Herpes zoster (Shingles) : What Is It ? Treatment , Nursing Management and Advice For Patient

Herpes zoster (Shingles) : What Is It ? Treatment , Nursing Management and Advice For Patient

It is an inflammatory viral condition caused by varicella zoster virus.

Epidemiology

Herpes zoster (HZ) is more prevalent in people who are immuno compromised i.e those withPost-organ transplant patient those receiving chemotherapy or radiation therapy for malignancies or patient with AIDS. Hz is not always associated with HIV/AIDS, elderly people can get and some times people without immuno suppuration can get it.

Herpes zoster represents as a reactivation of latent varicella (chicken pox) and may reflect a lower immunity. It is believed that the viruses responsible for the out break lies dormant inside nerve cells in the sensory ganglion of the spinal cord. Later, when the latent viruses are reactivated they travel by way of the peripheral nerves to the skin.

Clinical manifestation

The eruption is generally preceded by pain, which may radiate over the entire region supplied by the nerves. The pain may be burning, lancinating (sharply cutting) stabbing or aching. In some patients the pain is absent and in some patients itching and tenderness may occur over the area.

The lesions are grouped vesicles appear on the red and swollen skin following a dermatone. The early vesicles contain serum and later, rupture and form crusts. The inflammation is usually unilateral, involving the thoracic, cervical and cranial nerves.

The blisters are usually confined to narrow region of the face or trunk. The clinical course varies from 1 to 3 weeks. If an ophthalmic branch of trigeminal nerve is involved the patient may have painful eye. Inflammation and rash on the trunk may cause pain at the slightest touch. In eye it causes keratitis, uveitis, ulceration and blindness. The healing time varies between 7 and 26 days Herpes zoster in healthy adult is usually localized and benign, however, in immuno suppressed patient, the disease may be severe and the clinical course acutely disabling.

Management and Nursing intervention

The goal of treatment is to relieve the pain and reduce complication. These include infection, scarring post herpetic nuralgia & eye complications.

1. The pain is controlled with analgesics and may require neurontin (gabapatin) for pain control

2. Systemic corticosteroids given to patient over age of 50 to reduce the incidence and duration of complication. Healing is usually more rapid in those who have been treated with steroids.

3. started early antiviral drug such as systemic Acyclovir is effective in reducing the pain and halting the progress of the disease and assess the discomfort and response to medication on patient( try to get the patient in24 to 48 hours)

4. Apply wet dressing or medication to the lesion. Wet dressing (Compresses) is usually used for acute, weeping inflammatory lesion. This may be either sterile or non sterile.

5. Systemic antibiotic to control secondary infection

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Herpes zoster (Shingles) : What Is It ? Treatment , Nursing Management and Advice For Patient 2018-12-26T00:03:00-08:00 Rating: 4.5 Diposkan Oleh: David Maharoni