A parent reports that her five-year-old child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms
The nurse recognizes that this child might have: 1. Rubeola (measles).
2. German measles (rubella).
3. Chickenpox (varicella).
4. Fifth disease (erythema infectiosum).
4
Rationale 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.
Rationale 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.
Rationale 3: Varicella (chickenpox) and rubella (German measles) are unlikely if the child has had all recommended immunizations.
Rationale 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.
Global Rationale:
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