RESUMEN
Children with a petechial rash commonly present to emergency departments. The rash can be associated with serious illnesses, such as invasive meningococcal disease (IMD), but is usually associated with less severe conditions. This article discusses the common and important causes of petechial rash, including IMD, viral illnesses, trauma, Henoch-Schönlein purpura and idiopathic thrombocytopenic purpura. It also analyses the National Institute for Health and Care Excellence (NICE) ( 2014 ) pathway for management of petechial rash in children and examines treatment of the various causes. The article includes two relevant case studies and discusses the role of emergency nurses.
Asunto(s)
Enfermería de Urgencia/normas , Exantema/diagnóstico , Exantema/enfermería , Rol de la Enfermera , Guías de Práctica Clínica como Asunto , Adolescente , Niño , Preescolar , Femenino , Humanos , Vasculitis por IgA/diagnóstico , Vasculitis por IgA/enfermería , Lactante , Recién Nacido , Masculino , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/enfermería , Púrpura/diagnóstico , Púrpura/enfermería , Púrpura Trombocitopénica Idiopática/diagnóstico , Púrpura Trombocitopénica Idiopática/enfermeríaAsunto(s)
Diagnóstico Precoz , Rol de la Enfermera , Diagnóstico de Enfermería/organización & administración , Sepsis/mortalidad , Sepsis/enfermería , Niño , Preescolar , Ahorro de Costo , Procesamiento Automatizado de Datos/economía , Procesamiento Automatizado de Datos/organización & administración , Humanos , Lactante , Recién Nacido , Capacitación en Servicio/economía , Capacitación en Servicio/organización & administración , Comunicación Interdisciplinaria , Colaboración Intersectorial , Tiempo de Internación/economía , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/economía , Infecciones Meningocócicas/mortalidad , Infecciones Meningocócicas/enfermería , Diagnóstico de Enfermería/economía , Diagnóstico de Enfermería/métodos , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/economía , Infecciones Neumocócicas/mortalidad , Infecciones Neumocócicas/enfermería , Garantía de la Calidad de Atención de Salud/economía , Garantía de la Calidad de Atención de Salud/organización & administración , Sepsis/diagnóstico , Sepsis/economía , Tasa de SupervivenciaRESUMEN
Meningococcal disease is a leading cause of death in children and young people. Part 1 of this two-part series discussed its epidemiology, pathophysiology, signs and symptoms (Dowson, 2014). Part 2 reviews the diagnosis, management and prevention of this disease.
Asunto(s)
Profesionales para Control de Infecciones , Infecciones Meningocócicas , Enfermería Pediátrica/métodos , Choque Séptico , Niño , Humanos , Infecciones Meningocócicas/enfermería , Infecciones Meningocócicas/prevención & control , Infecciones Meningocócicas/terapia , Choque Séptico/enfermería , Choque Séptico/prevención & control , Choque Séptico/terapiaRESUMEN
This article is based on two case studies in which children with suspected meningococcal disease were brought to the author's emergency department. It examines the signs and symptoms of the disease, and discusses its management. Emergency practitioners should understand and recognise the signs and symptoms of serious meningococcal disease and refer children to paediatric services immediately.
Asunto(s)
Meningitis Meningocócica , Infecciones Meningocócicas , Algoritmos , Urgencias Médicas , Femenino , Humanos , Lactante , Masculino , Meningitis Meningocócica/diagnóstico , Meningitis Meningocócica/enfermería , Meningitis Meningocócica/terapia , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/enfermería , Infecciones Meningocócicas/terapiaAsunto(s)
Meningitis Meningocócica/enfermería , Infecciones Meningocócicas/enfermería , Sepsis/enfermería , Cefalosporinas/uso terapéutico , Niño , Preescolar , Diagnóstico Precoz , Alemania , Humanos , Lactante , Meningitis Meningocócica/diagnóstico , Meningitis Meningocócica/tratamiento farmacológico , Meningitis Meningocócica/prevención & control , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/tratamiento farmacológico , Infecciones Meningocócicas/prevención & control , Vacunas Meningococicas/administración & dosificación , Penicilina G/uso terapéutico , Sepsis/diagnóstico , Sepsis/tratamiento farmacológico , Sepsis/prevención & controlAsunto(s)
Meningitis Meningocócica/enfermería , Infecciones Meningocócicas/enfermería , Sepsis/enfermería , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Meningitis Meningocócica/diagnóstico , Meningitis Meningocócica/terapia , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/terapia , Diagnóstico de Enfermería , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Embarazo , Pronóstico , Sepsis/diagnósticoAsunto(s)
Infecciones Meningocócicas/enfermería , Neisseria meningitidis Serogrupo C , Adolescente , Causas de Muerte , Niño , Preescolar , Estudios Transversales , Alemania , Humanos , Lactante , Meningitis Meningocócica/mortalidad , Meningitis Meningocócica/enfermería , Meningitis Meningocócica/prevención & control , Infecciones Meningocócicas/mortalidad , Infecciones Meningocócicas/prevención & control , Choque Séptico/mortalidad , Choque Séptico/enfermería , Choque Séptico/prevención & control , Tasa de SupervivenciaRESUMEN
The impact on parents of having a child admitted to a paediatric intensive care unit (PICU) with meningococcal disease (MD) is discussed. Analysis, synthesis and evaluation of how nurses within a PICU can use a theoretical framework to identify and facilitate a decision-making process, regarding the support required by the parents of these children, is outlined. Peplau's interpersonal/conceptual framework is used as a basis for the investigation.
