Enfermedades Infecciosas

Prof. Mayra Pedroza

RN.MSN.PhD

Objectives
Describe the causes and course of common
infectious disorders of childhood.
Assess the child with an infectious disorder.
Plan nursing care for the child with an
infectious disorder.
Implement nursing care specific to the child
with an infectious disorder.

Definitions
Incubation period= time between the invasion of
an organism and the onset of symptoms.
Prodromal period = time between the beginning
of nonspecific symptoms and specific symptoms.
Children are infectious during the prodromal
period.
Illness =specific symptoms are evident.
Convalescent period =interval between the time
symptoms begin to fade and the child returns to
full wellness.

Chain of Infection

Time Frame of Infectious Disease

Rubeola (Measles)
Incubation period 10-20 days
Agent: paramyxovirus
Communicable period 4-days before to 5 days
after rash appears
Source: respiratory tract secretions, blood,
urine
Transmission: Airborne

Assessment Rubeola
Fever
Malaise
The three Cs: Coryza, cough, conjunctivitis
symptoms of a head cold. Inflammation of the
mucous membranes, nasal congestion.

Red rash last 6-7 days

Kopliks spots
Small red spots with bluish white center, last 3
days, located bucal mucosa

Interventions

Airbone droplet precautions

Quiet activities, bed rest
Cool mist vaporizer
Dim lights is photophobia present
Administer antipyretics for fever

Rubeola (Measles)
Kopliks Spots

Rash

Rubella (German Measles)

Agent: Rubella virus
Incubation period: 14-21 days
Communicable period 7 days before and 5
days after rash appears
Source: Nasopharyngeal secretions, blood,
stool, urine
Airborne

Assessment

Low-grade fever
Malaise
Pink red rash
Petechial red point spots in soft palate

Interventions
Supportive treatment
Isolate from pregnant women

Rubella (German Measles)

Mumps
Agent: Paramyxovirus
Incubation period: 14-21 days
Communicable period: immediately before
and after parotid glands swelling begins
Source: saliva
Transmission: droplets

Assessment

Fever
Headache and malaise
Anorexia
Jaw and ear pain
Swelling in front of the ear, above the jawline

Orchitis
Inflammation of testes
Could cause sterility

Interventions

Droplet precautions
Bed rest
Avoid foods that require chewing
Hot or cold compress for neck
Warm compress to relieve orchitis

Mumps

Chickenpox (varicella)
Agent: varicella-zoster virus
Incubation period: 13-17 days
Communicable period: 1-2 days before the
onset rash to 6 days after the first crop of
vesicles
Source: respiratory, contact
Transmission: direct contact, airborne,
contaminated objects

Assessment

Slight fever
Malaise
Anorexia
Macular rash
Pustules lesions
Various stages of lesions present at the same time.

Itching

Interventions
Isolation
Supportive care
Isolate high risk children from infected
children
Return to school as soon as lesions are crusted

Chikenpox (varicella)

Pertussis (whooping cough)

Agent: bordella pertussis
Incubation period: 5-21 days
Communicable period (during catarrhal
period)
Source: respiratory secretions
Transmission: droplet, contaminated articles

Interventions

Isolation
Antimicrobial therapy
Administer pertussis immune globulin
Adequate hydration and nutrition
Humidified oxygen
Pulse oximeter

Pertussis (Whooping cough)

Diphtheria
Agent: corynebacterium diphtheria
Incubation period 2-5 days
Communicable period: until virulent bacilli are
not longer present
Source: nasal discharge, lesions of infected
person
Transmission: direct contact contaminated
articles

Assessment
Low grade fever
Malaise sore throat
Foul smelling, mucopurulent discharge
offensively malodorous

Lymphadenitis, neck edema, bull neck

Interventions

Strict isolation
Administer diphtheria antitoxin
Bed rest
Antibiotics
Humidified oxygen
Tracheostomy tray and care for emergencies

Diphtheria

Poliomyelitis

Agent: Enteroviruses
Incubation period: 7-14 days
Communicable period: unknown
Source: oropharyngeal secretions and feces
Transmission: direct contact

