Test 8 File Infectious Communible Diseases

Front 1

The immune response involves white blood cells called what ?

Back 1

Lymphocytes

Front 2

Which 2 white cells are the most important?

Back 2

B and T Cells

Front 3

Each B and T cell is programmed to recognize and respond to what specific protein ?

Back 3

an Antigen

Front 4

Are there different antigens present on one cell membrane?

Back 4

yes

Front 5

When lymphocytes encounter their specific antigens, what happens ?

Back 5

they Bind in a "lock and key" manner and destroy the cell.

Front 6

How do B cells respond to a specific protien/antigen ?

Back 6

they transform into antibody secreting cells.

Front 7

WHat is the purpose of a b cell transforming into an antibody secreting cell?

Back 7

to bind to its specific antigen causing its destruction

Front 8

Some B cells remain in circulation. What do these B cells carry ?

Back 8

each one will carry specific memory for each antigen.

Front 9

How do T cells respond to their specific protein/antigen?

Back 9

they transform into Helper, cytotoxic, or memory cells.

Front 10

1.What is the job of a T helper cell?
2. WHat happens when an antigen is presented to a B cell without a helperT cell?
3.Do cytotoxic T cells act alone ?

Back 10

1. they help B cells change into antibody secreting cells.
2. the B cell does not respond
3.Yes, without B cells

Front 11

What cells are destroyed by cytotoxic T cells ?

Back 11

Those infected by a virus or a cancer cell changed by mutation.

Front 12

Can T cells become memory cells ?

Back 12

Yes

Front 13

T cells remain in ciruculation for years. What relation does this pose with anitgens ?

Back 13

The T cell will respond again if their anitgen should appear.

Front 14

WHat is the response time of B and T cells the first time they are exposed to their antigen?

Back 14

Weeks

Front 15

If RE-EXPOSURE of the same antigen occurs, B and T cells respond in how long of a period ?

Back 15

Immediately to destroy the invader.

Front 16

Is the immune response normally well controlled ?

Back 16

Yes

Front 17

If the immune response is not well controlled, what happens ?

Back 17

Autoimmune disease may occur and self antigens may be attacked.

Front 18

HIV-1 & HIV-2 retro virus replicate in what manner ?

Back 18

"Backward Manner"

Front 19

What does "Bacward Manner" mean?

Back 19

Going from RNA to DNA

Front 20

What does the HIV virus infect and kill ?

Back 20

Hiv infects the helper T Lyphocytes (T4/CD4 cells)

Front 21

Name 4 other types of CELLS that HIV infects.

Back 21

1. B Lymphocytes
2. Promyelcytes
3. Fibroblasts
4. Lngerhans

Front 22

1. Because HIV targets the immune system what does it result in?
2. WHen T4/CD4 cells are less than ___, risk for infections are high?

Back 22

1. opportunistic infection
2.less than 400, a severely depressed immune system

Front 23

What is the normal range for T4,CD4 cells?

Back 23

500-800

Front 24

What is the window period for HIV antibodies to be produced and detected?

Back 24

produced: 3 days
detected: usually 3-6 months possibly not for a year

Front 25

Before antibodies are produced does the patient test positive or negative?

Back 25

Negative

Front 26

What is the incubation time for HIV ?

Back 26

1/2 to 10 years

Front 27

Name 5 ways of HIV transmission.

Back 27

1. Blood
2. Semen
3. Breast Milk
4. Vaginal Secretions
5. Cervical Secretions

Front 28

Name 5 ways of NONPROVEN HIV transmission

Back 28

1. Saliva Tears CSF
2. Sex
3. Blood Transfusions
4. Paranatally
5. Needle Sharing

Front 29

HIV Risk Factors - Name 5 risk factors.

Back 29

1. Unprotected Sex
2. Multiple Partners
3. IV drug users
4. Unlucky Fetus
5. Blood Trasfusions

Front 30

Prevention of HIV - Name 3 preventative measures.

Back 30

1. Monogomy
2. Abstinence
3. Condoms

Front 31

HIV SUBJECTIVE Clinical Findings - NAME 6 symptoms

Back 31

1. Anorexia
2. Fatique
3. Dyspnea
4. Chills
5. Sore Throat
6. Chronic Weakness

Front 32

HIV OBJECTIVE findings - Name 6 symptoms.

Back 32

1. Night Sweats
2. Enarged lymphnodes
3. Weight loss greater than 10%
4. Chronic Diahrrea Greater than 30 days
5. HIV Encephalopathy
6. Presence of opportunistic infections/malignncies

Front 33

What is HIV Encephalopathy ?
Name 4 symptoms.

Back 33

1. Memory loss
2. Decrease in coordination
3. Partial paralysis
4. Mental Deterioration

Front 34

What are the diagnostic tests for HIV ? Name the 2 tests.

Back 34

1. Elisa Western Blot Test to detect HIV antibodies
2. Polymerase Chain Reaction (PCR) Test for presence of HIV

Front 35

Polymerase Chain Reaction (PCR) Test -

1. It detects the T4/CD4 cell count. At what # does it indicate possible HIV?

2. What ratio does it detect?

Back 35

1. Less than 200
2. low T4 (helper cell) T8(supressor cell) Ratio

Front 36

WHat is the The HIV Viral Load measure?

Back 36

the amount of HIV in a blood sample. High levels will develop AIDS faster.

Front 37

AIds is confirmed with what lab results?

Back 37

CD4/T cell count less than 200

Front 38

What is the defining condition of the development AIDS ?

Back 38

Esophageal thrush PCP, etc.

Front 39

WHat are the opportunistic infection from HIV?

Back 39

1. Pneumocystis Carinii Pneumonia--Respiratory problem
2. TB
3.GI: anorexia, diarrhea, thrush, waisting syndrome
4. oncology: kaposis sarcoma, B cell lymphoma
5. Neuro: HIV encephalopathy, crytococcus neoformans, progressive multifocal leukoencephalopathy, toxoplasma gandii, central and peripheral neuropathies
6. depression(multifactorial)
7. Skin: kaposis herpes zoster, molloscum contagiosm viral, generalized folliculitis
8. high risk for HPV cervical neoplasia, PID, menstrual abnormalities

Front 40

WHat is unique about TB when related to HIV?

Back 40

absent immune response to TB test, dx with sputum (mycobacterium avium, MAC)

Front 41

O = ONCOLOGICAL

What type of cancer is associated with AIDS in the oncological area ?

Back 41

Kaposis Sarcoma, B cell lymphomas.

Front 42

N = NEURO

AIDS related Neurological problems include.

1. HIV __________
2. Crytococcus _________
3. Progressive multifocal _____ ____ ___ ___ ____ ___ _____ ______

Back 42

1. HIV encephalopothy
2. Crytococcus neoformans
3. Progressive multifocal leukoencephalopothy toxoplasma gandii CMV central and periperal neuropathies.

Front 43

D = DEPRESSION

Is AIDS associated Depression multifactorial or semifactorial ?

Back 43

Mutifactorial. Semifactorial is a word that I made up...LOL

Front 44

S = SKIN PROBLEMS

AIDS related skin problems include.

1. Kaposis ______ ______
2. Molloscum _______ ______
3. ________ folliculitis

Back 44

1. Kaposis herpes zoster
2. Molloscum contagiosm viral
3. Generalized foliculitis

Front 45

G = GYNECOLOGICAL

AIDS related gynecological problems include.

1. Increase risk in HPV ________ ______.

2. PID _______ abnormalities.

Back 45

1. HPV cervical neoplasia

2. PID menstrual abnormalities.

Front 46

What Antibiotic are used for AIDS ? Name the three.

Back 46

1. Trimethoprim prophalaxix
2. tx of PCP
3. Biaxin Zithromax for MAC

Front 47

What Antifungals are used for AIDS ? Name the Two.

Back 47

1. Amphotericin B or diflucan for meningitis
2. Nystatin swish for thrush

Front 48

What Antiviral is used used for AIDS to help blindness?

Back 48

Ganciclovir prophalaxis for CMV
(retinitis from CMV is the leading cause of blindness in patients with AIDS.)

Front 49

What antidiahrreal medicine is used in AIDS patients ?

Back 49

Sandostatin (synth of somatostatin)

Front 50

What anti depressants are used for AIDS patients ? Name 3 kinds.

