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Infectious and Communicable Diseases. Ball & Bindler Donna Hills APN EdD. Clinical Considerations. Etiology: bacterial, fungal, viral, or protozoan Cluster of symptoms are disease specific fever secondary to the release of prostaglandins, triggered by the invading organism

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infectious and communicable diseases

Infectious and Communicable Diseases

Ball & Bindler

Donna Hills APN EdD

clinical considerations
Clinical Considerations
  • Etiology: bacterial, fungal, viral, or protozoan
  • Cluster of symptoms are disease specific
  • fever secondary to the release of prostaglandins, triggered by the invading organism
    • may be a beneficial physiologic response. Fevers < 101-101.5 may not be treated right away.
clinical management
Clinical Management
  • Fevers > 101.5 are only treated with Acetominophen or Ibuprophen;not Aspirin due to association with Reye’s syndrome
  • Symptomatic relief with viruses
  • Antibiotics with bacterial infection; (anti-fungal or protozoan as applicable)
  • Prevention of transmission/Isolation of infected child.
  • Good handwashing/ bacteriostatic hand gel
the toxic child
The Toxic Child
  • exhibits more severe symptomatology of illness
  • high fever, lethargy, poor ability to focus or give eye contact, decreased tone, poor perfusion (delayed cap refill), hypoventilation or hyperventilation, cyanosis, saturation less than 95% on room air, significantly low temperature in a premie or child with neurologic impairment.
evaluating child with fever illness
Evaluating Child with Fever/illness
  • Body’s natural defense against infection

Low grade fever may be beneficial to fight off organisms or enhance the effect of antibiotics.

  • Antipyretics are usually given for temps >100 or 101 Ax (per Dr.’s order).
  • Fevers >102 should be treated
    • Some children experience febrile seizures so may treat more rapidly in this case.
    • Acetominophen or Ibuprophen are preferred in children: no ASA d/t assoc with Reyes Syndr.
case study 1 month old with a fever
Case Study: 1 month old with a fever
  • Mrs. Carole calls the pediatric office to report that her 1 mo old has an axillary temp of 101. She is eating a little less than usual but otherwise seems fine.
  • What is your response to Mrs. Carole and what is your rationale?
otitis media
Otitis Media
  • Used to be a common cause for fever
  • Incidence is now decreased with the use of the HIB and PCV vaccines.
  • Some children are still anatomically prone to OM due to poor eustachian tube dysfunction with or without a URI
  • Treatment with antibiotics: Amoxicillin, Azithromycin, Augmentin, Cefuroxime.
  • Persistent fluid (SOM) can lead to hearing loss over time.
infectious skin infestations
Infectious Skin Infestations
  • Lice (Pediculosis Capitis)
    • Common among children of all socioeconomic levels; ages 3-10yr most common.
    • Nits found on hair shaft
    • Incub for eggs 8-10 days
    • Presents with itching and “flaking”
    • Rx with Permethrin (Nix) shampoo
    • Lindane is last resort: neurotoxic
    • No-nit policy can be diffic for parents; not recommended by AAP.
scabies
Scabies
  • Mite infestation: Sarcoptes scabei
  • Skin to skin contact; household transmission common
  • Most common in kids <2yrs
  • Presents with intense puritis and characteristic linear rash (on hands or fingers) or diffuse trunkal rash.
  • Rx with scabicide lotion (Permethrin 5%).
impetigo
Impetigo
  • Bacterial infection caused by staph or streptococcus.
  • Common sites: face, around mouth, hands, neck, and extremities, intertriginous areas.
  • Irritation or break in the skin serves as an entry
  • Presentation as pustule surrounded by erythema/edema, erupts with honey colored crust.
  • Bullous impetigo: vesicles enlarge, stim by release of endotoxin: coalesce
  • Spread to face or extr: self innoculation.
infectious and communicable diseases11
Infectious and Communicable Diseases
  • Review and study table 12-5 pgs 620-635.
  • Complete the worksheet/handout for infectious diseases.