Infectious+Dz+Immunization

//**Infectious Diseases, Immunizations **//




 * //*Handwashing is the best defense against the spread of infectious disease*// **

This link is for the CDC's Guidelines for Isolation Precautions
@http://www.cdc.gov/hicpac/2007IP/2007ip_appendA.html

====The videos below feature the diseases behind common childhood illnesses for which we have now have immunizations. These diseases used to and still do kill afflicted children. World wide 10 million children die every year! Global travel has made immunization even more important. Nurses must be able to educate parents about vaccination. If the parent has questions and concerns about vaccines remember, this is a parent who cares and an opportunity to teach! ====
 * The chain of infection: **

The chain of infection begins with an //infectious agent or pathogen// .

This pathogen must survive without multiplying in a //host//  or on an inanimate object.

Then the pathogen then leaves the reservoir or host through a //portal of exit//  such as blood or bodily secretions such as urine, feces, respiratory secretions and saliva.

The //mode of transmission//  to another host can be through direct bodily contact through saliva, droplets from the respiratory tract, body contact, blood, bodily fluid from the urinary, gastrointestinal route or reproductive tract. Pathogens can also spread through contaminated surfaces or food or through animal or insect vectors.

<span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Portal of entry// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> can be through the respiratory tract, the gastrointestinal tract, the urinary tract, the skin, mucous membranes or across the placenta.

<span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Susceptible host// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> can get ill when the pathogen invades and the host has no immunity or the immune system is dysfunctional.

=<span style="color: #1ec253; font-family: 'Times New Roman',Times,serif; font-size: 32px;">Toddlers and Preschoolers: =

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Playing with animals may get bit or scratched, can cause cat scratch fever or tineacorporis (ring worm)
<span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Communicable diseases <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> are high during this time period <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">The primary goal of nursing is to prevent these diseases through <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">immunizations <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Once there is a <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">breakdown <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> the goal is to stop the spread and to decrease and prevent complications as able. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Children with immunodeficiency or those suppressed with steroids are susceptible to devastating complications.


 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 23px;">Viruses: **

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 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Varicella (chicken pox) **

<span style="color: #0da113; font-family: 'Times New Roman',Times,serif; font-size: 17px;">(Varicella zoster virus) <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;"> – Airborne (droplet) transmission and to a lesser degree direct contact with contaminated objects.

<span style="color: #1d870c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Incubation <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;"> is 2-3 weeks.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">The patient is contagious up to 24 hours prior to the first eruption and remains contagious until the last vesicles have crusted over.

<span style="color: #20990c; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Fever, malaise, anorexia, rash beginning on the trunk and back and spreading to the face and limbs.

<span style="color: #31940f; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Therapeutic management: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Administration of anti-viral acyclovir (Zovirax) <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">varicella-zoster immune globulin or IVIG in immune compromised children. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Antihistamines to relieve itching and skin care to prevent infection. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Trim child's nails, keep hands clean <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Oatmeal baths, calamine lotion <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Popsicles, jello

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Vaccine is available.

<span style="color: #11a817; font-family: 'Times New Roman',Times,serif; font-size: 21.969999313354492px;">Chickenpox
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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Painful varicella infection affecting a single dermatome (body area innervated by a specific area of the spinal cord). <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Reactivation of virus which lies dormant in the spinal column
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Herpes Zoster (Shingles) **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Caused by human herpes virus type 6, rarely 7 <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Peaks at 6-15 months, highest incidence 6-24 months, rarely after age 3 <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Most likely transmitted in the saliva of healthy adult mouths, and respiratory secretions <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubation 5-15 days contagious unknown
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Roseola Infantum (Exanthem Subitum) **

<span style="color: #3ab51b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Persistent high fever for 3-5 days followed with sudden drop in temperature and appearance of rash, coryza, sore throat, <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">lymphadenopathy, cough and coryza (cold symptoms).

<span style="color: #14a811; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Management: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Fever control, maintaining fluid balance and comfort measures. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Antipyretics. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Teach parents fever control and discuss precautions for febrile seizures.

