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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My Study Plan

Concepts Covered:

  • Prenatal Concepts
  • Musculoskeletal Disorders
  • Respiratory Disorders
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Adulthood Growth and Development
  • Integumentary Disorders
  • Hematologic Disorders
  • Pregnancy Risks
  • Oncologic Disorders
  • Postpartum Complications
  • Fetal Development
  • Endocrine and Metabolic Disorders
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Labor Complications
  • EENT Disorders
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Liver & Gallbladder Disorders
  • Microbiology
  • Infectious Disease Disorders

Study Plan Lessons

OB Course Introduction
Pediatrics Course Introduction
Care of the Pediatric Patient
Care of the Pediatric Patient
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vitals (VS) and Assessment
Overview of Childhood Growth & Development
Developmental Stages and Milestones
Growth & Development – Infants
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Growth & Development – School Age- Adolescent
Eczema
Gestation & Nägele’s Rule: Estimating Due Dates
Impetigo
Pediculosis Capitis
Burn Injuries
Burn Injuries
Fundal Height Assessment for Nurses
Physiological Changes
Sickle Cell Anemia
Sickle Cell Anemia
Discomforts of Pregnancy
Iron Deficiency Anemia
Hemophilia
Nutrition in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Pediatric Oncology Basics
Anemia in Pregnancy
Leukemia
Cardiac (Heart) Disease in Pregnancy
Nephroblastoma
Nephroblastoma
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
HELLP Syndrome
Fertilization and Implantation
Fever
Dehydration
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Appendicitis
Obstetrical Procedures
Intussusception
Umbilical Hernia
Constipation and Encopresis (Incontinence)
Constipation and Encopresis (Incontinence)
Strabismus
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Acute Bronchitis
Postpartum Interventions
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Postpartum Discomforts
Breastfeeding
Pneumonia
Asthma
Asthma
Cystic Fibrosis (CF)
Sudden Infant Death Syndrome (SIDS)
Congenital Heart Defects (CHD)
Congenital Heart Defects (CHD)
Postpartum Hematoma
Defects of Increased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Obstructive Heart (Cardiac) Defects
Subinvolution
Mixed (Cardiac) Heart Defects
Mixed (Cardiac) Heart Defects
Postpartum Thrombophlebitis
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Epispadias and Hypospadias
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Meningitis
Transient Tachypnea of Newborn
Retinopathy of Prematurity (ROP)
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Autism Spectrum Disorders
Erythroblastosis Fetalis
Addicted Newborn
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Tocolytics
Betamethasone and Dexamethasone
Scoliosis
Magnesium Sulfate
Opioid Analgesics
Prostaglandins
Uterine Stimulants (Oxytocin, Pitocin)
Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
Phytonadione (Vitamin K)
Hb (Hepatitis) Vaccine
Rubeola – Measles
Rubeola – Measles
Mumps
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Influenza – Flu
Acute Otitis Media (AOM)
Antepartum Testing
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cerebral Palsy (CP)
Chorioamnionitis
Cleft Lip and Palate
Clubfoot
Conjunctivitis
Cystic Fibrosis (CF)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Eczema
Enuresis
Epiglottitis
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fever
Gestational Diabetes (GDM)
Gravidity and Parity (G&Ps, GTPAL)
Hemophilia
Hydrocephalus
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Imperforate Anus
Impetigo
Incompetent Cervix
Intussusception
Marfan Syndrome
Mastitis
Maternal Risk Factors
Meconium Aspiration
Meningitis
Menstrual Cycle
Omphalocele
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Postpartum Hemorrhage (PPH)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Reye’s Syndrome
Rheumatic Fever
Scoliosis
Signs of Pregnancy (Presumptive, Probable, Positive)
Spina Bifida – Neural Tube Defect (NTD)
Tonsillitis
Varicella – Chickenpox