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Nsg 6435 final exam study guide docx
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Nsg 6435 final exam study guide docx
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Know znormal zand zabnormal zfindings; zknow zexpected zrisks, zcomplications, zsigns/symptoms;zphysical zexam zfindings; zhow zto zdiagnose, ztreat, zmanage, zeducate zpatients/guardians, zpatho, zand
zpharm zfor zthe zfollowing:
Varicella
Expected z risks:
Never zhad zthe zvaccine, znever zexposed zto zVaricella. z More zsevere zin zadolescents zand
zadults zthan zyounger zchildren.
Those z at z risk z include z (MayoClinic z 2019):
• Newborns z of z unvaccinated z mothers z or z mother z who z never z had z chickenpox
• Adolescents z and z adults
• Pregnant z women z who z haven’t z had z chickenpox z or z the z vaccine
• Smokers
• Immunocompromised z (chemo, z HIV, z ect.)
• Long z term z steroid z use z (as z seen z with z asthma z or z COPD)
Complications:
Severe z – z cerebellar z ataxia, z encephalitis, z viral z pneumonia, z hemorrhagic z conditions
z (CDC, z2016). z Secondary zbacterial zinfections, zpneumonia, zencephalitis, zhepatitis, zand zReye
zsyndrome z (Hay, zLevin, zDeterding, zAbzug, z& zSondheimer, z2014, zp.271)
Other z– zsepticemia, ztoxic zshock zsyndrome, znecrotizing zfasciitis, zosteomyelitis, zbacterial
zpneumonia, zseptic zarthritis z(CDC, z2016)
Physical z findings z (Signs/Symptoms):
Fever, zloss zof zappetite, zh/a, zmalaise z(MayoClinic, z2019). z Classic ztriad zof zlow zgrade
zfever, zmalaise, zand zrash z(Papadopoulos, z2018).
“Dew zdrops zon za zrose zpetal”; zRash z– zclassic zappearance, zstarts zon zscalp, zface,
zor ztrunk zRash zhas z3 zphases z(MayoClinic, z2019):
1) raised z pink z bumps z (papules), z which z break z out z over z several z days;
2) small zfluid-filled zblisters z(vesicles), zwhich zform zin zabout zone zday zand zthen zbreak
zand zleak;
3) Crusts z and z scabs, z which z cover z the z broken z blisters z and z take z several z more z days z to
z heal.
,How z to z Diagnosis; z Treatment; z Management; z Pharma
Diagnosis zis zbased zon zS/S zand zpresentation. z Bloodwork zand zcultures zof zlesions zcan zbe
zdone zto zconfirm zchickenpox z(MayoClinic, z2019).
In zyounger zchildren, zsymptomatic ztreatment zonly z(Tylenol/Ibuprofen zfor zfever, zetc)
z(Papadopoulos, z2018).
Adolescents zand zadults, zat zincreased zrisk, zneed za zmore zaggressive ztreatment zthat zcan
zinclude zPO zor zIV zAcyclovir. z Varicella-zoster zimmunoglobulin zcan zbe zuse zin zhighly
zsusceptible zindividuals z(Papadopoulas, z2018).
Management z includes z (Cleveland z Clinic, z 2018):
• Cool, z moist z rag z to z rash
• Keep z temperature z down
• Try z to z prevent z child z from z scratching z (cut z fingernails)
• Use z lotion z with z an z antihistamine z on z the z rash z and/or z give z OTC z antihistamines
• Give z cool z bath z or z shower z daily z (can z also z give z an z oatmeal z bath).
Education
Child zcan zreturn zto zschool z7 zdays zafter zrash zappears, zdoes znot zhave zto zwait zuntil zscabs
zare zhealed z(Cleveland zClinic, z2018).
Chickenpox zis zcontagious zfor zabout z2 zdays zbefore za zrash zappears zand zis zcontagious zuntil
zthe zvesicles zhave zcrusted zover z(roughly z1 zweek) z(Nemours, z2019).
Keep zchild zaway zfrom zthose zat zrisk z(newborns, zpregnant zwomen, zelderly,
zimmunocompromised).
, Anyone zwho zhas zhad zchickenpox zhas zthe zpotential zto zhave zshingles zlater zin zlife
z(Nemours, z2019).
Someone zwith zshingles zcan zspread zchickenpox zbut znot zshingles zto zthose zthat zhave znever
zhad zchickenpox zor zthe zvaccine z(Nemours, z2019).
Patho
Acquired zby zinhaling zairborne zdroplets zfrom zan zinfected zhost zand zinfects zthe zconjunctivae
zand zmucosa zof zupper zrespiratory ztract z(Papadopoulos, z2018).
Humans z are z only z known z vector z for z chickenpox.
Viral zproliferation zin zlymph znode z2-4 zpost zinitial zinfection zfollowed zby zprimary zviremia
z4-6 zpost zinfection z(Papadopoulos, z2018).
Measles
Expected z risks:
Has za z90% zsecondary zinfection zrate z(Chen, z2019). z Can zaffect zpeople zof zall zages, zalthough
zprimarily zthought zof zas za zchildhood zillness z(Chen, z2019).
Complications:
Rash zcan zbecome zhemorrhagic zand zcan zbe zfatal zdue zto zdisseminated zintravascular
zcoagulation z(DIC) z(Hay zet zal., z2014, zp. z515).
Bacterial zsuperinfection zand zviral zcomplications zcan zmanifest zas za zURI, zobstructive
zlaryngitis, z otitis, zdiarrhea, zmastoiditis, zcervical zadenitis, zbronchitis, ztransient zhepatitis,
zand zpneumonia z (Hay zet zal., z2014, zp. z515).
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