Back 50

1. Prozac
2. Tofranil (also relieve fatique)
3. TCA's

Front 51

1. What is the action of 1. Antiretroviral Therapy?
2. What are the 3 Antiretroviral therapies?

Back 51

1.Inhibit and decrease viral replication.
2. A. NRTIs
B.Protease Inhibitors
C. NNRTI's

Front 52

AIDS Antiretroviral Therapy:

How does (NRTI's)Nucleotide Reverse Transcriptase Inhibitors treat HIV?

Back 52

Inserts a bit of protein (called a nucleoside) into the developing HIV DNA chain, blocking further development of the chain.

Front 53

What NRTI's are used for AIDS patients ?

Back 53

ZDV, AZT, Retrovir

Front 54

AIDS Antiretroviral Therapy:

1. WHat are the 3 Protease Inhibitors that treat HIV?

2. How do they treat HIV?

Back 54

1. A. Invirase
B. Norvira- a newer 1 X/daily
C. Grixivan
2. Prevent the protease enzyme from cutting HIV proteins into the proper lengths needed to allow viable virions to assemble and bud.

Front 55

AIDS Antiretroviral Therapy:

NNRTI's is the abreviation for what?

Back 55

Non-Neceoside Reverse Transcriptase Inhibitors

Front 56

AIDS Antiretroviral Therapy:
1. What is the name of an NNRTI?
2. How does this drug treat HIV?

Back 56

1. viramune
2. Reverses transcriptase enzyme to block the process needed to convert HIV RNA into HIV DNA

Front 57

Nutritional Therapy for AIDS patients.

What are the 4 nutrution therapies used on AIDS patients ?

Back 57

1. Calorie counts
2. Oral supplements (advera specific for aids pts)
3. Parenteral Nutrition
4. Appetite Stimulants

Front 58

1. What 2 Therapy medicines are used on AIDS patients ?
2. What labs are monitored?

Back 58

1. A.Synthetic Oral Progesterone: Megase - Increases fat stores

A. Marinol - decreased nausea and anorexia

2. BUN, serum, protein, albumin, transferrin levels, hgb, hct

Front 59

Supportive Nursing care is important in the Nutrition Therapy of AIDS/HIV patients.

Name some supportive nursing techniques to help the patient.

Back 59

1. Assist with ADL's eating

2. Administer parenteral therapy

3. Monitor related labs (diahrrhea and weight loss decrease intake)

4. Anelgesics

5. Meticulous skin care

6. Positioning and turning patient

7. Oxygen Therapy nebs

8. C&DB - energy conservation relaxation training (Kaposis, respiratory infections/SX)

9. Educate and assist with living will, hospice, preventing transmission, prevention of self from OI's reportable disease HIV AIDS & T4/CD4 less than 200

10. Standard and blood body fluid precautions pos reverse isolation

Front 60

WHat are the Reportable STD's and how often must they be reported?

Back 60

1. Syphillis, Gonorhea, Chlamydia-reported within 2 days
2. HIV AIDS t4/CD4 <200-reported monthly

Front 61

Name 9 STD's

Back 61

1. Ghonorrhea
2. Chylmadia Infection
3. Gardenella
4. Vulvitis
5. Syphilis
6. Pelvic Inflammatory Disease
7. Herpes
8. Trichomonis Vaginosis
9. HPV Genital Warts

Front 62

chylmadia
1. WHat is the causative organism?
2.WHat problems can it cause?
3. What problems for neonates?
4. What meds treat this?

Back 62

1. C. trachomatis sequelae?
2. PID, ectopic pregnancy, and infertility
3. conjunctivitis, pneumonia in 1st month of life
4. doxycycline 100 mg bid x7 days or erythromycin 500 mg x 7 days or amoxycillin in pregnancy

Front 63

ghonorrhea

1. WHat problems can it cause?
2. WHat problems can it cause for neonates?
3. WHat is the medication tx?

Back 63

1. sterility in males and females, tubal obstruction, acute salpingitis, & Eptopic pregnancy
2. conjunctivitis, corneal abrasions, blindness, & pneumonia in the first month
3. Rocephin

Front 64

What are the symptoms of Gardenella ?

Back 64

Vaginosis bacterium abundant frothy grey white discharge with fishy odor vaginal mucosa pink.

YIKES !!! :-)

Front 65

1. Vulvitis is most common in who?
2.What are the suggestions to patients ?

Back 65

1.younger women
2.Instruct to wear cotton underclothes and pantyhose with cotton crotch.

Front 66

1.Syphillis is very painful.
T or F
2.What are the signs ?

Back 66

1.False - it is not painful
2.painless chancre on the perineum is a sign

Front 67

Pelvic Inflammatory Disease leads to what complications ?

Back 67

Increases the woman's risk of ectopic pregnancy and sterility.

Front 68

Herpes

What is the Rx ?

Back 68

Acyclovir (apply with Q-tip and use gloves)

Do not use other drugs as they prevent lesions from drying up

No sex when lesions are present
Annual pap smears

Front 69

Trichomonis Vaginosis

Back 69

-protozoan
-frothy greenish yellow fould discharge
-Tender red vaginal mucosa.
-Rx = Flagyl
-Flagyl contraindicated with alcohol use, will cause tacycardia, N & V, palpitations, and flushing.

Front 70

HPV Gentital Warts

1.Are they a precursor to cancer ?
2What is the Tx?

Back 70

1.Yes
2.Removed with lazer or cyrosurgery

Front 71

Cervical Carcinoma HPV and herpes are risk factors.

Other risk factors include the following 5 risks. List 5

Back 71

1. Sexual intercourse at a young age

2. Multiple sex partners (Whore)

3. Intercourse with a high risk male

4. Mom used DES during her pregnancy

5. Smoking

Front 72

Herpes Virus has 7 related viruses.

Name the seven.

Back 72

1. Herpes Simplex 1
2. Herpes Simplex 2
3. Vricelaa zaster virus
4. Epstein-Barr
5. Cytomegalovirus
6. HHV6
7. HHV7

Front 73

Herpes Simplex 1 & 2:organism
1. What does it infect ?
2. How is it transmitted ?
3.What are the symptoms ?
4. NSG care?
5. Incubaton period?

Back 73

1. A. HSV 1 infects oral, ocular and facial.
B. HSV 2 infects genitals
2. Transmitted via contact with mucous membrane sevretios.
3. painful lesions
Malaise fever
Virus progresses to sensory nerve cells
Can reactivate during psychological or emotion stress
Reactivation similar to primary SX with no systemic infection signs and decrease severity/duration
4. Teach patient about the tranmission to others (avoid direct contact during outbreaks)
Encourage patient to decrease stress.
5. 2-12 days

Front 74

1. What is Tetanus used for?
2. How often does a patient get a tetanus shot ?
3. What are the 4 early signs of lock jaw ?

Back 74

1.Lock jaw bacterial disease of the nervous system enters body via a break in the skin.
2. Shot given every 10 years.
3. Early signs are:Stiff neck, abd dysphagia, locked jaw
Later signs: Fever, increases BP, Severe muscle spasms

Front 75

Hepatitis Type B



It targets the liver.

What are 3 ways it is transmitted ?

What is the incubation period ?

Most common in what population ?

___ % are perinatally acquired ?

Back 75

Transmission via blood
1. needles
2. maternal blood to neonates (mucas during delivery)
3. Body fluids (sex)

There are higher concentrations in blood/serous fluids; lower in semen, vaginal fluid, and saliva

Incubation period = 45 - 180 days

Most common in young adults 20-39.

24% of cases are perinatally acquired.

Front 76

Hepatitis LABS

Back 76

HBsAG
1st marker detected hep B surface anitigen elevation for >6 months dx chronic infection

IgM anti-HBc (IgM class antibody to hep B core antigen); diagnostic for HBV (detetable at the time of clinical onset. Decrease to sub-detectable levels with 6 months)

IgG anti-HBc marker of past infection. Persistently elevated in chronic HBV. Anti-HBs beccomes detectable during convalescence after the disappearance of HBsAG their presence (past acute infection) indicate recovery and immunity from re-infection.

Elevated alanine aminotransferase (ALT) by about 8 weeks and jaundice by about 10 weeks of expoure.

NEG IgM anti-HBc together with a positive test for HBsAG in a single serum spec indicates chronic HBV infection.

Front 77

What is the Immunization for pre-exposure, post-exposure, infants and newborns for HBV ?

Back 77

Pre-exposure prophylaxix with hepatitis B vaccine (series of 3 shots)

Infants immunization schedule given before discharge from hospital 2 months and 6 months

Post-exposure prophylaxis with Hepatitis B immune globulin (HBIG) and Hepatitis B vaccine

Infant born to mom with HBV given within 12 hours of birth.

