Pediatric Nursing Study Guide

Pediatric Nursing Study Guide
Includes topics about childhood diseases, growth and development, pediatric oncology
nursing, and congenital diseases among others.
Infectious and Immune Disorders
Function of immune system
• 1st line of defense
o Skin/mucous membranes
o Passive immunity from mom
o Maternal circulation/breast milk
• Cannot produce immunoglobulins (antibodies)
• Until approx. 2 mos. of age
• Immune system not fully functional until 6 years of age
• Those babies that are breast fed, usually have less ear infections
• Stimulates production of antibodies against a specific foreign substance (antigen)
• Contraindications
o Anaphylaxis
o High doses of steroids (<14 days)
o Acute febrile illness – greater than 39
o Common cold/minor illness NOT contraindicated
o Chronic illness (cancer)
o Taking immunosuppressive drugs
o Egg allergy – flu shots
o Most up to date schedules on CDC.gov
Purpose of vaccines, misconceptions
• Misconceptions
o Causes autism
o Rotovirus vaccine is dangerous
o Vaccines have toxic ingredients – led and mercury
o Vaccines can fail
o Vaccines can cause the actual illness
o Parents can refuse vaccines
• Types
o Live (attenuated) – vaccines made from virus made from live virus
o Killed (inactivated viruses)
o Toxoids – diphtheria, tenus, - one type of vaccine – based on the toxin made
from the bacteria
o Human immune globulin – Igg Ige – weakened immune system and this helps
them bring up their immune system
o Herd immunity – vaccinate many to protect the few
Communicability periods of disease
• Incubation period – common cold = 1-5 days
o Time of exposure to the time the time symptoms arrive
o Chicken pox = 21 days
• Period of communicability – time it takes to transfer a disease from me to you
• Prodromal period – beginings off an illness – feeling eh, scratchy throat
• Sometimes difficult to tell the difference
• Virus
o Increased lymphocytes
• Bacteria
o Increased neutrophils
o Left shift – some of the white blood cells shift to make it look bacterial infection
Common viral and bacterial infections, treatment, and nursing care
viral
• Gastroenteritis
o Vomiting/diarrhea
â–ª Volume depletion
• Intravascular space
o Degree of dehydration
â–ª Determined by physical exam
â–ª Signs of dehydration – clammy – dry mucus membranes, dry skins
o Treatment
â–ª Mild/moderate
• Zofran (ondansetron)
• Oral hydration
â–ª Severe
• IV 20cc/kg isotonic solution
• Coxsackie disease (infants and young children)
o Hand/foot/ and mount disease
â–ª Fever
â–ª Sore throat
â–ª Malaise
â–ª Poor appetite
â–ª Rash and mouth sores occur 1-2 days after the above symptoms
â–ª Lasts about 1 week
• Conjunctivitis – pink eye – last 7-10 days
• Thrush
o Yeast infection
â–ª Oral (infants)
â–ª Urogenital (infants/toddlers; diaper dermatitis)
â–ª “Yeast infection” (adolescent girls)
â–ª Intertrigo (skin folds of groin, armpits, torso)
o Treatment
â–ª Hygiene (limit moisture diaper area)
â–ª Topical/systemic antifungals (nystatin)
• 5
th disease
o Fever
o Runny nose
o Headache
o Rash (slapped cheek) then spreads (comes and goes)
o May last 2-39 days
• Chicken pox
• Measles, mumps, rubella
• Roseola (6-18 months)
o Sudden high fever (39.4-41.1) 3-5 days
o Rash several hours to 2 days after fever is gone
â–ª Blanches with pressure
â–ª Neck and trunk, may have whitish ring, lasts 24-48 hrs
• Monomucleosis (Epstein- Barr virus)
o Causes
â–ª Fever
â–ª Fatiguge
â–ª Sore throat
â–ª Swlooen glands
• Many have a rash (exanthem)
• Most have fever
• Most are accompanied by cold or flulike symptoms
• Most transmitted by direct contact with droplets or airborne particles
• Most can be prevented by immunization
• Treatment is mostly symptomatic
• Encephalitis is rare but can occur as a complication of most childhood viral infections
• Febrile seizures (most common from 3 months-5 yrs) 

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