Infection
What precaution is required for C. difficile?
Contact, washing hands with soap and water
What is the difference between Active and Passive immunity?
Active = body makes antibodies
Passive = body receives antibodies
A baby receives antibodies from the mother through the placenta during pregnancy or through breast milk. A patient receives immune globulin after exposure to diseases such as hepatitis B, rabies, or tetanus.
What are complications of GI viral infections?
Dehydration, Electrolyte imbalances, Hypovolemic shock
A child with scarlet fever has been taking amoxicillin for two days. The parent says the rash is improving and wants to stop the medication. How should the nurse respond?
The antibiotic should be completed as prescribed to fully eradicate the infection and prevent complications such as rheumatic fever or post-streptococcal glomerulonephritis.
Most common inherited cause of intellectual disability?
Fragile X Syndrome
What is the most common form of child maltreatment?
Neglect
Antipyretics, such as Acetaminophen and Ibuprofen, can be used to treat fever in children.
Aspirin may never be given to a child due to the risk of Reye syndrome.
After administering a subcutaneous injection, what is the safest way for the nurse to handle the needle to prevent a needlestick injury?
Activate the needle's safety device immediately after the injection, using a one-handed technique if appropriate.Do not recap the needle, as recapping significantly increases the risk of accidental needlestick injuries. Gloves should be worn as part of standard precautions but do not replace safe sharps handling practice
Name the six links in the chain of infection.
Infectious Agent, Reservoir, Portal of Exit, Transmission, Portal of Entry, Susceptible Host
Define and give 3 examples of a type 1 hypersensitivity reaction.
Type 1 is a anaphylactic reaction and is the most sever and rapid hypersensitivity.
Examples: Food allergies, bee stings, latex allergies, penicillin allergies, and seasonal allergies.
A school nurse assesses a child with a bright red rash across both cheeks that resembles a "slapped cheek." What viral illness does the nurse suspect, and what education should be provided to the family?
Fifth Disease (Parvovirus B19). The illness is usually mild in healthy children, but pregnant women should avoid exposure because the virus can harm the fetus.
A nurse is caring for a child with pertussis. Which assessment finding indicates the disease has progressed beyond the early cold-like stage?
Episodes of paroxysmal coughing followed by a characteristic "whooping" sound or vomiting after coughing.
Name 3 assessment findings suggest Down Syndrome?
Hypotonia, Low set ears, Short stature, depressed nasal bridge, small mouth, large protruding tongue, short neck
Name 4 types of abuse
Physical, sexual, emotional, neglect, financial/economic
A parent asks why antibiotics were not prescribed for their child's viral infection. How should the nurse respond?
Antibiotics treat bacterial infections, not viral infections. Most viral illnesses require supportive care while the body's immune system clears the infection.
What organs/body systems are play a role in immunity?
Bone marrow, Thymus, Lymph nodes, Spleen, Tonsils and Adenoids
Most effective way to prevent HAIs?
Hand Hygiene
Epinephrine
A child presents with fever, cough, conjunctivitis, and small white lesions inside the mouth before developing a generalized rash. Which viral illness should the nurse suspect, and what isolation precautions are required?
Measles (Rubeola). The child should be placed on Airborne Precautions because measles is highly contagious.
A child with diphtheria develops increasing difficulty swallowing and noisy respirations. Why is this finding concerning?
Diphtheria can form a thick pseudomembrane in the throat that can obstruct the airway, making airway management the highest priority.
A pregnant client asks the nurse if it is safe to have "just one glass of wine" each week during pregnancy. What is the best nursing response?
There is no known safe amount of alcohol during pregnancy, and complete avoidance is recommended to prevent fetal alcohol spectrum disorders
When should IPV screening occur?
Privately, without a partner present.
Define herd immunity
Herd immunity (also called community immunity) occurs when enough people in a population are immune to an infectious disease—through vaccination or previous infection—making it difficult for the disease to spread from person to person.
As a result, even individuals who are not immune are better protected because the chance of coming into contact with an infected person is much lower.
