A parent reports that her 5-year-old child, who has had all recommended immunizations, had a mild fever 1 week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which diagnosis does the nurse anticipate based on the current data?

Question

1. Rubeola (measles)
2. German measles (rubella)
3. Chickenpox (varicella)
4. Fifth disease (erythema infectiosum)

Answer 1

4
Explanation:
1. Children with rubeola have a high temperature and a blotchy maculopapular rash. Because there is a vaccination for rubeola, it is unlikely the child has it.
2. The rash of rubella is a pink, maculopapular rash that begins on the face and progresses downward to the trunk and extremities. The child is fully vaccinated, making this unlikely.
3. Varicella (chickenpox) and rubella (German measles) are unlikely if the child has had all recommended immunizations.
4. Fifth disease manifests first with a flu-like illness, followed by a red "slapped-cheek" sign. Then a lacy maculopapular erythematous rash spreads symmetrically from the trunk to the extremities, sparing the soles and palms.