Front 78

Hepatitis Type C



It targetrs the liver.

How is transmitted ?

How does it progress ?

How do you prevent it ?

Most common bloodborne infection in the United States. T or F ?

Immunization is the most effective for HCV. T or F ?

Back 78

Transmitted primarily through large or repeated direct percutaneous exposures to blood.

Progresses in majority of cases. Chronic HCV and further to Liver disease

Prevention - blood donor screening the risk behavior modification.

True - most common bloodborne infection in US

False - No immunization available

Front 79

Hepatitis C Diagnostics/Labs

Back 79

Serologic Essays for HEP C - RNA results may be reposrted as Pos neg ot intermediate.

Positive Diagnosis = EIA test- positive and supplemental - test positive.

Anti HCV - Antibody that develops in response to HCV infection; detectable in persons with acute, chronic and resolved infection

Front 80

Name the 2 Tx given for Hep C and info about them.

Back 80

1. Interferon - High iron levels in the iver might reduce the efficcy. Flu-like symptoms early in treatment. Later, side effects include fatigue, bone marrow suppression, and neuropsychiatric effects.

2.Ribavirin - Can include hemolytic anemia (caution with pre-exiting anemia, bone marrow sppression or renal failure CVD teratogenic.)
Patient should NOT become pregnant.

Front 81

HEPATITIS A FACT SHEET

1. Source of Virus ?

2. Route of Transmission ?

3. Chronic Infection ?

4. Prevention ?

Back 81

1. Feces

2. fecal - oral

3. No

4. Pre/post exposure and immunization

Front 82

HEPATITIS B FACT SHEET

1. Source of Virus ?

2. Route of Transmission ?

3. Chronic Infection ?

4. Prevention ?

Back 82

1. Blood/blood derived body fluids

2. Percutaneous permucosal

3. Yes

4. Pre/post exposure and immunization

Front 83

HEPATITIS C FACT SHEET

1. Source of Virus ?

2. Route of Transmission ?

3. Chronic Infection ?

4. Prevention ?

Back 83

1. Blood/blood derived body fluids

2. Percutaneous permucosal

3. Yes

4. Blood donor screening; risk behavior modification.

Front 84

Mononucleosis (focus peds)

1. An acute self limiting infectious disease caused by _______.

2. How transmitted ?

3. Incubation period ?

4. What are the symptoms ?

5. Diagnostics ?

6. Manifestations ?

7. Rx ?

8. How long do the Sx last ?

Back 84

1. Epstein Barr Virus

2. Tranmitted by contact with pharyngeal secretions droplet airborne.

3. Incubations is 4-6 weeks

4. Symptoms include fever, lymphadenopathy, pharyngitis and fatigue.

In children, the disease is mild early signs HA malaise, fatigue, chills, low grade fever, loss of appetite, puffy eyes.

Full blown - fever, sore throat, cervical adenopathy (cardinal signs), atypical lymphocytes.

5. Positive Epstein Barr titer test is >1:29

6. Splenomegaly (may persist several months) palatine petechiae, macular eruption (especially the trunk) exudative phaaryngitis tonsilitis hepatomegaly, abnormal LFT and bruising.

7. Primarily symptomatic, with enforced be rest to prevent serious complications of the iver or spleen

Analgesics to control pain

Saline gargles for throat for discomfort

8. Sx subsides in 7-10 days - Fatigue subsides in 2-3 weeks.

Front 85

Rubeola (Measles)

1. Definition ?

2. Diagnostics ?

3. Sx

4. Treatment ?

5. Prevention ?

Back 85

1. Resp. disease caused by a virus.

2. Diagnostic is based on clinical findings.

3. Sx = rash kopliks spots (Ist seen buccal and oral mucosa) - Increase temp - cough - runny nose - red weary eyes - Lasts about 1 week.

Koplik's spots on buccal mucosa (grayish white) and mucopapular rash at hairline that spreads down to the feet.

4. Symptomatic care includes antipyretics, rest and analgesics, fluid intake and dark room for photophobia.

5. Prevent by MMR (mumps, measles and Rubella)

Front 86

Tuberculosis
1. What is it?
2. WHat is the organism that causes it?
3. What are the sx?
4. WHat are the obj. sx?
5. What are the lab studies?
6.WHat are the Dx?
7. What is the tx?
8. Side Effects of tx?
9. Imp. Info.?

Back 86

1.airborne, infectious, communicable disease. Al veoli become infected from inhaled droplets containing tubercle bacilli.
2. mycobacterium tuberculosis, Incubation: 4-12 weeks to the formation of primary lesion , lung tissue react to the bacillus by producing protective cells that engulf the diseased organism forming tubercles.
3. fever, night sweats, cough with yellow mucous, anorexia, weight loss, fatigue, & formation of lesions (tubercles) in any organ of the body. Hemoptysis occurs as a result of cavitary spread
4. apical rales, amphoric bronchial sounds, decreased resp. excursion, cyanosis (advanced cases)
5. leukocytosis, increased sed rate, microscopic study of a specimen of sputum.
6. PPD or Mantou detect M. Tuberculosis infection by positive reaction (induration) 48-72 hours after test. Induration greater than 10mm, inchildren less than 5 mm=negative, sputum study is positive for acid fast bacillus and M tuberculosis
7.Isoniazid, used for Tx and prophalaxis for 6-12 months in persons at risk f

Front 87

Meningitis
1. Organism?
2. Sx?
3. Dx?
4. NSG Measures?
5. Potential Complications?

Back 87

1. aseptic, caused by virus, or secondary to lymphoma leukemia or brain abcess, septic caused by bacteria haemophilus influenzae, strep pneumonae, or neiseria, meningitis (most common causes)
2. recent infection (Strep AB) opsistohotonos (rigid hyperextension of the neck) H/A nuchal rigidity photo phobia and petichae, rash, and purpuric lesions seen in neiseria meningitis, +KERNIGS SIGN (legs cant fully extend when pt is lying with thighs flexed) +Bruzinskis sign (neck flexion produced knee hip flexion)
3. CSF stain and blood test
4. assess fever H/A irritability vomiting, provide rest, quiet environment, position on side, maintain fluid balance, I&O, weights, emotionaal support parents, droplet precautions, isolation until on IV ABX X 24-48 hrs
5.seizure, vascular collaps, high intracranial pressure due to accumulation of purulent drainage. SHOCK, Waterhouse Frederickson Syndrome caused by bile adrenal hemorrhage resulting in low adrenocorticoid secretions causing shock petechiae rash echymootic lesions

Front 88

Strep Infection
1. Cause?
2. WHich area of body?
3. What type of forms can it occur in?

Back 88

1. pathogenic bacteria of one of several species of the genus streptococcus or their toxins.
2. Almost any organ of the body
3.cellulitis, endocarditis, erysipelas, impetigo, meningitis, pneumonia, scarlet fever, tonsillitis, UTI, TSS, & strep throat

Front 89

Conjunctivitis
1. What 4 organisms are linked to this?
2. What are 5 causes?
3. How is it transmitted?
4. What are the sx/signs?
5. What is the TX?

Back 89

1. staph, strep, pneumococcus, and haemophilus influenzae
2. allergens, bacteria, trauma, virus, & occupational irritants
3. direct contact w/ infected objects, common.
4. inflammation & infection of the conjunctivia, itching
5. depends on cause, antibiotic eye drops, clean drainage from inner to outer canthus, warm moist compress, treat photophobic pts with darkened room, cold compress to relieve itching.

Front 90

WHat are 5 nosocomial infections?

Back 90

1. UTI
2. Pneumonia
3. Clostridium Difficile
4. Methicillin-Resistant Staphylococcus Aureus (MRSA)
5. Vancomycin-Resistant Enterococcus (VRE)

Front 91

Nosocomial Infections
1. What is treated in these cases?
2. WHat are they treated with?
3. What will prevent the spread of nosocomial infections?

Back 91

1. symptoms
2. antipyretics, analgesics, antibiotics, wound care, IV fluid therapy, antiemetics, and antidiarrheal
3. handwashing

Front 92

Are gram negative or gram positive organisms associated more w/ nosocomial infections?

Back 92

Gram Negative

Front 93

What are 8 common gram negative organisms?

Back 93

1. E. Coli
2. Klebsiella
3. Enterobacteria
4. Serratia
5. Pseudomonas Aeruginosi
6. Proteus
7. N. Meningitis
8. Bacteroides Fragilis

Front 94

What are the 2 most common sources of blood stream infections?

