Herpes Zoster (Shingles): shingles is caused by reactivation of the varicella zoster virus
Assessment:
• Unilateral clustered skin vesicles along peripheral sensory nerves on the trunk, thorax, or
face; linear distribution along a dermatome
• Fever, malaise
• Burning, pain, neuralgia (pain due to nerves)
• Paresthesia
• Pruritus
Risk Factors: individuals who have never had chicken pox and who have not been vaccinated
against disease
Dx: Culture-to identify the organism
Determined by visual examination
Tzanck smear-to verify a herpes infection
Interventions:
• Isolate the client because exudate from the lesions contain the virus-maintains std
precautions and contact precautions as appropriate
• Assess for signs and symptoms of infection-skin and eye infections; skin necrosis can
occur
• Assess neurovascular status and 7th cranial nerve function g Bell's palsy is a
complication
• Use air mattress and bed cradle on bed if hospitalized, and keep the environment cool to
ease pain
• Prevent client from scratching and rubbing the affected area
• Instruct client to wear lightweight, loose cotton clothing, avoid wool and synthetic
clothing
• Teach client about prescribed therapies; astringent compress may be prescribed to relieve
irritation and pain and to promote cross formation and healing
• Teach the client about measures to keep the skin clean to prevent infection
• Vaccination for shingles is recommended for adults 60/+ years of age to reduce risk
• Teach client about topical treatment and antiviral medications
• Antiviral medications-acyclovir, famciclovir, valacyclovir (Valtrex) w/i 72hrs
Tx: Silver sulfadiazine to ruptured vesicles, analgesia, vaccine (Zostavax)
Assessment:
• Unilateral clustered skin vesicles along peripheral sensory nerves on the trunk, thorax, or
face; linear distribution along a dermatome
• Fever, malaise
• Burning, pain, neuralgia (pain due to nerves)
• Paresthesia
• Pruritus
Risk Factors: individuals who have never had chicken pox and who have not been vaccinated
against disease
Dx: Culture-to identify the organism
Determined by visual examination
Tzanck smear-to verify a herpes infection
Interventions:
• Isolate the client because exudate from the lesions contain the virus-maintains std
precautions and contact precautions as appropriate
• Assess for signs and symptoms of infection-skin and eye infections; skin necrosis can
occur
• Assess neurovascular status and 7th cranial nerve function g Bell's palsy is a
complication
• Use air mattress and bed cradle on bed if hospitalized, and keep the environment cool to
ease pain
• Prevent client from scratching and rubbing the affected area
• Instruct client to wear lightweight, loose cotton clothing, avoid wool and synthetic
clothing
• Teach client about prescribed therapies; astringent compress may be prescribed to relieve
irritation and pain and to promote cross formation and healing
• Teach the client about measures to keep the skin clean to prevent infection
• Vaccination for shingles is recommended for adults 60/+ years of age to reduce risk
• Teach client about topical treatment and antiviral medications
• Antiviral medications-acyclovir, famciclovir, valacyclovir (Valtrex) w/i 72hrs
Tx: Silver sulfadiazine to ruptured vesicles, analgesia, vaccine (Zostavax)
