Infectious diseases - Pediatric: Nursing

A communicable disease is an infection that spreads from person-to-person. These diseases can be transmitted through the air, respiratory droplets, or physical contact with a contaminated surface.

Pediatric patients are more likely to contract communicable diseases because of their immature immune systems and lack of understanding of infection control.Now, some communicable diseases, like measles, influenza, rotavirus, and varicella have vaccines available to help prevent their spread; while other diseases, like scarlet fever and fifth disease, do not.

Vaccines, along with infection control measures, like hand washing and personal protective equipment, or PPE, can help limit the spread of common communicable diseases.Okay, so, immunity can be acquired actively or passively.

Active immunity happens when a person makes their own antibodies, like after recovering from a disease, like fifth disease, or is given a vaccination, like a flu shot for influenza.

Now, vaccines use a weakened or inactivated version of a pathogen and the body’s natural defenses to strengthen the immune system against that pathogen.

This can help prevent a disease, and may limit its spread, if a person encounters the pathogen in the future.On the other hand, passive immunity occurs when a person receives the antibodies needed to fight the disease, like when a fetus receives IgG antibodies through the placenta, or when a newborn exposed to the hepatitis B virus is given immune globulin.

Alright, now along with vaccines, infection control measures also limit the spread of communicable diseases.Standard, or routine, precautions are broad protocols used to prevent infection when caring for all patients and involve hand hygiene by either washing with soap and water or alcohol-based disinfectants; and preventing contact with infectious agents using PPE, like gloves, gowns, masks, or face shields.

On the other hand, transmission-based precautions are based on the specific method of a disease’s transmission and are used alongside standard precautions.

Transmission-based precautions include contact, droplet, and airborne precautions. First, contact precautions should be used with diseases that can be transferred from a surface like an infected person’s hand or doorknob, to another person.

An example of this is rotavirus, which is transmitted by fecal-oral contact and causes severe watery diarrhea, vomiting, and fever.

Contact precautions typically require a gown and gloves to be worn during contact with patients or their environment.Next, droplet precautions are used with patients infected with diseases that can be transferred on large respiratory droplets that hang in the air for a short amount of time after an infected person coughs or sneezes, like with influenza, a viral respiratory infection which can cause fever, fatigue, and body aches.

Droplets can’t travel long distances, so PPE, like a mask and gloves, can help prevent infection.Lastly, airborne precautions are used in the care of patients with diseases transmitted through the air that can linger for longer periods of time.

For example, measles, a viral infection that leads to fever, cough, sore throat, rash, and Koplik spots. Airborne precautions include use of an airborne isolation room which allows air to flow into the room, but prevents it from escaping back into general circulation, keeping the airborne pathogen isolated.

In addition, health care personnel will don a gown, gloves, and either a mask or respirator when providing care.When caring for your pediatric patient with a communicable disease, your goals of nursing care include implementing infection control measures, providing care to your patient, and teaching about how to treat the infection and prevent its spread.

First, you’ll implement transmission-based precautions in addition to standard precautions. For example, if your patient has signs and symptoms of varicella, or chickenpox, which can be transmitted through contact and air, you'll institute both contact and airborne precautions by placing them in an airborne isolation room and donning a gown, gloves, and mask or respirator.

Then, you’ll administer prescribed medications and provide supportive care to treat symptoms. Many pediatric communicable diseases like varicella manifest as skin conditions, like itchy rashes.

You can help manage these symptoms by administering cool baths or using lotions that have been stored in the refrigerator, keeping your patient’s nails trimmed short to prevent scratching, and offering distraction activities, like games.

Lastly, be sure to teach your patient and their caregivers about the infection, its treatment, and how it’s transmitted.

Instruct them on techniques to limit spread, like hand washing, using a tissue when sneezing, and covering their mouth when coughing, as well as how to use any required PPE.

Also, discuss your patient’s vaccination plan with caregivers, as well as keeping all follow-up appointments. Alright, as a quick recap....

Communicable diseases are infections that spread from person-to-person and can spread through airborne, droplet, or contact transmission.

Vaccines, in combination with infection control measures, can help prevent many of these diseases and may limit their spread.

Standard, or routine, precautions that should be taken with every patient as well as transmission-based precautions based on specific diseases.

When caring for your pediatric patient with a communicable disease, implement infection control measures, and provide care and education.