Alright high am smasku

1. 1/16/2024
MEASLES
MR. MWELWA RN.RPCHN.BSc N
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2. GENERAL OBJECTIVE
• At the end of the lecture/discussion, the
student nurses should be able to gain
knowledge on Measles.
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3. INTRODUCTION
• Measles is a common infectious disease
of childhood with a world-wide
distribution.
• It causes high morbidity and mortality
especially in developing countries.
• It seriously affects the nutrition and
growth of children.
• 21 strains of measles virus have been
isolated to date.
• Licensed vaccine to prevent disease
became available in 1963.
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4. Definition
❑MEASLES is an acute highly contagious
viral disease caused by measles virus
and it is characterized by fever, URT
catarrhal inflammation, koplik’s spots and
maculopapules.
❑MEASLES is an acute highly
communicable disease caused by
measles virus, a member of the
paramyxovirus of the genus morbilli
virus(g.J.Ebrahim,1981)
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5. TYPES
❑RUBEOLA MEASLES(RED MEASLES):
Also known as "hard measles" or just
“measles.“ Although most people recover
without problems, rubeola can lead to
pneumonia or inflammation of the brain
(encephalitis).
❑RUBELLA MEASLES(GERMAN
MEASLES): Also known as "three-day
measles." This is usually a milder disease
than red measles. Incubation period is 10
days to 2 weeks.

6. MODE OF TRANSMISSION
• Direct contact with infectious droplets
• Airborne spread
• Usually spread is through respiration
• Contact with fluids from an infected
person’s nose and mouth is highly
contagious
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7. INCUBATION
• Lasts 4-12 days during which there are
no symptoms
• Infected person remains contagious from
the appearance of first symptoms until 3-
5 days after eruption of the rash
• 90% immuno-compromised individuals
get the disease if in contact with infected
person
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8. SIGNS & SYMPTOMS
❑PRODROMAL STAGE(1-2DAYS)
• Stage of non-specific symptoms
✓Fever due to infection
✓Coryza
✓Cough
✓Malaise due to infection
✓Conjunctivitis associated with lacrimation
and photophobia
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9. CONT…
❑CATARRHAL STAGE(2-3DAYS)
• Evidenced by:
✓Runny nose
✓Conjunctivitis
✓Barking cough
✓Miserable appearance of child
✓Koplik spots (diagnostic of measles)
• Disease highly infectious during this
stage
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10. CONT…
❑EXANTHEMATOUS STAGE(3-4DAYS)
✓Koplik spots disappear
✓Maculo- papular rash develops, first at
back of ears, fore head and spreads to
the trunk and rest of the body.
✓Spots become numerous and fuse to
form the characteristic blotchy
appearance of measles
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11. CONT…
❑RESOLUTION STAGE(5-6DAYS)
✓Rash begins to disappear following same
sequence of its appearance accompanied
by either fine or serious desquamations
✓Rash lasts for about 6-7days
✓Fever falls following onset of rash
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12. INVESTIGATION
• History of fever, coryza ,cough and
conjunctivitis,
• Observation of koplik spots
• Confirmation of positive IgM antibodies
• Isolation of measles virus RNA from
respiratory specimens
• FBC will show low WBCs
• Eye swab for m/c/s
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13. TREATMENT
• Multi vitamin 1 tablet od for 14/7
• Vitamin A to prevent xeropthalmia
100,000 iu
• Antibiotics to deal with super added
bacterial infections e.g. amoxyl 25mg/kg
tds for 5/7
• Tetracycline eye ointment qid for 5/7
• Calamine lotion application to minimize
itching
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14. CONT…
• Keep child warm and comfortable
• Steam inhalation
• Isolate all cases of measles
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15. PREVENTION
❑The most effective way to prevent
measles is through vaccination against
the disease.
