Nurs 341 – Study Guide - Exam 2
Chapter 15: Nursing Care of the Child with an Infection
Know the infectious process (including tables, diagrams, boxes, etc.)
- Table 15.2 Stages of Infections disease (P452)
Incubationl: Time from entrance of pathogen into the body to appearance of first symptoms;
during this time, pathogens grow and multiply
Prodrome: Time from onset of nonspecific symptoms such as fever, malaise, and fatigue to more
specific symptoms
Illness: Time during which child demonstrates signs and symptoms specific to an infection type
Convalescence: Time when acute symptoms of illness disappear
- Table Common laboratory and diagnostic test 15.1 P458-9
Know the chain of infection (including tables, diagrams, boxes, etc.)
, Know Lab & Diagnostic Tests (including explanation, indication, and implications)
- Table 15.1 Function of WBCs by leukocyte type (P451)
Know Sepsis (especially signs/symptoms in infants and neonates-but not exclusively)
- The endotoxins cytokine (producted by bacteria) are responsible for the clinically observable
effects of the sepsis
- Hypothermia is a S&S in neonate and those with severe disease.
- The other S&S: Child just does not look or act right; Crying more than usual, inconsolable;
Fever; Lethargic and less interactive or playful; Increased irritability; Poor feeding or poor suck;
, Rash (e.g., petechiae, ecchymosis, diffuse erythema); Difficulty breathing; Nasal congestion;
Diarrhea; Vomiting; Decreased urine output; Hypotonia; Changes in mental status (confused,
anxious, excited); Seizures; Older child may complain of heart racing.
- Hypotension is a late sign of sepsis. The child can be quite ill before blood pressure drops.
Irritability and not “acting right” to parents is an early sign of serious illness.
- FEVER MANAGEMENT
→Fever is a sign of illness, not a disease; it is the body’s weapon to fight infection.
→Diurnal variation may allow temperature changes as much as 1°C (1.8°F) over a 24-hour
period, peaking in the evening.
→Antipyretics are used if the child demonstrates discomfort. Always check correct doses before
administration. Never give aspirin or aspirin-containing products to a child younger than 19 years
with a fever due to the risk of Reye syndrome.
→In some children fever can be associated with a seizure or dehydration, but this will not lead to
brain damage or death. Discuss the facts about febrile seizures (see Chapter 16 for further
information on febrile seizures).
→Watch for the signs and symptoms of dehydration; it is important to provide oral rehydration
by increasing fluid intake.
→Dress the child lightly and avoid warm, binding clothing or blankets.
→The use of sponging with tepid water is controversial; if used, encourage the parent to give an
antipyretic prior to sponging. Ensure the sponging does not produce shivering (which causes the
body to produce heat and maintain the elevated set point), and reinforce the importance of
using tepid water, not cold water or alcohol. Instruct the parent to stop if the child experiences
discomfort.
→Call the provider for:
- Any child younger than 3 months of age who has a rectal temperature above 38°C
(100.4°F).
- Any child who is lethargic or listless, regardless of temperature.
- Fever lasting more than 3–5 days.
- Fever greater than 40.6°C (105°F).
- Any child who is immunocompromised by illness, such as cancer or HIV, will need further
evaluation and treatment.
Chapter 15: Nursing Care of the Child with an Infection
Know the infectious process (including tables, diagrams, boxes, etc.)
- Table 15.2 Stages of Infections disease (P452)
Incubationl: Time from entrance of pathogen into the body to appearance of first symptoms;
during this time, pathogens grow and multiply
Prodrome: Time from onset of nonspecific symptoms such as fever, malaise, and fatigue to more
specific symptoms
Illness: Time during which child demonstrates signs and symptoms specific to an infection type
Convalescence: Time when acute symptoms of illness disappear
- Table Common laboratory and diagnostic test 15.1 P458-9
Know the chain of infection (including tables, diagrams, boxes, etc.)
, Know Lab & Diagnostic Tests (including explanation, indication, and implications)
- Table 15.1 Function of WBCs by leukocyte type (P451)
Know Sepsis (especially signs/symptoms in infants and neonates-but not exclusively)
- The endotoxins cytokine (producted by bacteria) are responsible for the clinically observable
effects of the sepsis
- Hypothermia is a S&S in neonate and those with severe disease.
- The other S&S: Child just does not look or act right; Crying more than usual, inconsolable;
Fever; Lethargic and less interactive or playful; Increased irritability; Poor feeding or poor suck;
, Rash (e.g., petechiae, ecchymosis, diffuse erythema); Difficulty breathing; Nasal congestion;
Diarrhea; Vomiting; Decreased urine output; Hypotonia; Changes in mental status (confused,
anxious, excited); Seizures; Older child may complain of heart racing.
- Hypotension is a late sign of sepsis. The child can be quite ill before blood pressure drops.
Irritability and not “acting right” to parents is an early sign of serious illness.
- FEVER MANAGEMENT
→Fever is a sign of illness, not a disease; it is the body’s weapon to fight infection.
→Diurnal variation may allow temperature changes as much as 1°C (1.8°F) over a 24-hour
period, peaking in the evening.
→Antipyretics are used if the child demonstrates discomfort. Always check correct doses before
administration. Never give aspirin or aspirin-containing products to a child younger than 19 years
with a fever due to the risk of Reye syndrome.
→In some children fever can be associated with a seizure or dehydration, but this will not lead to
brain damage or death. Discuss the facts about febrile seizures (see Chapter 16 for further
information on febrile seizures).
→Watch for the signs and symptoms of dehydration; it is important to provide oral rehydration
by increasing fluid intake.
→Dress the child lightly and avoid warm, binding clothing or blankets.
→The use of sponging with tepid water is controversial; if used, encourage the parent to give an
antipyretic prior to sponging. Ensure the sponging does not produce shivering (which causes the
body to produce heat and maintain the elevated set point), and reinforce the importance of
using tepid water, not cold water or alcohol. Instruct the parent to stop if the child experiences
discomfort.
→Call the provider for:
- Any child younger than 3 months of age who has a rectal temperature above 38°C
(100.4°F).
- Any child who is lethargic or listless, regardless of temperature.
- Fever lasting more than 3–5 days.
- Fever greater than 40.6°C (105°F).
- Any child who is immunocompromised by illness, such as cancer or HIV, will need further
evaluation and treatment.