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 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Red Measles (Rubeola) **

<span style="color: #169e13; font-family: 'Times New Roman',Times,serif; font-size: 150%;">Measles
<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">From respiratory tract, blood and urine, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Droplet spread usually, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubates 10-20 days, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Contagious mainly in prodromal stage -4-5 days, <span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Fever, malaise, cough conjunctivitis, Koplik spots then rash

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Saliva direct contact with droplet <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubates 14-21 days <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Most contagious before and after swelling, fever, malaise, headache, anorexia, ear ache,
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Mumps (Paramyxovirus) **

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">3 types, source fecal, oropharyngeal secretions, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubation 7-14 days but up to 35 days <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Virus in throat up to a week after infection and in feces 4-6 weeks after infection. <span style="color: #18ab27; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Abortive/inapparent – fever, uneasiness, sore throat, headache, anorexia, vomiting abdominal pain for a few hours to a few days, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Nonparalytic - same as abortive more severe with pain and stiffness in neck, back and legs, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Paralytic - similar to nonparalytic with recovery then paralysis
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Polio (enteroviruses) **

<span style="color: #18ad1e; font-family: 'Times New Roman',Times,serif;">Polio
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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">3 day measles <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Spread through nasopharyngeal secretions but also in blood, stool, urine. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubates 14-21 days <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Contagious 7 days before to 5 days after, <span style="color: #2bb015; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Low grade fever, headache, malaise, anorexia, mild conjunctivitis, coryza, sore throat cough, lymphadenopathy, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Rash gone by 3rd day <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">* Highly dangerous to pregnant woman
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Rubella (German Measles) **

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Treatment depends on cause. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Infants can contract infections during birth, Chlamydia trachomatis, Neisseria Gonorrhoeae, or HSV. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Chemical conjunctivitis may occur from instillation of neonatal eye ointment. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Bacterial conjunctivitis traditionally treated with Polysporin, Polytrim, or Sulamyd. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Throw out eye makeup, do not rub or touch eyes <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Viral
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Conjunctivitis **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Inflammation of the oral mucosa, infectious or noninfectious.
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Stomatitis **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Benign but painful associated with trauma (biting cheek), allergy or emotional stress.
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Aphthous stomatitis **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Caused by HSV (type 1) – recurrent herpes labialis – <span style="color: #10a127; font-family: 'Times New Roman',Times,serif; font-size: 18px;">cold sores or fever blisters. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Initial infection fever, red throat, with vesicles and swollen lymph nodes. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">When it reoccurs vesicles due to emotional stress, dental procedures, sunlight.
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Herpetic gingivostomatitis **<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> –

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Stomatitis also occurs with **<span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">hand-foot-and-mouth disease **<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> and **<span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">herpangina **<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> (same as hand-foot and mouth by only mouth manifestations) caused by enteroviruses (coxsackieviruses) <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Problem is oral intake due to pain. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Acetaminophen, Motrin, may need codeine. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Orabase, Anbesol, Kank-A. Lidocaine or homemade mixture equal parts Benadryl and Maalox provides analgesia, anti-inflammatory, protective coating. <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Bland liquids through a straw.

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media type="youtube" key="jPUQakhyPDA?version=3" height="439" width="616" <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Tetanus caused by Clostridium bacteria. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">The bacteria live in soil, saliva, dust, and manure; it can enter the body through a deep cut. <span style="color: #d90229; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Symptoms: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Painful tightening of the muscles, all over the body, "locking" of the jaw, impossible to open your mouth or swallow. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;"> Tetanus - medical emergency, need treatment in a hospital. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Routine childhood immunization. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Booster, every 10 years. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Proper wound care.
 * <span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 23px;">Bacterial infections: **
 * <span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Tetanus: **

