Health Promotion and Maintenance
46. The parent of a young child phones an advice nurse to report that the child is ill. The child has a reddish pinpoint rash most concentrated in the axilla and groin areas, a high fever, flushed cheeks, and abdominal pain. The parent also reports that the child's tongue is dark red with white spots. A nurse should recognize these symptoms as indicative of which infection?
Test-Taking Tip
Recall that two pediatric infections have the symptom of a strawberry-like tongue: Kawasaki disease and scarlet fever.
Content Area: Child Health, Infectious Disease; Integrated Process: Nursing Process, Assessment; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Pathophysiology
Health Promotion and Maintenance
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Answer 1 is incorrect because, although children with mumps have a fever, the other symptoms are not present. Answer 2 is incorrect because children with measles have a fever and rash, but the rash spreads from the face to the rest of the body, becoming more prominent in the upper body. The other symptoms are not present. Answer 3 is correct because these symptoms are classic for scarlet fever. The child develops a high fever, abdominal pain, flushed cheeks, and strawberry tongue, as well as a generalized pinpoint red rash that is more concentrated in the axillae and groin. Answer 4 is incorrect because varicella begins with a macular rash, progressing to papular and then vesicular lesions. The child also has a fever but the other symptoms are not present.
