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Zoster
Infection
known as Chickenpox
Acute disease cause by a DNA virus.
Highly contagious
Most common in children.
Easily transmissible through airborne,
droplets, direct contact with blisters
Statistics reveals
Worldwide
distribution
Common on crowded places.
10th most common childhood disease in
the Philippines.
Diseases
5-Year Average
(2003-2007)
2008*
Number
Rate
Number
Rate
1,647,178
1840.6
683,443
837.90
780,199
871.8
3. Bronchitis/Bronchiolitis
593,284
732.50
519,821
580.8
4. Hypertension
371,467
457.60
499,184
557.8
581,611
712.70
434,445
485.4
6. Influenza
381,371
470.40
362,304
404.8
7. TB Respiratory
111,418
137.30
96,497
107.8
22,225
27.60
35,381
39.5
36,240
44.60
32,541
36.4
10. Chickenpox
29,197
40.40
25,677
28.7
CNGH
3
cases April
1 case on the first week of
April
2 cases by the end of April
General Objective
knowledge, skills
and the right attitude in the
Acquisition of the
Specific Objectives
To
To
To
To
To
Significance of the
Study
This
Significance of the
Study
To patient: to promote understanding of the
disease process; its prognosis and nursing and
medical management.
To the professionals: as a reference in
planning an effective management of patients
diagnosed with Varicella Zoster Infection.
To the society: as a reference in the
investigation of suspected Varicella Zoster
infection as well as the preventive measures and
precautions to be considered in case of living in a
susceptible community.
CLIENT PROFILE
RANK: S1YN
CLIENT PROFILE
BIRTH
CLIENT PROFILE
CHIEF COMPLAINTS:
ON and OFF FEVER X 4 DAYS;
RASHES AT FACE AND LEGS X 4 DAYS
SORE THROAT and ITCHINESS
BODY PAIN PS: 7/10
health
COMPREHENSIVE HISTORY
4
Last
immunized as a child.
hospitalization
Physical Assessment
SCALP/
HAIR
all areas and is free from masses,
lumps, and dandruff with no areas of
tenderness upon palpation.
Hair - evenly distributed.
Some parts show Varicella lesions
on the ventral part of the head.
Physical Assessment
FACE
Oval
There
Patient
NUTRITIONAL PATTERN
normal
meal pattern
eats fruits and vegetables. He has a
good appetite with no difficulty in
chewing and swallowing food.
drinks approximately 7-9 glasses of
water everyday
Hypoallergenic diet upon admission.
ELIMINATION PATTERN
defecate
morning.
He sometimes experiences some
difficulty in defecating yet he just eat
fruits high in fiber like papaya and ripe
mangoes to facilitate his elimination
pattern.
He urinates 3-5 times a daily during
hospitalization.
ACTIVITY- EXERCISE PATTERN
independent
in performing activities of
daily living such as feeding, general
mobility, toileting, bathing, grooming
and home maintenance.
He also has a routine 20-30 exercise
composed of jogging and walking once
or twice a week.
Spends his leisure time by playing
games on his phone during confinement
COGNITIVE- PERCEPTUAL PATTERN
Patient
SELF-PERCEPTION SELF- CONCEPT PATTERN
the
During
ROLE-RELATIONSHIP PATTERN
nuclear
married
family structure
Again Christian.
Anatomy and
Physiology
Disease
Non-immunized
Stress
Varicella Zoster
Virus
Infected
person
No known
history of
VZV
HOST
Sneezing
Coughing
Contact with
blisters
Upon Admission
Exposed to crowd
Lack of sleep
Hematology Result
following therapeutics
such as Acyclovir 500
mg/tablet, 4 tablets
once a day per orem for
5 days and Paracetamol
500mg/tablet, 1 tablet
PRN for Temperature of
38.3 degrees Celsius.
