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The nurse is assessing an 8-year-old boy suspected of having Rocky Mountain spotted fever. Which of the following signs and symptoms would the nurse expect to find?

Explanation

•Rocky Mountain spotted fever starts with a fever, usually within a few days of a tick bite. Along with a headache and myalgia, a maculopapular rash develops 2-6 days after the onset of a fever. The rash first appears in the wrists and ankles, then spreads centripetally to the trunk.

•Rocky mountain spotted fever is the most common rickettsial disease seen in the United states and is transmitted by ticks. It can be a life-threatening illness if undiagnosed or untreated.

•Stiff neck and a positive Kernig's sign is indicative of meningitis.

•Spasms of the jaw and arching of the back are signs of tetanus.

•A circular outward expanding rash is a classic sign of early Lyme disease.

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