Old Peds

Front 1

What are the symptoms of Varicella (Chickenpox)in healthy children?

Back 1

Fever/Rash

Front 2

In compromised children what do you treat Varicella with?

With in how long?

Back 2

Acyclovir (oral or IV)-24 hours of rash

Front 3

What does Acyclovir decrease?

What is the drawback for using this drug?

Back 3

Acyclovir decreases number of lesions and shortens time of illness.

Draw back is that this treatment is very costly

Front 4

Wht can be given to children at high risk with in 96 hours of exposure of Varicella?

Back 4

Varicella Zoster Immune Globulin (VZIG)

Front 5

What kind of isolation is used for children exposed to Varicella?

Back 5

Strict isolation until vesicles have crusted over. (Strict isolation especially for immunosuppressed children)

Front 6

What kind of skin care can we do to prevent secondary infections?

Back 6

Prevent scratching, keep nails short or use mittens

Front 7

What kind of skin care can we do to help relieve the itching of Varicella?

Back 7

give baths, AVENO/oatmeal, calamine lotion

Front 8

What 2 drugs are usually employed for relief of Varicella itching?

Back 8

Benadryl, Acyclovir

Front 9

What is the caution when using Benadryl or Caladryl lotions over open sores?

Back 9

Use of lotions/ointments over open sores increases the absorption and may result in over-dosing

Front 10

When vaccinating an immunosuppressed child what kind of immunization would you not want to use?

What would you use instead?

Back 10

Would not give the live Varicella virus.
You would give VZIG instead

Front 11

When vaccinating with the Varicella vaccinewhat should you not give the child?

Back 11

ASA products for 6 weeks

Front 12

After having the Varicella vaccine who do children have to stay away from?

Back 12

Must stay away from pregnant women-especially in the first half of pregnancy

Front 13

What are the unkown aspects of Cytomegalovirus CMV?

Back 13

Incubation time, infectious period are unkown, and very limited experience in the treatment of pediatric patients

Front 14

There are 4 symptoms that may be included in CMV?

What are the adolescent symptoms?

Back 14

(Birth)Jaundice, lethargy, enlarged spleen/liver, petechial rash

Adolescents may experience more mono type symptoms

Front 15

What is the incubation time of Ebstein-Barr (Mono)?

Back 15

Incubation- 4/7 weeks

Front 16

What is the infection time of Mono?

Back 16

Unknown, but thought to be before onset of symptoms to 6 months after recovery

Front 17

There are the 8 symptoms of Mono?

Back 17

Fever, exudate pharyngitis, lymphadenopathy, hepatosplenomegaly, HA, abdominal pain and fatigue

Front 18

What are the ways to transmit Mono?
(The kissing disease :])

Back 18

Saliva, intimate contact, and blood with no set season

Front 19

What is the EMERGENCY complication associated with Mono and left scapula/shoulder pain?

Back 19

Risk of RUPTURED SPLEEN
Other: swelling of tonsil/pharnx

Front 20

The only treatment for mononucleosis is?

Back 20

Possible steroid for pharyngeal swelling

Front 21

What are some points for family and child education related to Mono? 5

Back 21

Avoid contact sports until parent approves. Do not share food, drink or utensils. Keep well hydrated. Teach good handwashing to avoid the spread of infection. Discuss the importance of rest and possible length convalescence

Front 22

What is the agent involved with Poliomyelitis (Polio)?

What is the incubation period?

Back 22

Agent: Enterovirus
Incubation: 7-14 days

Front 23

Where is Polio during the infectious period and for how long?

Back 23

Oropharyngeal secretions- shed in the pharynx for 1 week after infection and in feces for 4-6 weeks

Front 24

What are the 6 initial symptoms related to Polio?

Back 24

fever, malaise, nausea, HA, pharyngitis and abdominal pain

Front 25

The intial symptoms of Polio may progress to stiffness in __(3)__ to s/s or what?

Back 25

Stiffness in neck, back, legs

may progress to s/s of nervous system paralysis

Front 26

What kind of preventitive measures should be taken with Polio to prevent contractures?

