Question

Which order would the nurse expect to be included in the plan of care for a client with herpes zoster? a. Administer ibuprofen \(800 \mathrm{mg} \mathrm{q} 4\) hours for pain b. Prevent contact with persons who have never had chickenpox c. Keep affected area tightly covered with a moisturepreserving dressing d. Monitor for change in respiratory status every 4 hours

Short answer

Prevent contact with persons who have never had chickenpox.

Step-by-step solution

- Identify Relevant Information About Herpes Zoster

Herpes zoster, also known as shingles, is caused by the reactivation of the varicella-zoster virus. It typically presents with painful, blistering skin rashes along nerve paths.

- Understand Transmission and Risks

Herpes zoster is not as contagious as chickenpox but can cause chickenpox in those who have never had it or have not been vaccinated. The virus spreads through direct contact with fluid from the rash blisters.

- Analyze Each Option

a. Administering ibuprofen is often for pain management but not specific for herpes zoster care.b. Preventing contact with persons who haven't had chickenpox prevents spreading the virus.c. Covering the affected area with a moisture-preserving dressing can increase the risk of bacterial infection and discomfort for the client.d. Monitoring respiratory status is not directly related to the specific care of herpes zoster unless complications arise.

- Select the Most Appropriate Nursing Order

Given the transmission method of herpes zoster, preventing contact with persons who have never had chickenpox (option b) is the most effective preventative measure to include in the plan of care.

Key concepts

herpes zoster

Herpes zoster, commonly known as shingles, is an infection caused by the reactivation of the varicella-zoster virus. This is the same virus responsible for chickenpox. After a person recovers from chickenpox, the virus remains dormant in their nerve tissues. Years later, it can reactivate as herpes zoster. This condition typically presents with a painful, blistering rash that follows a nerve line on one side of the body. Symptoms can include:

• Severe pain
• Tingling or burning sensation on the skin
• Blisters that form and then crust over
• Fever and headache

Understanding the characteristics and symptoms of herpes zoster is essential for effective nursing care and management.

nursing interventions

Nursing interventions for clients with herpes zoster focus on symptom management and preventing complications. Here are common interventions:

• Pain management: Pain control is crucial. Nurses can administer analgesics like ibuprofen or prescribe antiviral medications such as acyclovir to reduce severity and duration of symptoms.
• Skin care: Keeping the affected area clean and dry, applying cool compresses, and using prescribed topical creams can help alleviate discomfort.
• Comfort measures: Suggesting loose clothing and avoiding scratching can further reduce irritation and prevent secondary infection.
• Education: Educating clients about the proper application of medications, importance of hand hygiene, and avoiding skin-to-skin contact with others who haven't had chickenpox or the vaccine.

These interventions aid in managing symptoms and minimizing the risk of further complications.

infection control

Infection control is vital in managing herpes zoster due to the potential for the virus to spread. Proper infection control practices include:

• Personal protective equipment (PPE): Nurses should use gloves when applying topical medications or dressing the affected area.
• Hand hygiene: Maintaining strict hand hygiene before and after client contact helps prevent virus transmission.
• Isolation protocols: If the client has extensive or disseminated herpes zoster, placing them in contact precautions to limit spread within healthcare settings.
• Cleaning and disinfecting: Ensuring that surfaces and equipment in contact with the patient's skin are thoroughly cleaned and disinfected.

These measures are essential to prevent transmission to other clients and healthcare workers.

transmission prevention

Preventing the transmission of herpes zoster involves several strategies:

• Avoiding contact with susceptible individuals: Clients with active herpes zoster should avoid contact with people who have not had chickenpox or the varicella vaccine.
• Covering the rash: Keeping the affected area loosely covered can reduce the risk of spreading the virus through fluid from blisters.
• Vaccination: Encourage vaccination against herpes zoster for older adults, which can prevent the onset of shingles.
• Education: Informing clients about the nature of herpes zoster, transmission risks, and the importance of adhering to preventive measures.

Implementing these strategies helps protect the broader community from virus transmission.