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34 Cards in this Set

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What is ESR?
What does it indicate?
erythrocyte sedimentation rate -- greater than 15-20 indicates inflammation
What are most nosocomial infections caused by?
staphylococcus aureus
Chickenpox
incubation period?
Assessment?
what is rash like?
Transmission? -- precautions?
Nursing considerations?
slight fever, tired, anorexia
rash -- pruritic, all three stages present
transmission - spread by direct contact, droplet
NI: isolate till crusted -- no aspirin -- calamine
Diphtheria
Incubation period?
Assessment?
transmission?
Precautions?
prodromal -- resembles cold -- white gray pharyngeal membrane
transmission -- direct contact, through carrier
NI: droplet precautions until 2 negative nose and throat cultures -- complete bedrest -- suctioning - respiratory distress
Pertussis
Assessment?
Transmission?
Precautions?
NI?
prodromal -- URI 1-2 weeks -- whooping cough (night)
Transmission: direct contact, droplet
NI: isolation during mucousy period (catarrah)
encourage fluid, high humidity, restful environment, suction
**Rubella -- other name?
incubation
Assessment?
transmission?
Precautions
Other name -- german measles
Asessment -- low grade fever, tired, maculopapular rash that begins on face and spread to entire body - petechial spots may occur on soft palate
NI: isolate from pregnant women, symptoms subside first day after rash appears,
Transmission: droplet
Rubeola -- other name?
incubation? communicable?
Assessment?
Precautions?
Other name -- measles
communicable 4 days before and 5 days after rash
assessment -- fever, malaise, cough and koplik spots -- then rash begins behind ears and spread down -- turn brownish
NI: respiratory precautions, dim lights -- isolate till 5th days -- airborne precautions
Scarlet fever
Caused by?
incubation?
communicable?
Transmission?
Assessment?
NI?
Caused by group A, beta-hemolytic streptococci
communicable -- during incubation and clinical illness
Transmission -- direct, droplet -- inegstion of contaminated food or milk
Assessment: abrupt high fever, fluelike -- red find papular rash in axilla, groin,neck that spread to body, tongue coated and papillae become red and swollen (strawberry tongue), tonsils and pharynx swollen
NI: respiratory, bed rest, fluids, droplet till 24 hours after antibiotics, fluids, soft diet
Mono
cause?
incubation?
communicable? HOW?
Assessment?
NI:
Cause -- epstein barr virus
communicable -- before onset to 6 months after
Assessment: fever, sore throat, ab pain, lypmph and hepatosplenomegaly
NI: watch for splenic rupture (ab pain, LUQ pain, left shoulder pain) -- family don't share cups, etc.
Tonsillitis
Cause?
Treatment?
Complications?
Cause -- positive GpA Strep
TX -- antibiotics
Complications -- rheumatic fever, glomerulonephritis
Mumps
incubation?
communicable? How?
Transmission?
Assessment?
NI?
communicable -- immediately before and after swelling begins -- through saliva
transmission -- direct contact, droplet
Assessment: -- fever, HA, anorexia, earache followed by parotid gland swelling, orchitis (infl. of testes)
NI: respiratory, bedrest till swelling subsides, soft foods, orchitis -- apply warmth and tight fitting underwear
Roseola
caused by?
incubation?
Assessment?
NI:
Caused by herpes virus incubation 5-15 days
assessment? fever for 3-5 days followed by rash 1-2 days(blanches),
NI: Supportive
Poliomyelitis
Cause?
Incubation?
Transmission?
Assessment?
NI:
Caused by enteroviruses
transmission -- oral secretions and feces
transmission -- direct contact with person, fecal/oral and oropharyngeal routes
Assessment: fluelike followed by sore and stiff and paralysis
NI: enteric precautions, bed rest, respiratory, physical therapy
Fifth Disease?
Cause?
Incubation?
assessment?
NI?
Caused by HPV
incubation? 4-14 days
Airborne precautions include what?
What diseases are airborne?
private room -- negative air pressure -- 6-12 exchanges/hr
door closed
mask on patient if transported