<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif;">Pertussis, Whooping Cough
media type="youtube" key="l5SHtdczSBc?version=3" height="376" width="672" <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Bordetella pertussis, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Called the 100 day cough <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Incubation 6-20 days, direct contact or droplet. <span style="color: #cf044d; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Begins as a cold, with sneezing, cough and low-grade fever then paroxysmal coughing. <span style="color: #d6093a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Nursing Measures/Treatment: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Culture with nasal swab and obtain slides to send to the lab for examination <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Check vaccination status of patient, if unvaccinated, administer immunization <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Check on vaccination status of family and contacts <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Wear a mask if within 3 feet of patient <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">If no mask was worn and you find out patient was positive for Pertussis contact employee health for prophylactic antibiotics <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">If patient is positive for Pertussis administer Antimicrobials – erythromycin or azithromycin <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Depending on patient age, symptoms, and stability of patient, follow respiratory measures as needed, i.e. hydration, O2, SAT monitoring, etc

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Transmitted by direct contact with infected individuals or contaminated articles. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Incubation is 2-5 days. Can be contagious for 2-4 weeks.
 * <span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Diptheria (Corynebacterium diphtheriae) **

<span style="color: #d10f32; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Symptoms may manifest in different areas. In the nasal area may present as a cold with mucopurulent discharge. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Tonsillar-pharyngeal symptoms include malaise, anorexia, sore throat, fever, white or grey membrane, and lymphadenitis. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">In severe cases septic shock can occur with death in 6-10 days.

<span style="color: #de093c; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Therapeutic management: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Equine antitoxin IV (as long as no allergy) <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Penicillin G <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">bed rest to prevent myocarditis <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">possible tracheostomy <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">treatment of infected contacts.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Vaccine is available ~ DTap

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Group A beta-hemolytic streptococci transmitted by respiratory secretions. <span style="color: #d90d3e; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Acute fever, sore throat, headache and a red sandpaper rash. White strawberry tongue on day 1 followed by a red strawberry tongue on day 2. Pharynx and tonsils, red, swollen, and edematous. <span style="color: #e60b33; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Management: <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Antibiotics, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">school absence for at least 24 hours, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">fever control, <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">saline gargles, maintain fluids with popsicles and cool jello.
 * <span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Scarlet fever ** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">–

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<span style="color: #dc1e1e; font-family: 'Times New Roman',Times,serif; font-size: 29px;">Infectious Diseases: Germs and stuff, yikes!

<span style="color: #1ec253; font-family: 'Times New Roman',Times,serif; font-size: 36px;">School age risk for infection:

====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">// Share // friendships, clothes, hair brushes, bedding, food, drinks, toys, do not cover their mouths while coughing, ineffective hand washing: ====

====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Leads to head lice, scabies, pinworms, tineacorporis and tineacapitis (ring worm) Videos pertaining to these conditions are under Integumentary. ====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Erythema infectiosum or Fifth’s disease
<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Human Parvovirus, HPV B19 <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Transmitted by respiratory secretions and blood. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Incubation for 4-14 days. It is communicable prior to appearance of symptoms.
 * <span style="color: #23b83e; font-family: 'Times New Roman',Times,serif; font-size: 24px;">Erythema infectiosum (Fifth disease) **

<span style="color: #25c22b; font-family: 'Times New Roman',Times,serif; font-size: 18px;">Clinical Manifestations: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Mild systemic symptoms, occasional fever, slapped cheek appearance followed by a lacy rash on the trunk and limbs. Rash appears on face first. The rash tends to fade and reappear. Other symptoms include fever, myalgia, lethargy, nausea, vomiting and abdominal pain. Incidence usually seen in the late winter and spring in the elementary and junior high school age students. Management of fever and symptoms.

<span style="color: #389e1e; font-family: 'Times New Roman',Times,serif; font-size: 130%;">Therapeutic Management: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Administration of analgesics, antipyretics, and anti-inflammatory medications. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">May result in complications if mother is infected during pregnancy. <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">May attend school once the rash appears as they are not contagious.

