Pertussis – Whooping Cough

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Ashley Powell
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Included In This Lesson

Study Tools For Pertussis – Whooping Cough

Pertussis (Image)
Pertussis Pathochart (Cheatsheet)
Immunization Schedule (Cheatsheet)
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Outline

Overview

  1. Highly contagious respiratory infection caused by the Bordetella pertussis bacteria that is easily prevented with vaccine.

Nursing Points

General

  1. Spread via direct contact with droplets
  2. The time between exposure and the development of symptoms is on average 7–14 days
  3. Prevention
    1. Immunization:
      1. DTaP: for infants and young kids – given at 2, 4, 6, 15 months and 4-6 years
      2. Tdap: for adolescents and adults
        1. Booster recommended for adolescents
        2. Recommended for pregnant women in 3rd trimester to help protect newborns

Assessment

  1. Catarrhal stage – upper respiratory infection
    1. Runny nose
    2. Fever
    3. Mild cough
  2. Paroxysmal stage
    1. Cough progresses
      1. Worse at night
      2. Short rapid coughs followed by high-pitched “whoop sound” as patient tries to breathe in.  
    2. Coughing can be so forceful that patients vomit, break ribs and become exhausted.
    3. Lasts 4-6 weeks

Therapeutic Management

  1. Isolate patient
  2. Initiate droplet  precautions
  3. Dx- nasopharyngeal swab for culture
  4. Position patient on side during coughing spells to reduce risk of aspiration
  5. Encourage fluids
  6. Humidified oxygen
  7. Antibiotic therapy
    1. Erythromycin
    2. Clarithromycin
    3. Azithromycin
  8. Monitor for complications
    1. Respiratory distress and cyanosis
    2. Rib fractures
    3. Pneumonia

Nursing Concepts

  1. Immunity
  2. Infection Control
  3. Oxygenation

Patient Education

  1. Isolate child from other children
  2. Pain relievers may help alleviate discomfort

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Transcript

Hey guys, glad you are joining me here! In this lesson we are going to talk about pertussis, which is also known as whooping cough.
Whooping cough is a highly contagious respiratory infection caused by the organism bordetella pertussis, which you can see in the photo here. What happens during pertussis is that the bacteria attach to the cilia which are the tiny little hairlike things that line the upper respiratory system. The bacteria causes damage and inflammation in the airway.

The crazy thing with whooping cough is that it symptoms can actually last up to 6 weeks.

It can be prevented with the DTaP (Diphtheria, Tetanus and Pertussis) vaccine which is given at 2, 4, 6, 15 months and again between 4-6 years. You may be thinking wait- I thought it was called the Tdap. Well, the Tdap is what’s used for adolescents and adults, whereas the DTaP is given to infants and kids.

In your assessment there are two different stages to look for. The first is the catarrhal stage. Catarrh is just a fancy word for inflammation in the airways. During this stage you’ll see fever, increased nasal secretions, and a mild cough. The second stage is the paroxysmal stage and this is when the cough really progresses. Patients experience these coughing spells – where they have a bunch of short rapid coughs followed by a high-pitched whooping sound. These spells tend to be worse at night and can be so bad that they cause vomiting and may be fracture ribs.

Like I mentioned symptoms can last up to 6 weeks- so it can be pretty exhausting.

Just a quite note- The patients we are most worried about are our infants. They may develop pneumonia and their airways are actually still pretty soft so the intense coughing can cause a lot of damage. Apneic episodes are common in infants and for them whooping cough can be life threatening. So be extra vigilant with your assessment- looking out for signs of respiratory distress.

These patients need to be on droplet precautions. Our nursing care is focused on supporting respiratory effort. These patients may benefit from humidified O2 and elevating the head of bed.

Antibiotics are given as well. The most common one give is azithromycin.

Patient education is important because we need to make sure caregivers know that symptoms can last a long time.

Your priority nursing concepts for a pediatric patient with pertussis are immunity, infection control and oxygenation.
Pertussis is a respiratory infection that is very contagious and caused by bordetella pertussis.

It is preventable with the DTaP immunization, which is given at 2, 4, 6, 15 mo and 4-6 years.

There are 2 stages to the disease, the first pretty much just looks like an upper respiratory tract infection and the second is when the cough progresses to the classic “whooping cough”.

Treatment is supportive and antibiotics.

