ISABELA STATE UNIVERSITY

CITY OF ILAGAN CAMPUS

College of Nursing

NUR 312
CHARLES Z. ARIOLA JR., MSN, LPT, RN.
Subject Professor
 MEASLES
 is a highly contagious illness caused by a virus that replicates in
the nose and throat of an infected child or adult.
Causative Agent
Morbilli
Paramyovirus
Rubeola Virus
MEASLES
MANIFESTATIONS OF MEASLES
1. Pre-eruptive Stage
●Three (3) C’s
-Coryza
-Cough
-Conjunctivitis
●Kuplick Spots
-Fine red spots with bluish white spot at the center
-Found at the inner cheeks
-This is the PATHOGNOMONIC SIGN of Measles
KUPLIK SPOTS
MANIFESTATIONS OF MEASLES
2. Eruptive Stage
●Rashes are now present
●Maculopapular Rashes
-Flat to elevated
-Reddish in color
-With blotchy appearance
-In the vernacular, pantal-pantal
-Face of the patient looks bloated
-Cephalocaudal distribution
▪Appears first on the hairline
▪Head to toe distribution
-Appears on the 3RD DAY of illness
-Within two (2) to three (3) days, the entire body will be covered with rashes
MACULOPAPULAR RASHES
MANIFESTATIONS OF
MEASLES
3. Post-eruptive Stage
-Time when rashes start to disappear
-Fine, branny desquamation appears
-Then the desquamation peels off
-Peeling off proceeds in a cephalocaudal manner
-It is only the rashes that will be peeling off, NOT THE SKIN of the patient
Concept!
-Use of Colantro
-Has a burning effect
-Causes skin to likewise peel off
-Use of colantro is now discouraged
 DIAGNOSTIC TEST FOR
MEASLES
Concept!
There is no specific diagnostic test for measles
1.Clinical Observation
Medical Management for Measles
Symptomatic Management
Recovery dependent on Nursing Care
 NURSING CARE
-Maintain and increase body resistance of the patient
-Provide the following:
-Adequate rest
-Adequate nutrition
●No diet restrictions
● Provided that patient is not a hypersentitive individual (i.e. prone to
allergies)
● Seafood or poultry products are contraindicated if the patient is allergic
to these foods
● Increase oral fluid intake
● Especially those rich in Vitamin C
 NURSING CARE
● Keep patient’s back dry and warm
▪Rationale
-Exposure to draft gives rise to cough and cold
-It gives rise to a good medium for growth of microorganisms
-Leads to pulmonary complications like pneumonia, which could lead to death
● Provide hygienic measures
▪ Eye care
-Measles patients have much “MUTA”
-To prevent eye complications
▪ Ear care
-To prevent otitis media
▪ Mouth care
▪ Nasal care
▪ Skin care
-Taking a bath or taking a sponge bath is not contraindicated
-However, do not expose the patient to draft
 OTHER NURSING CARE

●Symptomatic nursing care

●Patient is photophobic
-Provide dim and quiet environment

Important Concept!
Attack of measles gives permanent immunity to the disease
Key Concept!
When is the patient communicable?
Patient is communicable before rashes appear or during the pre-eruptive stage.
 PREVENTIVE
1. Immunization
MEASURES
● Anti-measles vaccine (AMV)
● When given:
-Age of nine (9) months
● Dosage:
-0.5 cc
● Route:
-Subcutaneous
● Site:
-Deltoid muscle
● Important Instructions to be given to the mother of the patient!
-Child may experience fever
-Give paracetamol to lower the body temperature
-After three (3) to four (4) days, child will have a rash formation. This is a NORMAL REACTION to the
-vaccine
-In fact, it is a good reaction, indicating that the patient’s body has produced anti-bodies to measles
IMPORTANT CONCEPT
● In the private setting, MMR vaccine is given…
● When:
-Age of fifteen (15) months
● Dosage:
-0.5 cc
● Route:
-Subcutaneous
● Site:
-Deltoid muscle
● Ask mother if the child has allergies to egg and neomycin
-MMR is made up of duck embryo and neomycin
-If patient is allergic to egg
▪Give vaccine
▪ But observe for signs and symptoms of allergies
-If patient is allergic to neomycin
▪ Do NOT give MMR vaccine
▪ It may cause anaphylaxis
 
 IMPORTANT CONCEPT

 
• Important Concept!
• DOH Program on Measles
• Ligtas Tigdas Immunization Program in 2004

• Mode of Transmission
• Airborne
• Prevention
• Proper disposal of nasopharyngeal secretions
• Cover the mouth when coughing or sneezing
• Key Concepts!!!
• Measles is not fatal by itself
• Common complications
• Bronchopneumonia
• Encephalitis