MEASLES

MEASLES
(RUBEOLA)
What is Measles?
 Measles is transmitted primarily from person to person by large respiratory droplets but can also spread by
the airborne route as aerosolized droplet nuclei.
 An infection of the respiratory system caused by measles virus belonging to paramyxovirus group.
 Primary site of infection =nasopharynx
 Primary viremia (2-3 days post exposure)
 Secondary viremia (5-7 days post exposure)
 *** Systemic infection which means it affects the person holistically. The MV is transmitted via
respiratory means. The primary site of infection is the respiratory epithelium of the nasopharynx
*2-3 days P invasion/replication a primary viremia occurs leading to infection of RES (reticuloendothelial
system) – basically the lymphoid organs which is part of the immune system
*5-7 days P initial infection a second viremia occurs affecting respiratory tract as well as possibly other
organs
Measles Virus
 Measles virus is a member of the genus Morbillivirus of the family Paramyxoviridae.
Clinical Manifestations:
The 3 C’s:
 Cough, coryza, conjunctivitis

 Koplik’s spots
 MV rash
 Maculopapular
 Macule – red lesion flushing
 Papule – raised red lesion
***The 3 C’s are cough, coryza (inflammation of the mucus membrane lining the nasal cavity causing
nasal congestion), and conjunctivitis (inflammation of conjunctivia = aka pinkeye in US)
***Koplik’s spots (small white lesions mentioned) inside the mouth – are parthognomonic of measles
***Maculopapular is a portmanteau of the two words
***Rash starts from the hairline involving the face and neck, throughout body to extremities
Confluence of rash means blending together
Diagnosis:
Diagnosis of Measles is usually done via serology—looking for measles antibodies in blood serum,
and the disease is usually most likely to occur among unvaccinated individuals.
Physical Examination
Physical examination is to measure vital signs and other measurements and examination of all parts of
the body using the techniques of inspection, palpation, percussion, and auscultation. (Potter, 2005:
159)
Physical Assessment of Measles :
Typically in 3 days with malaise and high fever.
Cough, runny nose, and conjunctivitis occurs in 24 hours. These symptoms gradually increased,
reaching a peak with the appearance of rash on day four.
About two days before the rash, spots appear on the mucous membranes in the mouth. Spots increased
in number at 3 days and spread to all mucous membranes. It emerged at the end of the second day after
the rash.
Rash appears first on the hair area and then spread from head to foot about 3 days. During this phase,
high fever, lymphadenopathy, and pharyngitis, occurred in a typical. Left rash began to decrease more
than 5 to 6 days. Fever persists for 3 days in the time of rash that is usually because of complications.
Treatment
There is no treatment for uncomplicated measles. The interventions below are to provide support and
treatment of the symptoms.
Isolation- Patients will need to be on isolation precautions to decrease transmission within the
community. Emphasize the need for immediate isolation when early catarrhal symptoms appear
Skin care- Measles causes extreme pruritus. Nursing interventions include keeping the patient's nails
short, encourage long pants and sleeves to prevent scratching, keeping skin moist with health care
provider recommended lotions, and avoiding sunlight and heat.
Eye care- Treat conjunctivitis with warm saline when removing eye secretions and encourage patient
not to rub eyes. Protect the eyes from glare of strong light.
Hydration- encourage oral hydration. Medical literature encourages the use of Oral Re-hydration
Solution.
Temperature control- Antipyretics should be administered to the patient as ordered for a temperature
greater than 100.4 Fahrenheit unless directed elsewise by a healthcare provider. Be sure to remind
parents not to administer aspirin due to the risk of Rey's syndrome.
Supplements- Vitamin A has been shown to help decrease mortality in children under the age of two
years. The American Academy of Pediatrics provides dosage recommendations here.
Patients should seek emergency medical treatment for the following signs and symptoms-
-Intolerance to food and/or unable to drink adequately.
-Altered level of consciousness and/or seizures.
-Severe respiratory infection.
-Severe diarrhea
Patient Education
The best way to treat measles is to prevent it. The best prevention is vaccination. The vaccine used to
prevent the measles is the MMR vaccine (measles, mumps, and rubella). According the the National
Center for Immunization and Respiratory Diseases, "Two doses of this vaccine are needed for
complete protection. Children should be given the first dose of MMR vaccine at 12 to 15 months of
age. The second dose can be given 4 weeks later, but is usually given before the start of kindergarten at
4 to 6 years of age."
1. Keep infected person in isolation until the 5th day of rash.

2. Keep the patient in bed until fever and cough subside.
3. Provide eye care (i.e., clean eyelid, irrigate eye with saline).
4. Protect eyes of patients from glare of strong light as they are apt to be inflamed.
5. Keep the patient in an adequately ventilated room but free from drafts and chilling to avoid
complications of pneumonia.
6. Increase fluid intake during fever.
7. Increase humidity in the patient’s room to relieve cough.
8. Administer tepid baths and apply soothing lotion (such as calamine) to relieve itching of skin.
9. Immune serum or gamma-globulin may be given to modify illness and reduce complication.
10. Antibacterial therapy may be given as ordered for treatment of complication (i.e., respiratory
infection or gastroenteritis).
11. Maintain good body hygiene of patient to reduce the risk of secondary infection from the
lesions.
12. Use a cool mist vaporizer, mouthwash, and tablets to suck on to keep mucous membranes
moist.
13. Give analgesic, antipyretic, and anti-pruritus as ordered to reduce pain, lower body
temperature, and reduce the itching.
Then explain the science behind the safety of MMR vaccine
LEVEL OF COMMUNICABILITY
***It is important to remember that the patient is infectious 2-4 days before the rash appears and
remains infectious 2-5 days after the onset of the rash.

MEASLES

Uploaded by

Copyright:

Available Formats

MEASLES

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

MEASLES

Uploaded by

Copyright:

Available Formats

MEASLES

 Cough, coryza, conjunctivitis

Physical Assessment of Measles :

Typically in 3 days with malaise and high fever.

-Altered level of consciousness and/or seizures.

-Severe respiratory infection.

1. Keep infected person in isolation until the 5th day of rash.

Then explain the science behind the safety of MMR vaccine

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.