Rubella: Signs, Exam, and Diagnosis (Pediatric Nursing)

00:00 Many patients with rubella have few or no symptoms.

00:03 Symptoms can be cold-like including a runny nose, a cough, or sneezing.

00:08 The primary symptom though is a rash and this is gonna start on the face and spread to the trunk and then the limbs.

00:14 It's usually going to fade after 3 days and it's gonna be pink or light red, and maybe itchy.

00:20 There are other signs and symptoms including a low-grade fever, swollen lymph nodes in the neck, joint pains, headache, conjunctivitis, and Forchheimer's sign which are red papules that we see on the soft palate.

00:33 These are gonna occur in 20% of cases.

00:35 We can also see these in other conditions including strep throat.

00:38 Here's the rubella rash.

00:40 Now, use caution when diagnosing a patient's rash because this looks a lot like roseola and it can also resemble the measles. So first, you wanna get your patient's medical history.

00:50 Then, you're gonna evaluate their immunization status and this is to exclude other causes of their fever and rash.

00:56 One dose of the MMR is 97% effective against rubella.

01:01 Next, you'll move on to your physical exam.

01:04 This includes the vital signs, a thorough head, eyes, ears, nose, throat exam, cardiac, respiratory, and a full skin exam.

01:12 Now, this part's important because rubella is so teratogenic, you want to do a pregnancy test in women of child-bearing age.

01:18 Rubella needs to be reported to the Health Department in all suspected cases.

01:23 How do you diagnose rubella? You can do this via lab testing and you need to consult your local and state Health Department for guidance. Testing is strongly recommended.

01:32 A positive rubella IgM antibody will show up a short time after this characteristic rash.

01:39 These IgM antibodies can remain positive for up to one year.

01:42 There are gonna be some risk factors for a heightened clinical suspicion and this is maybe your patient is unvaccinated or they've had a recent international travel.