Asunto(s)
Cuidados Críticos/métodos , Infecciones Meningocócicas/enfermería , Modelos de Enfermería , Padres/psicología , Enfermería Pediátrica/métodos , Adulto , Niño , Humanos , Unidades de Cuidado Intensivo Pediátrico , Relaciones Profesional-FamiliaRESUMEN
Meningococcal sepsis is a potentially life threatening disease. Recent advances have led towards increased emphasis being placed on early identification and prompt aggressive management of these patients. This article outlines the disease pathology, describing a case study to illustrate the management and nursing care of a child with meningococcal sepsis. Current therapies are also discussed.
Asunto(s)
Cuidados Críticos/métodos , Infecciones Meningocócicas/enfermería , Sepsis/enfermería , Femenino , Humanos , Lactante , Padres/psicología , Enfermería Pediátrica/métodosRESUMEN
Meningococcal disease is an infection caused by Neisseria meningitidis, a gram-negative diplococcus that is the leading cause of bacterial meningitis in children and young adults in the United States, with an estimated 2,600 cases reported each year. N. meningitidis infection rates are highest in children 3 to 12 months of age. Four distinct clinical situations are associated with meningococcal infection. The most common is asymptomatic nasopharyngeal colonization. Benign bacteremia is discovered in the absence of classical clinical findings of meningococcemia, but blood cultures are positive for N. meningitidis. Meningitis, the most common pathologic presentation, is associated with fever, headache, and nuchal rigidity. The mortality rate is about 5% in children and 10% to 15% in adults. Meningococcemia, the most severe form of infection, may involve petechial rash, hypotension, and disseminated intravascular coagulation. It is a fulminant condition that can, if untreated, progress from initial symptoms to coma and death in 12 to 48 hours. Spread of these endemic cases can be controlled by administering prophylactic antibiotics to close contacts of patients.
Asunto(s)
Infecciones Meningocócicas , Niño , Diagnóstico Diferencial , Brotes de Enfermedades , Humanos , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/tratamiento farmacológico , Infecciones Meningocócicas/epidemiología , Infecciones Meningocócicas/enfermería , Infecciones Meningocócicas/prevención & control , Educación del Paciente como Asunto , Enfermería Pediátrica , Materiales de Enseñanza , Estados Unidos/epidemiologíaRESUMEN
This article discusses meningococcal disease and outlines the role of the nurse in treating patients who may suffer from meningitis, one of the illnesses caused by meningococcal disease. It goes on to discuss how nurses can support the relatives of these patients.
Asunto(s)
Infecciones Meningocócicas/enfermería , Adolescente , Adulto , Niño , Preescolar , Cuidados Críticos/métodos , Notificación de Enfermedades , Familia/psicología , Humanos , Lactante , Recién Nacido , Infecciones Meningocócicas/diagnóstico , Infecciones Meningocócicas/terapia , Pronóstico , Apoyo SocialAsunto(s)
Bacteriemia/diagnóstico , Meningitis Meningocócica/diagnóstico , Infecciones Meningocócicas/diagnóstico , Evaluación en Enfermería/métodos , Bacteriemia/enfermería , Preescolar , Humanos , Lactante , Meningitis Meningocócica/enfermería , Infecciones Meningocócicas/enfermería , Enfermería Pediátrica/métodosRESUMEN
Meningococcemia is a true infectious emergency that requires tremendous skill and collaboration among health-care professionals to reduce the high morbidity and mortality associated with this disease. Complications and sequelae may effect virtually every body system with meningococcal disease. The critical care nurse plays a crucial role in preventing and recognizing complications to reduce serious consequences, including respiratory distress syndrome, myocarditis, cardiovascular collapse, coagulopathies, major skin loss, and limb amputations.
Asunto(s)
Bacteriemia/complicaciones , Infecciones Meningocócicas/complicaciones , Bacteriemia/mortalidad , Bacteriemia/enfermería , Niño , Cuidados Críticos , Humanos , Infecciones Meningocócicas/mortalidad , Infecciones Meningocócicas/enfermería , Evaluación en Enfermería , Registros de EnfermeríaRESUMEN
This case presentation will discuss the pathophysiology of a child in septic shock due to Neisseria meningitidis. The most prevalent nursing care concerns of this case encountered during the pediatric intensive care unit (PICU) and during the general floor stay will be addressed. The nursing skill required for identifying problems and planning care that clearly fall under the nursing domain also will be covered. In addition, the complexities of this case demonstrate that collaboration between the PICU nurse and the general pediatric nurse is imperative for successful patient outcome. A.W. was a 5 1/2-month-old infant transported to our PICU from a referral hospital in the state. Diagnosis at time of admission was meningococcemia, disseminated intravascular coagulopathy, septic shock, respiratory failure, and purpura fulminans. There was a 2- to 3-day history of a runny nose, cough, and vomiting. On the day of admission, A.W. had three seizures and developed a fever and a purpuric rash.