Pertussis – Whooping Cough

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Ashley Powell
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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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S25 Week 4 Study Plan (Community Health, OB, Peds)

Concepts Covered:

  • Respiratory Disorders
  • Prenatal Concepts
  • Community Health Overview
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Oncologic Disorders
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Labor Complications
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders

Study Plan Lessons

Care of the Pediatric Patient
Menstrual Cycle
Family Planning & Contraception
Vitals (VS) and Assessment
Epidemiology
Growth & Development – Infants
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Environmental Health
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Pediculosis Capitis
Burn Injuries
Fundal Height Assessment for Nurses
Technology & Informatics
Maternal Risk Factors
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Nephroblastoma
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Postpartum Discomforts
Breastfeeding
Asthma
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Eczema