Back 26

Encourage the child to move, ROM excersizes and the use of footboards to prevent contractures

Front 27

1. What does treatment of Polio involve?


2. What s/s should you be watching for?

Back 27

1. Child specific but bed rest, mild sedatives to relieve anxiety, and promote rest, moist hot packs

2.Monitor or s/s of respiratory paralysis (difficulty talking, ineffective cough, inability to hold breath or shallow/rapid respirations

Front 28

1. The preventative treatment for Polio is the Inactivated Polio Virus (IPV) which can be given what route (2?

2. The common reaction to IPV is?

Back 28

1. Can be given SubQ or IM

2. soreness at the injection site

Front 29

What is the AAP recommended dosing schedule?

Back 29

The AAP recommendes 4 doses, all IPV given at 2mo, 4mo, 6-18mo, and 4-6y/o. (Unless 3rd dose is given after 4y/o)

Front 30

1. What is the incubation period of an animal with Rabies?


2.What is the infection period?

Back 30

1. Incubation- 5 days to more than 1 year

2. infectios: 10 days (if animal is still healthy, rabies is unlikely)

Front 31

What are the S/S of a Rabies bite?

Back 31

Symptoms are vague at onset, but may include drooling, decreased ability to swallow. ONCE THE VIRUS IS ESTABLISHED IT IS FATAL.

Front 32

How does Rabies travel through the body in relation to feet/face/children?

Back 32

Since the virus travel the axons of the motor and sensory neurons, bites on feet/legs can take longer than bites on face/head and shorter time in children.
(If bit on leg-not the same medical emergency as if bit on face)

Front 33

What are the 3 ways Rabies can be transmitted?

Back 33

1. bites with contaminated saliva 2. scrathces with infected claws of animals 3. bat infested caves

Front 34

Rabies treatment can be preventative from vaccinated animals, but what other treatment options should you employ?

Back 34

Theraputic managment prevention through education, educate children not to pet strange animals. After bite determination made by animal and observation of animal for 10days, administer (HRIG) and (HDCV)

Front 35

In determination is made to treat the treatment schedule goes?

Back 35

Humand Rabies Immune Globulin
(HRIG)-1/2 of the dose is infiltrated locally around the wound; other 1/2 is admin. IM

Human Diploid Cell Vaccine (HDCV) is best if adnmin. 48 hours after bite, then on days 3,7,14, & 28

Front 36

There are several (5) nursing considerations for a child with a Rabies bite?

Back 36

1. Obtain complete history of the event.
2. Examine and document a description of the wound.
3. Distraction techniques and theraputic play for those who mush undergo rabies treatment series.
4. For the child who develops Rabies: strict isolation per hospital policy and support of parents through the grieving process.
5.Family education is key to prevention.

Front 37

1. Where should HepB vaccine be given in an infant?

2. Who is HepA recommended for?

Back 37

1. anterolateral thight

2. >1y/o with chronic liver disease

Front 38

When dealing with infectious diseases what 2symptoms should be reported to the child's PCP?

Back 38

Headache and Fever

Front 39

1.With regard to bacterial infections when does sepsis occur in the body?

2. What are the most common causitve organisms?

Back 39

1.When bacteria or their poisonous products (endotoxins) enter the blood stream, affecting the entire body.

2. Group- B Strep and E-coli

Front 40

1. Sepsis affects how many term babies a year?

2. How many pre-term babies?

Back 40

1. 8/1000 affected

2. 300/1000 affected

Front 41

Treatment of Sepsis includes several factors:
(none of which i think will be on the test:/ but just in case!)

Back 41

Treatment includes: Cultures (bloo, urine, nasopharyngeal, and CNS), CBC with differential and C-Reactive Protein (inflammation)

Front 42

Antibiotic treament of what 2 drugs is started until ____ is obtained?

Back 42

Amoxil, Gentamycin- C&S (culture and sensitivity).

You can not afford to wait for C&S

Front 43

If giving Gentamycin (aminoglycoside) you should always check what?