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 * <span style="color: #1dab1a; font-family: 'Times New Roman',Times,serif; font-size: 18px;">FLU **

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 * <span style="color: #1ec253; font-family: 'Times New Roman',Times,serif; font-size: 31px;">Family teaching: **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Often in the outpatient and ambulatory care system and later before discharge in an acute care setting, children are sent home with illnesses to recuperate. Parental teaching is vital to guide these parents as they care for their child so teaching is crucial. Remember to provide clear, simple explanations, have the patients acknowledge their understanding and ask the patient or caregiver to repeat back the instructions. //Then document, patient acknowledged understanding and returned demonstration. If this is not done you cannot be reimbursed for this effort!// <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Family teaching topics often discussed: **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Daycare centers sick policies, where food is prepared, ratio of children to daycare workers.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Immunizations questions welcomed and answered.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Medications, comfort measures, therapies

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Sick child care

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Discharge instructions

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">How do I know if they are not getting better?

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">When can they return to school or daycare?


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Educate: use of medications, comfort measures and when to call the doctor. **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Illness information

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">How to handle illness at home <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">How long illness may last

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">How long they will be contagious <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">When can they return to school

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Signs and symptoms of worsening illness – spell it out!

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Who to call, what to do and where to go if the child gets worse


 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Common OTC Medications: **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Tylenol - analgesic, antipyretic; may be in cold meds, helps with headaches, malaise, sore throat, muscular aches,pain

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Ibuprophen (also known as Motrin, Advil) takes care of these symptoms and relieves inflammation as well.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Benadryl or Atarax for itching

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Beware of aspirin products and derivatives

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Do not assume that parents know the differences between medications or what is in a cold and flu OTC medication


 * <span style="color: #c40c2d; font-family: 'Times New Roman',Times,serif; font-size: 140%;">*Some medications contain aspirin which is not recommended for ill children because of Reyes syndrome **
 * <span style="color: #c40c2d; font-family: 'Times New Roman',Times,serif; font-size: 140%;">This list is from the National Reyes Foundation **

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Comfort Measures/Teaching tips: <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Handwashing! Cover your cough! No kissing! <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Popsicles, gatorade, pedialyte, ice chips, suckers for sore throats (Boo-Boo pops) and dehydration, cool or warm compresses <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Pruritic lesions (chicken pox) can be soothed with baking soda or oatmeal added to baths. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Calamine can be applied topically to dry the lesions <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Scratching needs to be discouraged, pat. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Aquaphor for eczema <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Fingernails should be kept short and clean. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Cool the burn, but no ice! Blisters are the body’s Band-Aid. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">ORT, clear liquids <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Monitor for dehydration - output, fontanelles, sunken eyes, skin <span style="font-family: Times New Roman,Times,serif;">tugor, tears <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Monitor symptoms, record occurrences, diary <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Diet – increase fiber, fluid (constipation) <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">For diarrhea - increase fluid intake, <span style="font-family: 'Times New Roman',Times,serif; font-size: medium;">yogurt with probiotics are good, crackers, clear soup. Avoid - caffeine, sugarless gum, milk - <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Baths, barrier cremes <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Humidifiers <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Place child in the bathroom with mist from the shower, cold night air. <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Monitor how hard they are breathing, are they making sounds? <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Monitor color <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Headaches/ joint aches – Dim lights, decrease sound and visitors, warm baths, ice or warm compresses, monitor for fever, neck pain versus nuchal rigidity <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Injuries – 5 P’s, monitor pain, swelling, color, RICE, Ibuprophen
 * <span style="color: #1ec253; font-family: 'Times New Roman',Times,serif; font-size: 23px;">Comfort Measures: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Integumentary: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">GI bugs: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">GU: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Respiratory illnesses: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Neuro: **
 * <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Musculoskeletal: **

//<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">*Some diseases are reportable by law to local and state health departments, who then report them to the CDC. The CDC monitors disease trends and the effectiveness of intervention //

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">*Dehydration - dry mouth, low output (not going to the bathroom, decrease in wet diapers), sunken fontaneles or eyes.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">*Worsening condition - spell it out

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">*Difficulty breathing, color off

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">*Change in LOC: unrousable, lethargic...

