Pediatric and Adolescent Skin Immunization Student Outline PDF

**Pediatric and Adolescent Skin** **Immunizations** - **Measles, Mumps** - **Type:** Live attenuated - **Dosage:** 0.5 mL SQ - **Age:** 12 -- 15 months; 4-6 years (2 doses) - Give MMR and varicella vaccines on the same day or at 28 days apart. -...

**Pediatric and Adolescent Skin** **Immunizations** - **Measles, Mumps** - **Type:** Live attenuated - **Dosage:** 0.5 mL SQ - **Age:** 12 -- 15 months; 4-6 years (2 doses) - Give MMR and varicella vaccines on the same day or at 28 days apart. - **Storage:** Refrigerate - **Common side effects:** Fever, erythema or pain at injection site, swollen cheeks or neck glands, noncontagious rash, joint pain. - **Serious side effects:** allergic reaction or anaphylaxis, febrile seizures, deafness, meningitis, encephalopathy, thrombocytopenia, coma, permanent brain damage. - **Contraindications:** prior anaphylactic reaction, allergic reaction, pregnancy, immunodeficiency, HIV. - **Nursing Management:** - Ask about immune suppression, Reconstituted vaccine is clear, yellow solution, may give to a child with an egg allergy, given to children with HIV unless severely immunocompromised, Give TB test on same day as MMR or 4-6 weeks later, educate adolescent girls to avoid pregnancy 4 weeks after immunization. - **Chickenpox** - **Type:** Live attenuated - **Dosage:** 0.5 mL SQ - **Age:** 12 -- 18 months; 4-6 years - Give MMR and varicella vaccines on the same day or at 28 days apart. - **Storage:** Frozen - **Common side effects:** erythema or pain at injection site, fever, rash. - **Serious side effects:** allergic reaction or anaphylaxis, rare cases of encephalitis, pneumonia, erythema multiforme, Stevens--Johnson syndrome, thrombocytopenia, seizure, and Guillain--Barré syndrome. - **Contraindications:** prior anaphylactic reaction, allergic reaction, pregnancy, immunodeficiency, active intreated TB. - **Nursing Management:** - Vaccine is clear to pale yellow solution, educate adolescent girls to avoid pregnancy 3 months after immunization, antiviral agents should not be used 1 day before or 21 days after vaccine, avoid salicylates (ASA) for 6 weeks after vaccinated. **Childhood Communicable Diseases** - **Measles** - Caused by morbillivirus, spread via respiratory droplets and airborne transmission. - Incubation: 7--14 days; contagious 4 days before to 4 days after rash appears. - **Prodromal Stage:** - High fever, cough, runny nose, conjunctivitis, **Koplik spots** (blue-gray spots on buccal mucosa). - **Rash Stage:** - Dark red-to-purple maculopapular rash, starting on the face and spreading to the body. - Fatigue, photophobia, and lymphadenopathy. - **Complications:** Ear infections, diarrhea. **Severe:** Pneumonia (most common cause of death), encephalitis. - **Treatment:** - Supportive care only, Antibiotics for secondary infections, Post-exposure: MMR vaccine (within 72 hours) or immune globulin (within 6 days). - **Nursing Care:** - Airborne isolation; only immune visitors allowed. - Use cool mist for airways, give antipyretics, and dim lights for photophobia. - Keep skin clean and dry, and offer soft, cool foods. - **Mumps** - Caused by rubulavirus, spread via respiratory droplets. - Incubation: 12--25 days; contagious 5 days before and after salivary gland swelling. - **Symptoms:** Fever, malaise, muscle aches, swollen salivary glands (parotid, sublingual, or submaxillary). Earache, headache, pain with chewing, decreased appetite. May be asymptomatic in some cases. - **Complications:** Orchitis, oophoritis, meningitis, encephalitis, or deafness (rare). - **Treatment:** Supportive care only. - **Home Care:** Rest, symptom relief, soft foods, and fluids. Avoid acidic or spicy foods. - Use droplet precautions. - Exclude from school/childcare until 5 days after swelling onset. - Provide analgesics/antipyretics for fever and pain. - Monitor for complications like meningitis or orchitis. - **Chickenpox** - Caused by the varicella-zoster virus (human herpesvirus 3). - Spread via airborne droplets, direct contact with lesions, or mucous membranes. - Incubation: 14--21 days. Contagious 1--2 days before rash until lesions crust over. - **Symptoms:** - Early: Fever, malaise, anorexia, headache, irritability. - Rash: Starts on trunk, face, and scalp; progresses from macules to papules, vesicles, and crusts (1--3 weeks). - Mouth ulcers may decrease fluid intake. - **Treatment:** Supportive care; IV acyclovir for high-risk groups; immune globulin for exposed at-risk children. - **Comfort Measures:** Fever control (acetaminophen/ibuprofen), antihistamines, soothing baths, Caladryl lotion, short nails, cotton mittens. - **Monitoring:** Watch for complications like dehydration, encephalitis, or respiratory distress. **Other Childhood Diseases** **Impetigo** - Cause: Bacterial infection (Staphylococcus aureus or Streptococcus pyogenes). - Symptoms: Red sores that rupture, ooze, and form a honey-colored crust. Often around the mouth, nose, and extremities. - Transmission: Direct contact with lesions or contaminated objects. - Treatment: - Topical antibiotics - Oral antibiotics - Prevention: Keep nails short, maintain good hygiene, avoid contact with sores. **Tinea (Ringworm)** - Cause: Fungal infection caused by dermatophytes - Symptoms: Circular, scaly patches with a clear center (on scalp, body, feet, or groin). - Transmission: Direct skin contact, contaminated items, or pets. - Treatment: - Topical antifungals - Oral antifungals - Prevention: Avoid sharing personal items, keep skin clean and dry. **Pediculosis (Lice Infestation)** - Cause: Infestation with lice - Symptoms: Intense itching, visible lice or nits (eggs) on hair shafts or clothing seams. - Transmission: Close contact or sharing personal items. - Treatment: - Medicated shampoos/lotions - Fine-tooth combing to remove nits. - Prevention: Avoid sharing personal items, regular scalp checks in close-contact environments. **Acne** - Cause: Blockage of hair follicles with oil and dead skin, influenced by hormones, bacteria or genetics. - Symptoms: Blackheads, whiteheads, pustules, cysts, and nodules, commonly on the face, back, and chest. - Treatment: - Mild: Topical treatments. - Moderate/Severe: Oral antibiotics, hormonal therap, or isotretinoin. - Prevention: Gentle skin cleansing, avoiding picking or squeezing lesions, using non-comedogenic products.