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Rubeola/Measles template

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Description of Rubeola/ Measles/ First DiseaseAcute, highly contagious viral disease with a characteristic rash. Associated with a significant degree of morbidity and mortality worldwide
Risk Factors for RubeolaLack of immunization (MMR given at 12 and 15 months) Waiting rooms with an infected pt (spread by microaerosolized resp droplets) Incubation period is 7-18 days, but usually 10 days Pts are contagious from 1-2 days prior to onset of symptoms until 4 days after appearance of the rash
Assessment Findings in Prodromal Stage (2-4 days) of RubeolaUpper resp infxn symptoms Fever up to 104F The 3Cs: cough, coryza, and conjunctivitis Presence of Koplik's spots (white spots on buccal mucosa) is pathognomonic Malaise
Assessment Findings in Rash Phase of RubeolaEmergence of maculopapular rash and elevation of temp up to 104.7F occur simultaneously Pharyngitis, cervical lymphadenopathy and splenomegaly often accompany rash Rash appears behind forehead and ears initially Over the first 24 hours, rash spreads to face, neck, and arms Next 24 hours, rash spreads to trunk and thighs Rarely rash can become hemorrhagic leading to fatality After 3-4 days, rash begins to clear and may leave a brownish discoloration and scaling
Diagnostic Studies for RubeolaMeasles specific IgM titers (must draw no sooner than 5 days after rash appears) Substantial rise in IgG titers between acute and convalescent phase Nasopharynx culture if done within 24 hours of onset of rash
Prevention of RubeolaRoutine vaccination at 12 and 15 months, that age 4-6 Resp isolation until 4 days after rash appears (Isolate immunocompromised pts for entire illness) Vaccination with live virus within 72 hours after exposure can provide protection Immunoglobulin if given within 6 days after exposure
Nonpharmacologic Management of RuebolaAntipyretic measures Oral fluids Antitussives Room humidification
Pharmacologic Management of RubeolaWater miscible vitamin A for children 6 months to 2 years in developing countries has been shown to decrease morbidity and mortality
Pregnancy Considerations in RubeolaDuring pregnancy there is significant increase in fetal morbidity and mortality Immunoglobulin recommended for susceptible pregnant women who have been in contact with known rubeola pt
Consult/Referral for RubeolaReport to local public health department Consider referral for all severe cases, prenant women, and immunocompromised pts
Expected Course for RubeolaMild to severe symptoms depending of age and immune status of pt

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