Immunizations and communicable diseases in children

  1. what is a communicable disease
    illness that is directly transmitted (acquired from person or vector) by contact with body fluids, or indirectly transmitted by contact w a contaminated object
  2. what is an infectious disease
    any communicable disease caused by microorganisms that are commonly transmitted from one person to another or from an animal to a person
  3. what three factors must be present for a communicable disease to occur
    • -infectious agent, pathogen
    • -effective means of transmission or spread of the infectious agent
    • -a susceptible host
  4. what is passive immunity?
    -antibodies produced in another human

    ex: mother passes antibodies (proteins capable of responding to specific infections) to the fetus during third trimester by the placenta an d to the newborn through breast milk...decreases in newborn in months after birth
  5. Why are infants/children vulnerable to disease
    -preterm receive fewer maternal antibodies

    • -immunity decreases in the months after birth
    • -immunodeficiency and poor health 
    • -poor hygiene behaviors (fecal-oral & respiratory route most common
  6. what is active immunity?
    infants/children develop active immunity with antibody development for specific infections through immunization or exposure to the natural disease through contacts with other children and adults
  7. what are steps nurses can take to prevent the spread of disease
    • -wash hands, hand sanitizer
    • -separate quarantine from well
    • -promote/provide immunizations
    • -eliminate habitat for reservoir of the host
    • -kill pathogen (sanitize toys)
    • -educate children and parents
  8. what is a killed virus vaccine
    vaccine contains a microorganism that has been killed but is still capable of inducing the human body to produce antibodies.

    exp: inactivated poliovirus vaccine
  9. What is a toxoid?
    a toxin that has been treated (by heat or chemical) to weaken its toxic effects but retain its antigenicity

    exp: tetnus toxoid
  10. what is a live virus vaccine?
    a vaccine that contains a microorganism in live but weakend form.

    Exp: measles and varicella vaccines
  11. what is an acellular vaccine?
    a vaccine that uses proteins, such as from pertussis, rather than the whole bacterial cell to stimulate the process of active immunity
  12. What are recombiant forms?
    an organism that has been genetically altered for use in a vaccine

    Exp: hepatitis B and acellular vaccine
  13. what are conjugated forms of vaccines
    al altered organism joined with another substance to increase the immune response

    Exp: the haemophilus influenzae type b (Hib) vaccine in conjugated with a protein carrier like tetnus toxoid, but no immunity to tetanus occurs when it is the protein carrier
  14. what are some responses a child might have to a vaccine
    Local: erythema, swelling, pain, and induration at the site of the injection

    Systemic: fever, fussiness or irritability, malaise, anorexia, rash

    Allergic: epinephrine 1:1000 (0.01 ml/kg IM)
  15. what is full immunization defined as:
    • -4 doses of DTP/DT/DTaP
    • -3 doses of IPV, Hib, HepB
    • -1 dose of MMR and varicella
  16. What are some common misconceptions about vaccines?
    • -vaccine-preventable diseases have been eliminated
    • -immunization weakens the immune system or overload system causing harmful effects
    • -it would be better to let the child get the disease than get immunized
    • -vaccines do not work, children still get the disease
    • -vaccines may cause serious conditions such at autism
  17. what are some guidelines to reduce the number of missed opportunities to administer immunizations
    • -use combination injections
    • -educate staff to review childs record
    • -send reminders to parents
    • -schedule childs next immunization visit prior to them leaving the office
    • -immunizations can be given when child is sick
    • -give several vaccines at same visit; 2 injections in 2 different sites on the same extremity
  18. what is the nurse required to record when giving immunizations
    • -date
    • -vaccine
    • -manifacturer
    • -lot # & expiration
    • -site & route
    • -name title and address of person who administered
  19. how can the nurse reduce pain and anxiety for the patient and parent
    -coach parent ot hold and talk to child during shot

    -infants up to 4 months of age, give 24% sucrose water to suck immediately beofre injection (reduce pain); then allow to suck on pacifier or breastfeed during injection