Back 43

HEARING/hearing tests

Front 44

1. What is the Agent of Diptheria?

2. Incubation period?

3. Infectious period?

Back 44

1. Corynebacterium Diptheriae

2. Incubation: 2-5 days

3. Infectious period: 2-4 weeks or until 3 negative cultures are obtained

Front 45

There are several symptoms of diptheria, such as:

Back 45

Foul smelling mucopurulent nasal discharge, low grade fever, malaise, thin gray membranes on pharynx causing "bull neck or neck edema" and lymphadenitis, hoarsness to potential airway obstrucion and cyanosis

Front 46

Transmission occurs through direct contact with___ and occurs more often in____?

Back 46

carrier/individual or contaminated objects; occurs more often in Fall/Winter

Front 47

What is the treatment for Diptheria?

Back 47

Admin of IV Diptheria antitoxins and antibiotics (PCN or E-Mycin)

Front 48

1.Primary prevention of Diptheria is through what immunization?

Back 48

DTaP vaccine (Diptheria + tetanus + Pertussis)

Front 49

1.What is the immunization schedule for DTaP?

2. What are common with DTaP admin?

Back 49

1.Give DTaP at 2mo, 4mo, 6mo, 15-18mo, and 4-6y/o

2. Mild reactions are common with DTaP, mostly low grade fever

Front 50

Other than IV meds what treatment options should be employed when dealing with Diptheria? (4)

Back 50

1.Isolation
2.Admin Complete Care to maintain bedrest
3.Have suctioning equipment ready at bedside in the even of airway obstruction
4.Humidified O2

Front 51

1.What is the agent of Pertussis (Whooping Cough)?

2.Incubation period?

Back 51

1.Bordetella Pertussis

2.Incubation period: 6-20days (usual 10days)

Front 52

What are the 3 infectious periods of Pertussis and their duration?

Back 52

1. Catarrhal phase: 1-2 weeks

2.Paroxysmal phase: 2-4 weeks

3.Convalescent phase: 1-2 weeks

Front 53

Symptoms vary by phase of Pertussis.
1.What are the symptoms of the Catarrhal phase?

2.Paroxysmal phase?

Back 53

1. S/S of Cat. Phase: runny nose, watery eyes, mild cough, and low fever

2.S/S Paro. Phase: Severe cough in repetition, followed by a massive inspiration (Whoop, vomiting, protrusion of tongue, salivation, and distention of neck veins

Front 54

How is Pertussis transmitted?

Back 54

Through direct contact with infectious respiratory droplets, person or contaminated objects

Front 55

Treatment (again in more detail)

Back 55

1.Strict droplet isolation
2.bed rest to prevent myocarditis
3.PCN/E-mycin to child and close contacts
4.Steroids and Albuteral inhailer
5.Humidified O2 if necessary
6.Suctioning of secretions and observe for s/s of obstructions
7. Small frequent meals

Front 56

PRIMARY PREVENTION IS PERTUSSIS VACCINE

Back 56

PRIMARY PREVENTION IS PERTUSSIS VACCINE

Front 57

1. What is the agent of Scarlet Fever?
2. The incubation period?
3. The infectious period?

Back 57

1. Agent: Group A, beta hemolytic streptococci
2. Incubation period: 1-7 days
3. Infectious period: Acute phase to 24 hr after antibiotic therapy has begun

Front 58

A symptom of Scarlet Fever is a fine red papular rash in the __(3)___ regions, which spreads to body.

Back 58

Rash in axilla, groin, and neck which spreads to body

Front 59

If the red streaks develop in the skin folds of the axilla and antecubital fossa it is a sign of what?

Back 59

PASTIA SIGN-DESQUAMATION BEGINS ON FACE AFTER 7 DAYS & PROCEEDS DOWNWARD

Front 60

Besides a rash, the other 7 s/s of Scarlet Fever (Scarlatina) are:

Back 60

1. Abrupt high fever 2.vomit 3. HA 4. Malaise 5. Abdominal pain 6. Pharyngitis and 7. Chills

Front 61

Describe the “Strawberry Tongue” in association to Scarlet Fever:

Back 61

Starts as white furry covering with red projecting papilla and the 4th day that sloughs off leaving a BEEFY-RED swollen tongue

Front 62

1. What do the tonsils look like during Scarlet Fever?
2. Soft Palate?

Back 62

1. Tonsils are red and swollen with gray exudate
2. Petechial Hemorrhages cover the soft palate

Front 63

How can Scarlet Fever be transmitted?