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 * <span style="color: #e24b4b; font-family: 'Times New Roman',Times,serif; font-size: 1.4em;">*Some diseases are reportable by law to local and state health departments, who then report them to the CDC. The CDC monitors disease trends and the effectiveness of interventions. **

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">PPE media type="youtube" key="OdpGKsredP0" width="560" height="315"

Contact Droplet and Airborne Precautions! media type="youtube" key="K3vrl47PzxU" width="546" height="408"

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Remembering when to use Airborne Droplet or Contact Precautions



<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Remembering isolation requirements:



<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Modified contact for C-Diff

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 * <span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 32px;">Immunizations **

//<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 29.899999618530273px;">~ FYI ~ // <span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**Edward Jenner** **1796** - first vaccine - inoculated assistant against smallpox with a cowpox lesion from a milkmaid.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**Jonas Salk** **1955** polio vaccine.
<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**10 million children** world wide die yearly from vaccine preventable diseases! ====**<span style="font-family: 'Times New Roman',Times,serif; font-size: 19.401199340820313px;">Global travel **<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> has made immunization even more important. ====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**Recommended vaccines:**
====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Hepatitis B, hepatitis A, diphtheria, pertussis, tetanus, measles, mumps, rubella, //Haemophilus influenzae// type b (Hib), invasive //Streptococcus pneunomoniae//, influenza, human papillomavirus, rotavirus, invasive meningococcal, and polio. ====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Polio is still endemic in Afghanistan and Pakistan.
====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Leaders in this area convinced the people that polio vaccinations were in reality an attempt to decrease fertility and spread HIV. Many children died or were paralyzed before the World Health Organization in combination with other leaders educated the public. ====

@http://www.polioeradication.org/Polioandprevention/Historyofpolio.aspx

WHO disease notifications for 2016 ====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**Britain - Andrew Wakefield** intimated that the MMR vaccine could be loosely linked to autism in the world-renowned publication //The Lancet//. ====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Decline in MMR immunizations but autism rates increased.
====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Thimerosol, a mercury-containing agent that has been added to **multiuse vaccine vials** as a preservative. These are rarely used anymore. ====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**2009**, the **U.S. Court of Federal Claims** published **Omnibus Autism Proceeding**.
====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">After reviewing 5,000 pages of transcripts, 939 medical articles, 50 expert reports, and testimony from 28 experts, that the MMR and thimerosal-containing vaccines, independently or together, were not causal factors in the development of autism or ASD. ====

====<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">**1990** CDC and FDA initiated the **Vaccine Adverse Event Reporting System (VAERS)** to provide a single system as a replacement for the separate monitoring programs operated by the two agencies. ====

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<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 19px;">*Vaccinations are generally started at age 2 months because a fever prior to 2 months involves an automatic hospital admission and septic workup. * =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Nurses must be able to <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">educate parents <span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">about vaccination. If the parent has questions and concerns about vaccines remember, this is a parent who cares and an opportunity to teach! =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Parents need to be reassured that they can <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">call anytime <span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;"> that they have concerns or worries. <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">We encourage <span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;"> parents to utilize a <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">medical home. =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Many times children present with various different **immunization records**. These are recorded into the office record and cosolidated for them. They must sign a consent and give permission for records to be sent from another office. Records may be available on the state DHEC site. =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">IM in <span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Vastus lateralis <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> (thigh) muscle up to age 4. =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Older child - <span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">deltoid muscle <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> IM, Subcutaneous injections, fatty area, back of the upper arm. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Comfort holds <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> which can help stabilize the leg and comfort the child located in the PowerPoints located in this Wiki. Pain Change PowerPoint which discusses the importance of sweetease, frezzy spray, stickers and bandaids! =====

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 23px;">**Center of Pediatric Medicine:** <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 23px;">**Background Immunization Information:**

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<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 21px;">**Sites for Administration:** <span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Up to age four - vastus lateralis muscle (large upper outer thigh muscle), subcutaneous immunizations - fatty outer thigh area. <span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Older child - intramuscular immunizations deltoid muscle, subcutaneous injections fatty portion on the back of the upper arm. <span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Comfort holds which can help stabilize the leg and comfort the child located in the PowerPoints located in this Wiki.

