Communicable Diseases PDF

COMMUNICABLE DISEASES The prevalence of most communicable diseases in children has decreased as immunizations have been developed and become part of routine pediatric care. The use of antibiotics has further reduced the incidence of complications from such infections. Some common childhood communica...

COMMUNICABLE DISEASES The prevalence of most communicable diseases in children has decreased as immunizations have been developed and become part of routine pediatric care. The use of antibiotics has further reduced the incidence of complications from such infections. Some common childhood communicable diseases for which immunizations are available include chickenpox, measles, mumps, rubella, and whooping cough. Communicable diseases have common patterns: Incubation period: the initial stage after exposure before symptoms are apparent Prodromal period: when the symptoms first become apparent; symptoms may be vague and not specified to the pathogen Acute illness: as the pathogen replicates, more severe and specific symptoms are present Decline stage: symptoms gradually improve Convalescence: symptoms resolve INFECTION CONTROL Standard Precautions Use barrier protection such as gloves, goggles, gowns, and masks. The purpose is to prevent contamination from all body fluids, secretions, and excretions. Respiratory Hygiene Cover mouth and turn head away when coughing and sneezing. Offer surgical mask for persons who are coughing. Use tissues to contain respiratory secretions. Keep distance from others when coughing. Airborne Precautions For illnesses transmitted by airborne particles. Droplet Precautions For illnesses transmitted by large particle droplets. Contact Precautions For illnesses transmitted by direct contact or contact with items. Chicken Pox/Varicella Chickenpox (varicella) is a highly contagious viral respiratory disease transmitted through the air, direct contact, and through contaminated objects. Contracting chickenpox during pregnancy can possibly cause birth defects or a life-threatening illness. Clinical Manifestations prodromal phase: 24 hours of low-grade fever malaise anorexia acute phase: pruritic rash to face, trunk, extremities rash appears as papules (raised red/pink bumps), then forms into vesicles (small-fluid filled blisters), then the blisters break and leak and form crusts and scabs typically lasts about a week Therapeutic Management antipruritic or antihistamine medications for itching acetaminophen for discomfort or fever Nursing Management For hospitalization, implement airborne contact precautions until lesions are crusted. Educate parents about home care. Isolate ill child from children at high risk and unvaccinated individuals until lesions are crusted. Encourage skin care. apply pressure on itchy areas rather than scratching smooth and shorten nails place mittens on young children bathe daily without soap Dress in lightweight, loose clothing to keep cool. Encourage child to drink fluids. Measles Measles Measles (rubeola) is a highly contagious respiratory disease caused by a virus. It is spread through the air and by direct co ntact of the droplets of infected persons. Clinical Manifestations prodromal phase fever malaise cough conjunctivitis Koplik’s spots (pinpoint red spot with white specks in buccal cavity) lasting 3-4 days acute phase irregular macular erythema rash appears beginning on face and behind ears and spreading to feet (lasts up to 7 days) vomiting diarrhea anorexia lymphadenopathy Therapeutic Management analgesics for pain vitamin A Nursing Management educate parents about home care maintain isolation until fifth day of rash encourage rest administer antipyretics for fever dim lights for photophobia clean eyelids with warm saline if secretions are present use cool mist vaporizer MUMPS Mumps (parotitis) is a viral infection that can cause swelling in the salivary glands. It is spread through the air and by direct contact. Clinical Manifestations prodromal phase fever malaise headache anorexia for 24 hours acute phase unilateral or bilateral edema and tenderness of parotid gland (by day 3) earache that is aggravated by chewing Therapeutic Management nonsteroidal anti-inflammatory drugs to relieve pain, decrease inflammation, and reduce fever analgesics for pain Nursing Management educate parents about home care apply warm or cool compress for edema encourage rest administer analgesics for pain encourage fluids and soft, bland foods GERMAN MEASLES (RUBELLA) German measles (rubella) is a viral disease spread through direct contact with nasopharyngeal secretions of infected persons. Clinical Manifestations prodromal phase young children have no symptoms besides rash adolescents have lymphadenopathy for 1 to 5 days low-grade fever headache sore throat anorexia clear nasal discharge cough acute phase within 3 days a pinkish red maculopapular rash begins on face and spreads to trunk, then to extremities Therapeutic Management analgesics for pain antipyretics for fever Nursing Management educate parents about home care medicate for fever and comfort avoid exposure to pregnant women WHOOPING COUGH Whooping cough (pertussis) is a bacterial respiratory disease. It is spread through the air. Clinical Manifestations prodromal phase 1-2 weeks of upper respiratory tract infection signs and symptoms cough sneezing little or no fever headache anorexia acute phase 4-6 weeks of dry, hacking cough followed by prolonged inspiration (“whoop” sound most often at night) vomiting of thick, stringy mucus convalescent stage 1-2 weeks of decrease in coughing and whooping Therapeutic Management antibiotic therapy Nursing Management educate parents about home care promote rest encourage fluids provide cool mist humidifier or humidified oxygen observe for signs of airway obstruction Nursing management of communicable diseases Identify the Infectious Organism History of recent known exposure Evidence of clinical manifestations Immunization history History of having the disease Prevent Spread Advocate for immunization as primary prevention. Report the incidence of communicable diseases to the local public health department. Implement measures to prevent the spread of communicable diseases. Follow isolation protocols. Follow strict handwashing. Use cough/respiratory etiquette. Prevent Complications Most children recover without difficulty from communicable diseases; however, certain groups of children are at risk for comp lications. Children with immunodeficiency are at risk for viremia from the varicella-zoster virus; antivirals may be used to treat varicella infections in immunocompromised children. Children with hemolytic disease are at risk for aplastic anemia from fifth disease. An increased incidence of pertussis has prompted a recommendation for a booster vaccine. Promote Comfort Itching cool baths refrigerated lotions (ex. calamine) lightweight clothes administer antipruritic medications keep nails short Fever antipyretic medication manipulate environment (fans) Sore throat lozenges and analgesics saline rinses Nursing management for Vaccinations Contraindications Administering a live virus to a severely immunocompromised child live virus vaccines include measles, mumps, rubella (combined vaccine), rotavirus, and varicella Administering a live virus when recently receiving passive immunity (for example, after immunoglobulin administration or from maternal antibodies) Administering measles, mumps, rubella, and varicella vaccines to a pregnant woman Administering vaccines if the client has an allergy to components of the vaccine Administration Ensure proper storage of vaccine to protect potency. Reconstitute per manufacturer’s direction. Rotate site of injections when several vaccines are needed at once. Administer injections simultaneously when several are needed.