Rubeola – Measles

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Study Tools For Rubeola – Measles

Measles (Image)
Measles Rash (Image)
Airborne Precaution Diseases (Mnemonic)
Immunization Schedule (Cheatsheet)
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Outline

 

  1. Highly contagious viral infection caused by the measles virus
    1. 9 out of 10 people exposed to measles will become infected
  2. MMR Vaccine (Measles, Mumps, Rubella)
    1. 2 doses given
      1. 12-14 months
      2. 4-6 years

General

  1. Incubation period of 10-20 days
  2. Transmission: Airborne
    1. Contagious until 5 days after the rash appears
  3. Was extremely rare in the United States due to immunizations.
  4. Outbreaks are on the rise in the U.S.
    1. Contributing factors:
      1. Increasing cases in poorly immunized parts of the world
      2. Increasing globalism and traveling
      3. Undervaccination in vulnerable communities
      4. 2019 outbreak is the worst since 1994

Assessment

  1. Onset 10-12 days after exposure
  2. High Fever (40C/104F)
    1. Lasting 4-7 days
  3. Three C’s
    1. Coryza
      1. Irritation and swelling of mucous membranes in nose
    2. Cough
    3. Conjunctivitis
  4. Koplik’s spots
    1. Small grayish-white spots that appear inside the cheeks
  5. Rash
    1. Small, flat or raised spots that are reddish, brown.
    2. May group together to form patches
    3. Starts on the face and spreads cephalocaudal (head to toe)

Therapeutic Management

  1. Airborne precautions
    1. Ensure there are no pregnant caregivers
  2. Supportive Care
    1. Provide rest and quiet environment
    2. Maintain adequate hydration
    3. Eye Care for conjunctivitis
    4. Vaporizer/Humidifier for cough
  3. Medications
    1. No specific antiviral treatment
    2. Antipyretics
    3. Analgesics
    4. Vitamin A supplement
      1. 50% reduction in morbidity and mortality
      2. Prevents eye damage and blindness
  4. Monitor for complications
    1. Otitis media
    2. Bacterial pneumonia
    3. Encephalitis
    4. Blindness
    5. Hearing loss
    6. Learning difficulties

Nursing Concepts

  1. Immunity
  2. Infection Control
  3. Health Promotion

Patient Education

  1. Importance of immunization
    1. Collective immunity
  2. Avoid use of aspirin due to risk of Reye’s Syndrome

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Transcript

Hey everyone, in this lesson we are going to talk about Measles or Rubeola. Just a quick note- there is another disease called Rubella or German Measles. Rubella is less severe in kids than Rubeola but, Rubella is super dangerous for both pregnant mothers and fetuses. It can cause birth defects and miscarriages. We are focusing on Rubeola or Measles because it is more severe and seen more often in kids than German Measles.
So, Rubella is an extremely, extremely contagious viral infection that can cause a lot of negative, long-term side effects. Guys, it’s so contagious that if you aren’t immunized against it and you come into contact with someone who has it there is a 90% chance that you will become infected.

It’s spread via contact with droplets and can be airborne as well.

It used to be very rare in the United States, but is not now the rise. In fact, there is currently an outbreak of Measles in the United States that the worst that’s been seen since 1994.

The rise in cases is caused by a complex, combination of things – like increasing globalism as well as undervaccination. We all know- there has been a lot of controversy around the safety of the MMR vaccine- which immunizes kids against Measles, Mumps and Rubella. A study done in the 1998 reported a link between the MMR vaccine and autism and this resulted in a decline in immunization. This study has been totally discredited. I talk a bit more about this in the Autism Spectrum Disorder lesson if you want to check that out!

So, it’s really important that we educate parents on the safety and importance of the MMR vaccine to help stop these outbreaks and protect those in the community that are vulnerable. The most vulnerable are infants and kids with compromised immune systems.

If caregivers consent to it, the MMR vaccine is given between 12 and 15 months and again between 4 and 6 years.

For your nursing assessment there are several pretty classic symptoms to be familiar with.

First, measles usually causes a high fever- like 40 degrees celsius or 104 degrees fahrenheit. Then you have the classic 3 C’s, which are Coryza, Cough, and Conjunctivitis. Coryza is just a fancy word for inflammation of the mucous membranes in the nose.

Koplik spots may then appear on the inside of the cheek. They are these small grayish-white spots you see here in the photo. These are only associated with the diagnosis of measles-so if you see them you know exactly what the diagnosis is!