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Aseptic <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> technique =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Label <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> any vaccines as needed. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Wipe <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> the hub of the vial with alcohol before drawing up the vaccine. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Aspirate <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> prior to injection with intramuscular injections but not with subcutaneous injections. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">MMR and Varicella <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> need reconstituting, only 2 live injectable vaccines and the only two administered subcutaneously. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Polio <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> by itself is also injected subcutaneously but it is rarely given alone. =====

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<span style="color: #46ba21; font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Rotavirus <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;"> is also a live virus, administered orally. =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Place extra alcohol wipes and band-aids on the tray along with some stickers or a prize and you are ready to go! =====

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 * <span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 26.857999801635742px;">Children who died or received a severe injury can receive compensation. Required to have health records which indicate: **=====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">the month, day and year of the administration =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">the vaccine administered =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">manufacturer =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">lot number and expiration date =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">site and route of administration =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 21px;">Name, address, and title of healthcare provider administering the vaccine =====

**<span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28px;">Contraindications to vaccine administration: **

 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 17px;">A history of severe anaphylactic reaction to a vaccine or its components =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Encephalopathy within 7 days of the administration of DTP/DTaP =====
 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 17px;">A history of seizures =====

**<span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28px;">Precautions: **

 * =====<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 17px;">need to be taken when administering live viruses such as Chicken pox (varicella) and MMR (Measles, mumps, rubella) to teenage girls or women of childbearing age. =====

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**<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 19px;">* Note: If caregivers fall behind on immunizations you do not start the series over! Simply administer the absent, needed shots. ** =====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Redness and soreness at the site <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Low grade fever <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Slight irritability
 * <span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28px;">Teach Parents child may experience: **

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">*If the child were to cry uncontrollably for 3 hours or more after the administration of tylenol or more or run a fever over 102 they need to be seen.* =====

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Give acetaminophen (Tylenol) for pain

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 18.800600051879883px;">Entirely different medicine however, pediatricians usually recommend one or the other so parents do not get confused. Motrin, ibuprophen, can be given every 6-8 hours. ===== <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Warm compresses to legs <span style="font-family: 'Times New Roman',Times,serif; font-size: 18.200000762939453px;">Bicycle legs

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">Hep B, polio (IPV), Diptheria tetanus pertussus (Dtap) = (Pediarix), haemophilus influenzae (Hib) = (Pedvax), Pneumococcal = (Prevnar 13) and Rotavirus = (Rotateq) =====

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 19px;">These first year shots protect the children from hepatitis B, polio, diptheria, tetanus and pertussis, 13 strains of pneumococcal infection, haemophilus influenzae and rotavirus. =====

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<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">***At 12 months the child is given the first MMR, Varicella and Hepatitis A shots. From this point on until the child is a teenager all shots have been given ideally and boosters are given from this point forward.** =====

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<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 19px;">In the state of SC these shots are required for school and daycare and can only be omitted by the parents signing a religious waiver.* =====

<span style="color: #de3f3f; font-family: 'Times New Roman',Times,serif; font-size: 1.3em;">Controversies...
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<span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28.600000381469727px;">Newborn Testing: <span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28.600000381469727px;">

<span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28.600000381469727px;">This is a fact sheet about newborn screening located at the SCDHEC. <span style="color: #58d331; font-family: 'Times New Roman',Times,serif; font-size: 28.600000381469727px;">The link is below.

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<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 21px;">**Newborn Screening F.A.Q. Sheet**

