Varicella (chicken Pox) Flashcards
Varicella- zoster virus (VZV)
Causes primary infection chicken pox
Even though you get cured varicella virus can remain in the body. When it gets reactivated - what is it?
Shingles (herpes zoster)
How is chicken pox transmitted?
Respiratory secretions
Contact
Where can varicella zoster virus (VZV) enter through
Respiratory tract, conjuctiva, or direct contact with vesicular bumps
How long is chicken pox contagious
1-2 days before rash appears and until all lesions have crusted
Why should we keep a child who is diagnosed with chicken pox away from other people and especially immunocomprimised?
It is highly contagious
If a child with chicken pox is hospitalized what precautions are they on?
Airborne precautions
Contact precautions
First sign in children of chicken pox/varicella
Rash
Adults first sign of chicken pox/varicella
1-2 days fever
Malaise (all occur before rash)
Varicella rash order
Macule to papule to vesicle to vesicle rupture to crusting
Where can these lesions appear?
Most lesions on the trunk and mucous membranes
Mucous membranes the rash can be spotted on
Mouth, resp tract, conjuctiva, cornea , vagina etc
In a healthy child how many lesions per crop can appear as well as how many crops ?
200-500 lesions per crop
A total of 2-4 crops
S/s varicella
Malaise
Fever up to 102f for 2-3 days
Vesicular rash
Itching!!
Complications of chicken pox
Secondary bacterial infections of skin
Pneumonia
CNS manifestations
Examples of secondary bacterial infections of skin
Access, cellulitis, necrotizing fasciitis
Varicella in immunocompromised
High risk for disseminated diseases (multi system involvement and hemorrhagic)
Most frequent complications of varicella in an immunocompromised pt
Pneumonia
Encephalitis
Children with HIV that catch varicella
At high risk for morbidity
Medication for varicella
Acyclovir ( Zovirax)
Acyclovir (Zovirax) benefits
Decrease the number of lesions
Shortens duration of fever
Decrease itching lethargy and anorexia
Post exposure prophylaxis
Varicella vaccine for people w/o immunity but has to be given within 5 days of exposure
What can the varicella outbreaks control?
Outbreaks in child care facilities and schools, sports
Interventions
Skin care
Apply pressure instead of itching
Topical calamine
Distraction
Fingernails short or wear mittens
Keep cold
No aspirin
Why is skin care important and what is important to keep in mind
To keep clean and avoid bacterial infection.
Watch for skin irritants
What is important to keep in mind when using topical calamine or any other topical antihistamine
Avoid using an oral antihistamine because using both oral and topical can be toxic.
When using oatmeal baths for skin care as a treatment what can we keep in mind?
Lukewarm bath and no soap
How long do babies have maternal immunity up to
1 year
How many doses and when is the varicella vaccine given
2 dose series
Give at 12-15 mo and 4-6 years
What is important to do after pt recieved vaccine
Document immunity!!
