A nurse is performing a physical assessment on a new 3-year-old boy. The mother answers "no" when asked if the child is up to date with vaccinations. The child presents with slight fever and spasms of coughing that make a "whooping" sound
The mother said that occasionally the child vomits after coughing so hard. What disease would the nurse suspect? A) Tetanus
B) Pertussis
C) Diphtheria
D) Haemophilus influenzae type b
B
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Pertussis or "whooping cough" is a highly contagious bacterial respiratory disease occurring most commonly in young children who have not been immunized. Symptoms begin with bronchitis and a slight temperature elevation. The cough steadily worsens, leading to paroxysms (spasms) of coughing, characterized by a "whooping" sound. The person may cough so hard that he or she vomits or becomes dyspneic (labored breathing). Early symptoms of tetanus include the inability to open or close the jaw, difficulty in swallowing, and stiffness in the neck and abdomen. Typically, symptoms are a throat inflammation. Diphtheria also may appear in the nose, larynx, or trachea, and is followed by the formation of a whitish-gray membrane that is closely adherent and cannot be removed without causing bleeding. Haemophilus influenzae type b (Hib) is a serious, bacterial infection that may affect many organ systems, causing pneumonia, meningitis, epiglotitis, endocarditis, osteomyelitis, cellulitis, otitis media, and septic arthritis.
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