Back 94

1.vascular access devices
2. IV fluids

Front 95

Pneumonia
1. WHat % of Noso infections?
2. Strep Pneumonia colonizes where?
3. What are the sx?

Back 95

1. 15%
2. oropharynx and causes risk for hospitalized pt's
3.fatigue/malaise, enlarged lymph nodes, tachycardia, tachypnea, elevated WBC's, SOB/dyspnea, cough, pleuritic chest pain, adventitous breath sounds

Front 96

Adventitious Breath sounds
1. Crackles AKA?
2.Wheezes AKA?

Back 96

1. rales
2.rhonchi
3.pleural friction rubs
4.stridor

Front 97

UTI
ALmost all pts acquire 1.______ after 2.____ days of catheter use.

Back 97

1.bacteriuria
2.10

Front 98

1. WHat is Clostridium Difficile?
2. How to prevent spreading?
3. SX?

Back 98

1. bacterium that is spread by environmental sources and personnel
2. relatively resistant to handwashing and cleaning agents
3. diarrhea, with excessive flatus, and abdominal discomfort

Front 99

Methicillin-Resistant Staphylococcus Aureus (MRSA)
1. How common is it?
2. Can it be eliminated in hospital?
3. Sx?
4. What could this lead to?

Back 99

1. Most common NoSo infection
2. rarely ever
3. boils, impetigo, cellulitis, abcesses, wound infections, fatigue, malaise, enlarged lymph nodes, tachycardia, tachypnea, & elevated WBC's
4. pneumonia, osteomyelitis, septicemia, endocarditis, meningitis, hepatic or splenic abcess

Front 100

1.What is osteomyelitis?
2. WHat are the sx?

Back 100

1. a bone infection caused by bacteria
2. Bone pain, Fever, General discomfort, uneasiness, or ill-feeling (malaise), Local swelling, redness, warmth,
Nausea

Front 101

Vancomycin-Resistant Enterococcus (VRE)
1. What is it?
2. Is it a common noso infection?
3. How is it spread?
4. Sx?

Back 101

1. normal flora of the GI tract
2. 3rd most frequent in U.S.
3. spreads easily-from hands and objects
4. redness, edema, pain, tenderness, fatigue, tachycardia, tachypnea, elevated WBC's

Front 102

Staph Infections
1. What is it?
2. What are the staph infections of the skin?
3. Staph of the blood and what can it result to?
4. What is Staph Pneumonia?
5. WHat is staff of the GI tract?

Back 102

1. one of many pathogenic species of staphylococcus, commonly characterized by the formation of abcesses of the skin or other organs.
2.carbuncles, folliculitis, foruncles, hidradenitis suppartiva
3. bacteremia, can result in endocarditis, meningitis, or osteomyelitis
4. often follows influenzae or other viruses and may be associated with chronic or debilitating ilness
5. acute gastroenteritis

Front 103

Acute Gastroenteritis
1. How do you get it?
2. Tx?

Back 103

1. may result from an enterotoxin produced by certain species of staph in "contaminated food."
2. bed rest, analgesics, and an antimicrobial drug resistant to "penicillinase"(an enzyme secreted by many species of staph), surgical drainage-especially of deep abcesses is often necessary

Front 104

What is penicillinase?

Back 104

an enzyme secreted by many species of staph

Front 105

Herpes Zoster
1. What is it?
2. Sx?
3. What family is it in and where does it lie dormant?

Back 105

1. contagious viral infection presents with skin erruptions, vessicles along nerve pathway.
2. pain and flu-like
3. chicken pox, herpes virus lies dormant in nerve tissue after infection

Front 106

Salmonella
1. What is it?
2. Gram neg or pos?
3. How is it prevented?
4. Most frequent sources?
5. Incubation period?
6. How long do sx last?
7. Sx?
8. Tx?
9. Ab signs can resemble what?
10.What can abx cause?
11. NSG Int. ?

Back 106

1. rod shaped bacteria that includes species causing typhoid fever, paratyphoid fever, and some forms of gastroenteritis. ex. Samonellosis
2. gram negative
3. adequate cooking, good refridgeration, proper handwashing
4. poultry and eggs ie. cookie dough
5. 6-48 hrs.
6. 2-5 days
diarrhea & fever =2 weeks
7. initial: nausea and vomiting
later: colicky ab pain, fever, bloody, watery diarrhea
8. non specific
9. acute pendicitis, or cholecystitis
10. prolonged excretion of salmonella in stools
11. symptomatic, monitoring, I&O, encourage fluids, prevent dehydration, prevent skin break down

Front 107

Shigellosis
1. AKA?
2. organism?
3. Transmission?
4. Sx?
5. Diagnosed how?
6. Tx?
7. Int.?
8. Is this a reportable disease?

Back 107

1. bacillary dysentry
2. bacteria shigella
3. hand-to-mouth contact w/feces of infected individuals. Organisms can be carried in stools of asymptomatic people for up to several months and may be spread through contact w/ contaminated objects, food or flies, especially in poor crowded areas.
4.Initially: fever and ab cramping
Later: diarrhea
5. isolating and identifying shigella n a specimen of stool
6. supportive, prevent dehydration, antimicrobials if severe or if risk of further transmission is great.
7. ISOLATION, strict handwashing prec., I&O
8. yes

Front 108

Hepatitis A
1. How is it spread?
2. Sx?

Back 108

1. oral-fecal route, or by contaminated food or water that contains the virus.
2. jaundice, fatigue, abd pain, anorexia, nausea

Front 109

Pinworms
1. caused by what organism?
2. what type of infection?
3. Sx?

Back 109

1. entorobius vermicuaris
2. parasitic
3. severe itching

Front 110

Giardiasis
1. AKA what?
2. caused by what organism?
3. How long doo sx last?
4. Sx.?
5. P.C.?

Back 110

1. travelers diarrhea
2. protozoa giardi
3. a few days
4. NVD, slight fever, ab cramps
5. dehydration

Front 111

Immunity
1. Active
2. Passive
3. Natural
4. Acquired

Back 111

1. host produces own antibodies in response to natural (exposure) or artificial (vaccines and toxoids) antigens
2. from another source via placenta or colostrum of mother, immune serum (tetnus and diptheria antitoxin)
3. a nonspecific response to all invaders
4. injection of toxoid or in utero through breast milk

Front 112

WHo has a high risk of TB?

Back 112

leukemia pts

Front 113

1. Localized infection sx.?
2. Systemic infection sx.?

Back 113

1. pain, swelling, redness, heat, impaired function of body part
2. fever, increased pulse and resp., lassitude, malaise, and loss of energy, anorexia, nausea and vomiting, enlarged tender lymphnodes

Front 114

What is the time period for a "chronic" condition?

Back 114

6 months or greater

Front 115

Anti-Inflammatory Agents
1. WHat do they do?
2. 2 examples?

Back 115

1. block prostoglandin synthesis(inhibit wound healing, and inhibit inflammatory process)
2. aspirin, motrin

Front 116

Antipyretics
1. WHat do they do?
2. 2 examples?

Back 116

1. block prostogladin synthesis, mediator for pain and fever in CNS
2. tylenol, & aspirin

Front 117

MMR
1. Not effective before what age?
2. Is it safe for HIV+ pts?
3. WHat does it do to TB?
4. How should it be give in relation to PPD?
5. WHat age are children vaccinated?

Back 117

1. 1
2. yes
3. suppresses it
4. at same time or 4-6 weeks apart
5. 1, 4 , & 11

Front 118

DPT
1. What are the contraindications?
2. When is pertusis not given?
3. What ages should it be given?

Back 118

1. neuro disorder, hx of encephalopathy w/in 7 days of previos dose
2. if >7 y/o or currently has pertusis
3. 2, 4, 6, and 18 months

Front 119

When should a person get the Inactivated polio virus?

Back 119

if immunocomprommised

Front 120

Hep B Vaccine
1. When is it given and how many?
2. WHat to do if mom is HbsAG?

Back 120

1.1st one at birth followed by 2 more (3 total)
2. give HBIG & 1st hep Bvaccine at birth

Front 121

WHo should get the Hep A Vaccine?

Back 121

people at risk
ie. day care workers

Front 122

1. What is Bacille Calmette-Guerin vaccine?
2. WHo gets this vaccine?

Back 122

1. TB immunization
2. Given to pts at risk

Front 123

H. Influenzae-changes yearly

1.Who get it?
2. WHat test can be falsified by having the flu?