The rash associated with measles is pretty extensive, covering a large portion of the body. You have small flat or raised reddish brown spots. The flat spots are called macules. The raised ones are called papules. When they occur together people call it a maculopapular rash. In measles, these spots become so numerous that they actually join together making it look like large patches. The rash will spread from head to toe.

So, the first thing to do if you suspect a child has measles is place them on airborne precautions- remember this always takes a bit of extra effort because it requires a special mask called the N95- so always make sure the staff taking care of this kid have been properly fitted for this type of mask.

For the most part all we can do is provide supportive care. So we encourage rest, monitor hydration status (giving fluids as needed), provide eye care for the conjunctivitis and a cool mist vapor may help with the cough.

Medications that may be given to child with measles are, antipyretics like acetaminophen and ibuprofen. Remember, no aspirin for kids because it can cause Reye Syndrome! In cases where the child has to be hospitalized, Vitamin A may be given because this is shown to drastically improve outcomes and prevent damage to the eyes.

This brings me to the topic of complications. Some cases of measles will be handled outpatient and the child will have few long-term issues- but complications can happen and they are devastating. In the short-term, patients may develop life threatening pneumonia or encephalitis. Long-term these kids may end up with blindness, hearing loss and learning disabilities. Monitoring for these complications has to be part of our nursing care plan!

Your priority nursing concepts for a pediatric patient with measles are immunity, infection control, and health promotion.
Let’s go over your key points for this lesson! Measles is a highly contagious, viral infection. Remember, people are contagious until 5 days after the rash appears!

It’s spread through aerosolized droplets so make sure airborne precautions are in place as soon as you suspect the measles.

In your assessment the major things to know are high fever, the 3 C’s, Koplik Spots (on the inside of the cheek) and a very extensive rash.

Treatment is supportive and in severe cases vitamin A is given to improve outcomes and prevent damage to the eye. And remember a major part of health promotion is educating on the importance of immunizations. Measles can be prevented with the MMR vaccine.

Complications are a big deal with measles- pneumonia and encephalitis are the most common causes of death for patients with measles and hearing loss and blindness can occur as well.

That’s it for our lesson on Measles. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

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  • Musculoskeletal Disorders
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  • Documentation and Communication
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  • Concepts of Pharmacology
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Lab Panels – The Basics and What YOU Need to Know 2 – Live Tutoring Archive
Fundamentals Course Introduction
Legal & Ethical Issues in ER
Nursing Care and Pathophysiology of Osteoporosis
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
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3rd Degree AV Heart Block (Complete Heart Block)
6 Rights of Medication Administration
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Nursing Care and Pathophysiology for Arterial Disorders
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Nursing Care and Pathophysiology for Chlamydia (STI)
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Nursing Care and Pathophysiology for Crohn’s Disease
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Nursing Care and Pathophysiology for Gout
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Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
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Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
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Nursing Care and Pathophysiology for Parkinsons
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Nursing Care and Pathophysiology for Sickle Cell Anemia
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Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
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Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Anxiety
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Nursing Care Plan (NCP) for Decreased Cardiac Output
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Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
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Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Process – Assess
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Nutrition (Diet) in Disease
Nutrition Assessments
Nutrition in Pregnancy
Obstetrical Procedures
Obstructive Heart (Cardiac) Defects
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Order of Lab Draws
Osteosarcoma
Outline Question Method (Note taking)
Ovarian Cancer
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Personality Disorders
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Postpartum Physiological Maternal Changes
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Renal (Kidney) Failure Labs
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Restraints
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Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
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Rubeola – Measles
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Thinking Like a Nurse
Thoracentesis
Thorax and Lungs Assessment
Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)
Thrombocytopenia
Thyroid Cancer
Time Management
Tocolytics
Tocolytics
Tonsillitis
Topical Medications
Total Bilirubin (T. Billi) Lab Values
Trach Care
Trach Suctioning
Transient Tachypnea of Newborn
Transition To Practice
Transition to Practice Course Introduction
Trauma Survey
Triage in the ER
Troponin I (cTNL) Lab Values
Types of Exercise
Types of Schizophrenia
Umbilical Hernia
Urinary Elimination
Using Aseptic Technique
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Varicella – Chickenpox
Varicocele
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms
Vitals (VS) and Assessment
Vomiting
What Guides Nurses Practice
What is CCMM?
White Blood Cell (WBC) Lab Values
Working night shift
Working with a Preceptor
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Wound Drains