NSG 6435 FINAL EXAM STUDY GUIDE 100% corrected and updated
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Course
PEDS NSG 6435
Institution
South University
NSG 6435 FINAL EXAM STUDY GUIDE
Know normal and abnormal findings; know expected risks, complications, signs/symptoms; physical exam findings; how to diagnose, treat, manage, educate patients/guardians, patho, and pharm for the following:
Varicella
Expected risks:
Never had the vaccine...
nsg 6435 final exam study guide 100 corrected and updated
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PEDS NSG 6435
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NSG 6435 FINAL EXAM STUDY GUIDE
Know normal and abnormal findings; know expected risks, complications, signs/symptoms; physical
exam findings; how to diagnose, treat, manage, educate patients/guardians, patho, and pharm for the
following:
Varicella
Expected risks:
Never had the vaccine, never exposed to Varicella. More severe in adolescents and adults
than younger children.
Those at risk include (MayoClinic 2019):
• Newborns of unvaccinated mothers or mother who never had chickenpox
• Adolescents and adults
• Pregnant women who haven’t had chickenpox or the vaccine
• Smokers
• Immunocompromised (chemo, HIV, ect.)
• Long term steroid use (as seen with asthma or COPD)
Complications:
Fever, loss of appetite, h/a, malaise (MayoClinic, 2019). Classic triad of low grade fever,
malaise, and rash (Papadopoulos, 2018).
“Dew drops on a rose petal”; Rash – classic appearance, starts on scalp, face, or trunk
Rash has 3 phases (MayoClinic, 2019):
1) raised pink bumps (papules), which break out over several days;
2) small fluid-filled blisters (vesicles), which form in about one day and then break and
leak;
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,3) Crusts and scabs, which cover the broken blisters and take several more days to heal.
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, How to Diagnosis; Treatment; Management; Pharma
Diagnosis is based on S/S and presentation. Bloodwork and cultures of lesions can be done to
confirm chickenpox (MayoClinic, 2019).
In younger children, symptomatic treatment only (Tylenol/Ibuprofen for fever, etc)
(Papadopoulos, 2018).
Adolescents and adults, at increased risk, need a more aggressive treatment that can include
PO or IV Acyclovir. Varicella-zoster immunoglobulin can be use in highly susceptible
individuals (Papadopoulas, 2018).
Management includes (Cleveland Clinic, 2018):
• Cool, moist rag to rash
• Keep temperature down
• Try to prevent child from scratching (cut fingernails)
• Use lotion with an antihistamine on the rash and/or give OTC antihistamines
• Give cool bath or shower daily (can also give an oatmeal bath).
Education
Child can return to school 7 days after rash appears, does not have to wait until scabs are
healed (Cleveland Clinic, 2018).
Chickenpox is contagious for about 2 days before a rash appears and is contagious until the
vesicles have crusted over (roughly 1 week) (Nemours, 2019).
Keep child away from those at risk (newborns, pregnant women, elderly,
immunocompromised).
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