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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Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Community Health Overview
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Emotions and Motivation
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Labor Complications
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Cardiac Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Shock
  • Infectious Disease Disorders
  • Nervous System
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Epidemiology
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Legal Considerations
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Fundal Height Assessment for Nurses
Injectable Medications
Somatoform
Technology & Informatics
Fall and Injury Prevention
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
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
Overview of the Nursing Process
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Proton Pump Inhibitors
Schizophrenia