A healthcare provider prescribes a 750 mL lactated Ringer's (LR) bolus to infuse over 3 hours, followed immediately by a maintenance infusion of 125 mL/hr.
How many total milliliters (mL) of IV fluid will the patient receive during the first 8 hours of therapy?
Negative-pressure room and N95 are used for what type of isolation?
Airborne (TB, Varicella)
A patient develops generalized urticaria (hives) while receiving a unit of PRBCs. What type of reaction is this and what is the first nursing action?
Allergic reaction
Stop the transfusion immediately
A parent asks why their child with varicella should stay home from school even after the fever has resolved. How would the nurse respond?
The child remains contagious until all of the lesions have crusted over. Returning too early increases the risk of spreading the virus to others, especially immunocompromised individuals and pregnant women.
A child is diagnosed with community-acquired MRSA (CA-MRSA). The parents ask how to prevent spreading the infection to other family members. What teaching should the nurse provide?
Teach the family to:
Parents ask why their child with Down syndrome has appointments with a cardiologist, speech therapist, physical therapist, and endocrinologist. How would you explain the need for multiple specialists?
Down syndrome affects multiple body systems. Children commonly experience congenital heart disease, hypotonia, thyroid disorders, developmental delays, and speech difficulties. A multidisciplinary team provides comprehensive care and promotes optimal growth and development.
What is the priority when abuse is suspected?
Ensure patient safety and assess privately.
What is the difference of peak and trough with Vancomycin?
Peak - measures the highest concentration of the drug in the blood stream. Helps to determine whether the drug concentration is high enough to effectively kill bacteria.
Trough - measures the lowest concentration of the drug in the blood stream. Helps determine whether the medication remains at a therapeutic level and assess the risk for drug toxicity.
Ensure we receive Vancomycin trough level results before administering the next dose!
A healthcare provider prescribes 1,200 mL of 0.9% normal saline to infuse over 10 hours. The available IV tubing has a drop factor of 15 gtt/mL.
At how many drops per minute (gtt/min) should the nurse regulate the IV infusion?
30 gtt/min
gtt/min = volume/time x drop factor
Differentiate Colonization from Infection
Colonization = The presence of microorganisms without host interference/interaction with the host
Example: S. aureus colonized on skin without interruption or irritation
Infection = A host interaction with an organism
Example: S. aureus with an incision entering the wound = immune system
What change in the patient's health status could precipitate an infection?
A patient eats shrimp for the first time and experiences no symptoms. Six months later, after eating shrimp again, the patient develops hives, wheezing, and facial swelling. Which principle of allergic reactions best explains why the severe reaction occurred after the second exposure?
Sensitization. The first exposure to an allergen does not always produce an allergic response. Instead, the immune system becomes sensitized by producing allergen-specific IgE antibodies. With repeated exposure, these IgE antibodies trigger mast cell degranulation and histamine release, resulting in an allergic reaction.
A 4-year-old is admitted with fever, painful oral ulcers, and vesicular lesions on the palms of the hands and soles of the feet. What viral illness does the nurse suspect, and what nursing interventions are appropriate?
Hand-Foot-and-Mouth Disease (Coxsackievirus). Nursing care includes maintaining hydration, administering pain and fever medications as prescribed, encouraging soft, cool foods and fluids, and educating parents about good hand hygiene to prevent transmission.
Bacterial Conjunctivitis = thick yellow purulent drainage
Education: wash hands, apply ophthalmic ointment directly along the conjunctival sac, avoid touching the medication tube on the eye, avoid sharing personal items
A school-age child with cerebral palsy is admitted for pneumonia. During assessment, the nurse notes frequent coughing while eating and drinking. Which complication is the priority concern?
Aspiration
What are 4 characteristics of violent families?
Social Isolation, Abuse of power, Achohol/drug abuse, Intergenerational transmission
When should hand hygiene be performed?
When hands are visibly soiled
After caring for patients with C. difficile
After using the restroom
What equipment should be at the bedside of a patient with Epiglottitis?
Tracheostomy/intubation equipment