Back 123

1.people at risk->65 y/o, young, health care workers, immunocompromised, people w/ chronic resp problems, metabolic diseases
2. false positive HIV test

Front 124

what is the sequence for tetanus (td)?

Back 124

2 dt 1-2 months apart then a booster at 6-12 months then every 10 years

Front 125

What do TB and meningitis have iin common?

Back 125

both are reportable diseases

Front 126

Neutrophils increase with what?

Back 126

bacterial infection or inflammatory disease

Front 127

Lymphocytes increase with what?

Back 127

bacterial or viral infection

Front 128

Monocyte levels increase with what?

Back 128

in response too infections of all kinds, inflammatory disorders, and inflammation

Front 129

Eosinophils increase with what?

Back 129

inflammation

Front 130

Rubella titers of what number shows resistance to german measles?

Back 130

1:20

Front 131

What 2 tests are diagnosis for syphillis?

Back 131

1.VDRL(Venereal Disease Research Laboratory)
2.RPR (rapid plasma reagin)

Front 132

Positive acid fast bacilli in the sputum is diagnostic for what?

Back 132

TB

Front 133

What are culture and sensitivity reports used for?

Back 133

finds appropriate antibiotic

Front 134

What is mantoux test?

Back 134

Identifies TB, false neg in immunosupressed pts

Front 135

when does erythrocyte SED rate increase?

Back 135

with inflammation and infection

Front 136

What 2 things are serum screenings diagnostic for?

Back 136

HIV and Hep viruses

Front 137

What is a contraindication for all immunizations?

Back 137

a child with active aids

Front 138

1.How long should a person with meningitis be in isolation?
2. What type of precautions are used?

Back 138

1. until 24-48 hrs after abx are started
2. Droplet

Front 139

How can an infant be monitored for dehydration?

Back 139

daily weights

Front 140

1.NSG INT for pt with meningitis?
2. NSG measures for pt with vaginitis?
3.NSG INT for pt with pruritus?

Back 140

1. cool, nonstimulating environment
2. sitz bath
3. skin care

Front 141

WHat should be assessed....
1.prior to admin of analgesics?
2.prior to admin of abx?
3. give what to relieve dysuria?
4. give what to inhibit infection?
5.Consider modifications of drugs with what?

Back 141

1. vitals
2.allergies
3. urinary analgesics
4.antivirals
5.related to pts age

Front 142

1.refer pt with AIDS to who?
2. Refer pt with TB to who?
3. What to do for child who has mono?

Back 142

1. support group
2. community health
3. listen

Front 143

What is most important for pt with TB?

Back 143

adhere to medication regimen

Front 144

Bronchitis
1. signs/symptoms?
2. Caused by what?
3. tx?
4. abx if indicated?
5.Who are abx indicated for?
6. upper or lower airway infection?
7. given for cough supression

Back 144

1. cough, purulent sputum, rhonchi, sometimes fever
2. mostly viral, but also: H. Influenzae, S. Pneumoniae, & Moraxella
3. cough supression, beta agonists, can hasten syptomatic resolution
4. erythromycin, doxycycline, and TMP/SMX (trimethoprim and sulfamethoxazole)
5. in acute axacerbations, or chronic bronchitis in smokers
6. lower
7.Benzonatate or codeine

Front 145

Bronchiolitis
1. occurs in who?
2. WHat age is it the most serious in?
3. Caused by what
4. When does it occur?
5. WHat type of ilness is it?
6.Pathology?
7. What are the initial sx?
8.WHat are the sx of progression?
9. What are the sx of severe ilness?
10. upper or lower airway infection?
11. What lab tests are done?
12. What are dx tests?

Back 145

1.young children and infants
2. 2 and under
3. usually Respiratory Sinctial Virus also caused by parainfluenzae, adenovirus, influenza virus, and rhinovirus
4. usually winter
5. acute lower airway viral respiratory illness
6.edema and inflammatory infiltration of the bronchial walls
7. rhinorrhea, pharyngitis, wheezing, eye drainage, sneezing, coughing, low-grade fever
8.increased coughing and wheezing, air hunger, tachypnea, retractions, cyanosis
9. tachypnea >70/min, listlessness, apneic spells, poor air exchange, poor breath sounds, nasal flaring, prolonged expiratory phase, retractions
10. lower
11. CBC=usually normal
Blood gases, O2 sat levels, CXR can be normal or show air trapping and peribronchial thickening
12.nasal wash for RSV culture, and antigen Assay

Front 146

1.What are the supportive measures for bronchiolitis?
2.When is Ribavirin considered for tx?
3. WHo should not work w/ pts receiving this med?
4. What are the prophylaxis for RSV?
A. not preferred
B.Preferred

Back 146

1. antipyretics, iv fluids, humidified O2, nebulized bronchodilators (albuterol), epinephrine
2. if croup or bronchiolitis secondary to RSV in high risk groups
3.pregnant nurses
4.A.RSV-IGIV respigram, given via IV monthly, interferes w/ immunizations, preg workers shouldnt care for child receiving this med
B. Monoclonal antibody palivizumab, given IM, doesnt interfere with vaccines

Front 147

Viral Induced Asthma
1. What is it?
2. Complications?
3. Mostly occurs where?
4. seen in what age group?
5. upper or lower?
6. characterisitics?
7. tx?

Back 147

1. edema of bronchial mucosa and bronchospasm leads to decreased bronchiole caliber which leads to airtrapping and hyperinflamation
2. mucous plugging of bronchi causing atelactasis
3. right middle lobe
4. late infancy, early childhood
5.URI
6. wheezing, productive cough
7. bronchodilators, corticosteroids

Front 148

Pneumonia
1. what type of ilness?
2. How is it spread?
3. clinical man.?

Back 148

1. bacterial, viral(most common), parasitic, or fungal
2. direct or indirect contact
3. high fever, cough w/ white sputum, tachypnea, pleuritic chest pain, crackles(rales, rhonchi, dullness to percussion, nasal flaring, retractions, egophony (increased resonance of voice sounds heard when auscultating the lungs), pallor/cyanosis, restless, irritable, lethargy, anorexia, vomiting, diarrhea, ab pain, CXR: diffuse or pathcy infiltration with peribronchial distribution

Front 149

What are the differential diagnosis for pneumonia?

Back 149

heart failure, malignancy, pulmonary embolism, pulmonary vasculitis, eosinophilic pneumonia, and inflammatory lung diseases

Front 150

What is the most sensetive physical finding of pneumonia in children indicating an x ray even in the absense of rhales?

Back 150

tachypnea

Front 151

All or a large segment of one or more pulmonary lobes involved indicates what kind of pneumonia?

Back 151

Lobar pneumonia

Front 152

What type of pneumonia begins in terminal bronchioles, consolidated patchesin, nearby the lobules, AKA lobar pneumonia

Back 152

Bronchopneumonia

Front 153

What type of pneumonia is an inflammatory process confined within the alveolar walls and peribronchial tissues and interlobar tissues?

Back 153

interstitial pneumonia

Front 154

What is localized acute inflammation of the lung without the toxemia associated with lobarpneumonia

Back 154

Pneumitis

Front 155

Viral Pneumonias
1. How do they present?
2.What is the most common cause in early life?
3. Other causes?
4. Where is the inflammation?
5. WHat type of precautions?
6. What type of Med is given?
7.Prevention?
8.WHat puts person at risk?

Back 155

1. respiratory distress
2. RSV
3. parainfluenza, adenovirus, influenza viruses
4. begins in the resp. mucosa of major bronchi, and spreads transmurally and endobronchially into the adjacent interstitium as well as into the peripheral air spaces
5. respiratory isolation
6. non aspirin antipyretic
7. influenza vaccines A & B
8. varicella and measles vaccine

Front 156

Primary Atypical Pneumonia
1. what type?
2. most prevalent inn what age group?
3. Sx?
4. More prevalent in what type of conditions?
5. How long does it take to run course?
6. What type of tx?

Back 156

1. mycoplasma pneumonia
2. 5-12 y/o
3.chest pain, cough, mild chills, fever, myalgia
4. overcrowded areas
5. 7-10 days
6. symptomatic

Front 157

Bacterial Pneumonias
1. Onset sx?
2. Caused by what pathogens?
3. involves what area?
4. WHat forms during recuperative stage?