Back 63

Transmission is through Airborne (inhalation or ingestion) and direct contact seen greater in late Fall, Winter, and Spring

Front 64

What are the 6 complications that can accompany Scarlet Fever?

Back 64

1. Sinusitis 2. OM 3.Mastoiditis 4. Peritonsillar Abscess 5. Rheumatic Fever 6. Glomerulonephritis

Front 65

1. Treatment of Scarlet Fever includes ___ and ___ after confirmation of strep culture?
2. Pts are on _____ precaution for 24hrs after antibiotic and are encouraged to ____ and ___.

Back 65

1. Penicillin or E-mycin
2. Respiratory precautions encouraged to drink fluids and bed rest.

Front 66

For treatment of Scarlet Fever, GIVE ANTIBIOTICS FOR FULL 10 DAYS AS PRESCRIBED

Back 66

For treatment of Scarlet Fever, GIVE ANTIBIOTICS FOR FULL 10 DAYS AS PRESCRIBED

Front 67

1. What is the agent in Rocky Mountain Spotted Fever?
2. Incubation period?
3. Transmission?

Back 67

1. Agent: Rickettsia Rickettsii
2. Incubation period: 2-14 days from bite of infected dog tick or wood tick
3. Transmission: bite of infected tick seen more in April-October

Front 68

1. What are the s/s of RMSF for the first 2 days?
2. After the 3rd day what are the s/s?

Back 68

1. 1-2 days: s/s bon-specific signs, HA, fever, N&V, and Mylgia
2. 3rd day: Maulopapular or petechial reaas beginning wrist/palm and ankle/sole and spreading to body

Front 69

1. Treatment of RMSF includes early detection and starting ____ , ____ a day.
2. Second choice is ____, but not used because of ____ staining.

Back 69

1. Starting Doxycycline twice a day
2. Second choice is Tetracycline, teeth staining

Front 70

Educate parents to use repellents everywhere but ___ and ___, and with caution in regard to infants due to ______.

Back 70

Face and hands, encephalopathy

Front 71

1. Children’s skin should be checked ____ a day.
2. Tick must be attached for ____ hours before infecting.

Back 71

1. Twice a day
2. 4-6 hours; and remove with tweezers as close to skin as possible

Front 72

1. The incubation period of Lyme Disease is?
2. Transmission is by?

Back 72

1. 3-32 days
2. Transmission infected deer tick bite usually in April-October

Front 73

1. What is the Agent of Lyme Disease?
2. Infectious period?

Back 73

1. Borellia Burgdorferi
2. Can not be spread from person to person

Front 74

Symptoms of Lyme Disease come in 3 phases: Early localized, Early disseminated, and Late Disseminated. Describe S/S in each:

Back 74

1. Early localized: local skin reaction to bite with “bull’s eye” and flu like symptoms
2. Early disseminated: Severe HA, N&V, and joint and muscle pain
3. Late disseminated: Chronic arthritis, extreme fatigue, and cardiac complications

Front 75

A treatment for Lyme Disease includes the Lyme Disease vaccine, approved for ____y/o and given initially then __mo and __mos later.

Back 75

Approved for 15-70y/o, it is given initially then at 1 mo and 12 mos later

Front 76

1. What is the drug of choice for treatment of children >9?
2. Younger than 9?
3. You would give ___/___ for fever and body/joint pain.

Back 76

1. Doxycycline for >9
2. Amoxil for younger than 9
3. Tylenol/ Motrin Duh :)

Front 77

Nursing considerations for Lyme Disease are the 5 basic ones for most all diseases 
Can you name them?

Back 77

1. Obtain thorough history
2. Physical examination and documentation of any rashes or lesions
3. Vitals
4. Educate parents about the importance of giving full course of antibiotics
5. Important to teach preventative strategies

Front 78

1. What should you teach parents about how to dress to prevent tick bites?
2. You should check for ticks ____ to prevent prolonged attachment
TICK MUST BE EMBEDDEDD FOR >24 HOURS TO TRANSMIT DISEASE

Back 78

1. Have child and parent wear long sleeved shirts and long pants, tucked into socks to keep ticks on the clothes and not hiding on the body.
2. at the end of day to prevent prolonged attachment
TICK MUST BE EMBEDDEDD FOR >24 HOURS TO TRANSMIT DISEASE

Front 79

What are the 3 most common Helminths (Worms)?

