A preschool-age child is brought to clinic for evaluation of…

A preschool-age child is brought to clinic for evaluation of a rash. The Family Nurse Practitioner notes an intense red eruption on the child’s cheeks and circumoral pallor. What will the nurse practitioner tell the parents about this rash?   Correct Answer: Expect a lacy, maculopapular rash to develop on the trunk and extremities. This “slapped cheek” rash is consistent with fifth disease, or erythema infectiosum, and will be followed by a lacy, maculopapular all-over rash. It is not a prodrome of rubella or roseola, and immunizations are not indicated. Although it is mostly benign, there can be serious sequelae, especially for pregnant women.  

A 5-month-old infant who has a 3-day history of cough and rh…

A 5-month-old infant who has a 3-day history of cough and rhinorrhea has developed an audible expiratory wheezes and increased coughing. Infant has been afebrile and feeding well.  The infant’s immunizations are up-to-date. The physical exam reveals a respiratory rate of 50 breaths per minute, coarse expiratory wheezing, oxygen saturation is 96% on room air and no retractions. What is the recommended treatment for this infant? Correct Answer: Recommend increased fluids and close follow-up. The infant has bronchiolitis and is stable. Increasing fluids and following up closely are indicated as long as oxygen saturations and hydration are normal. Bronchodilator trials are not recommended because of the risk of adverse effects and questionable efficacy. Viral cultures are performed if hospitalization is necessary or when symptoms are severe. Corticosteroid medications are not indicated.