Measles 101: The Basics for Nurses

While debates about measles vaccination swirl around the current U.S. measles outbreak, most U.S. nurses have never actually seen the disease itself, and right now we are a lot more likely to encounter a case of measles than of Ebola virus disease. Here, then, is a measles primer.

Symptoms.

Measles is an upper-respiratory infection with initial symptoms of fever, cough, runny nose, red and teary eyes, and (just before the rash appears) “Koplik spots” (tiny blue/white spots) on a reddened buccal mucosa. The maculopapular rash emerges a few days after these first symptoms appear (about 14 days after exposure), beginning at the hairline and slowly working its way down the rest of the body.

Infected people who are severely immunosuppressed may not have any rash at all. “Modified” measles, with a longer incubation period and sparse rash, can occur in infants who are partially protected by maternal antibodies and in people who receive immune globulin after exposure to measles.

Transmission.

The virus spreads via respiratory droplets and aerosols, from the time symptoms begin until three to four days after the rash appears. (People who are immunosuppressed can shed virus and remain contagious for several weeks.) Measles is highly contagious, and more than 90% of exposed, nonimmune people will contract the disease. There is no known asymptomatic carrier state, […]

2019-01-22T15:31:41-05:00February 11th, 2015|infectious diseases, nursing perspective|3 Comments
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What Ever Happened to a Good History?

ky olsen/via Flickr ky olsen/via Flickr

By Karen Roush, MS, RN, FNP, clinical managing editor

What ever happened to a good history? We were taught as NP students that the history portion of the exam was as important as the physical. In fact, in most cases it’s what you learn in the history—from asking the right questions and really listening to the patient’s answers—that gives you the information you need to figure out what is going on. The physical findings either support what you’re thinking or lead you to ask more specific questions.

A good history isn’t just listening to the patient’s answers to your questions; it’s listening to all the information they offer. Take for example, the middle-aged construction worker who takes his lunch hour to come in to the clinic complaining of a cold. He lists the usual symptoms, cough, fatigue, a little shortness of breath, and then as you’re starting the exam he casually mentions that he hasn’t been to a doctor in 15 years.

Someone who’s managed to stay out of a doctor’s office for 15 years and now shows up, on his lunch hour, because of a simple cold? So, you ask some more questions and learn about some chest pressure he attributes to the coughing he’s been doing and about […]

2016-11-21T13:05:39-05:00January 10th, 2014|nursing perspective, Patients|4 Comments
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‘Incompatible With Life’

Shirley Phillips has a doctorate in physical therapy and currently works for a federally funded research and development program studying human performance in aviation. She was an airline pilot prior to her daughter’s birth.

AshleyAndShirley Ashley and Shirley

The pediatrician was working with a medical student when Ashley had another of her 105 degree fevers. The remnants of a birthmark on her forehead glowed crimson beneath the fringe of bangs I used to conceal it. It always seemed like a warning sign designed just for me, her mother.

I sat quietly while the pediatrician asked for permission to share some information about Ashley’s rare genetic condition with the medical student. Given her intellectual disabilities at the age of two, she was probably not going to understand a word he said, but I instinctively reached to cover her ears.

This resulted in the pediatrician saying, “See how her ear canals are curvy? And her ears are set low on her head? Notice her wide nasal bridge, and her barrel-shaped chest. I am certain when Ashley was born they knew right away that genetic testing was needed. Three or more abnormalities, like the club foot, the wide nasal bridge, the . . . ”

“Wait just a minute,” I said, hardly recognizing my own voice as I stammered out my dismay, interrupting the sage […]

2016-11-21T13:06:46-05:00August 12th, 2013|nursing perspective|0 Comments
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Science and Suffering: My Two Months Battling the Aliens

By Ronald Pies, MD, professor of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University, Syracuse, New York; clinical professor of psychiatry, Tufts University School of Medicine, Boston; editor-in-chief emeritus of Psychiatric Times. Dr. Pies is also the author, most recently of, The Three-Petaled Rose, an exploration of the synthesis of Judaism, Buddhism, and Stoicism (iUniverse).

Doyle Alphabet by fdecomite, via Flickr Doyle Alphabet by fdecomite, via Flickr

It all started suddenly: weird, creeping sensations in my forehead and between my eyes, especially when I lay on my back or bent my head forward. The expression “my skin is crawling” quickly came to mind. Over the next few days, I began to experience intense pressure in my forehead and a weird sensation on the bridge of my nose—as if a large clothespin had been clipped onto it. Within a few days, it felt like someone had poured a sack of concrete into my head.

My self-diagnosis was sinusitis—a term that covers many etiologies. But most cases of sinusitis begin with head or facial pain and nasal discharge—not the strange sensations my wife and I soon started calling “the aliens.”

Nevertheless, I began an aggressive self-treatment program: decongestants, aspirin, and something called a Neti pot—an ancient form of nasal irrigation using […]

2018-03-27T16:37:04-04:00June 12th, 2013|Nursing|3 Comments
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September Is Ovarian Cancer Awareness Month

By Jim Stubenrauch, senior editor

OvarianCancerArticleThis month, AJN is joining in the nationwide effort to raise awareness and promote education about ovarian cancer. The September issue contains an original research paper on “Women’s Awareness of Ovarian Cancer Risks and Symptoms” by Suzy Lockwood-Rayermann, PhD, MSN, RN, and colleagues. The authors analyzed data collected from an online survey completed by more than 1,200 women ages 40 and older and found that awareness of ovarian cancer symptoms and risk factors is low. This suggests that nurses have an excellent opportunity to educate patients and help them get diagnosed at earlier stages of the disease when it’s more treatable.

You can also hear an interview I conducted with Dr. Lockwood-Rayermann on our podcasts page.

I’ll summarize the study below, but first, you might want to know that cancer survivor, actress, and women’s health activist Fran Drescher wrote on a related topic in this month’s Viewpoint, “Women, Take Control of Your Bodies!” Drescher discusses her battle with uterine cancer and the crucial support her sister Nadine, a nurse, provided on her “medical oddysey.” After writing a book about her experience, Cancer Schmancer, Drescher started the Cancer Schmancer Movement, an organization dedicated to promoting education, legislation, and social reform aimed at early detection of cancer. […]

2016-11-21T13:22:49-05:00September 1st, 2009|nursing research|5 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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