Back 157

1. fever, and tachypnea
2. staph, pneumococcus(strep pneumonia), & haemophilus influenza
3.primarily alveolar involvement with out airway involvement
4. pneumatoceles-transcient accumulations of interstitial air that have escaped through necrotic bronchial foci and are usually of little significance, resolving over time

Front 158

TB
1.WHat type of infection?
2. Caused by what?
3. How is it transmitted?
4. How are kids usually infected?
5. Etiology?
6. WHat does erosion of blood vessels lead to?
7. DX?
8. What do labs show?
9. WHat do xrays show?
10. What test is used for detecting current or past infections?

Back 158

1. granulomatous
2. acid fast bacillus, mycobacterium, TB, & M. Bovis
3. inhalation/ingestion of infected droplets or by ingestion of M Bovis
4. by member of household
5. proliferation of epithelial cells which surround and encapsulate the multiplying bacilli(attempt to block off disease) forming tubercle. Extension of primary lesion @ original site causes progressive tissue distruction as it spreads with in the lung , discharges material from foci, to other areas of the lungs (bronchi opleura) or produces pneumonia
6. by primary lesion causes wide spread dissemination of the ubercle bacillus to near and sites, (miliary tuberculosis) areas commony affected are meninges, lymphnodes, and bones
7. physical exam, Hx., CXR, TB results, organism CX and must determine if pt is in active quiessant or healed stage
8. leukocytosis, and increased SD rate
9.infiltrates, mediastinal lymphadenopathy, ceseation, pleural effusion, and calcification
10. Purified Protein Derivative (PPD) (mantoux), A hardened raised

Front 159

TB continued......
1.Tx?
2. Danger signals for pt to call Dr.?
3. How long does drug therapy last?
4. What does infecting organism produce?

Back 159

1. isoniazid, pyrazinamide, paraaminosalicyclic acid, streptomycin, rifampin, ethambutol, dihydrostretomycin, ultraviolet radiation, and heat. A combo of drugs is prescribed with fnct tests of kidneys, liver, eyes, ears to test toxicity
2. cough, weight loss, fever, night sweats, and hemoptysis
3. up to 1 year
4. tuberculin, a toxic substance, as the bacillus disentigrates

Front 160

TB Clinical Manifestations
1.Beginning
2.progression
3. Immunization

Back 160

1. fever, malaise, anorexia, weight loss, cough may or may not be presemnt(progresses over weeks to months), aching pain and tightness in chest, hemoptysis (rare)
2. resp rate increases, poor lung expansion on affected side, diminished breath sounds and crackles, dullness to percussion, fever persists, generalized sx: pallor, weakness, anemia, and weight loss
3. bacillus calmette guerin (BCG)

Front 161

Nasopharyngitis
1. upper or lower resp infection?
2. what is it?
3. what is it caused by?
4. what sx present in a younger child?
5. What sx present in an older child?
6. What are the physical sx?

Back 161

1. upper
2. common cold (coryza) caused by viruses
3. rhino virus, RSV, or adeno virus, influenza virus or parainfluenza virus
4. irritability, restlessness, sneezing, vomiting, and/or diarrhea
5. dryness, irritation of nose and throat, sneezing, chilly sensation, muscular aches, cough
6. edema and vasodilation

Front 162

Pharyngitis
1. What is it?
2. What is pt with this infection at risk for?
3. Sx in a younger child?
4. Sx in an older child?
5. Physical signs?
6. extra signs in an older child?
7. Treatment?
8. Complications?
9. DO what after on Abx for 24 hrs?

Back 162

1. group AB-hemolytic strep infection/strep throat
2. acute rheumatic fever, acute glomerulonephritis, and acute kidney infection
3. fever, general malaise, anorexia, moderate sore throat, and headache
4. high fever, HA anorexia, dysphagia, ab pain, vomiting
5.hyperemia
6. mid fiery red edematous pharynx, hyperemia of tonsils and pharynx may extend to soft palate and uvula, follicular exudate that spreads and coalesces to form pseudomembrane on tonsils, enlarged tender cervical glands
7.oral PCN combo of rifampin and PCN more effective in erradicating GABHS
8. can lead to rheumatic fever, or RHD, scarlet fever, acute glomerulonephritis, fever chills, whitish purulent drainage on red painful throat
9. throw away toothbrush

Front 163

which tonsils for the waldeyer tonsillar ring?

Back 163

pairs of tonsils

Front 164

which tonsils are the pharngeal tonsils?

Back 164

adenoids

Front 165

Which tonsils are removed during a tonsilectomy?

Back 165

palatine or faucia tonsils

Front 166

what are the tonsils callled at the base of the tongue?

Back 166

lingual tonsils

Front 167

what tonsils are not part of the ring and are near the eustation tube?

Back 167

tubal tonsils

Front 168

WHat are reasons that a person would need a tonsilectomy?

Back 168

1. repeated strep infection
2. hx of peritonillar abcess
3. massive hypertrophy that interferes w/ eating, breathing, malignancy, or obstruction of the airway
4. adenoidectomy if overgrowth obstructing breathing performed without removal of palatine tonsils
5. positive cx for bacteria

Front 169

What are contraindications for tonsilectomy or adenoidectomy?

Back 169

1.cleft palate
2. infection at time of surgery
3. oncontrolled systemic disease
4. blood dyscrasias

Front 170

What is a post of complication of tonsilectomy?

Back 170

hemorrhage, early sign:cont'd swallowing from trickling of blood

Front 171

Mono
1. What is it?
2. Caused by what?
3. How is it transmitted?
4. Contagious?
5. who is it mild in?
6. early signs?
7. Later signs?
8. WHat are common features?
9. tx?
10. Sx subside when?
11. fatigue subsides when?

Back 171

1. acute self limiting infectious disease
2. epstein barr
3. droplet infection
4.not really
5. kids
6.headache, malaise, fatigue, chills, lowgrade fever, loss of appetite, puffy eyes
7. fever, sore throat, *cervical adenopathy(cardianl sign), atypical lymphocytes
8.splenomegaly, palatine petechia(can persist several months), macular eruption especially on the trunk, exudative pharyngitis/tonsilitis, hepatomegaly, abnormal liver function, and bruising
9. symptomatic, enforced bed rest to prevent comp. of liver and spleen, analgesics for pain, saline gargles for throat discomfort
10.7-10 days
11. 2-3 weeks

Front 172

Influenza
1. AKA?
2. caused by what?
3. effects wha in the body?
4. how is it spread?
5. mild or severe?
6. Most severe in who?
7. sx?
8. WHat type of cough is common with this?
9. Comp.?
10. WHat type of tx?
11. Prevention?
12. sign of 2 bacterial infections

Back 172

1.flu
2.viruses that change from time to time
3.upper and lower resp. tract
4. direct contact, large droplet, contaminated articles
5. mild-severe
6. infants
7.dry throat & nasal mucosa, dry cough, hoarseness, sudden fever, flushed face, photophobia, myalgia, hyperesthesia, prostration
8. subglottal croup esp. in infants
9. severe viral pneumonia, hemorrhagic encephalitis, secondary bacterial infection (otitis media, sinusitis, pneumonia)
10.symptomatic, fever reduction, (no asa rsik for reyes),-maintain hydration, symmetrel effective for sx reduction for type A if given w/in 24 hrs
11. inactivated influenza virus reccomended for children with health problems
12. early onset of fever or prolonged fever

Front 173

What is the most prevalent disease in childhood?

Back 173

otitis media

Front 174

WHat happens in relation to age when referring to Otitis Media?

Back 174

hhighest incidents in age 6 months-2, incident decreases with age, except small increase at 5-6 years

Front 175

WHat are the risk factors for otitis media?

Back 175

family history, exposure to 2nd hand smoke, households with many members, daycare attendance, position while drinking

Front 176

What babies have lower incidence of otitis media?

Back 176

breast fed

Front 177

What is otitis media?

Back 177

inflammation of the middle ear

Front 178

How long does acute otitis media last?

Back 178

rapid and short, lasts about 3 weeks

Front 179

What is otitis media with effusion?

Back 179

inflammation of the middle earwith collection of fluid present in middle ear space

Front 180

WHat is chronic otitis media with effusion?

Back 180

mid ear effusion that persists beyond 3 months

Front 181

When should you use ABX for otitis media?

Back 181

if 3 infections in last year or high risk for bacterial infections

Front 182

WHat is Myringotomy?

Back 182

surgical incision of the ear drum

Front 183

What is tympanoplasty?

Back 183

insertion of pressure equalizing tubes

Front 184

Polyvalent pneumococcal polysaccharide vaccines reduce incident of what?
How old do you have to be to get vaccine?

