NCLEX Review Guide: Pediatric Infectious Diseases - Measles, Mumps, and Rubella

Disease Characteristics

• Measles (Rubeola): Highly contagious viral infection causing fever, cough, and characteristic red rash starting at hairline and spreading downward
• Mumps: Viral infection primarily affecting salivary glands, causing painful swelling of parotid glands and potential complications
• Rubella (German Measles): Mild viral infection with pink rash, but extremely dangerous to pregnant women due to teratogenic effects

Measles (Rubeola)

• Prodromal phase: High fever (104°F), malaise, photophobia, and the 3 C's (cough, coryza, conjunctivitis)
• Koplik spots: Small white spots with red halos inside mouth, pathognomonic for measles
• Rash appears 3-4 days after fever onset, starting at hairline and spreading cephalocaudally
• Complications include pneumonia, encephalitis, and secondary bacterial infections

Mumps

• Painful swelling of one or both parotid glands, making chewing and swallowing difficult
• Low-grade fever, headache, and malaise typically precede gland swelling
• Orchitis in post-pubertal males can lead to sterility
• Other complications: meningitis, encephalitis, and hearing loss

Rubella (German Measles)

• Mild symptoms: low-grade fever, headache, and pink maculopapular rash
• Rash starts on face and spreads downward, lasting about 3 days
• Lymphadenopathy, especially post-auricular and suboccipital nodes
• Congenital rubella syndrome: cataracts, cardiac defects, hearing loss, intellectual disability

Isolation Precautions

1. Measles: Airborne precautions until 4 days after rash onset
2. Mumps: Droplet precautions until 5 days after parotid swelling
3. Rubella: Droplet precautions until 7 days after rash onset

Supportive Care

• Maintain hydration and provide antipyretics (avoid aspirin due to Reye's syndrome risk)
• Dim lighting for photophobia in measles patients
• Soft foods and adequate fluids for mumps patients with painful swallowing
• Monitor for complications: respiratory distress, neurological changes, or secondary infections

• Focus on isolation precautions - this is frequently tested on NCLEX
• Remember that Koplik spots are pathognomonic (characteristic) for measles
• Associate mumps with parotid gland swelling and potential orchitis in males
• Link rubella with pregnancy risks and congenital defects

• ☐ Can you identify the isolation precautions for each disease?
• ☐ Do you know the characteristic signs of each condition?
• ☐ Can you explain the complications of each disease?
• ☐ Do you understand the importance of MMR vaccination timing?