Comparative Analysis of Common Infectious Diseases: Symptoms, Diagnosis, and Treatment, Exams of Nursing

Download Comparative Analysis of Common Infectious Diseases: Symptoms, Diagnosis, and Treatment and more Exams Nursing in PDF only on Docsity! Nursing 629 Exam 3 88 Questions with Answers 2024 Hand, Foot, and Mouth Disease (HFMD) - ✅✅✅Caused by the Cossack virus 3-6 day incubation period Symptoms: -Low grade fevers -sore throat, poor appetite -malaise prior to rash -Petechial rash, blisters start. -Oral lesions, then hands and feet. -Sometimes can have on torso and extremities. -Look like canker sores with yellow ulcers and red halo. Treatment- Tylenol, warm baths. Orange depending on age. Magic moulthwash (Benadryl and Maalox) mixture. push hydration. Education: -very contagious- must have all of the lesions crusted prior to going back to school. -Illness can last up to one week. Hand-foot-and-mouth disease - ✅✅✅· pustular, ulcerating lesions o on the hands and feet o oral ulcers Herpes Simplex Virus - ✅✅✅Spread by respiratory droplets, contact with active lesion, and contact with body fluid. Symptoms -fever -malaise -fever -swollen glands -grouped vesicles with an erythematous base -gingiva that bleeds easily with small yellow ulcers. Treatment -Symptomatic treatments- oral antivirals or topical antivirals to shorten length of illness. -will most likely last 2-3 weeks Roseola - ✅✅✅Caused by -human herpesvirus 6 (HHV-6) and 7 (HHV-7) Symptoms -High fever for several days -rash lasting for 1-2 days small pink spots that are patches with white rings around spots -rash usually starts on trunk and moves to extremities Treatment -Fluids, Tylenol, ibuprofen for fever, and rest. -Symptoms appear within two weeks post exposure Chickenpox - ✅✅✅-Seeing an uptake in this disease as a lot of people are not vaccinating with MMR Caused by Varicella zoster -headache -anorexia -neck and muscular pain -can get a macular rash on trunk Diagnosis -PCR or serological tests Treatment -Corticosteroids for the swelling, and NSAIDS for pain Fifths disease - ✅✅✅Erythema infectiosum Human parvovirus B19 Incubation 4-14 days Symptoms -Prodromal, fever, headache, nausea, and diarrhea -sore throat -Slapped cheek rash -Followed by reticular lace like rash on trunk -Maybe associated with arthralgia -petechia on hands and feet Diagnosis -parovirus IGM IGG Treatment -symptomatic treatment Fifth disease - ✅✅✅· fiery red, maculopapular facial rash concentrated on the cheeks o Slapped cheek appearance Lime disease stage 1 - ✅✅✅Borrelia burgdorferi- spread by deer ticks Stage 1 -2 weeks after the bite they will get that classic erythema migraines. -The ration starts with a nice annular macule or papule at the side of the bite within 24- 48 hours and -within that first 1-2 weeks they will start noticing that classic bull's-eye lesion, so at first after the tech has expelled itself they will notice that maculopapular red lesion, and then you will notice the bull's-eye with a 1-2 weeks later Lyme Disease Stage 2 Symptoms - ✅✅✅Secondary lesions Neurological cardiac generalized illness lasts weeks to 2 years without treatment. Lyme disease stage 3 - ✅✅✅-months to years after if not treated -recurrent arthritis -encephalopathy and polyradiculoneuropathy -myalgia, arthralgias Treatment for lime disease - ✅✅✅Less than 8 years old Amoxicillin 50mg/kg/day TID for 14 days older than 8 years doxycycline single 200mg daily or 4mg/kg/BID for 14 days Rocky mountain spotted fever - ✅✅✅Spread by ticks Clinical features -fever greater than 104 -cough -photophobia -myalgias -GI upset -AMS -Maaculopapular rash Diagnosis IFA- gold standard PCR Treatment -doxycycline (only illness you give this under the age of 8) Cat scratch disease - ✅✅✅Bartonella henselae Clinical features -systemic illness -erythematous popular 1 week after inoculation -linerar patter that follow the cat scratch -lymph node involvement that can last 1-2 months Diagnostic IFA Treatment -moist wraps -symptomatic treatments -needle aspiration -antibiotics if bacterial involvement or immunocomprimised Deficiency of factor 8 and factor 