Hand foot and mouth disease

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Counseling

Mouth sores can make drinking painful for several days.

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Counseling

Giving tylenol or motrin before drinks can help with mouth pain, and aspirin should be avoided. The virus spreads easily, so wash hands often, especially after diaper changes, clean toys and surfaces, and avoid sharing cups and utensils. Return precautions given including not drinking well or fewer wet diapers, prolonged fever, headache with stiff neck, unusual sleepiness or weakness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Hand foot and mouth disease
• Well hydrated
• No neck stiffness, lethargy, or neurologic signs
• Home with supportive care
• Discussed that the rash and mouth sores usually resolve in 7-10 days
• Discussed that fingernails or toenails can rarely fall off a few weeks later and usually grow back
• Follow up as needed

Mouth sores can make drinking painful for several days. Recommended supportive care with OTC medications as needed with an emphasis on hydration and soft foods and cool liquids. Giving tylenol or motrin before drinks can help with mouth pain, and aspirin should be avoided. The virus spreads easily, so wash hands often, especially after diaper changes, clean toys and surfaces, and avoid sharing cups and utensils. Return precautions given including not drinking well or fewer wet diapers, prolonged fever, headache with stiff neck, unusual sleepiness or weakness, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Oral ulcers, palm/sole vesicles, buttocks rash, fever
Meningitis, encephalitis, paralysis (rare)
Home or clinic trial or ED
OTC fever and pain medicine; no aspirin; fluids
Course 7-10 days
Nail loss weeks later, grows back
School: fever-free, well enough, drooling controlled
Hand hygiene, disinfection, avoid close contact
When to seek care

Return precautions in the template

not drinking well or fewer wet diapersprolonged feverheadache with stiff neckunusual sleepiness or weakness

Hand foot and mouth disease

What the sources cover

Return precautions in the template

Sources