < 3 years
    • Peak age: 6-15 months, occurs year-round
    • Incubation: 5-15 days
    • Symptoms: High fever, pinpoint rash on trunk, absence of respiratory symptoms, NO itching.
Management
  • Reduce discomfort with Tylenol or Motrin
  • Monitor for febrile seizures due to fever
  • No immunizations required; no major long-term effects.

Rubella (German Measles)

  • Agent: Rubella virus
  • Characteristics:
    • Peak age: pre-teen to adolescent
    • Seasonal: Spring months
    • Incubation: 14-21 days
    • Transmission: Via droplet and contact
    • Symptoms include low-grade fever, mild cough, sore throat, lymphadenopathy, arthritic pain, rash from face to trunk.
Management
  • Relieve joint pain
  • Control fever with Tylenol/Motrin
  • Droplet precautions necessary
  • Risk of birth defects if mother is not immune during pregnancy.

Measles (Rubeola)

  • Agent: Measles virus
  • Characteristics:
    • Peak age: young adults/adults
    • Seasonal: Winter and spring
    • Incubation: 10-20 days
    • Transmission: Via droplet
    • Symptoms: High fever, malaise, lymphadenopathy, Koplik’s spots (diagnosis sign), respiratory symptoms, conjunctivitis, photophobia.
Rash Management
  • Appears on day 4 as red-brown, very pruritic (itchy)
  • Management includes:
    • Comfort measures
    • Antipyretics and antihistamines
    • Vitamin A supplementation
    • Dark environment for photophobia, sunglasses for eye protection
    • Management of potential complications such as pneumonia and encephalitis
    • Airborne precautions
    • Cool mist vaporizer for cough and nasal discharge.

Additional Viral Diseases

Varicella (Chickenpox)

  • Agent: Varicella-Zoster Virus (VZV)
  • Characteristics:
    • Peak age: older children to young adults
    • Incubation: 2 - 3 weeks
    • Transmission: direct contact, droplet spread, contaminated objects
    • Symptoms: Low-grade fever, malaise, rash that appears 24 hours after prodromal symptoms, transitioning through macule, papule, vesicle, to crust, primarily on the trunk.
Nursing Management
  • Scabs typically do not scar if left alone
  • Administer antihistamines, antipyretics, and analgesics
  • Implement contact and droplet precautions
  • Isolate infected children until vesicles have dried
  • Avoid aspirin due to risk of Reye’s syndrome
  • Consider use of Acyclovir (Zovirax) and VariZIG for at-risk children.

Fifth Disease

  • Agent: Parvovirus B-19
  • Characteristics:
    • Peak age: 2-12 years
    • Incubation: 4 to 14 days
    • No vaccination available
    • Teratogenic risks (causes congenital defects)
    • Symptoms: Headache, fever, malaise, rash beginning on face and spreading to extremities and trunk after around 1 week.

Mumps

  • Agent: Paramyxovirus
  • Characteristics:
    • Incubation Period: 14-21 days
    • Classic symptom: inflammation of salivary glands, fever, malaise, resulting in difficulty eating
    • Recommended diet: soft or liquid foods
    • Droplet precautions required.

Pertussis (Whooping Cough)

  • Agent: Bordetella pertussis
  • Transmission: Droplet or direct contact
  • Incubation: 6 to 20 days
  • Symptoms: Short, rapid coughs with a “whoop” sound, low-grade fever, respiratory symptoms lasting up to 6 weeks.
  • Treatment: Erythromycin or Azithromycin (Z-pack)
  • Droplet precautions for a minimum of 5 days after antibiotics are started.

Scarlet Fever

  • Agent: Group A Beta-hemolytic