Cpt C MC also ordered
for D5NSS 1 liter
regulated at 40-41
gtts/min for 3 cycles
Received by the
afternoon shift 3pm11pm NOD with
elevated body
temperature of 38
degrees Celsius and skin
warm to touch. Nursing
interventions were
rendered such us: cold
compress applied to
forehead, encouraged to
increase fluid intake,
regulated IVF fluid to its
desired rate and
Paracetamol 500 mg
tablet was given.
1800H
Latest temperature
recorded: 36.1 degrees
Celsius.
1500H
Encouraged patient to
verbalize feelings and
concerns, placed on a
comfortable position,
advised not to prick
blisters. Encouraged to
practice personal hygiene
and observe proper
handwashing.
0830H
1100H
0800H
Patient complained of
itchiness all over body. The
following intervention was
rendered by NOD: Assessed
health status, encouraged
verbalization of feelings
and concerns, instructed to
increase fluid intake,
instructed to avoid
scratching of vesicles and
removal of crusts, advised
to practice personal
hygiene and handwashing,
monitored at intervals for
unusualities.
MOD ordered for IVF to be
consumed then discontinue
after last ordered cycle of
D5LR and was noted by
Patient was
discharged per MODs
order in fair condition
and upon
accomplishment of
clearance. Discharged
health teachings were
imparted and
acknowledged by the
patient.
Name of the
Drug
Classification
Mechanism of Action
Indication
Nursing
Considerations
Generic
Name:
Acyclovir
Brand
Name:
Herpex
Dosage:
200mg
Frequency:
4 tabs once a
day
Route:
Oral
Antiviral drug
The acyclovir is
converted to an active
form by the virus itself,
and the virus then uses
the active form of
acyclovir rather than
the nucleoside it
normally uses to
manufacture DNA, a
critical component of
viral replication.
Recurrent
genital Herpes
infection.
Assessment
History: Allergy to
acyclovir,
Herpes Zoster
infection
( Shingles)
Chickenpox( Va
ricella) PO
Teaching points
Oral acyclovir is not a
cure.
Side effects
nausea,
Vomiting, diarrhea and
headache. agitation,
confusion, rash
Contraindicat
ion:
hypersensitivit
y
Avoid sexual
intercourse while
visible lesions are
present.
You may
experience these
side effects:
Nausea, vomiting,
loss of appetite,
diarrhea;
headache,
dizziness.
Report difficulty
urinating, rash,
increased severity
or frequency of
recurrences.
Name of the
Drug
Classificatio
n
Generic
Analgesics
Name:
Antipyretic
Paracetamol
Brand
Names:
Fevergan
Classificati
on:
Dosage:
500 mg
Frequency:
PRN
Route: Oral
Mechanism of
Action
Indication
Nursing
Considerations
Decreases fever
by inhibiting the
effect of
pyrogens on the
hypothalamus by
Vasodilation.
Relief of
mild to
moderate
pain;
treatment of
fever
Assess patients
fever or pain;
type of pain,
location, intensity,
duration,
temperature and
diaphoresis.
Contraindic
ation
Relieves pain by
Hypersensiti
inhibiting
vity to the
prostaglandin
drug.
synthesis at the
History: Allergy to
acetaminophen,
impaired hepatic
function, chronic
alcoholism,
pregnancy,
lactation
Give drug with
food if GI upset
occurs.
Discontinue drug
if hypersensitivity
reactions occur.
Problem list
Increased
body temperature
Impaired skin integrity
Knowledge deficit regarding Varicella
Zoster infection
Assessment
Nursing Diagnosis
Objective of care
Subjective
Elevated
At the end of
C. Nursing
cues:
bodyCare Plans
8 hours
temperature nursing
Maam ta
intervention
sinti man iyo
the Patient
caliente pati
will be able
duele el di
to maintain
mio cabesa
body
as verbalized
temperature
by the
within normal
patient.
range of
36C to 37.5
Objective
C
cues:
Skin warm to
touch
Temperature
of 38C.
Interventions
*Assess
health
condition of
the patient
*Provide a
wellventilated
environment
*Encourage
significant
others to
perform tepid
sponge bath
or cold
compress.