Assessment

Fever
Malaise
Anorexia
Nausea
Headache
Abdominal pain
Paralysis

Interventions

Enteric precautions
Supportive treatment
Bed rest
Monitoring for respiratory paralysis
Physical therapy

Poliomyelitis

Scarlet Fever
Agent: Group A beta-hemolytic streptococci
Incubation period: 1-7 days
Communicable period: 10 days clinical illness,
may persist for months
Source: nasopharyngeal secretions
Transmission: direct contact, droplet,
contaminated milk or foods

Assessment
High fever, flushed cheeks, vomiting,
headache, enlarged lymph node in neck
Malaise, abdominal pain, sandpaper like rash
Strawberry tongue
Desquamation
Acute glomerulonephritis

Interventions

Respiratory precautions
Antibiotic therapy
Supportive therapy
Bed rest
Encourage fluid intake

Scarlet Fever

Strawberry
tongue

Mononucleosis

Agent: Epstein-Barr virus

Incubation period:4-6 weeks
Communicable period: unknown
Source: oral secretions
Transmission: Direct intimate contact

Assessment
Fever, malaise, headache, fatigue, nausea,
abdominal pain
Sore throat, enlarged tonsils
Lymphadenopathy,
Hepatosplenomegaly
simultaneous enlargement of both the liver
(hepatomegaly) and the spleen (splenomegaly).

Macular rash on trunk

Interventions
Provide supportive care
Bed rest to prevent splenic rupture
Monitor signs of splenic rupture
Include abdominal pain, left upper quadrant pain,
left shoulder pain

Mononucleosis

Rocky Mountain Spotted Fever

Agent: Rickettsia ricketsii
Incubation period: 2-14 days
Source: tick from a mammal, most often from
rodents and dogs
Transmission: Bite of infected tick

Assessment

Fever
Malaise
Anorexia
Vomiting
Headache
Myalgia
Muscle pain

Pethechial rash ankles and wrists)

Interventions
Vigorous supportive care
Antibiotics
Protection from tick bites

Rocky Mountain Spotted Fever

Enterobiasis (Pinworm)
Agent: Enterobius vermicularis
Source: common pinworm present in
temperate climate
Eggs are ingested or inhaled
Female and males deposit eggs in perineal area
and migrate through the anus

Transmission
Ingestion or inhaled eggs
Improper hand wash

Assessment

Intense perianal itching

Irritability
Restless
Poor sleep
Bed-wetting
Short attention span
Urine infection

Interventions
Identify worms
Use flashlight to inspect the anal area after the
child is asleep
Tape test: press transparent sticky tape

Enteric precautions
Anthelmintic medications
Teach hand washing

Enterobiasis (Pinworm)

Immunizations
Begin immunizations at birth
Live virus vaccines generally not administered
to child with severely deficient immune
system
Check expiration date on vaccines bottle
Cool compresses for first 24 hrs.

Reactions
Local reactions
Tenderness, erythema, swelling at injection site
Low grade fever
Behavioral changes, drowsiness, unusual crying,
Anorexia

Minimizing local reactions

Inject into the appropriate recommended site

Anaphylactic Reactions
Secure and protect
Airway
Circulation

Prevent future exposure to the antigen

Administer antihistamine for reactions
Benadryl
Adrenalyn

Immunizations
Hep B
Soon after birth or beefore leaving hospital, second
dose 1-2 months later, final dose 6-18 months

DTaP
2,4,6 months
15-18 months
4-6 yrs.

Tdap
11-12 yrs.

ContImmunizations
Haemophilus influenza
2,4,6 months
12-15 months

Influenza vaccine
6 months with risk factor patients

Inactivated poliovirus vaccine (IPV)

2,4,6 18 months
4,6 yrs.

ContImmunizations
MMR (meales, mumps, rubella)
12-15 months
4-6 yrs
11-12 yrs

Varicella
12-18 months
13yrs if not had the disease or vaccine

ContImmunizations
Pneumococcal conjugate vaccine (PVC)
2,4,6, and 12-15 months

Immunizations