NCLEX Review Guide: Infectious Diseases & Pediatric TORCH Infections

Infection Control & Prevention

• Standard precautions are used for all patients and include hand hygiene, PPE, safe injection practices, and respiratory hygiene.
• Contact precautions are required for multidrug-resistant organisms (MRSA, VRE, C. diff) and involve gown and gloves for all patient contact.
• Droplet precautions are used for influenza, pertussis, and meningitis, requiring surgical masks within 3 feet of patient.
• Airborne precautions require N95 respirators and negative pressure rooms for tuberculosis, measles, and varicella.

Common Childhood Infections

• Respiratory Syncytial Virus (RSV) is the leading cause of bronchiolitis in infants under 2 years, requiring contact and droplet precautions.
• Kawasaki Disease presents with prolonged fever >5 days, strawberry tongue, bilateral conjunctivitis, and requires immediate treatment to prevent coronary artery aneurysms.
• Epiglottitis is a medical emergency; never attempt to visualize the throat as it may cause complete airway obstruction.
• Pertussis (whooping cough) presents with paroxysmal coughing fits followed by inspiratory "whoop" and requires droplet precautions.

Congenital Infections Overview

• TORCH represents congenital infections: Toxoplasmosis, Other (syphilis, varicella), Rubella, Cytomegalovirus, and Herpes simplex virus.
• These infections can cause intrauterine growth restriction, microcephaly, hearing loss, and developmental delays when acquired during pregnancy.
• Primary maternal infection during pregnancy poses the highest risk to the fetus compared to reactivation of latent infections.

TORCH Screening Process

1. Obtain maternal history of symptoms during pregnancy
2. Perform serologic testing for IgG and IgM antibodies
3. Assess newborn for characteristic physical findings
4. Implement appropriate isolation precautions if indicated
5. Initiate early intervention services for affected infants