• Measles vaccine contains a live
attenuated measles virus
• Available in both monovalent and
combined formulations
• In Zambia the vaccine is given as a single
antigen subcutaneously(0.5mls)
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16. CONT…
❑Isolate all cases of measles
❑Prompt reporting and management of
measles
❑Increased surveillance of the disease
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17. COMPLICATIONS
• Mild to serious diarrhoea
• Pneumonia
• Middle ear infection (Otitis media)
• Malnutrition
• Laryngitis
• Encephalitis
• Corneal ulcers
• Complications are more serious amongst
adults who catch the disease
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18. NURSING CARE
❑AIMS
• To prevent spread of infection
• To prevent complications
• To relieve sign and symptoms
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19. ENVIRONMENT
• Patient will be nursed in an isolation ward
but to prevent infection spread
• Patient will be nursed in a well ventilated
room to prevent other respiratory tract
infection
• Patient will be nursed in a well lit room
for easy observation and for orientation to
time and place
• Will include the oxygen giving apparatus
for use because patient is dyspnic
• I will include the drip stand in the room for
IVI when need arises
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20. POSITION
• Patient will be nursed in fowlers position
to promote lung expansion and relieve
dyspnea
• I will change the patient’s position two
hourly to prevent development of
pressure sores
• As the condition improves I will let the
patient adopt any position of comfort to
promote rest
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21. REST
• I will play the radio at low volume to
promote rest
• I will answer all phone calls promptly to
prevent disturbing the patient there by
promote rest
• I will do related procedures in blocks to
promote rest
• I will administer prescribed analgesics in
order to promote rest
• I will ensure that squeaking trolleys a oiled
to prevent noise and there by promote rest
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22. OBSERVATION
• I will do vital sign to act as the base line
data in order to know if the condition is
improving or deteriorating
• I will observe for cyanosis which may
indicate respiratory involvement and give
oxygen therapy when necessary
• I will observe Dyspnea if present will prop
up the patient to promote lung expansion
and there by relieve dyspnea
• I will observe the pressure area to detect
on set of pressure sore development
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23. CONT…
• I will observe the rash for improvement
or deterioration and report the physician
so that appropriate action is taken
• I will observe the patient’s facial
expressions to detect pain and administer
prescribed analgesics like panadol
• I will observe the feeding pattern of my
patient and take measures like giving
small frequent meals to promote appetite
• I will observe the respirations to detect
tachycardia and report accordingly
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24. PSYCHOLOGICAL CARE
• I will explain the disease process in order
to raise the knowledge levels and thereby
alley anxiety
• I will encourage the patient’s mother to
ask question and I will answer
accordingly those I cant answer I will refer
to the physician
• I will explain all procedures to my patient
in order to allay anxiety
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25. CONT…
• I will involve a successfully managed
case to come and talk to my patient in
order to allow the patient ask pressing
question and get answer this will improve
the patients out look on his condition.
• I will involve the loved ones in his care in
order for him not to feel neglected.
• I will provide diversional therapy in order
to shift the patient’s mind from the
hospital routine and his condition
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26. CONT…
• I will involve my patient’s mother in
planning care in order for him not to feel
left out
• I will explain to the mother that as the
health care team we re doing everything
possible to ensure that he get better in
order to promote co-operation
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27. HYGIENE
• I will offer baths to my patient in order to
remove dead epithelium and promote
comfort
• I will do hair care to promote self esteem
and also prevent pediculosis
• I will do nail care to prevent auto infection
• I will do mouth care to prevent halitosis
• Any soiled linen and clothes will be
changed to promote comfort
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28. ELIMINATION
• I will provide a lot of fluids and roughage
to prevent constipation
• I will prove copious fluids in order to
promote renal wash out and there by
prevent renal problems
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29. NUTRITION
• I will provide energy giving foods like
nshima to provide the energy needed for
the metabolic processes
• I will provide protein foods like fish and
beans to promote replacement of worn
out tissues
• Vegetables and fruits will be provided to
raise the immunity and promote skin and
mucous membrane integrity
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30. CONT…
• I will provide a lot of oral fluids to prevent
dehydration due to excessive sweating
and promote bringing up of phlegm
• I will serve small frequent meals to
promote appetite
• I will allow the mother to bring food
preferred by the patient in order to
promote appetite
• I will do regular mouth washes in order to
promote appetite
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31. EXERCISE
• If my patient is confined to bed i will do
passive exercises like limb movement
and massage in order to prevent muscle
atrophy and promote blood circulation
• I will encourage the patient to do deep
breathing exercises in order to promote
lung expansion
• I will encourage early ambulation as soon
as the condition permits in order to
prevent deep vein thrombosis and other
complications of immobility
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32. MEDICATION
• I will administer prescribed analgesic like
panadol at the right time to promote rest
• I will give prescribed drugs in order to
promote recovery
• I will ensure that the drugs are swallowed
in my presence to promote recovery
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33. I.E.C
• I will educate the patient and its mother
about his condition in order to create
awareness and prevent recurrence of the
condition
• I will explain the need for taking the
medication in order to promote
compliance
• I will educate the patient about the sign
and symptoms of the condition for early
diagnosis and treatment thereby
preventing complications
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34. CONT…
• I will talk to the patient about the need to
take a balanced diet using locally
available foods in order to boost the
immunity
• I will advise my patient’s mother to ensure
that children a sent to the children’s clinic
where they will be vaccinated, thereby
preventing complications
• I will talk to the patient and his mother
about the need to take a balanced diet
using locally available foods in order to
boost the immunity
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35. REFERENCE
• Hockenberry M. J, (2009). Wong’s nursing
care of infants and children, (8th ed.), St
Louis: Mosby.
• Hull.D. And johnston.D.(1999). Essentials of
paediatrics. Churchill livingstone, london.
• G.T. Ebrahim.(1981). Paediatric practice in
developing countries. Macmillan education
limited, london.
• Walensiky L.D (1999): Rapid Access
Pediatrics. Lippincott. New York.
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36. TO EVERY CLOUD, THERE IS A SILVER
LINING
THANK YOU.
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