Question

A mother of a 12-year-old child informs the phone triage nurse that she has just removed a tick from her daughter's scalp and asks whether she needs to be concerned about Rocky Mountain spotted fever. The nurse's BEST response includes teaching about the clinical manifestations to look out for which include:

A) Arthralgia and pharyngitis.
B) Erythema migrans and migratory polyarthritis.
C) Nonpruritic maculopapular rash and nausea.
D) Mild fever and headache.

Answer 1

In response to the concern about Rocky Mountain spotted fever after a tick bite, the mother should watch for a nonpruritic maculopapular rash that spreads from the extremities to the trunk, nausea, fever, and headache. Early recognition and treatment are critical.

Step-by-step explanation:

The concern about Rocky Mountain spotted fever (RMSF) following a tick bite is valid. RMSF is caused by Rickettsia rickettsii, transmitted through the bite of an infected hard-bodied tick. Nurses often advise to monitor for specific symptoms post-tick removal. The mother should be told to watch for nonpruritic maculopapular rash, which initially begins at the hands and wrists before spreading to the trunk, and systemic symptoms like nausea. Other signs include fever, headache, abdominal pain, vomiting, and muscle aches. A characteristic of RMSF, unlike other tickborne diseases such as Lyme disease, is that the rash often starts at the extremities rather than the site of the bite. Early treatment with antibiotics is critical, hence the importance of early recognition.