*Encourage
to increase
fluid intake.
Evaluation
At the end of
8 hours
nursing
intervention,
the patient's
latest body
temperature
is 36.1C.
Assessmen
Nursing
Objective
Diagnosis
of care
Evaluation
Interventio
ns
*Administere
d anti pyretic
medication as
ordered.
*Monitored
patients core
temperature
at frequent
intervals.
Assessment
Subjective
cues:
Manada ya ta
crisi butuy na
dimiyo cara
hasta na
dimiyo pi es
as verbalized
Objective
cues:
Presence of
vesicular
Lesions all over
the body. Some
of the lesions
are vesicles
filled
With serous
fluid; others are
darker in color.
Nursing
Objective of
Interventio
Diagnosis
Care
ns
Impaired skin
integrity
Related to
Varicella Zoster
Infection
At the end of
the patients
hospital stay
and series of
interventions
carried out, the
patients
skin lesions will
heal without
evidence of a
secondary
infection.
*Assess
patients
condition
*Educate
patient on the
following:
Wash the
hands each
time the area is
touched.
Wash any
soiled clothes
or linens in
warm water
and soap.
Evaluation
At the end of
the patients
hospital stay
and series of
interventions
carried out,
The Patients
skin lesions are
dry and crusty,
with no new
blister
Formation.
Skin lesions
healed without
evidence of a
secondary
infection.
Assessment
Nursing Diagnosis
Objective of
Interventions
Care
*Educate patient to
always trimmed
fingernails and avoid
scratching the affected
areas.
*Take medications as
prescribed.
Evaluation
Assessment
Nursing
Diagnosis
Objective of
Care
Interventions
Evaluation
Subjective
cues:
Ara pa gayot
ya krisi
chickenpox
comigo,cosa
gaha yo debe
hace para
puede ayuda
di mio cuerpo
Deficient
knowledge of
the cause of
the skin
disorder and
recommended
Treatment.
At the end of 8
hours nursing
intervention
the Patient will
be able to
Verbalize
understanding
of the disease
process and
participate in
the treatment
plan.
Provide verbal
and written
instructions for
self-care.
At the end of 8
hours nursing
intervention
the Patient
acknowledged
the health
teachings
being imparted
to him.
Si,mas ya
puede yay o
intende el cosa
ta pasa na di
mio cuerpo. O
hala keda ya
iyo bueno
*Encourage
proper
hygiene.
*Teach how to
take care of
skin lesions.
*Wear a clean
cotton
undershirt
each day.
*Do not allow
other family
members to
use your
towels.
Assessment
Nursing Diagnosis
Objective of Care
Interventions
*Encourage clients to
avoid all forms of
friction (touched,
scratched by hand)
*Take medications as
prescribed
*Educate patient on
how to create a
cleansing solution.
Instructed patient to
mix one liter of water
with one teaspoon of
salt and use this as
cleanser.
Evaluation
Discharge Planning
MEDICATION
-Promotes adherence
measures by thoroughly
explaining the importance of
taking multivitamins to
improve immunity.
EXERCISES
TREATMENT
HEALTH
TEACHING
DIET
SPIRITUAL
NURSING
Conclusion
Varicella Zoster Infection or commonly known as
Chickenpox is highly contagious disease caused by
herpes virus varicella, characterized by vesicular
eruptions on the skin and mucous membranes
usually with mild constitutional manifestations.
Because it is widely distributed, anyone can be
susceptible for contracting the disease even adults
has no excuse. Seeking consultation and taking the
proper management is essentially important as it
provides mutual benefit; to the patient, it will halt
the spread of the virus in the body which can lead to
serious complications and to the community for
minimizing the risk of contracting the disease from
the infected individual which can pose a larger
threat of a possible epidemiological outbreak.
Isolating the patient is considered and meticulous
handling of the case by following the infection
control protocol is a must. With proper management
of the disease, the patient can recover and restore
-ENDMuchisimas
Gracias!