[Respiratory] Pertussis (Whooping cough)

• Respiratory infection caused by the bacterium Bordetella pertussis
• Spread from person to person by coughing, sneezing, and close contact.
• Vaccination is available

펄테시스

1. Clinical Manifestations

• Catarrhal phase
  • 1-2 weeks of mild cough, rhinitis, sneezing, low-grade fever
• Paroxysmal phase
  • 2-6 weeks of violent spasmodic coughing attacks followed by an inspiratory "Whoop"
  • Cough is so violent, that can cause
    • Post-tussive emesis
    • Syncope
    • Rib fractures
    • Apnea
    • Bleeding (eye,brain)
  • Convalescent phase
    • Mild cough may persist for 6-10 weeks, resolving gradually
  • Diagnostics: Nasopharyngeal swab PCR

2. Nursing interventions

• Standard and droplet precautions
• Antibiotics
• Humilified air
• Increase fluid intake
• Signs of airway obstruction
  • Suction as needed
• Complications: Apnea, rib fractures, pneumonia
• Notify the local health agency

3. Client teaching

• Avoid triggers that stimulate coughing: exercise, smoke, cold tempertature
• Antibiotic postexposure prophylaxis for all household contacts
• Vaccinations
• Mild cough may persist for 6-10 weeks
• Clients are considered contagious until hey have completed 5 full days of antibiotics

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IF you are performing triage to assign a private room first, it need to be a client with suspected pertussis who has paroxysms of coughing,

B/C

Paroxysms of rapid coughing that lead to vomiting are a key feature of pertussis infection. Pertussis is a highly contagious disease and requires droplet precautions. It can be deadly if contracted in infancy before baccination is started. This client should be placed in isolation immedicately to prevent the spread of disease.

 

+ Cough suppressants interfere with the expectoration of mucus plugs that develop in the airway and are not recommended for perfussis b/c they are usually ineffective. 

 

+Offer small sips of fluids frequently: 켈록켈록대서 respiratory difficulty를 유발할 줄 알았는데,  Treatment consists of antibiotics and other supportive measures (eg. humidified oxygen, oral fluids) Small amounts of oral fluids help loosen mucus so it can be expectorated.

 

+The nurse should closely monitor for airway obstuction (eg. cyanosis) during coughting episodes, place clients on the side if vomitting, and suction the airway and provide oxygen as needed.