NURS 659 STUDY GUIDE WITH
COMPLETE SOLUTION
When performing an H&P on someone who comes in with an infectious
disease complaint, it's important to ask when their last dose of ____ was -
ANSWER antipyretics
Could be masking a fever
A minor with an STI requires a call to - ANSWER CPS
If someone comes in with GI complaints, what is something that's important
to ask about in their history that is unique to this? - ANSWER Diet history
Raw, undercooked foods, etc
A raise in neutrophils and bands indicates - ANSWER An acute bacterial
infection
Platelet count is often elevated during - ANSWER Acute infections
Elevations in CRP and ESR - ANSWER Indicate inflammation but don't tell you
much about the source or the situation, put in the context of the whole
patient
If not elevated unlikely to be a bacterial infection
Viruses rarely elevate
What is a fever defined as? - ANSWER >100.4 rectal or tympanic
In what population is a fever always an ED visit for sepsis workup? - ANSWER
<2 months
,The Rochester Criteria is utilized for what? - ANSWER To determine the risk
of a bacterial infection in an infant (typically <3 mo) as it's hard to detect one
otherwise
Briefly describe the Rochester criteria and some of the things it looks like -
ANSWER Does the infant appear generally well
Previously healthy infant?
No evidence of visible infection
Normal lab values (CBC, UA, etc)
Describe an infant who is low risk for a bacterial infection - ANSWER
Well-appearing >/= 4 weeks
No history of prematurity
Not on antibiotics currently or recently
No identifiable source of infection
With certainty of follow up
Other than an infant <2mo, when else would you consider hospitalization for
an infant with a fever? - ANSWER Parental anxiety
Evidence of systemic illness
FTT
,What are some important things to assess for on physical exam for fever? -
ANSWER Vital signs (low b/p) --> sepsis?
Irritability (meningitis, kawasaki)
Stiff/painful neck (meningitis?)
New heart murmur (endo, rheumatic fever)
Refusal to walk or altered mobility?
Why might a heart murmur not be concerning in fever? - ANSWER Kids often
get a murmur when they have a fever due to increased metabolism
However, put in the context of the illness, don't just write it off
What is something important to collect in the social history of a kid? -
ANSWER if they go to daycare or not
if they do, increased risk of infection, antibiotic treatment/antibiotic resistant
infections
Definition of fever of unknown origin - ANSWER More accepted definition
>101 for 2 weeks rectal with no etiology
What would you order to rule out leukemia in a FUO patient? - ANSWER CBC
with peripheral smear
, Pro and con of live vaccine immunity - ANSWER Longer immunity but
typically higher side effects
Why do maternal antibodies neutralize some vaccines? - ANSWER Destroy
the antigen before the baby's body can learn and recognize
Live vaccines should be given how many days apart? - ANSWER 28 days
Are reduced doses effective of vaccines? - ANSWER No, will not produce an
adequate immune response
Inactive vaccines can cause a reaction how long after vaccine?
Live vaccines? - ANSWER inactive: 48-72 weeks
live: 2-3 weeks
sometimes even cause a mild version of the disease 4 weeks after
What are the benefits of vaccine additives? - ANSWER Weaken the antigen so
it can do its job
Why are vaccine boosters needed? - ANSWER Not all antigens are capable of
COMPLETE SOLUTION
When performing an H&P on someone who comes in with an infectious
disease complaint, it's important to ask when their last dose of ____ was -
ANSWER antipyretics
Could be masking a fever
A minor with an STI requires a call to - ANSWER CPS
If someone comes in with GI complaints, what is something that's important
to ask about in their history that is unique to this? - ANSWER Diet history
Raw, undercooked foods, etc
A raise in neutrophils and bands indicates - ANSWER An acute bacterial
infection
Platelet count is often elevated during - ANSWER Acute infections
Elevations in CRP and ESR - ANSWER Indicate inflammation but don't tell you
much about the source or the situation, put in the context of the whole
patient
If not elevated unlikely to be a bacterial infection
Viruses rarely elevate
What is a fever defined as? - ANSWER >100.4 rectal or tympanic
In what population is a fever always an ED visit for sepsis workup? - ANSWER
<2 months
,The Rochester Criteria is utilized for what? - ANSWER To determine the risk
of a bacterial infection in an infant (typically <3 mo) as it's hard to detect one
otherwise
Briefly describe the Rochester criteria and some of the things it looks like -
ANSWER Does the infant appear generally well
Previously healthy infant?
No evidence of visible infection
Normal lab values (CBC, UA, etc)
Describe an infant who is low risk for a bacterial infection - ANSWER
Well-appearing >/= 4 weeks
No history of prematurity
Not on antibiotics currently or recently
No identifiable source of infection
With certainty of follow up
Other than an infant <2mo, when else would you consider hospitalization for
an infant with a fever? - ANSWER Parental anxiety
Evidence of systemic illness
FTT
,What are some important things to assess for on physical exam for fever? -
ANSWER Vital signs (low b/p) --> sepsis?
Irritability (meningitis, kawasaki)
Stiff/painful neck (meningitis?)
New heart murmur (endo, rheumatic fever)
Refusal to walk or altered mobility?
Why might a heart murmur not be concerning in fever? - ANSWER Kids often
get a murmur when they have a fever due to increased metabolism
However, put in the context of the illness, don't just write it off
What is something important to collect in the social history of a kid? -
ANSWER if they go to daycare or not
if they do, increased risk of infection, antibiotic treatment/antibiotic resistant
infections
Definition of fever of unknown origin - ANSWER More accepted definition
>101 for 2 weeks rectal with no etiology
What would you order to rule out leukemia in a FUO patient? - ANSWER CBC
with peripheral smear
, Pro and con of live vaccine immunity - ANSWER Longer immunity but
typically higher side effects
Why do maternal antibodies neutralize some vaccines? - ANSWER Destroy
the antigen before the baby's body can learn and recognize
Live vaccines should be given how many days apart? - ANSWER 28 days
Are reduced doses effective of vaccines? - ANSWER No, will not produce an
adequate immune response
Inactive vaccines can cause a reaction how long after vaccine?
Live vaccines? - ANSWER inactive: 48-72 weeks
live: 2-3 weeks
sometimes even cause a mild version of the disease 4 weeks after
What are the benefits of vaccine additives? - ANSWER Weaken the antigen so
it can do its job
Why are vaccine boosters needed? - ANSWER Not all antigens are capable of