    -apply pressure at injection site for 10 secs prior to injection

    -use vapocoolant spray

    -give two injections simutaneously

    -parent comforts after

    -age appropriate distractions
  20. what is the path and purpose of a fever in response to communicable disease?
    • -fever is increased body temp of 38 C (100.4F) taken rectal or oral
    • -endogenous pyrogens are released in response to invaders
    • -they travel to hypothalamus and trigger porduction of prostagladin E which raises body temp causing fever to occur
    • -this leads to cold response with chills and shivering, vasoconstriction, decreased peripheral perfusion
    • -body temp rises, then vasodilation occurs and the skin flushes becoming warm to touch
  21. what is toxic appearance with a fever?
    • -lethargy
    • -poor perfusion
    • -hypoventilation or hyperventilation
    • -cyanosis
  22. what children may be at greater risk for serious illness in association with a fever
    • -infants and children that have a toxic appearance
    • -neonates < 28 days old w temp over 100.4 (38c)
    • -children < 4 w temp over 105.8 (41c)
    • -children with sickle cell, shunt, CHD
  23. how does a nurse manage a fever
    • -pospone treatment of low grade under 102, to promote natural defenses
    • -antipyretics-acetaminophen/ibprofen (no asprin b/c of Reye syndrome)
    • -limit clothing
    • -monitor temp
    • -clear fluids
    • -finish all antibiotics
  24. chicken pox (varicella virus)
    • -direct contact
    • -contagious until lesions crusted over
    • -incubate 14-21 days
    • -airbourne and contact percaustions
    • -acteminophen/ibprofen
    • -benadryl
  25. Diphtheria
    • -occurs in colder months
    • -grey pharyngeal membrane
    • -antibiotic for 14 days
    • -emergency airway equiptment
    • -sore throat and enlarged lymphs
    • -contagious for 2-4 weeks or unti l4 days after antibiotics are started
  26. Enteroviruses (coxsackie virus)
    • -summer, early fall
    • -poor hygiene, overcrowding
    • -fecal, oral droplet
    • -incubate 3-6 days
    • -viral shedding may occur weeks or months after infection onset
    • -hand foot and mouth disease 7-10 days
    • -hand hygiene
  27. Fifth disease (erythema infectiosum)
    • -human parvovirus
    • -worldwide winter and spring
    • -epidemics q 3-7 years
    • -children 5-14
    • -respiratory and blood transmission
    • -incubation 4-21 days, rash for 7-10 days
    • -"slapped face"
    • -antiyretics, oatmeal bath, benadryl, keep out of sunlight
  28. haemophilus B
    • -spring and summer
    • -contagious for 3 days
    • -uppper respiratory infection, can enter blood stream
    • -iv antibiotics for 10 days
    • steroids, rifampin for exposed family (orange urine)
    • -antipyretics
  29. influenza
    • -oct-march in USA
    • -community outbreaks 4-8 weeks
    • -H1N1, H1N2 new strains
    • -abrupt onset
    • -N/V/D
    • -incubate 2 days
    • contagious for one week
  30. measles
    • -incubate 8-12 days, contagious 3-5 days before rash and 4 days after
    • -children very ill,, rash, treatment is upportive, death 1-3:1000
    • -airborne percautions
    • -antpyretics
    • -klopik spots
  31. meningococcus (menegitis)
    • -winter and early spring
    • -incubate 2-10 days
    • -contagious until 24 hours after antibiotic
    • -spetic shock, DIC Gangrenous necrosis, respiratory compromise
    • -spinal tap
    • -Iv antibiotics 5-7 dyas
  32. mononucleosis
    • -esptein barr virus
    • -Incubate 30-50 days
    • -supportive treatment
    • -steroids for pharyngeal swelling
    • -avoid contact sport for 4 week d/t liver and spleen elargemnt
  33. Mumps
    • -incubation12-25 days
    • -swollen glands, contagious 7 days prior to swelling and 9 days after
    • -analgesics and antipyretics
  34. Pertussis (whooping cough)
    • -pertussis or vaccine is long lasting
    • -barrowed glottis causes stridor or whooping
    • cough and respiratory symptoms last 3-9 weeks
    • -supportive treatment and antibiotics
  35. Pneumoncoccal
    • -nasopharynx
    • -unknown incubation, contagious unknown
    • -standard precautions, antipyretics
  36. Poliomyelitis
    • -all cases under 5 year old
    • -contagious 3-6 weeks ecreted feces
    • -incubation 7-10 days
    • -sore throat low grade temp
    • -asymmetric flaccid paralysis
    • -aseptic meningitis and paresthesias
    • -supportive treatment
  37. roseola (6th disease)
    • -human herpevirus
    • -6-24 months
    • -saliv and respiratory secretions
    • incubated 9-10 days
    • -contagious
    • -fever 3-7 days
  38. rotavirus
    • -most common cause of severe diarrhea in children under 5 year old
    • -incubate 24-72 hour
    • -fecal oral route
    • -virus found in stool for up ot 30 days
    • 10-20 diarrhea stool a day
    • -lasts 3-8 days
    • -fluid and electrolyte replacement
  39. Rubella
    • -incubates 14-23 days
    • -contagious a few days before
    • -mild disease
    • -tx is supportive
    • -infection during 1st trimester=congenital defects or fetal death
    • -children shed virus for 1 year
  40. Streptococcus A
    • -incubation varies
    • -spread by contact with pharyngitis or skin lesion
    • -pharyngeal, respiratory tract, scarlet fecer, pyodermal (impetigo)
    • -rapid strep antigen test
    • -antipyretics
    • -gargling
  41. Tetanus
    • -bacillus spore
    • -soil dust and animal excretions
    • -puncture wounds, burns broken skin
    • -not contagious
    • -spasms, mortaility in infants
  42. what are some diseases that are transmitted by animal hosts

    rabies infected saliva from animals

    rocky mountain spotted fever-tick bourne
  43. what is Disseminated Intravascular Coagulation (DIC)
    -condidtion in which blood clots form throughout the body's small blood vessels.

    -blood clots reduce/block blood flow thorugh the blood vessels, which can damage body organs

    -increased clotting uses up platelets and serious bleeding can occur (internal and external)

    -symptoms include petechiae or pupura
Card Set
Immunizations and communicable diseases in children
Immunizations and communicable diseases in children