NUR 203 Child Health Week 3 Part I (1)

NUR 203 CHILD HEALTH

West Virginia Junior College

Week 3 Part I

Learning Objectives

• Utilize the nursing process to develop and implement a patient-centered care plan based on evidence-based practice for children with infections or communicable illnesses.

• Discuss effective evidence-based strategies for reducing fever in pediatric patients.

• Create a collaborative evidence-based plan of care for pediatric patients with sepsis or scarlet fever, incorporating input from the patient, family, and health care team.

• Provide nursing care for children with viral infections, integrating knowledge of pathophysiology, pharmacotherapy, and consideration for family values and needs.

• Identify common types of conjunctivitis in pediatric patients.

• Discuss the most commonly diagnosed refractive errors in children.

• Incorporate cultural considerations in patient care and education for children with acute otitis media.

• Design a nursing care plan emphasizing communication and educational strategies that align with patient and family preferences after tube placement for pressure equalization in the ear.

• Analyze current health trends and protocols supporting health promotion and maintenance for diabetic pediatric patients.

• Develop an educational plan for parents focusing on essential nutrition for therapeutic outcomes.

Chapter 37: Nursing Care of the Child with an Infection

Role of Immunizations in Preventing Childhood Infections

• Importance of immunization in preventing viral and bacterial diseases.

  • Required for multiple doses for effectiveness.

  • Preventable diseases include:

    • Diphtheria, pertussis, tetanus (DPT)

    • Mumps, measles, rubella (MMR)

    • Varicella

    • Poliomyelitis

    • Other infections.

Types of Infectious Diseases

• Bacterial Infections: sepsis, community-acquired infections, etc.

• Viral Infections: viral exanthems, mumps.

• Zoonotic and Vector-borne Infections: rabies, Lyme disease.

• Parasitic Infections: pediculosis capitis (head lice), roundworm.

• Sexually Transmitted Infections (STIs): chlamydia, HIV.

Inflammatory Response

• Triggered by tissue injury, resulting in:

  • Capillary widening and increased permeability.

  • Increased blood flow, fluid release leading to symptoms like heat, redness, swelling.

  • Attraction of leukocytes and systemic responses such as fever and pain.

Function of White Blood Cells by Leukocyte Type

• Granulocytes: First line of defense; includes neutrophils, eosinophils, and basophils.

• Lymphocytes: Maintain immune responses; includes B cells, T cells, and natural killer cells.

• Monocytes: Second line of defense responding to severe infections.

Fever

• Infection stimulates endogenous pyrogens releasing signals to hypothalamus.

  • Results in increased body temperature through mechanisms like shivering and vasoconstriction.

Managing Fever in a Child with an Infectious Disease

• Keep linens clean and dry.

• Assess fluid intake; encourage oral or IV fluids as per orders.

• Notify physician about temperature as per guidelines.

• Administer antipyretics as ordered for discomfort.

• Use a consistent site for temperature measurements; reassess every 4 to 6 hours.

Stages of Infectious Diseases

• Incubation: Pathogen entry until the first symptom appears.

• Prodrome: Nonspecific symptoms (fatigue, malaise) before specific disease symptoms.

• Illness: Disease symptoms become evident.

• Convalescence: Acute symptoms begin to fade.

Chain of Infection

• Components include:

  • Infectious agent

  • Reservoir

  • Portal of exit

  • Mode of transmission

  • Portal of entry

  • Susceptible host.

Methods of Preventing Infectious Diseases

• Hand washing.

• Adequate immunization.

• Proper food handling and preparation.

• Judicious antibiotic use.

Limiting the Spread of Infections

• Standard precautions (Tier 1).

• Transmission-based precautions (Tier 2):

  • Airborne, droplet, contact precautions.

Pediatric Physiology and Immune System

• Infants and young children have immature immune responses, making them more susceptible to infections.

• Newborns show decreased inflammatory response, increasing infection risk.

• Cellular immunity is functional at birth; humoral immunity develops over time as the infant encounters new pathogens.

Common Treatments and Medications for Infectious Disorders

• Hydration: Essential for recovery.

• Fever Reduction: Important to manage symptoms.

• Medications: Include antibiotics, antivirals, antipyretics, and antipruritics.

Information Obtained in Health History

• Review past medical history (birth history, family history, immunization status).

• Current illness history: onset, duration, symptoms, prior treatments.

• Observe any change in usual behavior (feeding, irritability).

• Note exposure to ill contacts.

Assessments Made During Physical Examination

• Examine skin, mouth, throat, and hair for lesions or wounds.

• Assess hydration, vital signs, and perform palpation of skin and lymph nodes.

Common Laboratory Tests for Infectious Diseases

• Complete blood count (CBC).

• Erythrocyte sedimentation rate (ESR).

• C-reactive protein (CRP).

• Cultures: blood, stool, urine, throat, nasal swabs.

Nursing Interventions to Promote Comfort for a Child with an Infectious Disease

• Use diversional activities and distraction.

• Dress child lightly if febrile.

• Provide cool mist humidification and fluids.

• Administer prescribed analgesics and antipruritics, monitoring effectiveness.

Nursing Interventions to Promote Skin Integrity

• Monitor skin for signs of infection and changes in lesions.

• Encourage fluid intake and nutrition.

• Keep fingernails short to reduce skin irritation.

• Use prescribed antipruritics and topical ointments.

Key Teaching Points for a Child with an Infectious Disease

• Assess family's willingness to learn and provide adequate adjustment time.

• Repeat information and deliver in short sessions.

• Tailor teaching methods to the child's understanding level, involving multiple senses for effectiveness.

Laboratory and Diagnostic Tests Ordered for Sepsis

• CBC: typically shows elevated WBC levels.

• C-reactive protein: elevated in infections.

• Positive blood cultures indicate septicemia.

• Urine culture, cerebrospinal fluid analysis, can show signs of infection.

Bacterial Infections

• High-risk conditions include community-acquired methicillin-resistant Staphylococcus aureus, scarlet fever, and diphtheria.

Viral Infections Occurring in Children

• Characteristic rashes in viral illnesses include:

  • Rubella (German measles).

  • Rubeola (measles characterized by Koplik spots).

  • Varicella zoster (chickenpox).

  • Parvovirus B19 (fifth disease - slapped cheek).

  • Roseola infantum (sixth disease).

Zoonotic and Vector-Borne Infections

• Transmitted from animals or vectors; includes rabies, cat-scratch fever, Lyme disease, and Rocky Mountain spotted fever.

Parasitic and Helminthic Infections

• Parasitic: pediculosis (head and pubic lice), scabies.

• Helminthic: includes pinworm, hookworm, ascaris.

Sexually Transmitted Infections (STIs)

• Transmitted through sexual contact; some may pass to newborns in utero or during childbirth.

• High rates of STIs found in adolescents; detection in children can indicate abuse.

End of Week 3 Part I