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">**How long has DHEC done this testing?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Testing for <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">phenylketonuria (PKU) <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> began in 1965. A 1976 law made testing mandatory unless parents had religious objections. The other tests were recommended by the Newborn Screening Advisory Committee and approved by the DHEC board.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">**What diseases are on the test panel?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">The SC newborn screening panel includes all <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">28 core metabolic conditions <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> that are recommended by the March of Dimes and the American College of Medical Genetics. In addition it also includes screening for 24 secondary metabolic conditions that can cause severe problems if not found very early in life. The most common conditions are described below.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Phenylketonuria// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> is an error in amino acid metabolism resulting in profound mental retardation. The consequences can be avoided by very early detection and a diet low in the amino acid phenylalanine. About three babies with PKU are detected each year. Testing can also identify babies with other amino acid metabolism disorders as well as babies with certain organic acid metabolism disorders.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Congenital Hypothyroidism// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> results from the lack of thyroid hormone leading to mental retardation and slow growth. If detected early, thyroid hormone can be given and the consequences reduced or eliminated. About 20 babies are found each year with primary congenital hypothyroidism.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Persons with <span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Hemoglobinopathies (like Sickle Cell Disease)// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> may have impaired oxygen transfer ability and many painful and life-threatening conditions, some of which can be prevented through early diagnosis and monitoring. About 100 babies a year are identified with hemoglobinopathy disorders including sickle cell disease while another 2,400 are identified as carriers.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Galactosemia// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">is caused by an inability to metabolize galactose, a component of lactose found in milk and other foods. Serious gastrointestinal disturbances, failure to gain weight and jaundice may occur. Children with untreated galactosemia develop mental retardation, cataracts and speech delay. Some babies die in the early neonatal period from bacterial sepsis. If detected early, diets low in galactose can minimize the effects of the condition. About one baby a year is born with this condition. Other, less severe forms of galactosemia can also be found through this testing. In SC, around 15 babies are found with less severe forms of galactosemia each year.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Congenital adrenal hyperplasia// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">is an enzyme defect that affects the functioning of the adrenal gland with the overproduction of testosterone. Children with CAH may begin puberty at 3-5 years of age. In some cases, the child may experience dehydration, shock and death. Administration of adrenal hormones can prevent some serious consequences. About three babies a year are identified with this condition.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Medium chain acyl-CoA dehydrogenase// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> deficiency causes an error in fatty acid metabolism resulting in a child's blood sugar becoming dangerously low. About 20 percent of children with MCADD die before diagnosis if screening is not in place and those who survive may have serious residual effects. If detected early, the condition can be treated by making sure the child gets enough carbohydrate, especially during illness or other stressful times. About four babies a year are found with this condition. Testing can also identify babies with other fatty acid metabolism disorders.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Biotinidase deficiency// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> causes a baby to have difficulty using biotin, a vitamin that is found in foods, including breast milk and infant formula. Without biotin, the baby will not grow and develop properly. He or she may have seizures, hearing loss and skin problems. About one baby a year is found with this disorder.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">//Cystic fibrosis// <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;"> is a genetic disorder that is detected in 10 to 15 babies born in SC each year. When a baby has CF, some fluids in the body that should be thin and slippery are thick and sticky. These fluids can plug up some of the “tubes” or “channels” in the body. This affects the lungs and digestive system the most. Babies with CF often cough or wheeze and can get lung infections that need treatment with strong drugs. They also may not digest their food well, often in spite of a huge appetite. Poor digestion can cause diarrhea and poor growth. Babies found through screening often have not yet started to show much of these problems or to “act sick”.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**Do parents sign a consent form?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">There is no DHEC consent form for newborn screening. The DHEC Newborn Screening Manual; Law, Regulations, and Official Departmental Instructions states, "The provision of the screening test is covered under the informed consent signed by the parents at the hospital." Parents may refuse the tests only on religious objections.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**Do parents get any information in advance?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">The regulation requires hospital staff to provide information about the testing. The hospital may give the parents a pamphlet with information about the testing.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**How long does it take to do the testing?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">On average, testing is completed three working days after the specimen arrives in DHEC’s laboratory. If the results indicate a high likelihood that the infant has a newborn screening disorder, the physician of record is notified by phone by staff in the Division of Women and Children’s Services. If the results are less definite but still abnormal, the physician will be notified by mail. The laboratory needs to keep the specimens, which are blood spots, long enough to complete testing and allow for requests for routine additional tests or repeats.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**What happens to the information?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">Results are sent to the hospital or mid-wife and to the physician of record. Abnormal results are also immediately sent to DHEC’s Division of Women and Children’s Services for follow-up. The results from children with sickle-cell trait (carriers of sickle cell) are sent by the Laboratory to regional sickle-cell centers for counseling and follow-up.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**What happens to the blood specimens after laboratory testing is completed?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">The laboratory will destroy the residual blood specimens once they are no longer needed for testing. They are not used in research or for any purpose other than newborn screening.

