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Pertussis is an afebrile respiratory illness caused by the bacterium Bordetella pertussis. It is highly contagious and occurs in all age groups. Pertussis is spread by respiratory droplets generated through coughing, sneezing and even talking. People with pertussis usually spread the disease while in close contact with others, who then breathe in the bacteria. An infected person is most contagious early in the course of illness. After pertussis exposure, patients become contagious when symptoms develop. If left untreated, an infected person can spread pertussis for up to three weeks after symptoms begin. The attack rate (percent of those exposed who actually get the disease) among unimmunized household contacts is 90 percent. Although the vaccine is effective, immunity is incomplete and wanes over time. Therefore, anyone can contract pertussis infection. People who have been previously immunized are more likely to have milder symptoms, although they are still highly contagious. In a vaccinated child or adult, pertussis can mimic other cough-related illnesses. When to suspect pertussisPertussis should be suspected in any patient with a cough illness with no or mild fever, particularly if cough has persisted for more than one week. Additional key signs and symptoms include:
Pertussis testing instructions
Precautions that help limit disease transmission
Reviewed by: Julia Shaklee, MD, MSCE, Associate Hospital Epidemiologist and Medical Director
Pertussis, commonly known as whooping cough, is one of the most common vaccine-preventable disease in children under 5 years of age. It is known for its violent, uncontrollable coughing which makes it difficult to breathe, eat, or drink. Review this study guide and learn more about pertussis, its pathophysiology, stages, assessment findings, medical management, and nursing care management. What is Pertussis?Pertussis (whooping cough) is a respiratory tract infection characterized by a paroxysmal cough.
PathophysiologyHumans are the sole reservoir for B pertussis and B parapertussis.
Statistics and IncidencesSince the early 1980s, pertussis incidence has cyclically increased, with peaks occurring every 2-5 years.
Clinical ManifestationsTypically, the incubation period of pertussis ranges from 3-12 days; it is a 6-week disease divided into catarrhal, paroxysmal, and convalescent stages, each lasting 1-2 weeks.
Assessment and Diagnostic FindingsThe criterion standard for diagnosis of pertussis is isolation of B pertussis in culture.
Medical ManagementSupportive therapy is the mainstay of treatment in patients with active pertussis infection.
Pharmacological ManagementAntimicrobial agents given during the catarrhal phase may ameliorate the disease.
Nursing ManagementNursing management of a patient with pertussis include the following: Nursing AssessmentContinuous assessment is necessary in order to know possible problems that may have led to concerns that may occur during nursing care. • Airway patency. Maintaining patent airway is always the first priority. Nursing DiagnosisBased on the assessment data, the major nursing diagnosis are: • Ineffective airway clearance related to copious and tenacious bronchial secretions. Nursing Care Planning and GoalsThe major nursing care planning goals for pertussis:
Nursing InterventionThe nursing interventions for a patient with pertussis include:
EvaluationGoals are met as evidenced by:
Documentation GuidelinesDoumentation in a patient with pertussis include:
Practice Quiz: Pertussis (Whooping Cough)Nursing practice questions for Pertussis (Whooping Cough). Please visit our nursing test bank page for more NCLEX practice questions. 1. Nurse Sandra is handling a child with pertussis. During the assessment, the nurse will observed on which of the following characteristic of the child’s cough? A. A sour coughB. A chesty coughC. A hacking cough that ends with a whooping sound D. A barking, painful cough 1. Answer: C. A hacking cough that ends with a whooping sound
2. A clinical instructor is providing teachings among nursing students about the stages of pertussis. Which of the following is the final phase of a pertussis infection? A. Paroxysmal phaseB. Recovery phaseC. Catarrhal phase D. Convalescent phase 2. Answer: D. Convalescent phase
3. The recommended antimicrobial agents for chemoprophylaxis or treatment of Whooping cough (Pertussis) are EXCEPT A. Amantadine (Symmetrel)B. Erythromycin (Erythrocin) C. Trimethoprim-sulfamethoxazole (Septra) D. Azithromycin (Zithromax Tri-Pak) 3. Answer: A. Amantadine (Symmetrel)
4. Which of the following statements are true about Pertussis? Select all that apply. A. Pertussis (Whooping cough) is caused by the bacteria Bordetella pertussis. E. Early symptoms of the disease (runny nose, low-grade fever, and a mild, occasional cough) can last for 1 to 2 weeks. 4. Answer: A, B, C, and E.
5. A pregnant woman went to a community clinic to ask a health care provider about Dtap vaccination. Which of the following statements made by the HCP is true about the vaccine, except? A. After receiving a Tdap vaccine, the mother’s body will create antibodies and passes some of them to the baby prior to birth.B. If Tdap is administered before pregnancy, it should not be repeated between 27 and 36 weeks gestation.C. A single dose of Tdap vaccine will provide enough protection on the succeeding pregnancy. D. All women can receive a Tdap vaccine during the 27th through the 36th week of pregnancy. 5. Answer: C. A single dose of Tdap vaccine will provide enough protection on the succeeding pregnancy.
ReferencesSources and references for this study guide for polio:
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