Chicken Pox (Varicella)

chicken pox1

Definition:

is highly contagious disease caused by herpes virus varicella, characterized by vesicular eruptions on the skin and mucous membranes usually with mild constitutional manifestations.

Etiologic Agent:

Varicella zoster virus

Source of Infection:

Secretion of respiratory tract of infective persons.

Modes of Transmission:

  1. Direct Contact – with patient who sheds the virus from vesicles
  2. Indirect Contact – through articles fresh soiled by discharges of infected persons
  3. Airborne – or spread by droplet infection

Incidence:

Most frequent in childhood but it may occur at any age, including the neonatal period with peak age between 5 and 9 years old.

herpes zoster blister

Incubation Period:

From10-21 days with a mean of 14 days or 2 weeks

Period of Communicability:

The patient is contagious about a day before the eruption of rashes and continuous to be so up to the 5th or 6th day after the last scab formation or until all vesicles have become encrusted.

Clinical Manifestations:

  1. Prodromal symptoms are mild and consist of fever and malaise
  2. Rash
    • Start from trunk and then spread to other parts of the body
    • In bigger children, the lesions may be more widespread and severe
    • Rapid progressions so that transitions is completed in 6-8 hours
    • All stages are present simultaneously before all are covered scabs

Diagnostic Test:

  • Determination of V-Z virus though Complement Fixation Test
  • Determination of V-Z virus through Electron Microscopic examination of vesicular fluid

Complications:

  • Secondary infection of the lesions – furuncles, cellulites, skin abscess, erysipelas
  • Meningoencephalitis
  • Pneumonia
  • Sepsis

Treatment Modalities:

  • Zoverax 500mg/tablet, 1 tab 2x a day for seven days must be administered
  • Oral acyclovir 800 mg 3x a day for five days must also be given
  • Oral antihistamine can be taken to symptomatic pruritus
  • Calamine lotion will ease itchiness
  • Salicylates must not be given
  • Antipyretics for fever.

Nursing Management:

  1. Prevention of secondary infection of the skin lesions through hygienic care of the patient
  2. Attention should be given to nasopharyngeal discharges and disinfection of cloths and linen by sunlight or boiling
  3. Cut fingernails short and wash hands more often in order to minimize bacterial infections; may be introduced by scratching
  4. Calamine lotion over rashes
  5. Antipyretics for fever
  6. Isolation of patient; cannot be confined in general hospital; isolated until all lesions have become encrusted.

Preventive Measures:

  1. Active immunization with live attenuated varicella vaccine is necessary.
  2. Avoid exposure as much as possible to infected persons.

Nursing Care Plan – Chickenpox

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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