Diseases: measles, tubercolosis, varicella, disseminated zoster (shingles)
Droplet precautions
Transport of pt.
Examples of diseases?
Private room -- shared only if same infection
spatial separation of 3 feet between pt. and visitors
door can stay open
mask on patient if transported
Examples: streptococcus, pnemonia, meningitis caused by H. influenza type b mumps
contact precautions?
What types of diseases?
private or with same infection
clean, nonsterile gloves when entering
dedicated equipment or clean and disinfect between patients
Examples of diseases: MRSA, pediculosis, scabies
Tuberculosis
Assessment?
Progressive fatigue
Nausea
anorexia weight loss
irregular mense
low-grade fever over period of time
night sweats
cough with sputum - dull aching chest
Tuberculosis
Diagnostic
Skin testing -- PPD (mantoux test) -- read 48-72 hours
10-mm induration = positive -- doesn't mean active disease is present, but indicates exposure to TB or presence of inactive disease
greater than 5mm with aids is positive
Multiple puncture Test (Tine) -- test read in 48-72, vesicle formation = positive, positive reactions verified by ppd
Sputum smear for acid-fast bacilli
Chest x-ray for all people with positive ppd
Tuberculosis
How transmitted?
Aerosolization -- may lie dormant for years and come back with stress
Tuberculosis
Risk factors?
contact
IV drug abuser
Institutions
Lower class
Immigrants (latin America, Asia, Africa)
Tuberculosis
Treatment Plan
notify state health department
6-9 months of INH therapy -- not if over 35 if low risk (+ skin test and x-ray - yes) because of liver damage

Chemotherapy -- INH, rifampin, ethambutol, streptomycin

Isolate 2-4 weeks (3 negative sputum) after drug therapy initiated -- sent home before this because family already exposed
Tuberculosis
Teaching?
Cover mouth and nose with tissue
Avoid exposure to dust, silicone
Full courase of meds
two or more cultures negative -- client no longer considered infectious
Hepatitis
Assessment
Jaundice
Anorexia
RUQ pain
clay-colored stools, tea colored urine
pruritis
AST ALT elevated
prolonged PT
percutaneous liver biopsy
Hepatitis A
High Risk Group?
Transmission?
Daignostic?
Treatment?
NI?
High Risk: young children, daycares, international travelers
Transmission: fecal oral/shellfish (contaminated waters)
Diagnostic -- culture in stool and detect in serum before onset
TX: gamma glubin early posexposure
NI -- no preparation of food
Hepatitis B
High Risk group?
Transmission?
Diagnostic tests?
TX?
NI?
High risk -- drug addicts, fetuses from infected moms, homosexual, dialysis pt., healthcare workers
Transmission: parenteral drug abuse sex, blood and body fluids
Diagnostic: blood
Tx: hep B vaccine -- HBIg
NI: Chronic carriers -- frequent
Hepatitis C
High Risk?
Transmission?
diagnostic?
TX?
NI?
frequent blood transfusions
international travelers
hemophilia clients

Transmission: contact with blood and bodily fluids

NI: great potential for chronic
Hepatitis D
High Risk?
Transmission?
Diagnosis?
Where common?
Risk: drug addicts

coninfects with Hep B
transmission -- close personal contact

Diagnostic test -- HD Ag in serum

common in mediteraneum and middle eastern
Hepatitis E
High risk?
Transmission?
diagnostic?
NI?
Population group it affects?
Travelers from where?
UNderdeveloped countries

Transmission: oral-fecal -- bad water

resembles A -- does not become chronic -- seen in young adult and travelers from asia, africa, mexico
toxic hepatitis
risk group?
transmission?
treatment?
elderly

Drug-induced --

Transmission: noninfectious inflammation of liver

NI: remove causative substance -- LOC - increase fluids
Treatment for Hepatitis
precautions?
diet?
Medications?
Bedrest for severe symptoms
contact precaution
diet -- low fat, high calorie, carb, protein -- no alcohol
Meds -- vitamin K -- antiemetics -- tigan or dramamine -- no compazine (hepatic toxic) -- steroids
Hepatitis
Teaching?
avoid alcohol and hepatic toxic drugs -- aspirin and sedatives
can't donate blood
Lyme Disease
Assesment?
Stage 1
Stage 2
Stage 3
Stage 1 -- rash (bullseye) -- lymphadenopathy -- flulike
stage 2 -- (1-6 months if untreated) -- cardiac conductions problems, neuro (bells palsy - no permanent)
stage 3 -- arthralgias (several months later) -- may persist for years
Lyme Disease
Treatment?
Antibiotics -- doxycycline, ceftriaxone, azithromycin -- stage 1
IV penicillin later stages