<span style="color: #d33131; font-family: 'Times New Roman',Times,serif; font-size: 18px;">**Does DHEC do any DNA-based newborn screening or store purified DNA?** <span style="font-family: 'Times New Roman',Times,serif; font-size: 18px;">No. DHEC does no DNA-based (gene) newborn screening. The DNA is stored only because DNA is present in the blood cells. No purified DNA is stored.

<span style="color: #df3a3a; font-family: 'Times New Roman',Times,serif; font-size: 14pt;">References:

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Hockenberry, M. J., & Wilson, D. (2009). Wong's essentials of pediatric nursing (8th ed.). St. Louis, MO: Mosby Elsevier.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Potts, N. L., & Mandleco, B. L. (2012). Pediatric nursing: Caring for children and their families (3rd ed.). New York, NY: Delmar Cengage Learning.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">Creative commons licensed photo by P J Taylor

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Videos located at: <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Pertussus <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Hand foot and Mouth Disease <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Scarlet Fever <span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Pertussus <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://youtu.be/wuvn-vp5InE

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Hand foot and Mouth Disease <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://youtu.be/oRSe98lOv28

<span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">Scarlet Fever <span style="font-family: 'Times New Roman',Times,serif; font-size: 130%;">http://youtu.be/ZptvC4GVE6U

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">Diptheria https://youtu.be/poK8YMA2RtQ

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">Immunize every child http://youtu.be/myoH9ogEYKk

Whooping Cough by the Mayo Clinic http://youtu.be/l5SHtdczSBc

Tetanus by unicefusa http://youtu.be/jPUQakhyPDA

Polio https://youtu.be/Pdyb1FzG6nQ

Hepatitis https://youtu.be/1uBh7Z8QXUE

Rotavirus by Pkidsorg http://youtu.be/sYoCIfeVcFk

Pneumococcal disease by Pkidsorg http://youtu.be/ij6jMchYyFE

HIB by Pkidsorg http://youtu.be/iy9iywzE0z0

Measles by Ten http://youtu.be/6T5W-EWHjWg

Measles Outbreak by CBS http://youtu.be/wPAS11Ufe4I

Mumps https://youtu.be/ioUi727k9JM https://youtu.be/FkdQHaOxxyI

Chickenpox by Florida Dept. Of Health http://youtu.be/gMGsf8vwyC0

Polio in Africa by coleyyd http://youtu.be/oFm-Zq3XPGo

Fifth Disease by Healthy Kid Tips http://youtu.be/fXJhzMUA53I https://youtu.be/3yht6AIuihE

How Flu Viruses Attack by National Geographic http://youtu.be/TVLo2CtB3GA

Flu Attack by npr http://youtu.be/Rpj0emEGShQ

<span style="font-family: 'Times New Roman',Times,serif; font-size: 17px;">Sick care child video at <span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">http://youtu.be/AZ8G0_WTpn0

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">PPE https://youtu.be/OdpGKsredP0

Isolation: https://youtu.be/K3vrl47PzxU

<span style="color: #cc1319; font-family: 'Times New Roman',Times,serif; font-size: 17px;">References:

// Hockenberry, M. J., & Wilson, D. (2009). // Wong's essentials of pediatric nursing //(8th ed.). St. Louis, MO: Mosby Elsevier.//

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16.899999618530273px;">Newborn Testing FAQs: @http://www.scdhec.gov/Health/FHPF/LabCertificationServices/NewbornMetabolicScreening/FrequentlyAskedQuestions/

Potts, N. L., & Mandleco, B. L. (2012). //Pediatric nursing: Caring for children and their families// (3rd ed.). New York, NY: Delmar Cengage Learning.

<span style="color: #cc1319; font-family: 'Times New Roman',Times,serif; font-size: 17px;">Videos: Vaccine safety: https://youtu.be/fMsa7o48XBE

Court finds vaccines don't cause autism by Associated Press http://youtu.be/223o0pliEMs

Should I immunize my child by intermountain moms http://youtu.be/_0_Q7zuhunY