FIFTH DISEASE - PowerPoint Presentation

Slide1

FIFTH DISEASE

Nicole Mabardi, SN and Shaina Joseph, SN

University of South Florida, College of Nursing

January 30, 2014Slide2

WHAT IS FIFTH DISEASE?

Also known as

Erythema

Infectiousum

Mild rash due to

parvovirus B19

Parovirus

B19 only affects humans

Parovirus

B19 c

an

cause different symptoms depending on age; however, those affected usually do not have any symptoms.

It can cause the body to temporarily stop making new red blood cell

T

his can lead to anemia.

Fifth disease is mostly seen in children 2 to 15 years of age, but it can be found in adults as well.

Quick Fact

Fifth disease got its name because it was fifth in a list of historical classifications of common skin rash illnesses in children.Slide3

SYMPTOMS

Symptoms

at first are usually mild and nonspecific.

They include:

LOW GRADE FEVER

RUNNY NOSE

HEADACHE

JOINT PAIN (in adults)

After several days,

an

erythematous

rash

appears on the

face-specifically the cheeks-

of the infected child, giving them a “slapped cheek” presentation.

Days later, the rash spreads and

erythematous

blotches appear on

their chest, back, arms/legs,

and

buttocks.

The rash varies in intensity and comes and goes for several weeks.

The rash may be itchy (especially

if the rash is on

the soles of the feet).

It usually

goes away in 7-10 days but can last for several weeks. Slide4
Slide5

TRANSMISSION

The

virus spreads through respiratory secretions like saliva, mucous, and sputum.

Once infected by the virus, an individual will usually get sick within 4-14 days

.

The individual is most contagious when they have the fever like symptoms (right before the rash appears).

The virus can also spread through blood or blood products.

P

regnant women can also pass the virus to their baby.

Once a person has had Fifth Disease, they will have developed immunity to it (they won’t get it again).Slide6

Clinical Case

Five year old, Caucasian, male

Cultural considerations- Both parents present with child; sibling at home with grandma.

Admitted for Fifth Disease

Medical history of only a circumcision done at birth.

No known allergies

Subjective findings:

Mother states that patient had a fever of 101 a few days ago.

Patient states rashes itch.

Objective findings:

Rash over cheeks and body

Patient is itching

BP: 90/55; heart rate: 88; respirations:22; temperature: 98.7 F;

02 sat 97% Slide7

What

assessment data about this patient is particularly pertinent?

-

Fever/ flu-like symptoms that

have

lasted a few

days

.

-

R

ash that appears

first on

the child’s cheeks

and then spreads throughout the body after a few days of having these flu-like

symptoms. Slide8

Is

there additional data that you would like to obtain before you notify the physician about this patient?

-

When exactly symptoms appeared,

if anything was consumed

to relieve symptoms,

and the medical

history of

the patient

especially those with sickle cell

disease

(high

risk

). Slide9

Role Play With T

he Doctor

Nurse: Good morning doctor, I have a five year old Caucasian male who came in today with rashes over his cheeks and body. His parents say he did have a fever and other flu-like symptoms a few days ago. His parents are very concerned.

Doctor: Ok, I will come by and perform a physical exam. In the meantime, have blood work drawn to check for antibodies to the

parovirus

B19 virus. If

IgM

antibodies are seen, then the child may be in the middle of an infection or have had a recent infection of the

parovirus

B19

virus (depending on the stage they are at).

Nurse: Sounds good, Doc. I will get a blood sample of the patient.Slide10

What interventions would be appropriate for this patient? Which of these interventions are highest priority?

-

Treatment is symptomatic:

pain relief

fluids

rest

good hand washing**Slide11

What

potential problems or complications do you need to be prepared to handle?

How

would you do that?

Are

there other people that need to be involved to help? Consultations?

This is usually just a mild rash that tends to go away within a couple weeks or so, however, if the patient is a high risk

candidate (anemia) they should be closely monitored via blood test because it can lead to transient aplastic crisis, which is a rapid worsening of existing anemia lasting

7-10 days

. These patients will become very sick (fever, lethargy, rapid

HR,

and rapid breathing

).

If iron

levels are low,

iron supplements can be used

.

Parents

should be involved to make sure treatment is followed.

The Primary

Doctor should also be involved to confirm viral illness is resolving. Slide12

How often should the nurse reassess the patient?

Monitor Q2h (if hospitalized)

Educate parents and make sure they understand the disease processSlide13

Appropriate Patient/Family Teaching

Handwashing

is key

T

each

parents that

this

is a mild illness that will

resolve

O

nce

the rashes

appear,

child is able to return to school because it will not be contagious anymore

(it’s most

contagious during fever

).Slide14

Problems

Acute Pain

Knowledge Deficit

Fatigue

Body image disturbance

Priority Nursing Diagnosis:

Acute pain related to rashes as evidenced by verbal statements of discomfort from patient. Slide15

Goals

Short term goals

Patient will rate pain 0/10 by the end of my shift.

Patient will stop itching by the end of my shift.

Long term goals

Patient will not be in pain through discharge.Slide16

Developmental Stage and Milestones

Preschool (3-5 years of age)

Initiative vs Guilt

Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.

Milestones

Hops, skips, jumps, balances on one foot

Vocabulary of 2,100 words; uses sentences

Expresses through play and story-telling; imagination

Gender aware

Mood swings& dramatic behaviorSlide17

Family Structure/Support System

Both

p

arents at the bedside of

child

Open to healthcare advice

Sibling

at home with grandma

Approach to Invasive Procedures

Standard

Precautions

Good Hygiene/

Handwashing

GlovesSlide18

Treatment

Treatment

is

symptomatic:

pain relief

fluids

rest

good hand washing

Child can go to school once rash is present. Slide19

Documentation

Temperature

F

lu-like symptoms

Location

of

rashes

OLDCART

Patient/family

education. Slide20

Epidemiological and clinical features of erythema infectiosum in children in Novi Sad from 2000 to

2009

The reason for this study was to analyze the epidemiological (population)

and clinical characteristics of erythema

infectiosum (EI)

in

children. There were 88 children observed in the study that lasted from January

2000-December

2009

in

Vojvodina, in Novi

Sad(Serbia). The clinical characteristics were compared during and after the outbreak of EI and the results detected that 88 (44 boys, 44 girls) out of the 41,345 children had EI.

T

he average age of children getting infected were

7.59 +/-

3.339. The most common signs were rashes on the cheeks and limbs, though no children had serious complications. Slide21

Infectious diseases in children Fifth disease (Slapped cheek disease)

This article describes

Fifth

D

isease

, explains why it is important and analyzes the characteristics of the viral outbreak it can resemble. Slide22

References

Lowth

, M. (2013). Infectious diseases in children Fifth

disease

(Slapped cheek disease). 

Practice Nurse

, 

43

(10), 32-35

.

Prćić

, S.,

Gajinov

, Z.,

Zrnić

, B.,

Radulović

, A.,

Matić

, M., &

Djuran

, V. (2013). Epidemiological and clinical features of erythema infectiosum in children in Novi Sad from 2000 to 2009. 

Vojnosanitetski

Pregled

: Military Medical & Pharmaceutical Journal Of Serbia & Montenegro

, 

70

(12), 1081-1084.

doi:10.2298/VSP110607026P