Question

Communicable Diseases: Manifestations of Measles (RN QSEN - Patient-centered Care, Active Learning Template - System Disorder, RM NCC RN 10.0 chp 36)

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ACTIVE LEARNING TEMPLATE System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

System Disorder

Alteration in health( Diagnosis)

Measles: It is an acute highly contagious disease, often of childhood, caused by Measles virus, of genus Morbilli virus and is characterized by spreading red skin rash, fever and running nose.It is also known as Rubeola.

Risk factors

* Young children

* Child , who is not vaccinated

* Vitamin deficiency( especially Vitamin A)

* Close contact of a child with the infected children

* Malnourished children

* Children with HIV or Leukaemia ( Immunodeficiency state)

Expected findings

*Fever

* Cough

* red and watery eyes

* running nose

* a spreading red skin rash( appear after 3 days of first symptoms)

* Koplick spot( tiny white spots appear inside the mouth)

Laboratory tests

* Serologic test by collecting blood samples: to detect the specific IgM antibodies.

Diagnostic Procedures

- physical examination : for finding the characteristics of measles such as red rashes on the skin, Koplick spots.

- Blood test: to detect the presence of IgM antibodies

Pathophysiology related to Client problem

Measles is caused by Measles virus, a paramyxo virus that spread through coughing and sneezing. The mode of transmission can be airborne or droplets. It is a highly contagious disease. Virus can be remain viable in small aerosol droplets upto 2 hour.

Measles virus affects the respiratory system first and it attack the macrophages and dendritic cells in the lungs. The infected cells move to lymh nodes and other body parts and T cells also get infected by this virus. Infection of respiratory system causes running nose and cough. Gradually it affects skin, liver and thymus gland.

Health promotion and disease prevention

-MMR ( measles, mumps, rubella) vaccination for the children

-Human normal Immuno Globulin( HNIG)( for the immediate protection from measles)

- Avoid the children sending to school for atleast 5 days of appearance of rash

- try to avoid contact with the infected person

- Ensure nutrient diet for children to avoid malnourishment

Safety Consideration

- Pregnant women and young children should avoid contact with the infected person

- Avoid schooling and workplace during illness

Complications

* Diarrhoea and dehydration

* Ear infections

* Pneumonia and encephalitis( infection and inflammation of brain tissue) are the severe complications.

Patient centered care

Nursing care

- child should be isolated for four days after appearance of rash

- Report to health department of that locality.

-administer antipyretics and other medications according to physicians's order

- keep patient's skin clean, nail short, avoid exposure to sun

- Remove eye secretions with warm saline

- provide plenty of fluids

Medications

* Antivirals

Examples: ribavirin

* Acetaminophen to reduce fever

* Vitamin A : age specific dose can be administrated for preventing the complications of measles.

Client education

- Educate the patient/ parents regarding the importance of MMR vaccine

- Instruct that not to scratch the skin or rub the eyes

- Encourage to avoid sunlight and heat exposure to eyes

- Instruct to take plenty of oral fluids.

Therapeutic procedures

* Administration of Medications( oral or Intramuscular)

* Venipunctue for drawing blood samples( if necessary)

Interprofessional care

- Inform local health department

- Lab technician should be involved in blood test procedures