Back 79

1. Tapeworm
2. Flukes
3. Roundworms

Front 80

1. Transmission of Helminths (Worms)?
2. Tell the s/s of worms.

Back 80

1. Hand to mouth transfer from fecal, contaminated soil or ingesting infected or poorly cooked foods
2. S/s vary from no symptoms to abdominal pain, nocturnal itching, sleeplessness to anemia, nausea and weight loss

Front 81

1. Treatment includes ____ meds effective to the specific Helminth, given to ____?
2. What are 3 areas that pts need to be educated on in relation to Helminths (Worms)?
3. ___ fecal samples are collected, correctly marked, and _____ until collection.

Back 81

1. Oral meds must be given to entire family
2. Education includes: isolation procedures, personal hygiene and sanitary practices
3. Urine free fecal samples; refrigerated until collection

Front 82

Describe the development process of Enterobiasia (Pinworms):
1. Eggs can be _____ or ____ and mature in _____ as worms.
2. They then migrate out the ___ and lay eggs causing ____.
3. Child then ____ and eggs collect on ____; resulting in hand to ____contact.

Back 82

1. Eggs can be inhaled (airborne) or ingested, mature in intestines
2. Migrate out anus, causing itching
3. Child scratches collect on fingers/under nails, mouth contact

Front 83

1. The agent of Pinworms is:
2. Eggs can also adhere to surfaces and last for ____ without a ____.
3. What are 4 symptoms of Pinworms?

Back 83

1. Agent: nematode Enterobius Vermicularis
2. Can last for 24 hours without a host
3. Severe perianal itching, restlessness, irritability, bedwetting

Front 84

1. Treatment includes checking the child ____hrs after falling asleep for any signs of Pinwoms.
2. Doing a ____ ____ in the early morning before BM to be examined under a microscope.
3. ____ is the drug of choice for treating children >___y/o.

Back 84

1. check 2-3hrs after falling asleep
2. Tape Test in early AM
3. Mebendazole (Vermox), for children >2y/o.
*Treat family; wash clothes/ sheets/ hands.

Front 85

1. What is the incubation period for the STD, Gonorrhea?
2. Transmission of Gonorrhea includes: (2)

Back 85

1. Incubation period is 2-7 days
2. Transmission includes: 1. Intimate sexual contact (welcomed or not), 2. Perinatally (infection during birth process)

Front 86

1. S/S of infants with Gonorrhea?
2. Adolescent girls?
3. Adolescent boys?

Back 86

1. Infants: Opathalmia Neonatorum- a thick purulent discharge from eyes
2. Adolescent. Girls: purulent vulvovaginal discharge
3. Adolescent: Boys: purulent discharge resulting in a burning sensation

Front 87

What is dual treatment 1, what drugs are used, and who must be treated?

Back 87

Since people infected with Gonorrhea usually also present with Chlamydia and/or Syphilis, Dual Treatment 1 is used. This includes the use of Recephin and Doxycycline, and pt as well as their sexual partner must be treated.

Front 88

Complication of Gonorrhea:
1. What is PID in relation to Gonorrhea?
2. Nurses should suspect ____ in young adolescents.

Back 88

1. Gonorrhea infections lead to PID, which is the #1 cause of infertility in young women.
2. Nurses should suspect sexual abuse in young adolescents.

Front 89

1. What is the incubation time of Syphilis?
2. What is Syphilis confirmed by?

Back 89

1. Incubation time: 10-90 days (usually 21)
2. WASSERMAN TEST

Front 90

Symptoms usually exhibited in first 3 months and include: Rhinitis, rash, and hepatosplenomegaly. What STD is this?

