Case Study You are working as the assessment nurse in a clinic that is located within a community hospital. The hospital is in a rural area and the closest tertiary care facility is 40 miles from the clinic. The clinic serves as the primary care provider for the close- knit community. The first client that you see is Casey. Casey is a 3- year- old female. Her mom brought her to the clinic because of fever of 103.5 for 2 days that has accompanied cough, coryza (runny nose) and conjunctivitis. As you are completing your health history you learn that Casey’s dad has returned from Iraq about a month ago and she has a little sister at home who is 11 months old.
The cultural assessment indicates that the family is Jewish American. The parents both hold master’s degrees – dad has a career in the military and mom is staying home at this time to raise the family. She does free-lance journalism for several blogging sites. During your systems evaluation you note the following: Koplik’s spots located inside both cheeks and the beginning of a maculopapular rash that is on the forehead and down both cheeks. The mother has expressed a great deal of concern because since the fever has started Casey has been lethargic and not wanting to eat. You have a strong suspicion that Casey has the measles. You tell the parent to remain in the clinic room with the children while you go get the primary care physician. The physician completes a physical assessment and confirms the diagnosis of measles.
*For this week’s discussion, please answer the following questions:
1. What are the first actions that should be taken in the care of Casey?
2. What health risks predisposed Casey to obtaining the measles virus?
3. Are there any health risks for Casey’s little sister? Why or why not?
4. Based on Casey’s developmental stage, what information should be provided to her?
5. Using current evidence, discuss the education plan that should be provided for Casey’s mom.
6. Find the current prevalence rate of measles in your state (Maryland) of residence. What factors are contributing to an increased rate of measles outbreaks?