9 Males are only effected, but females are carriers Clinical findings -excessive bruising -prolonged bleeding -hemarthrosis in elbows, knees and ankles -prolonged ptt diagnosis -assay for factor 8 and 9 Management -replace factors 8 and 9 -prevent trauma or injury -avoid NSAIDs -hematology referral Von willebrand diseas - ✅✅✅Inherited disease in both sexes 3 types- either reduced vwf protein, abnormal protein, or absent in the vwf protein. Clinical features -epistaxis -easy brusing -prolonged bleeding -ecchymsis to trunk, upper arms and thighs -prolonged ptt -females have prolonged menstral bleeding. management -ddavp and replace factor vwf -avoid nsaids -avoid contact sports -prevent injuries -referral to hematology. Leukemia - ✅✅✅cancer that causes abnormal growth of leukocytic precursors in bone marrow -increase in immature WBC's -suppresses normal hematopoietic stem cells -leads to anemia and thrombocytopenia clinical features -anemia -pale -chronically tired -hx of repeat infections, bleeding, lymphadenopathy, bone and joint pain diagnosis CBC with diff. referral to heme onc. lymphoma - ✅✅✅Group of malignant tumors of lymph nodes and lymph tissue Associated with EBV and cytomegalovirus Clinical features -most common site of tumor is in intestinal tract (abdominal pain, distention, fullness, and constipation) -non tender lymph node enlargement -symptoms usually present late refer to oncology. Cellulitis - ✅✅✅-Bacterial infection of the skin involving the dermis and subq tissue -Group A beta strep and staph aureus most common organisms -May be H.flu esp in patients <3 years old diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling Diagnosis Wound culture CBC, blood culture if systemically ill Management antibiotic treatment, systemic symptoms and ill may need hospitalization MRSA infections - ✅✅✅•Clinical Presentation -Rapid onset -Abscess that is not draining, warm, erythematous, and painful •Treatment -Bactrim: children •>2 months old 8-12 mg/kg/day X 10 days •Bactrim DS bid X 10 days -Clindamycin •10-25 mg/kg/day (tid dosing) •300 mg qid -Leave open to air if possible -Cotton underwear if older Tinea corporis - ✅✅✅ringworm Characteristic rash -Pink, scaly, round with raised border Treatment -Topical antifungal cream 2 to 6 wks duration Education -Avoid contact with lesion -No contact sports X 48 hours of treatment verruca vulgaris - ✅✅✅common warts -Benign lesions of the epidermis caused by a virus -Transmitted by touch and commonly appear on the hands, around the periungual regions from nail biting, and on the plantar surfaces of the feet Treatment •OTC product: Compound W or similar •OTC cryosurgery kit •Duct tape •Liquid nitrogen •Retin A type products •Blunt dissection (plantar lesions) •Imiquimod cream Erythema Multiforme - ✅✅✅Acute, hypersensitivity syndrome Benign Usually follows an infection: HSV Clinical presentation -Red macules/papules that evolve into a target lesion -Lesions are fixed and often symmetric •Self-limiting condition •Symptomatic treatment -Analgesics -Antihistamines -Cool compresses -Viscous lidocaine Molluscum Contagiosum - ✅✅✅•Infection caused by the pox-virus •Most commonly seen on the face, trunk and axillae •Self-limiting: may take a few weeks to months •Spread by auto-inoculation •Incubation period: 2 to 7 weeks after exposure •Extremely contagious until gone Asymptomatic lumps May have a few or hundreds Physical exam findings -2-5 mm papule with umbilicated center -Flesh-toned, whitish/pink in color -Most often around the eye -Scaling and erythema around the periphery of the lesion may occur Treatment - Therapeutic, conservative treatment -Curettage to remove the papule -Cryosurgery: recheck in 1 to 2 weeks -Tretinoin nightly if > to 12 years Education -May resolve on own in 6 to 9 months -Contagious until lesions are gone -Benign -Recurrence is common Pityriasis Rosea - ✅✅✅Symptoms -Rash initially begins as a herald patch -Often mistaken for ringworm -29% have recent history of viral infection -Asymptomatic, slightly itchy rash Signs -Prodrome of malaise, sore throat, and fever may precede -Herald