Back 90

Congenital Syphilis

Front 91

1. X-Rays may show changes in the ____ and ____.
2. What do late stage symptoms of Congenital Syphilis include? (3)

Back 91

1. Changes in Femur and Humerus
2. Scarring of teeth and bones, sudden hearing loss, and damage to eyes

Front 92

1. Name some of the 7 symptoms of Acquired Syphilis:
2. A chancre is:

Back 92

1. Painless chancre at site of exposure, rash, adenopathy, malaise, fever, HA, and pharyngitis
2. A chancre is a single, rounded ulcer with a rubbery base and defined margins

Front 93

1. What are the 3 ways that Syphilis can be transferred?
2. What is the drug and dose used to treat Syphilis (alone)?

Back 93

1. Intimate contact (welcomed or not), transplacentally (any time during pregnancy), or during the birth process
2. Benzathine Penicillin G IM (1 dose)

Front 94

1. The STD Chlamydia has an incubation period of ____ days.
2. While Chlamydia may have few or no s/s, there are 4 s/s you should be aware of:

Back 94

1. Incubation7-21 days
2. Neonatal Conjunctivitis- (watery discharge that becomes purulent with edematous eyelid), nasopharynx infection leading to pneumonia, urethritis with dysuria, and mucopululent discharge.

Front 95

1. Transmission of Chlamydia can occur through? 2
2. What are the treatment options for Chlamydia?

Back 95

1. Perinatal, or sexual contact (welcomed or not)
2. Treating Conjunctivitis or Respiratory: 14 day E-Mycin, For uncomplicated GU infection and under 8y/o: treat with Zithromax, for older than 8y/o treat with Doxycycline

Front 96

1. The incubation period for the STD, Trichomoniasis is?
2. Two types of transmission occur with Trichomoniasis:

Back 96

1. Incubation is 4-28 days
2. Perinatal, or intimated contact (welcomed or not)

Front 97

1. Most males, and up to 50% of infected females are asymptomatic for this STD:
2. While others may complain of these 3 s/s:

Back 97

1. Trichomoniasis
2. Dysuria, itching, and frothy yellow/green foul smelling discharge

Front 98

What is given and who is treated for a pt with Trichomoniasis?

Back 98

Metronidazole (Flagyl) is given in 2-3 divided doses to treat. Partner needs to be treated at same time. ***Metronidazole (Flagyl) cannot be given to women in their first trimester of pregnancy

Front 99

An STD that is seen in women with profuse malodorous (Fishy-Smelling) discharge that sticks to the vaginal wall is:

Back 99

Bacterial Vaginosis

Front 100

1. What is the incubation period for the STD, Human Papillomavirus (Genital Warts)?
2. What are the 3 transmission methods and what decreases the spread of HPV/Genital Warts?

Back 100

1. Incubation is 4 weeks to many months
2. Perinatal, sexual contact (welcomed or not), and a break in the skin integrity; Condoms decrease the spread of HPV/Genital Warts

Front 101

1. What are the beginning S/S of HPV/Genital Warts?
2. There are 5 treatments for HPV/Genital Warts:

Back 101

1. Beginning symptoms of HPV/Genital Warts are small papules that grow into soft clustered lesions found in moist areas; such as labia, vagina, cervix, anus, glans penis, and mouth
2. Chemical ablation (acid treatment), surgery, cryotherapy, electrocautery, or laser
*** Women with vaginal warts are more likely to develop vaginal cancers

Front 102

1. Herpes Simplex Virus Type 2 has an incubation period of?
2. Herpes 2’s infectious period is?
3. S/S or Herpes 2 include?

Back 102

1. Incubation period is: 2-20 days
2. Infectious period is: At one time Herpes 2 was thought to be contagious only during an outbreak (acute phase) but now we know that it is contagious at all times (dormant times)
3. S/S of Herpes 2 are painful lesions in the groin area; such as the vulva, perineum, cervix, anal, and penile regions)

Front 103

1. Herpes 2 includes the same transmission routes: 2
2. Treatment of Herpes 2 includes 3 options:

Back 103

1. Transmission routes: Direct sexual contact with an infected person (welcomed or not) and perinatal contact during birth
2. Treatment includes: Infected mothers may opt of Cesarean Delivery, treatment with antiviral drugs use of condoms to decrease spread of Herpes 2