Varicella (chicken Pox)

Question 1

Varicella- zoster virus (VZV)

Answer 1

Causes primary infection chicken pox

Question 2

Even though you get cured varicella virus can remain in the body. When it gets reactivated - what is it?

Answer 2

Shingles (herpes zoster)

Question 3

How is chicken pox transmitted?

Answer 3

Respiratory secretions
Contact

Question 4

Where can varicella zoster virus (VZV) enter through

Answer 4

Respiratory tract, conjuctiva, or direct contact with vesicular bumps

Question 5

How long is chicken pox contagious

Answer 5

1-2 days before rash appears and until all lesions have crusted

Question 6

Why should we keep a child who is diagnosed with chicken pox away from other people and especially immunocomprimised?

Answer 6

It is highly contagious

Question 7

If a child with chicken pox is hospitalized what precautions are they on?

Answer 7

Airborne precautions
Contact precautions

Question 8

First sign in children of chicken pox/varicella

Answer 8

Rash

Question 9

Adults first sign of chicken pox/varicella

Answer 9

1-2 days fever
Malaise (all occur before rash)

Question 10

Varicella rash order

Answer 10

Macule to papule to vesicle to vesicle rupture to crusting

Question 11

Where can these lesions appear?

Answer 11

Most lesions on the trunk and mucous membranes

Question 12

Mucous membranes the rash can be spotted on

Answer 12

Mouth, resp tract, conjuctiva, cornea , vagina etc

Question 13

In a healthy child how many lesions per crop can appear as well as how many crops ?

Answer 13

200-500 lesions per crop
A total of 2-4 crops

Question 14

S/s varicella

Answer 14

Malaise
Fever up to 102f for 2-3 days
Vesicular rash
Itching!!

Question 15

Complications of chicken pox

Answer 15

Secondary bacterial infections of skin
Pneumonia
CNS manifestations

Question 16

Examples of secondary bacterial infections of skin

Answer 16

Access, cellulitis, necrotizing fasciitis

Question 17

Varicella in immunocompromised

Answer 17

High risk for disseminated diseases (multi system involvement and hemorrhagic)

Question 18

Most frequent complications of varicella in an immunocompromised pt

Answer 18

Pneumonia
Encephalitis

Question 19

Children with HIV that catch varicella

Answer 19

At high risk for morbidity

Question 20

Medication for varicella

Answer 20

Acyclovir ( Zovirax)

Question 21

Acyclovir (Zovirax) benefits

Answer 21

Decrease the number of lesions
Shortens duration of fever
Decrease itching lethargy and anorexia

Question 22

Post exposure prophylaxis

Answer 22

Varicella vaccine for people w/o immunity but has to be given within 5 days of exposure

Question 23

What can the varicella outbreaks control?

Answer 23

Outbreaks in child care facilities and schools, sports

Question 24

Interventions

Answer 24

Skin care
Apply pressure instead of itching
Topical calamine
Distraction
Fingernails short or wear mittens
Keep cold
No aspirin

Question 25

Why is skin care important and what is important to keep in mind

Answer 25

To keep clean and avoid bacterial infection.

Watch for skin irritants

Question 26

What is important to keep in mind when using topical calamine or any other topical antihistamine

Answer 26

Avoid using an oral antihistamine because using both oral and topical can be toxic.

Question 27

When using oatmeal baths for skin care as a treatment what can we keep in mind?

Answer 27

Lukewarm bath and no soap

Question 28

How long do babies have maternal immunity up to

Answer 28

1 year

Question 29

How many doses and when is the varicella vaccine given

Answer 29

2 dose series
Give at 12-15 mo and 4-6 years

Question 30

What is important to do after pt recieved vaccine

Answer 30

Document immunity!!