Back 184

pneumococcal OM
>2

Front 185

What is the NSG care for otitis media?

Back 185

relieve pain, fascilitate drainage, prevent comp., educate family (abx use rsik factors:hearing loss comp.), emotional support for child

Front 186

What are comp. of inadequate tx for otitis media?

Back 186

conductive hearing loss, perforated and scarred ear drum,
mastoiditis and inflammation of mastoid air space
cholesteatoma destructive cyst like lesion, intracranial infection-menningitis

Front 187

1. What are croup syndromes?
2. Swelling and obstruction in what region?
3. What immunizations can = prevention?
4. WHat resp. things should be monitored?
5. what should be used for O2 humidification?
6. should u intubate and ventilate?
7. Meds used?
8. WHen should u used abx?
9. SHould corticosteroids be used and why?
10. WHen should racemic epenephrine be used?

Back 187

1. general term applied to "symptom complex", characterized by barking or brassy cough, inspiratory stridor, and varying degress of resp. distress
2. larynx
3. LTB spasmodic laryngitis (viral types), & h influenza type B conjuegate reccomended for all infants
4. vitals, resp rate and effort, access use, spo2, o2 use, color
5. oxygen hoods,infants:tent, toddlers: cool mist
6. open airway, be prepared for worsening sx, tracheitis, LTB
7. antipyretics, nebs, no asa for viral types
8. acute epiglottitis, supra glottitis, acute tracheitis, or w/ secondary bacterial infection
9. yes they reduce inflammation
10.for more severe cases of larngotracheo bronchitis

Front 188

croup
Acute Epiglottis
1. WHat is it?
2. what age does it occur in?
3. Caused by what?
4. What are 3 clinical observations that indicate?
5. What are signs and sx?
6. What meds are not helpful in this?
7. what meds/abx are used?
8. do people need immunized?
9. should you visualize and culture swab?

Back 188

1. inflammation of the epiglotis mortality rate:5-10%
2. 2-7 y/o
3. h influenza type B (HIB vaccine decreased incident)
4. absence of spontanous cough, presence of drooling, & agitation
5. fever, flushed, dysphagia, perioral cyanosis, stridorous, tripod position (mouth open, tongue protruding, chin thrust out), hot potato voice
6. racemic epinephrine, and corticosteroids
7. abx against h influeza, & Rifampin to irradicate nasial carriage, as does everyone in household
8. no, it should induce natural immunity
9. no, could cause pulm and cardiac arrest

Front 189

What is hot potato voice?

Back 189

muffled voice

Front 190

croup
Laryngotracheobronchitis
1. AKA what?
2. is it common?
3. Sx in stage 1?
4. Sx in stage 2?
5. Sx in stage 3?
6. Sx in stage 4?
7. What should be implicated in child with severe resp distress?
8. What are early signs of airway obstruction?

Back 190

1. viral croup
2. most comon of the croups
3. hoarseness, croupy cough, inspiratory stridor when disturbed
4. continued resp. stridor, lower rib retraction, retraction of neck, accessory muscle use, labored resp.
5. signs of anoxia, and co2 retention, restlessness, anxiety, pallor, sweating, rapid resp.
6. intermittnet cyanosis, permanent cyanosis, cessationof breathing
7.npo, risk for aspiration
8. tachycardia, tachypnea, intercostal, substernal, and suprasternal retractions, flaring nares, increased restlessness, intubation may be needed

Front 191

croup
bacterial tracheitis
1. What is it?
2. what age does it affect?
3. sx are similar to what?
4. Unrespoinsive to what?
5. usually has a hx of what?
6. what type of secretions?
7. treat with what?

Back 191

1. features croup and epiglottis
2. 1 month-6 years
3. LTB
4. interventions
5. prev URI, with croupy cough and stridor unaffected by position, toxicity and fever
6. thich purulent tracheal secretions
7. vigurous humidified 02, antipyretics, abx, ET, intubation, freq suctioning, early recognition essential

Front 192

HArsh barky like a seal cough is indicative of what?

Back 192

croup

Front 193

What are reasons that a child with croup would need to be hospitalized?

Back 193

a toxic appearance, stridor, cyanosis, nneds o2, has mental status changes, unable to take adequate fluids, or has caretakers that are unable to properly monitor him

Front 194

What organisms commonly cause viral croup,& LTB?

Back 194

parainfluenza type 1-most common, parainfluenza type 3, adenovirus, echovirus, resp. synctial virus, influenza

Front 195

What 3 things will break a croup attack?

Back 195

1. cool mist vaporizer, a steam bath, night cool mist air

Front 196

WHat type of drugs should not be used with croup and why?

Back 196

sedatives and opiates, will depress respiratory drive
bronchodilators and expectorants, will iritate airway and increase obstruction

Front 197

WHat is the main difference between viral and spasmotic croup?

Back 197

spasmotic-milder course with easily controlled attack that go away quickly but return on subsequent nights
spasmotic-caused by viruses, allergies, hypersctive children, and are more predisposed to spasmotic croup

Front 198

WHich croup is rare but potentially deadly?

Back 198

diptheria

Front 199

What is diptheria?

Back 199

acute infectious laryngitis, causes obstruction by occluding the laryngeal inlet with a pseudomembrane

Front 200

Acute epiglottitis (supraglottis)?

Back 200

1-8 yrs.,bacterial, usually h influenza

rappidly progressive, dysphagia, stridor aggravted when supine, drooling, high fever, toxic appearance, rapid pulse and resp.
tx.:abx, aairway protection

Front 201

Acute Laryngotracheobronchitis

Back 201

3 months-8 years, viral, slowly progressive, URI, stridor, brassy cough, hoarseness, dyspnea, restlessness, irritability, low grade fever, nontoxic appearance, humidity, racemic epinephrine

Front 202

Acute Spasmodic laryngitis (spasmodic croup)

Back 202

3 motnhs-3 years, viral with allergic component, sudden, at night, URI, croupy cough, stridor, hoarseness, dyspnea, restlessness, sx awaken child, sx disapear during day, tends to recur, humidity

Front 203

Acute tracheitis

Back 203

1 month-6 years, bacterial, usually staph aureus, moderately progressive, URI, croupy cough, stridor, purulent secretions, high fever, no response to LTB therapy, give abx

Front 204

What is resp. failure?

Back 204

respiratory arrest, cessation of breathing, inability of respiratory apparatus to maintain adequate o2 of the blood with or without co2 retention

Front 205

What are the cardinal signs of resp. failure?

Back 205

restlessness, tachypnea, tachycardia, diaphoresis

Front 206

What are the early signs of Resp failure?

Back 206

mood change, H/A, change in resp rate/depth, HTN, exertional dyspnea, anorexia, increased cardiac and renal output, CNS Sx flaring nares, chest wall retraction, exp grunt, wheezing or prolonged expiration

Front 207

Signs of more severe hypoxia in resp. failure?

Back 207

hypo or hypertension, diminished vision, somnolence, stupor, coma, dyspnea, depressed respirations, bradycardia, cyanosis, peripheral or central, manage w/ artificial ventilation

Front 208

epinephrine?
1. action
2. implication

Back 208

1. adrenergic, acts on alpha and beta receptors, especially on heart and vascular and other smooth muscles
2. most useful drug, in cardiac arrest, dissapears rapidly from bloodstream after injection, may produce renal vessel constriction and decreased urine formation

Front 209

Sodium Bicarb
1.Action
2. Implication

Back 209

1. alkanizer, buffer
2. infuse slowly and only when ventilation is adequate, dont mix with catecholamines or calcium

Front 210

Atropine Sulfate
1. Action
2. Implication

Back 210

1. anticholinergic-parasympatholytic, increases cardiac output, & heart rate by blocking vegal stimulation in heart
2. used to treat bradycardia after ventilatory assesment, produces pupilary dilation, which constricts with light

Front 211

Calcium Chloride
1.action
2. implication

Back 211

1. electrolye replacement, needed for maintenance of normal cardiac contractility
2. used only for hypocalcemia, calcium blocker overdose, hyperkalemia, or hypermagnesemia, administer slowly, very sclerosing, admin in central vein

Front 212

Lidocaine
1.action
2.implication

Back 212

1.antidysrhythmic, inhibits nerve impulses from sensory nerves
2. used for ventricular dysrhythmias only

Front 213

Bretylium
1.Action
2. implication

Back 213

1. antidysrhythmic, inhibits release of norepineohrine in post-ganglionic nerve endings that control ventricular tachycardia
2. not a 1st line drug for ventricular tachycardia, used if lidocaine is not effective, administer rapidly