Patient education should focus on preparing caregivers for the length of the illness and also making people aware of the importance of immunizing against it!
That’s it for our lesson on Pertussis or Whooping cough. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

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6 week

Concepts Covered:

  • Gastrointestinal Disorders
  • Respiratory Disorders
  • EENT Disorders
  • Infectious Disease Disorders
  • Lower GI Disorders
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Medication Administration
  • Hematologic Disorders
  • Integumentary Disorders
  • Cardiovascular Disorders
  • Musculoskeletal Disorders
  • Endocrine and Metabolic Disorders
  • Renal and Urinary Disorders
  • Urinary System
  • Studying
  • Oncologic Disorders
  • Central Nervous System Disorders – Brain
  • Renal Disorders
  • Infectious Respiratory Disorder
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Sexually Transmitted Infections
  • EENT Disorders

Study Plan Lessons

Abdomen (Abdominal) Assessment
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acetaminophen (Tylenol) Nursing Considerations
Acute Bronchitis
Acute Otitis Media (AOM)
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Albuterol (Ventolin) Nursing Considerations
Alveoli & Atelectasis
Amoxicillin (Amoxil) Nursing Considerations
Anti-Infective – Antivirals
Anti-Infective – Macrolides
Anti-Infective – Penicillins and Cephalosporins
Anti-Infective – Fluoroquinolones
Appendicitis
Appendicitis – Assessment Nursing Mnemonic (PAINS)
Appendicitis Case Study (Peds) (30 min)
Appendicitis for Certified Emergency Nursing (CEN)
Assessment of a Burn Nursing Mnemonic (SCALD)
Asthma
Asthma Concept Map
Asthma management Nursing Mnemonic (ASTHMA)
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Base Excess & Deficit
Bisacodyl (Dulcolax) Nursing Considerations
Blood Brain Barrier (BBB)
Blood Type O Nursing Mnemonic (Universally Odd)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Bronchodilators
Bupropion (Wellbutrin) Nursing Considerations
Burn Injuries
Burn Injury Case Study (60 min)
Burns for Certified Emergency Nursing (CEN)
Cardiac Glycosides
Care of the Pediatric Patient
Casting & Splinting
Cefaclor (Ceclor) Nursing Considerations
Celiac Disease
Cerebral Palsy (CP)
Cimetidine (Tagamet) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Cleft Lip and Palate
Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)
Clubfoot
Congenital Heart Defects (CHD)
Conjunctivitis
Constipation and Encopresis (Incontinence)
Corticosteroids
Coumarins
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Cystic Fibrosis (CF)
Day in the Life of a NICU Nurse
Day in the Life of a Peds (Pediatric) Nurse
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Dehydration
Diarrhea – Treatment Nursing Mnemonic (BRAT)
Digoxin (Lanoxin) Nursing Considerations
Diphenhydramine (Benadryl) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Eczema
EENT Assessment
Enuresis
Epiglottitis
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Epispadias and Hypospadias
Famotidine (Pepcid) Nursing Considerations
Fever
Fever Case Study (Pediatric) (30 min)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluticasone (Flonase) Nursing Considerations
Gas Exchange
Gentamicin (Garamycin) Nursing Considerations
Glucose Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Guaifenesin (Mucinex) Nursing Considerations
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Hemophilia
Hierarchy of O2 Delivery
Hydrocephalus
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Ibuprofen (Motrin) Nursing Considerations
Immunizations (Vaccinations)
Imperforate Anus
Impetigo
Indomethacin (Indocin) Nursing Considerations
Influenza – Flu
Integumentary (Skin) Assessment
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Iron Deficiency Anemia
Isolation Precaution Types (PPE)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Lactulose (Generlac) Nursing Considerations
Leukemia
Levels of Consciousness (LOC)
Levetiracetam (Keppra) Nursing Considerations
Lung Sounds
Marfan Syndrome
Meningitis
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Meningitis for Certified Emergency Nursing (CEN)
Methylphenidate (Concerta) Nursing Considerations
Mixed (Cardiac) Heart Defects
Mumps
Nephroblastoma
Nephrotic Syndrome
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro Assessment
NSAIDs
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Hemophilia
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Meningitis
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pertussis / Whooping Cough
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Reye’s Syndrome
Nursing Care Plan (NCP) for Rheumatic Fever
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Tonsillitis
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Case Study for Pediatric Asthma
Obstructive Heart (Cardiac) Defects
Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)
Omphalocele
Opioid Analgesics
Pancrelipase (Pancreaze) Nursing Considerations
Pediatric Bronchiolitis Labs
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatrics Course Introduction
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Phenytoin (Dilantin) Nursing Considerations
Platelets (PLT) Lab Values
Pneumonia
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Pulmonary Function Test
Red Blood Cell (RBC) Lab Values
Respiratory Acidosis (interpretation and nursing interventions)
Reye’s Syndrome
Reyes Syndrome Case Study (Peds) (45 min)
Rheumatic Fever
ROME – ABG (Arterial Blood Gas) Interpretation
Rubeola – Measles
Salmeterol (Serevent) Nursing Considerations
Scoliosis
Selegiline (Eldepyrl) Nursing Considerations
Sickle Cell Anemia
Spina Bifida – Neural Tube Defect (NTD)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoma Care (Colostomy bag)
Strabismus
Sudden Infant Death Syndrome (SIDS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Thorax and Lungs Assessment
Tonsillitis
Topical Medications
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Umbilical Hernia
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Varicella – Chickenpox
Varicella Case Study (Peds) (30 min)
Vitals (VS) and Assessment
Vomiting
White Blood Cell (WBC) Lab Values
X-Ray (Xray)