Review – Communicable Disease of Childhood

HESI-Comprehensive-Review-for-the-NCLEX-RN
Communicable Disease of Childhood

The nursing care of children with communicable diseases is virtually the same for all, regardless of the particular disease.

1. Rubeola (measles)
   1. A highly contagious viral disease that can lead to neurologic problems or death
   2. Transmitted by direct contact with droplets from infected persons
   3. Contagious mainly during the prodromal period, which is characterized by fever and upper respiratory symptoms
   4. Classic symptoms include the following:

1. 1. Photophobia
   2. Koplik spots on the buccal mucosa
   3. Confluent rash that begins on the face and spreads downward
2. Varicella (chickenpox)
   1. Viral disease characterized by skin lesions
   2. Lesions that begin on the trunk and spread to the face and proximal extremities
   3. Progresses through macular, papular, vesicular, and pustular stages
   4. Transmitted by direct contact, droplet spread, or freshly contaminated objects
   5. Communicable prodromal period to the time all lesions have crusted
3. Rubella (German measles)
   1. Common viral disease that has teratogenic effects on fetus during the first trimester of pregnancy
   2. Transmitted by droplet and direct contact with infected person
   3. Discrete red maculopapular rash that starts on face and rapidly spreads to entire body
   4. Rash disappears within 3 days
4. Pertussis (whooping cough)
   1. Acute infectious respiratory disease usually occurring in infancy
   2. Caused by a gram-negative bacillus
   3. Begins with upper respiratory symptoms
   4. Paroxysmal stage characterized by prolonged coughing and crowing or whooping upon inspiration; lasts from 4 to 6 weeks
   5. Transmitted by direct contact, droplet spread, or freshly contaminated objects
   6. Treated by administering erythromycin
   7. Complications: pneumonia, hemorrhage, and seizures
5. Paramyxovirus (mumps)
   1. Incubation: 14 to 21 days
   2. Symptoms: Fever, headache, malaise, parotid gland swelling and tenderness; manifestations include submaxillary and sublingual infection, orchitis, and meningoencephalitis
   3. Transmitted by direct contact or droplet spread
   4. Analgesics used for pain and antiseptics for fever
   5. Bed rest maintained until swelling subsides

Nursing Care for Children with Communicable Diseases

1. Isolate child during period of communicability.
2. Treat fever with nonaspirin product.
3. Report occurrence to the health department.
4. Prevent child from scratching skin (e.g., cut nails, apply mittens, and provide soothing baths).
5. Administer diphenhydramine HCl (Benadryl) as prescribed, for itching.
6. Wash hands after caring for child and handling secretions or child’s articles.

HESI  Hint  • Children with German measles pose   a serious threat to their unborn siblings. The nurse should counsel all expectant  mothers, especially those with young children, to be aware of the serious consequences of exposure to German measles during pregnancy.

HESI Hint • Common childhood problems are encountered by nurses caring for children in the community or hospital settings.The child’s age directly influences the severity and management of these problems.

HESI Hint • Pediculosis is an infestation of lice on humans. The most common form is head lice, which affects the scalp and hair. Head lice appear as small  white flakes along the shaft of the hair.Treatment is directed toward killing  the  adult  lice,  combing  out the nits and using a hair product containing permethrin or pyrethrin. Anything that is in direct contact with the infestation has to be treated to decrease spread of the lice.