A parent reports that her 5-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. Chickenpox (varicella).
2. German measles (rubella).
3. Roseola (exanthem subitum).
4. Fifth disease (erythema infectiosum).
4
Rationale:
1. Varicella (chickenpox) and rubella (German measles) are unlikely if the child has had all recommended immunizations.
2. The rash of rubella is a pink, maculopapular rash that begins on the face and progresses downward to the trunk and extremities.
3. Roseola typically occurs in infants, and begins abruptly, with a high fever followed by a pale pink rash starting on the trunk and spreading to the face, neck, and extremities.
4. Fifth disease manifests first with a flulike 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.
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