Question

Pediatrics: Pertussis ( Whooping cough) ( please fill all lines)

1) Alterations in health (diagnosis)

2) Pathophysiology Related to Client Problem

3) Health Promotion and Disease Prevention

4) Risk Factors

5) Expected Findings

6) Laboratory Tests

7) Diagnostic Procedures

8) Safety Considerations

9) Nursing Care

10) Therapeutic Procedures

11) Medications

12) Client Education

13) Interprofessional Care

14) Complications

ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

Nursing Dignosis

Ineffective airway pattern related to choking coughing spells.

Pathophysiology

The infecting organism adheres to ciliated epithelial cells and multiplies.The resulting local mucosal damage induces paroxysmal coughing,which enhances disease transmission.Mucopurulosanguinous exudates forms in the respiratory tract,compromising the airway and leading to atelectasis.Various toxins produced during the infection impair local defenses and cause local tissue damage.Toxins may cause direct central nervous system injury.

Risk factors

• It is more common in infants and children who havent been fully vaccinated.a

Health Promotion and Disease Prevention

The DTaP vaccine is recommended for infants beginning at 2 months of age.5 doses of DTaP are given until age.one dose at 2 months of age,one dose at 4 months of age,one dose at 6 months of age,one dose between 15 and 18 months of age,and another dose between 4 to 6 years of age.Pertusis transmission is prevented by direct contact with respiratory droplets from coughing.Because of waning immunity in the adolescent population ,a booster called Tdap is recommended for children age 11 to 12 who completed a primary series of DTaP.

Laboratory tests

White bloodcell count and differential show leukocytosis and lymphocytosis.B.pertusis is found in nasopharyngeal swabs and sputum culture in early disease stages.

Diagnostic procedures

Chest X-Ray maybe normal or reveal hyperinflation with increased antero-posterior diameter and flattened diaphragm focal atelectasis ,peribronchial cuffing ,or pneumonia.it is also diagnosed through positive nasopharyngeal culture.

Medications

• Oxygen
• Antibiotics such as azithromycin,clarithromycin and erythromycin ,as first line agents.
• Antibiotics ,such as trimethoprim.
• IV fluid therapy.
• Booster Immunization.

Complications

• Pneumonia
• Otitis media
• Enceephalopathy
• Seizures
• Cerebral haemorrhage

Nursing Considerations

• Institute standard precautions and implement droplet precautions for the first 5 days after starting medication therapy.
• Provide oxygen ,as indicated,based on oxygen saturation levels and humidification,as ordered ;if needed,assist with respiration and ventillation .
• Administer IV fluid therapy ,as ordered;ensure patent IV access and inspect the insertion site for insertion ,infiltration or infection.
• Provide IV site care according to facility policy.
• Elevate the head of the bed to maximize chest expansion and ease the work of breathing.
• Evaluate the patient for complications caused by excessive coughing.
• Provide small ,frequent meals with fluids to promote nutrition.

Client Education

• Teach the patient about the underlying cause of the condition,diagnosis and treatment,including antibiotic therapy.
• Explain to the patient that disorder is usually transmitted via close contact with droplets from an infected person and the incubation period averages about 3 to 12 days.
• Advise the patient ,that once exposed ,the patient 's close contacts to get medical care and treatment because the patient is contagious for 3 weeks after exposure that the disease typically lasts about 4 to 8 weeks,and during the last 2 weeks the severity and frequency of the coughing episodes decrease.
• Also teach them the importance of immunization and vaccinations.
• Notify the practicioner of adverse reactions to the vaccine and getting booster vaccines .