Exhibits

A nurse is collecting data from an adolescent who has bacterial pneumonia. Which of the following findings is the priority for the nurse to report to the provider? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.)

A. Color tool: The color tool is typically used with older children who can understand color associations with pain levels. It is not as appropriate for an 18-month-old infant, who may not have the cognitive ability to understand this tool.
B. Numeric scale: The numeric scale requires the ability to understand numbers and associate them with pain levels, which is generally used for children aged 8 or older. An 18-month-old infant would not be able to use a numeric scale.
C. Poker Chip Tool: The Poker Chip Tool is used for children aged 3 and older who can understand the concept of "a few" versus "a lot" of chips. An 18-month-old would likely be unable to comprehend this tool.
D. FLACC scale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is specifically designed for infants and non-verbal children. It assesses pain based on observable behaviors, making it the most appropriate tool for assessing pain in an 18-month-old infant.

Rationale:

• Red rash on the face: The red rash on the face is common in all three viral infections but presents differently in each. In Fifth disease, it appears as a "slapped cheek" rash, bright red on the cheeks. In Measles, the rash starts on the face, particularly behind the ears, and spreads to the body. Rubella causes a mild pinkish-red rash that begins on the face and spreads down, but it is usually less intense than in the other two diseases.
• Koplik spots in the mouth: Koplik spots are a classic feature of Measles, appearing as small white spots inside the mouth, typically on the buccal mucosa opposite the molars, and are present before the rash. Fifth disease and Rubella do not present with Koplik spots.
• Fever: Fever is common in all three diseases but varies in severity. Fifth disease usually presents with a low-grade fever. Measles often causes a high fever that spikes before the characteristic rash. Rubella typically causes a mild fever, especially in the early stages.
• Lymphadenopathy: Lymphadenopathy is prominent in Measles and Rubella, where it often affects the cervical and postauricular lymph nodes. Fifth disease does not typically cause significant lymphadenopathy.