Question

a child was brought to the hospital with fever and vomiting. the vital signs of the child show a body temperature of 103 F and pulse rate of 130 beats per minute. physical examination shows a red and swollen tongue. which condition has the child most likely developed

Answer 1

The answer is SCARLET FEVER ,and it is also known as SCARLATINA

INTRODUCTION

It is an upper respiratory tract infection associated with a characteristics of rash and it is commonly seen in childrens aged 4-8 years and it may cause some complications such as;

-RHEUMATIC FEVER

-OTITIS MEDIA

   -PNEUMONIA

-SEPTICEMIA

-GLOMERULONEPHRITIS

-OSTEOMYELITIS

   -PERITONSILLAR ABSCESS

  -TOXIC MYOCARDITIS

MEANING

-It is a bacterial infection caused by GROUP A BETA HEMOLYTIC STREPTOCOCCUS BACTERIA

-It is charactrized by a bright red rashes on the body ,usually accomponied by a high fever and sore throat

EPIDEMIOLOGY

-commonly seen in children with the ages between 4-8 years

-incubation period is 3-6 days

-common in late winter and early spring season

MODE OF TRANSMISSION

-airbornedroplets-sneezing and coughing

-touching the infected skin

-sharing of contaminated clothes ,towel,bedlinen etc

RISK FACTORS

-genetics

-overcrowded ares

-childrens older than 3 years

  -contact with an infected people

SIGNS AND SYMPTOMS

-high fever

-headache

-dysphagia

-nausea and vomiting

-tachycardia

-very red ,sore throat

-strawberry colored tongue

-red skin rashes

-swollen glands on the neck

-body aches

-loss of appetite

-abdominal pain

-broken blood vessels in the folds of the body ,like knees,neck,

PREVENTIVE MEASURES

-cover your moth and nose when you sneeze and cough

-put your used tissues in thewaste bascket

-wash your hands frequentlly

-use alcohol based hand scrub

-isolation or staying away from others

-not sharing drinking glasses or eating utensils

PATHOGENISIS

The steps of pathogenesis as follows;

1-due to etiological factors

2-Goup A beta streptococcus secretes a number of toxins and enzymes

3-erythrogenic toxins causes the local lesions and inflammatory reactions

4-odema and cellular infitration

5-hyperthermia and skin rashes

DIAGNOSTIC EVALUATIONS

-History collection

-Physical examination

-Throat or nasal culture

-Serologic studies

-Complete blood count-increased ESR and white blood cell count

-Rapid antigen detection test

-Chest radiography

-Echocardiography

TREATMENT

OBJECTIVES;

-to reduce the further complications

-to treat the underlying causes

-to provide comfortable rest

-to maintain nutritional status and hydration status

-to prescribe medications as per orders

-to maintain personal hygeine

TREATMENT MODALITIES

MEDICAL TREATMENT

1- ANTIBIOTIC THERAPY

- The drug of coice is PENCILLIN

-The dose of orally administered pencillin is 250 mg two to three times daily for child weighing  less than 27 kg

-A full course of ten days is recommended

Patients who are allergic to pencillin may take oral ERYTHROMYCIN

2-ANTI-INFLAMMATORY-like aspirin

3-ANTI-PYRETICS-to treat fever

4-ANALGESICS -to reduce the pain

NURSING MANAGEMENT

-encourage rest and fluids

-treat sore throat

-control spread of diseases

-provide fever management

-provide non-pharmacological pain management

-providing diversional activities

-assess for cardiac and pulmonary atatus

-check the vital signs

-provide folow up care

-assess for the sideffets of antibiotic therapy

NURSING DIAGNOSIS

-HYPERTHERMIA RELATED TO INFLAMMATION

-ACTIVITY INTOLERANCE RELATED TO WEAKNESS

-IMBALANCED NUTRITIONAL STATUS LESS THAN BODY REQUIREMENT RELATED TO DYSPHAGIA

-HIGH RISK FOR INFECTION

-HIGH RISK FOR COMPLICATIONS

-

-