chicken pox- puritic (itchy) rash macule (red) papule (raised)- vesicle (fluid filled) spread by direct contact,

t, communicable 2 days before rash, isolation until all vesicles crusted, topical calamine lotion, avoid aspirin use tylenol. not aspirin with children
rubella- measles- macularpapular rash (red-raised) on face, then rest of body. spread by droplet, contact precautions, isolate from pregnant women, antipyretics (tylenol not aspirin) and analgesics reyes syndrome- caused by aspirin- cerebral edema and fatty liver mononucleosis- kissing disease- flulike aches, fever, enlarged lymph nodes, sore throat, 15-30 yr olds, spread by direct contact with oral secretions, avoid saliva for 3 months, rest and good nutrition. rest rest rest risk for ruptured spleen. tonsilitis- fever, white exudate on tonsils, treated with antibiotics, potential complications: rheumatic fever, glomerular nephritis tb- skin test mantoux (ppd) induration or hardness 10mm or greater (5 mm or greater in aids pt) or tine test looking for vesicles. symptoms include: fatigue, anorexia, low-grade fever, night sweats, cough with mucopurulent sputum streaked with blood, dyspnea nursing care: isolation for 2-4 weeks (3 negative sputum cultures), notify health dept. to evaluate contacts, teaching. medication: always on more than one to prevent drug resistance. isoniazid (inh), rifampin, ethambutol, stretomycin (im). on meds 6-9 months. hepatitis: jaundice, anorexia, ruq pain, clay-colored stools, tea-colored urine, pruritis, elevated alt, ast, prolonged pt. hep hep hep hep a-fecal/oral- do not prepare food b-parenteral/sexual- vaccine c-blood/body/fluids d-co-infects with hep b

hepatitis nursing care: rest, contact and standard precautions, low-fat, high calorie, high-protein diet, no alcohol, medications (vit k, antiemetic, corticosteroids, antihistamines) lymes disease stage 1- red area with papule develops into lesion with clear center (bulls eye), regional lymphadenopathy, flu-like symptoms stage 2- cardiac conduction defects, neurologic disorders (bells palsy-temporary paralyisis) stage 3- arthralgias, enlarged, inflamed joints prevention- cover exposed areas in wooded areas, check exposed areas for ticks nursing care- antibiotics for 3-4 wks (doxycillin) stds syphilis- painless chancre fades within 6 weeks, copper-colored rash on palms and soles, spread mucous membranes, congenital, treat with penicillin g im or erythromycin if patient has penicillin allergy

gonorrhea- thick discharge from urethra, asymptomatic in females, spread by mucous membranes, congenital, im rocephin doxycycline po, im aqueous penicillin with po probenecid (gout med) increased effectiveness of penicillin. complication pid genital herpes- painful vesicular genital lesions, reoccurs with stress, infection, menses, spread mucous membranes, congenital, acyclovir, sitz bath, monitor pap smears regularly due to high cervical cancer risk chlamydia- men: urethritis, dysuria. women: thick vaginal discharge and acrid odor. spread mucous membranes, congenital, tetracyline or doxycycline po may cause sterility if left untreated. notify sexual contacts. venereal warts- single, small papillary lesion spreads into large cauliflower cluster on perineum, vagina, penis, spread mucous membranes, congenital, curettage, cryotherapy with liquid nitrogen, kerotolytic agents. avoid intimate contact until healed. strong correlation with cancer. aids, hiv positive hiv (+)-presence of hiv in blood aids- defects in immune function, associated with positive hiv virus, opportunistic infections, cd4 counts below 200. opportunistic infections associated with aids: p. carnii pneumonia- sob, dry non productive cough c. albicans stomatitis- difficulty swallowing, white exudate back of throat c. neoformans- deabilitating type of meningitis cytomegalovirus (cmv)- lymphadenopathy, visual impairment kaposis sarcoma- most common, small purple brown, nonpainful, nonpuritic palpable lesions on body. aids transmitted by blood, body fluids, sharing iv needles, sex, transplacental, breast milk. clean blood spill up with bleach. elisa confirm with western blot decrease in wbcs contact and standard precautions, high protein, high calorie diet. symptomatic relief, support. stomatitis (inflammation of mouth), do not share toothbrush or razor. poison control- treat pt first then poison. call poison control center with what substance, when, how much, route of ingestion, condition now, age and wt. do not induce vomiting if danger of aspiration ( decreased loc or gag reflex) if child ingested pain thinner, lighter fluid, (petroleum distillate). corrosive.

if wasnt corrosive give ipecac (emetic) with small amount (4-8oz) of clear fluid to induce vomiting. position head lower than chest. dont give large amount of fluid. dont use milk, have a bottle of ipecac for everyone in household, 1 bottle per person. lead toxicity- blocks formation of hgb and toxic to the liver. irritability, decreased activity, increased icp. metal retardation in children. nursing care: chelating agents. accident prevention newborn: rear facing care seat, crib safety, no smoking, lead free paint infant: check water temp, avoid small objects (choking) toddlers: child proof home, 20 lb front facing car seat in back seat of car children: bicycle helmet, sports safety, swimming pool safety adolescents: teach ways to deal with anger, driving safety adults: handgun control, responsible sexual behavior, smoke and carbon monoxide detector elderly- higher risk for injury poor balance, slow reaction time, exercise and assistive devices, sufficient lighting, up and down stairs, good shoes, cleaning pathways triage- red- unstable, yellow-stable can wait, green- stable can wait longer, black- unstable, probably fatal. doa. bells palsy- tape eye shut at night, frequently use artificial tears to protect cornea from drying due to inability to close eye, place food in unaffected side of mouth, protect face from cold myelomeningocele- no pressure on back licorice can increase potassium loss set up field before donning gloves, above waist, outer inch is contaminated induration is area of hardened tissue, positive sign of tb on mantoux test, 5mm or> on hiv pt 10mm or> on reg pt. measure induration not redness eye drops- do put drops in middle inner cantus, push on inner angle of eye to prevent systemic contamination, and blink between drops, do not touch dropper, allow to flow to other eye or squeeze eye tightly aminophylline-xanthine bronchodilator-may cause rapid pulse and dysrythmias right side elevated- promotes emptying of stomach and prevents aspiration look for jaundice on posterior palate in asians. may be result of inh hepatotoxicity ileostomy- very irritating to skin, should empty at 1/3 full, keep bag on at all times, record output, do not use moisturizers prevents a good seal around stoma

narcan causes signs and symptoms of opiate withdrawl (heroin) n&v, restlessness, abd cramping, htn, tachycardia unintentional wrong- negligence (doing something bad, not doing something good) malpractice- duty, breach of duty, injury, causation of duty intentional wrong- assault- intentional threat battery- intentional touching of pt without consent invasion of privacy- release of information w.out client consent hep a- anorexia, malaise, lethargy, easily fatigued fundus at level of umbilicus then one finger down per day validate feelings and present reality menieres disease- stick to low sodium to avoid vertigo septic shock- dic- mini clots everywhere until clotting factors used up then hemmoraging. look for blood at venipuncture site and around iv catheter. acute glomerularnephritis is caused by strep ace inhibitors- blocks release of aldosterone causing potassium retention