Front 214

Adenosine
1. Action
2. Implication

Back 214

1. antidisyrthmic, causes a temporary block through the atrioventricular node and interrupts re-entry circuits
2. administer rapidly, very effective, minimal side effects

Front 215

Naloxone (narcan)
1.Action
2. Implication

Back 215

1. reverses respiratory arrest due to excessive opiate administration
2. evaluate level of pain because analgesic effects of opiods are reversed with large dose of naloxone

Front 216

Infusion
epinephrine hcl infusion

Back 216

adrenergic, titrated to desired hemodynamic effect

Front 217

infusion
dopamine hcl infusion

Back 217

agonist, acts on alpha receptors, causing vasoconstriction, increases cardiac output, titrated to desired hemodynamic effect

Front 218

infusion
dobutamine hcl infusion

Back 218

renergic direct acting B2 agonist, increases contractility and heart rate, titrated to desired hemodynamic response

Front 219

Lidocaine Hcl infusion

Back 219

antidysrhythmic, increases electrical stimulation threshold of ventricle, lower infusion dose used in shock, used for ventricular tachycardia

Front 220

Isoproterenol

Back 220

relaxes bronchial smooth muscle, increases cardiac contractility and heart rate, used for emergency treatment of atropine resistant bradycardia and shock, increased effects with epinephrine

Front 221

measles
1. WHat is it?
2. caused by what?
3. sx?
4. How long does it last?
5. How is it spread?
6. Is it contagious?

Back 221

1. respiratory disease
2. virus
3. rash, high fever, cough, runny nose, and red watery eyes
4. week
5. coughing, sneezing
6. very

Front 222

mumps
1. What is it?
2. caused by what?
3. sx?
4. how is it spread?

Back 222

1. disease of the lymph nodes
2. viirus
3. fever, headache, muscleache, swelling oof the lymph nodes close to the jaw
4. coughing and sneezing

Front 223

rubella
1. AKA?
2. what is it?
3. WHat is it caused by?
4.Sx?
5. how is it spread?
6. How long does it last?

Back 223

1. german measles
2. respiratory disease
3.virus
4. rash and fever
5. coughing and sneezing
6. 2-3 days

Front 224

Diptheria
1. what is it?
2. What is it caused by?
3. sx?
4. How is it spread?

Back 224

1. respiratory disease
2. bacteria
3. gradual onset of sore throat, low grade fever
4. coughing and sneezing

Front 225

tetanus
1. AKA?
2. what is it?
3. caused by what?
4. early sx?
5.later sx?
6. How is it spread?

Back 225

1. lockjaw
2. disease of the nervous system
3. bacteria
4. lockjaw, stiffness in neck and abdomen, difficulty swallowing
5. fever, elevated BP, severe muscle spasms
6. break in the skin

Front 226

pertussis
1.AKA?
2. What is it?
3. Caused by what?
4. Sx?
5. How is it spread?
6. Is it contagious?

Back 226

1. whooping cough
2. respiratory disease
3. bacteria
4. severe spasms of coughing that can interfere with eating, drinking and breathing
5. coughing and sneezing
6. highly

Front 227

Hep B
1. what is it?
2. caused by what?
3. sx when 1st infected?
4.WHat increases likelihood of early sx?
5. sx?
6. How is it spread?

Back 227

1. disease of the liver
2. Hep B virus
3. maybe not
4. age
5. yellow skin or eyes, tiredness, stomach ache, loss of apetite, nausea, joint pain
6. through contact of blood, or sex

Front 228

HIB
1. What is it?
2. Usually occurs in who?
3. serious in who?
4. Little risk after what age?
5.sx?
6. how is it transmitted?

Back 228

1.severe bacterial infection
2. infants
3. in kids under 1
4. 5
5. skin and throat infection, mpneumonia, meningitis, sepsis, and arthritis
6.coughing and sneezing

Front 229

Influenza
1.AKA
2. what is it
3. Caused by?
4. sx?
5. How is it spread?

Back 229

1.flu
2. highly infectious ilness
3. virus
4. fever, chills, dry cough, runny nose, body aches, headache, and sore throat
5. contact, airborne

Front 230

Polio
1. what is it?
2. Sx?
3. Transmission?

Back 230

1. disease of lymphatic and nervous system
2. fever, sore throat, nausea, headaches, stomach aches, stiffness in neck, back, and legs
3. contact

Front 231

Varicella
1. AKA?
2. What is it caused by?
3. Sx?
4. contagious?
5Transmission?

Back 231

1. chickenpox
2. virus of the herpes family
3.skin RASH OF BLISTER LIKE LESIONS USUALLY ON FACE, SCALP, OR TRUNK OF THE BODY
4.highly
5. coughing and sneezing

Front 232

Pneumococcal Disease
1.caused by what?
2. most common cause of what in children under 2?
3. Can end up in what?
4. Pneumococcus bacterium is where?
5. Why does it suddenly invade the body and cause disease?

Back 232

1. pneumococcus bacterium
2. pneumonia, meningitis, sepsis, ear infections, and sinusitis
3. pneumococcal pneumonia, bacteremia, meningitis
4. peoples noses and throats
5. its unknown

Front 233

sx of pneumococcal pneumonia?

Back 233

high fever, cough, chest pains

Front 234

Hep A
1. What is it?
2. cayused by what?
3. likelihood of sx early on increases with what?
4. sx, if present?
5. How is it spread?

Back 234

1. disease of the liver
2. hep A virus
3. age
4.yellow skin/eyes, tiredness, stomachache, loss of apetite, nausea
5.oral-fecal route, less often eating food or water containing the virus

Front 235

1.What is nephrotic sx?
2.WHat are the sx?

Back 235

1.sx that result from changes that occur to small functional structures in the kidneys.
2. high levels of preotein in the uriine, low levels of pretein in blood do to its loss in the urine, edema, ascites, high cholesterol levels in the blood

Front 236

1. What type of nephrotic sx is most common in children?
2. most common type of ideopathic nephrotic syndrome?
3. ideopathic nephrotic syndrom is more common in who?

Back 236

1. ideopathic nephrotic syndrome
2. minimal change nephrotic sx
3. boys

Front 237

WHat is the prognosis of a child with minimal change nephrotic sx?

Back 237

child usually has relapses of the ilness, but disease is managed, good prognosis, in rare cases:child gets kidney failure and needs dialysis

Front 238

congenital nephrotic sx
1.When does it occur?
2.Is it common?
3. inherited by what type of gene?
4. dEFINE # 3 ANSWER
5. what are the chances of carrier parents to have a child with this?
6. outcome?

Back 238

1. 1st week of life
2. rare
3. autosommal recessive
4. males and females equally effected, & inherited one copy of gene from each parent
5. 1/4
6. extremely poor

Front 239

What are sx of nephrotic syndrome?

Back 239

fatigue/malaise, low appetite, weight gain and facial swelling, ab swelling/pain, foamy urine, edema, pale finger nail beds, dull hair, ears cartilage may feel less firm, food intolerances or allergies

Front 240

How is nephrotic syndrome diagnosed?

Back 240

urine test for protein
blood test-for the protein albumin and cholesterol
renal ultrasound-non invasive, transducer passed over kidneyproducing sound waves which bounce off kidneyand transmit picture of organ, detects size and shap of kidney detects mass, kidney stones, cyst or other obstruction/abnormalities
renal biopsy-procedure where a small sample of tissue is taken from the kidney through a needle, sent for special testing to determine specific disease

Front 241

What is the tx for nephrotic syndrome?

Back 241

DETERMINED by Dr based on...
1. childs age, health, med history
2. extent of disease
3. childs tolerance for specific meds, procedures, or therapies
4. expectations of pt
5. pts opinion

Front 242

COuld a child with this disease need hospitalized?

Back 242

yes, for monitoring for edema if severe or BP or breathing problems

Front 243

Are meds needed?

Back 243

may be required to treat initial sx and during relapses

Front 244

What meds could be used?

Back 244

corticosteroids, immunosuppressive drug therapy, diuretics for edema, IV albumin, special diet to restrict salt and other specifications

Front 245

Why should a child receiving meds foor this not receive live vaccines?

Back 245

meds taken weaken the immune system, unless child has been exposed to chicken pox it could be recommended still

Front 246

What is long term outlook for nephrotic syndrome?

Back 246

relapses do occur in childhood, once reaches pubery its usually in remission, its uncommon for sx to return in adulthood but still possible