CHILD HEALTH NURSING;NURSING MANAGEMENT OF CHILDREN WITH COMMUNICABLE DISEASES

1. Nursing Management
For the Child With a Communicable
Disease

2. Introduction

3. Nursing assessment
• History
• Recent exposure to a known case
• Prodromal symptoms (symptoms that occur between early manifestations of
the disease and its overt clinical syndrome) or evidence of constitutional
symptoms, such as a fever or rash.
• Immunization history
• History of having the disease

4. Nursing Assessment
• Examinations
• Assess the child’s
• Hydration status and fluid intake
• Vital signs
• Comfort level and appetite.
• Observe for
• Seizures and toxic appearance (lethargy, poor perfusion, hypoventilation or
hyperventilation, and cyanosis).
• The child with a fever may be
• Irritable and restless, sleep fitfully, and have nonspecific muscular pain.

5. Nursing Assessment
• Identify febrile children who may be at higher risk for a serious
illness
• Infants and children having a toxic appearance.
• Newborns less than 28 days of age with a temperature over 38.0°C (100.4°F).
• Children less than 4 years of age with a temperature over 41.0°C (105.8°F).
• Children with conditions such as a congenital heart disease, ventriculo-
peritoneal shunt, asplenia, and sickle cell disease.
• Observe the child for other signs of infection,
• Such as a rash, nausea and vomiting, or diarrhea, as well as generalized
symptoms of a poor appetite, muscle aches, and malaise.

6. Nursing diagnosis
• Hyperthermia related to infectious disease process
• Impaired Skin Integrity related to skin lesions and scratching
• Impaired Oral Mucous Membrane related to infectious disease
process
• Fluid Volume deficit related to repeated episodes of vomiting and
diarrhea
• Ineffective Family Health Management related to complexity of care
required by child

7. Planning and Implementation
• Nursing care
• Collecting cultures
• Providing supportive care
• Administering antibiotics on schedule
• Monitoring antibiotic blood levels if indicated to ensure
appropriate results
• Promoting the child’s comfort, and
• Educating parents

8. Prevent Disease Transmission
• Isolate children with suspicious rashes and respiratory infections.
• Cover draining wounds and dispose of dressings appropriately.
• All items with which the infected child comes into contact are
considered contaminated (e.g., linens, toys, medical equipment).
• Use standard precautions and good hand hygiene.
• Recall that the fecal–oral and respiratory routes are the most
common routes of transmission in children.
• Wipe down hard surfaces in the examining room with an antiseptic
solution before another child uses the room.

9. Prevent Disease Transmission
• Wipe down toys in the waiting room daily with a nontoxic antiseptic
solution.
• Dispose of linens in appropriately marked linen bags.
• Ensure that all healthcare providers are fully immunized or that
unimmunized
• Pregnant healthcare providers are not exposed to children with
certain infections (e.g., Pertussis, rubella, or varicella)

10. Fever Management
• Removing unnecessary clothing.
• Encouraging increased fluid intake.
• Administering non-aspirin antipyretics.
• Identify clear fluids the child prefers to drink to encourage greater
intake.
• Parents often fear a fever, provide information and reassurance.
• Help them to recognize signs that the child’s condition is worsening.

11. Educating the Family
• Home care
• Medications
• Prevention of transmission
• Comfort
• Fluid intake
• Skin care

12. Educating the Family
• Medications
• To give antipyretics and antibiotics if
ordered
• Teach parents to give all the antibiotic
doses for the full number of days
prescribed (Antibiotic resistance)
• When over-the-counter medications
may be used

13. Educating the Family
• Prevention of transmission
• Educate parents about methods to reduce
disease transmission in the home.
• Encourage parents to limit the exposure of
family members, those with impaired
immunity
• Make sure that the ill child’s dishes and
utensils are washed in hot soapy water or
sanitized in a dishwasher.
• Place dressings with drainage in a plastic
bag for disposal to prevent contact by other
family members.

14. Educating the Family
• Comfort
• Encourage children to rest.
• Provide quiet diversional activities
such as board games, computer
games, DVDs, and music.
• Fluid intake
• Promote fluid intake and provide
foods that the child prefers and do
not cause discomfort.

15. Educating the Family
• Skin care
• Reduce itching of rashes with
lukewarm baths with Aveeno or
oatmeal and topical lotions.
• Keep the child’s hands clean and
nails trimmed.
• Cover the hands with clean socks
or mittens if scratching cannot be
controlled.

16. Evaluation
• Expected outcomes of nursing care include the following:
• Opportunities for spread of infection between clients and
family members are minimized.
• The child’s fever is effectively managed with antipyretics.
• The full treatment with antibiotics, if ordered, is completed