patch: 2-10 cm oval—round lesion appears first -Most common location is the trunk, proximal ext Therapeutic -Antihistamine -Topical steroids -Avoid sun exposure -Moisturize Scabies - ✅✅✅contagious skin disease transmitted by the itch mite •Clinical Presentation -Minor itching at first which progresses with itching worse at night 2.Polymorphous exanthem, usually truncal 3.Conjunctival injection 4.Erythema and/or fissuring of lips and oral cavity 5.Cervical lymphadenopathy •Illness not explained by other known disease process Management of Kawasaki disease - ✅✅✅•Coronary artery aneurysms develop in 15% to 25% of untreated children •May lead to ischemic heart disease or sudden death •Treatment -IV immunoglobulin -Aspirin -Echocardiography and cardiac consult Risk factors for otitis media in children - ✅✅✅-Boys -First born -Winter months -Bottle fed babies -Preemies -Daycare children -Children of smokers Most common pathogen causing AOM - ✅✅✅•75% of otitis media infections are viral •Acute Otitis Media bacterial pathogen - Less common •Pathogens - S. pneumoniae is •the most common -H. influenzae •Must treat with Augmentin (conjunctivitis + AOM) - M. catarrhalis Symptom and signs of AOM - ✅✅✅•Symptoms -Fever -Pain -Discharge from the ear -Tugging or batting at the ear -Irritability, crying, lethargy -Decreased appetite -Decreased sleep -Recent URI •Signs -Red, bulging TM -Retracted with pus -Decreased translucency of TM -No movement of the TM -Inability to see normal landmarks -Occasionally - hole in the tympanic membrane Treatment for AOM - ✅✅✅Less than 6 months- antibiotic therapy 6-24 months- antibiotics if fever over 102, certain diagnosis, bilateral infection, longer than 7 days of symptoms Greater than 2 years- Observation if not certain, antibiotics if there is fever, bilateral infection, severe pain, and fever over 102 and symptoms longer than 7 days. antibiotics for AOM - ✅✅✅amoxicillin 80-90 mg/kg/day BID for 10 days or if allergy can do cefdinir, azithromycin, clarithromycin Bullous Myringitis - ✅✅✅Mycoplasma pneumonia very painful treatment with macrolide. when to refer for PE tubes - ✅✅✅over three confirmed cases of ear infections in 6 months, or 4 or more in one year. otitis effussion - ✅✅✅Fluid build up in middle ear. If not resolving in 12 months or having hearing issues refer to ENT. Most of the time they will resolve 3 months after AOM, but if they do not then they need referral. otitis externa signs and symptoms - ✅✅✅•Symptoms -Discharge from the ear -Low grade fever -Recent history of swimming or placing something in ear -Pain with movement of the tragus -Redness around ear -Decreased hearing •Otalgia •Pain with movement of the tragus •Redness around ear •Decreased hearing •Fullness •Itching •Discharge when do funduscopic examinations start - ✅✅✅at 5 years at age. Viral conjunctivitis - ✅✅✅•Etiology -Adenovirus is the most common cause •Recent studies have shown that it can remain viable on plastic and metal surfaces for up to 1 month •Also can be HSV, herpes zoster, and varicella •Symptoms -*Watery discharge (profuse and clear), foreign body sensation, redness -URI symptoms are common including sore throat and fever -Red, itchy conjunctiva and swollen eye lids -Often bilateral •Signs -Normal visual acuity, PERRLA, EOMI, Fund normal -Mucoid-profuse watery discharge -Mild, diffuse injection and itching -*Preauricular lymphadenopathy •Treatment -Symptomatic only -Warm or cool compresses -Strict eye hygiene Bacterial conjunctivitis - ✅✅✅•Symptoms -Redness, swelling, *purulent discharge, itching No symptoms until eye complaints began • Signs -Normal visual acuity, PERRLA, EOMI, Fund nil -*Diffuse injection -No ciliary injection -*Unilateral at onset •Treatment -Topical antimicrobials x 5 to 7 days -Warm compresses qid x 10 to 20 minutes -Strict eye hygiene given contagion •Close observation and follow-up -Can develop into periorbital cellulitis, iritis, cyclitis, or choroiditis •Oral antibiotics for 7 to 14 days •Referral to ophthalmologist •May require hospitalization for IV antibiotics Allergic conjunctivitis - ✅✅✅•Symptoms -Bilateral -Severe Itching -Mucoid—stringy-like clear discharge -Cobblestone papillary hypertrophy in tarsal conjunctiva •Signs -Injected conjunctiva -Other physical examination findings such as: •Allergic shiners •Allergic crease •Rhinitis •PREVENTION •Saline solution, artificial tears •Cool compresses •Topical Antihistamines -Ketotifen (zaditor), epinastine (Elestat), and azelastine (Optivar) •Topical decongestants -Naphazoline hydrochloride (AK-con) •Mast-cell stabilizer -Cromolyn, sodium and lodoxamide (Alomide), Olopatadine (Patanol), nedocromil (Alocril) nasolacrimal duct conditions - ✅✅✅•Symptoms -Tearing, stickiness, and mucoid discharge in inner canthus -Blepharitis in lids and lashes -Nasal obstruction and drainage -Thin mucopurulent exudate from punctum lacrimale -Tenderness and swelling of duct •Management -Warm compresses -Daily massage -If bacterial infection suspected •Antibiotic drops -Saline irrigation of nasal passages •If persists over 1 to 2 weeks with interventions, referral to ophthalmologist -May probe duct at age 6 to 12 months Risk factors related to elevated cholesterol - ✅✅✅· Obesity · Diabetes · Hypertension · Family history: o Coronary heart disease prior to age 55 o Hyperlipidemia o Diabetes o Equal femoral and radial pulses o Normal PMI Symptoms of croup - ✅✅✅· Barking cough · Fever · URI symptoms Bronchiolitis - ✅✅✅· inspiratory and expiratory wheezing accompanied by: o fever o URI symptoms including profuse clear nasal discharge When to use inhaler to treat exercise induced asthma - ✅✅✅· asthma triggered by exercise, short-acting inhalers can make activities that need extra lung power more doable · Use rescue inhaler 15-30 minute prior to activity Kawasaki disease - ✅✅✅Clinical findings: · Fever for at least 5 days (102-104) · At least 4 of the following 5 features: o Changes in extremities Edema, erythema, ***desquamation (PEELING OF HANDS) o Polymorphous exanthem, usually truncal o ***Conjunctival injection o Erythema or fissuring of lips and oral cavity o Cervical lymphadenopathy · Coronary artery aneurysms develop in 15% - 25% of untreated children · May lead to ischemic heart disease or sudden death Treatment: · IV immunoglobulin · Aspirin · Echocardiography and cardiac consult Impetigo - ✅✅✅vesicles and honey-colored crusted lesions Pityriasis rosea - ✅✅✅· scaly, hyper-pigmented lesions in a fir tree distribution o usually found on trunk when can return to school for impetigo - ✅✅✅after 48 hours from treatment start treatment for otitis externa - ✅✅✅· Topical fluoroquinolone o Ciprofloxacin o ofloxacin Viral pharyngitis - ✅✅✅· Most common cause of sore throat · Caused by several different viruses including rhinovirus, adenovirus, EBV, RSV Symptoms: · Rhinorrhea · Low-grade fever · Conjunctivitis · Cough · Tonsillar exudate and/or enlarged tonsils · Malaise Treatment · Supportive care only for viral cause o Gargle with warm salt-water o Increase fluid intake o Tylenol or ibuprofen for fever/throat pain Infectious mononucleosis - ✅✅✅Viral infection caused by the Epstein-Barr virus Signs and symptoms · Malaise · Fatigue · Fever, chills, headache · Pharyngitis (may be painful, severe, and exudative) · Posterior cervical lymphadenopathy · Splenomegaly · Palatal petechiae Treatment is symptomatic · Rest · No vigorous exercise, contact sports, or heavy lifting for about 6-8 weeks (or until spleen is no longer enlarged) · Warm salt-water gargles · Avoid stress · Tylenol for fever, aches How long is it normal for newborns eyes to cross - ✅✅✅2 months of age. strep - ✅✅✅Strep Sx: Fever 103-104, rapid onset of sore throat, swollen glands, abdominal pain, HA, decreased appetite, no URI symptoms, Dysphagia, irritability, anterior cervical lymphadenopathy Strep objective: Exudative tonsils, rash, strawberry tongue, **anterior cervical lymphadenopathy Strep TX: Amoxicillin 50-80 mg/kg/day x 10 days PCN ALLERGY: Cephalosporin OR Macrolide Warm water gargles; Tylenol/NSAIDS Educational: Contagious-no school x 24 hrs. Discard toothbrush. Quick improvement. Mono - ✅✅✅Mono: Epstein-Barr Virus-Spread via saliva; Incubation period 2-5 weeks.