Pediatrics, part 76: Immune Disorders - Chickenpox, Fifth's Disease, & Roseola


Cathy covers the following infectious diseases: chickenpox, fifth's disease (erythema infectiosum), and roseola. She discusses the cause, transmission, incubation period, signs/symptoms, and treatment of each of these infections. At the end of the video, Cathy provides a quiz to test your understanding of some of the key points covered in the video.

  • 00:00 Introduction
  • 00:31 Chickenpox
  • 2:55 Fifth's Disease (Erythema Infectiosum)
  • 4:02 Roseola
  • 5:08 Quiz Time!

Full Transcript: Pediatrics, part 76: Immune Disorders - Chickenpox, Fifth's Disease, & Roseola

Hi, I'm Cathy with Level Up RN. In this video, I'll be going over some key infectious diseases within the pediatric population. Specifically, I'll be talking about chickenpox, fifth disease, and roseola. And then at the end of the video, I'm going to give you guys a little quiz to test your understanding of some of the key points I'll be covering, so definitely stay tuned for that. And if you have our Level Up RN pediatric nursing flashcards, go ahead and pull out your flashcards so you can follow along with me. Chickenpox is a highly contagious disease caused by the varicella-zoster virus. So after a chickenpox infection, the virus remains dormant in the body and can later become reactivated to cause herpes zoster, which is shingles. So of note, chickenpox is preventable through vaccination. So I had chickenpox as a child because there were no vaccines for it back then, and I later got herpes zoster or shingles as an adult. And I actually got it in nursing school, which was not a lot of fun. So the good news is that individuals who get vaccinated against chickenpox are unlikely to get this disease. And if they do, their symptoms will be very mild. Chickenpox is transmitted through the airborne route in addition to direct contact, and the incubation period is approximately two weeks. Signs and symptoms include fever, muscle aches, a decrease in appetite, as well as a vesicular rash. So this rash will consist of small fluid-filled blisters that are very itchy.

In terms of treatment, acetaminophen can be given for fever, and then topical calamine lotion as well as oral antihistamines can be used to help decrease itching. And then high-risk children may be prescribed an antiviral agent, such as acyclovir, to help prevent complications. And then one important thing I want to note is that aspirin should never be used because it can cause Reye's syndrome, which is a life-threatening disorder that affects the liver and brain. In terms of nursing care, you want to implement airborne precautions as well as contact precautions until all the lesions are dry and crusted over. You also want to advise the child's caregiver to keep the child's nails very short or apply gloves to prevent scratching of the rash. So when the child is scratching that rash, it increases the likelihood that they will spread the virus to others, and it can also cause skin infections as well as scarring.

Let's now talk about fifth disease, which is also known as erythema infectiosum. This is a common viral infection in children caused by parvovirus B19. It is spread through respiratory droplets and has an incubation period of approximately 5 to 10 days. Signs and symptoms include fever and malaise followed by a slapped-cheek rash on the face, then a maculopapular rash on the trunk. So our cool chicken hint to help you remember the rash on the face is to think of five fingers slapping the cheek. And that will help you to remember that with fifth disease, they have that slap cheek rash. In terms of treatment, treatment is really supportive and can include acetaminophen as well as NSAIDs for pain and fever. As a reminder, we would never give aspirin. And then as the nurse, you want to implement droplet precautions for a child with fifth disease.

The last infectious disease we're going to talk about is roseola, which is another common viral infection that occurs in children. This is caused by human herpesvirus 6 and is transmitted primarily through the saliva. The incubation period is approximately 9 to 10 days, and signs and symptoms include a high fever. And then after the fever resolves, a pink maculopapular rash will develop on the trunk and then spread to the face and extremities. Treatment is supportive again, and this includes acetaminophen or NSAIDs for fever. And again, as a reminder, we would not give the child any aspirin. And then we also need to advise our parents or caregivers to monitor the child for febrile seizures, which can occur in up to 15% of children with this illness due to the high fevers as well as the ability of the virus to penetrate the blood-brain barrier.

All right. It's quiz time, and I've got four questions for you.

Question number one. Which viral infection causes a slapped cheek rash on the face?

The answer is fifth disease or erythema infectiosum.

Question number two. Which viral infection causes a high fever followed by a maculopapular rash that begins on the trunk and then spreads to the face and extremities?

The answer is roseola.

Question number three. When is a child with chickenpox no longer contagious?

The answer is when all of the lesions have crusted over.

Question number four. After infection with chickenpox, the varicella-zoster virus can later become reactivated and cause blank.

The answer is herpes zoster or shingles.

All right. That's it for this video. I hope you found it to be helpful. Take care and good luck with studying.


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