into pants when in weeded areas. Avoid grass and shrubbery where ticks may be present. After being outside, a bare skin check (with special attention to the scalp, neck, armpits, and groin areas) is important to spot any ticks and remove them. Use of insect repellents such as those containing diethyltoluamide (DEET) can protect against insects. Use these cautiously. Chicken Pox: The varicella-zoster virus (VZV) is the agent which causes Chickenpox. It is usually spread by the inhalation of airborne respiratory droplets (sneeze or cough) from an infected host, but may also be spread by direct contact and contaminated objects. A person is usually contagious one to two days before a rash appears until all blisters have crusted over (usually 5-6 days after rash appears). Once a person has had the disease they usually develop lifetime immunity meaning, it is extremely rare that they would get it again. Assessment data : Usually the first symptoms of Chickenpox are fever, headache, and sore throat. A red pimple-like, highly pruritic rash usually appears 1-2 days after these initial symptoms. Some children however, will get the rash without having any early symptoms. Lesions are present in varying degrees at one time. Vesicles may also appear in the mouth, on the scalp, around the eyes, or on the genitals and can be very painful. Therapeutic Management : Most healthy children only need home treatment for Chickenpox such as, lotions, special bath preparations and medications to relieve itching/fever. AVOID USE OF ASPIRIN! –Possible association with Reye syndrome. Keep child cool-may decrease number of lesions. Teach child to apply pressure to itchy area rather than scratch it. Keep fingernails trimmed and short to avoid infection from scratching. Maintain airborne and contact precautions if hospitalized until all lesions are crusted. Teaching Plan : Exclude children from school or child care for at least five days after the first appearance of the rash and the entire rash has formed scabs. It can be more serious in newborns, teenagers, adults, pregnant women, and people who have a weakened immune system. To ease itching, add a handful of oatmeal or baking soda to bath water. Antihistamines may also help to alleviate itching. Health Promotion A Chickenpox vaccine is recommended to all children and adults with no evidence of immunity. 2 doses of the vaccine are 98% effective in preventing Chickenpox. Children who have never had Chickenpox should get 2 doses of Chickenpox vaccine at these ages: 1st Dose: 12- 15 months of age. 2nd Dose: 4-6 years of age (may be given earlier, if at least 3 months after the 1st dose) * Some people who are vaccinated against Chickenpox may still get the disease. However, it is usually milder with fewer blisters and little or no fever. Rotavirus : one of the most important causes of serious gastroenteritis among children and a significant hospital-acquired pathogen. Infants 6-12 months are most vulnerable, peaks in winter months . Rotavirus is transmitted fecal-orally and invades the GI tract, resulting in decreased intenstinal absorption secondary to intestinal damage or inflammation.
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