A nurse is assessing a child who was recently adopted from a foreign country and has not yet received any immunizations. The child has a high fever, rhinitis, and sore throat: The nurse also notes small, irregular, bright red spots with a blue-white center on the buccal membrane. What would the nurse suspect?

A. Dark red, macular lesions, and very pruritic:

Varicella lesions are typically pink or red and start as macules (flat, red spots) that develop into papules (raised bumps) and then vesicles (fluid-filled blisters). Dark red macular lesions are not commonly associated with varicella.

B. Various stages of lesions present at the same time, appear in successive crops, and very pruritic:

The presence of various stages of lesions (papules, vesicles, crusts) simultaneously, occurring in successive crops, and being intensely itchy are typical features of varicella.

C. Yellowish, scaly patches present on the scalp:

Yellowish, scaly patches on the scalp are not typical of varicella. This description is more indicative of conditions like seborrheic dermatitis rather than the rash associated with chickenpox.

D. A pink maculopapular rash starts at the hairline and spreads down the body.

Varicella rash usually begins as pink or red spots that develop into small, itchy, fluid-filled blisters (vesicles). These vesicles can then progress to form crusts and scabs. The rash often starts on the face, scalp, or trunk and then spreads to other parts of the body, gradually covering the entire body.

A. Apply warm, moist compresses to the neck area:

Warm, moist compresses are not typically used in the postoperative care of a tonsillectomy. Cold compresses or ice packs may be recommended to reduce swelling.

B. Observe for excessive swallowing:

Excessive swallowing may indicate bleeding, and close monitoring for any signs of bleeding is important.

C. Provide liquid acetaminophen with codeine as ordered:

Pain management is crucial postoperatively, and providing pain medication as ordered helps ensure the child's comfort.

D. Place the child in a partially prone position with the head turned to one side in the immediate post-operative period:

This position helps facilitate drainage and reduce the risk of aspiration. However, the specific positioning may vary based on the surgeon's preference.

E. Offer orange juice, lemonade, or milk to drink once awake and alert:

Citrus juices and milk are usually avoided in the immediate postoperative period to prevent irritation to the surgical site. Clear fluids or those recommended by the healthcare provider are typically introduced gradually.