Varicella – Chickenpox

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Ashley Powell
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Study Tools For Varicella – Chickenpox

Chickenpox (Image)
Acyclovir (Image)
Airborne Precaution Diseases (Mnemonic)
Varicella (Chickenpox) (Picmonic)
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Outline

Overview

  1. Highly contagious viral infection, caused by varicella-zoster virus
    1. Itchy, blister like rash on the skin.

Nursing Points

General

  1. Contagious
    1. Until 6 days after start of rash
    2. Crusts have formed on all lesions
  2. Spread via direct contact and airborne spread
  3. After infection, virus remains dormant and can become reactivated to cause shingles

Assessment

  1. Fever
  2. Malaise
  3. Small, extremely itchy blisters
    1. 3 stages
      1. Papule (small, red, raised)
      2. Vesicle (fluid trapped under skin, bubble-like)
      3. Crust (scabbed over)
    2. Profuse on trunk
    3. Sparse on limbs

Therapeutic Management

  1. Isolate child
  2. Initiate contact and airborne precautions
    1. Ensure there are no pregnant caregivers
  3. Promote skin integrity – prevent secondary skin infection
    1. Cut nails
    2. Apply mittens
    3. Calamine lotion
  4. Medications
    1. Acyclovir
      1. Give within 24 hours of rash appearance
    2. IVIG for immunocompromised patients
    3. Diphenhydramine
      1. To relieve itching
  5. Monitor for complications
    1. Varicella pneumonia
    2. Encephalitis
    3. Cellulitis  

Nursing Concepts

  1. Immunity
  2. Infection Control
  3. Comfort

Patient Education

  1. Contagious until all vesicles turn into scabs
  2. Prevent scratching
  3. Do not give aspirin due to risk of Reye Syndrome

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Transcript

Hey you guys, in this lesson we are going to talk about chickenpox. Chickenpox is caused by the Varicella Zoster Virus, so sometimes it’s called Varicella.

Chickenpox is a very contagious viral infection. It causes a widespread, very itchy rash. Remember I said it’s caused by the varicella zoster virus- which is actually the same virus that causes shingles. So the virus can reactivate later in life causing shingles and this is most often seen after the age of 60.

The virus is spread through contact with the rash and through coughs and sneezes- so these patients actually need to be on standard, contact and airborne precautions.

It used to be, sort of like a right of passage to get the chickenpox as a kid- and parents would even have “chickenpox parties” to just get it out of the way! The CDC doesn’t recommend this, especially now that there is an immunization for chickenpox. The immunization is given between 12-15 months and again between 4-6 years, which is the same as the MMR.

The major symptoms to look for with chickenpox are fever and a rash.

The rash has 3 stages. It starts as a pustule (a small bump that looks kinda like a zit), then becomes a vesicle (fluid filled blister), which then bursts and crusts over. One important thing to know about chickenpox is that kids are infectious until ALL pustules have crusted over and are drying out.

As you can imagine and may even remember from childhood- kids with chickenpox can be pretty miserable and irritable. They aren’t sleeping well and just feel pretty awful.

First things first- if in the hospital, these patients have to be on contact and airborne precautions. If they are at home they need to stay away from school until all lesions are crusted over.

First things first- if in the hospital, these patients have to be on contact and airborne precautions. If they are at home they need to stay away from school until all lesions are crusted over.

The most important part our nursing care is promoting skin integrity. One of the biggest complications of chickenpox is cellulitis. So nails need to be kept short to prevent kids from scratching and breaking open their skin. If the skin is open they are way more likely to get a secondary infection! If not scratching doesn’t seem like a feasible goal then mittens on the hands may be necessary. Baths and calamine lotion are very helpful as well.

Medications that may be given for chickenpox are diphenhydramine for the itching, antipyretics for fever, and acyclovir. Acyclovir is an antiviral that should be given for severe cases of chickenpox and for patients with compromised immunity.

Complications that you need to be on the look out for are varicella pneumonia, encephalitis and cellulitis.

Your priority nursing concepts for a pediatric patient with chickenpox are immunity, infection control and health promotion.
Chickenpox is a very contagious disease caused by the varicella zoster virus. Patients with chickenpox in the hospital need to be on standard, contact and airborne precautions. The major symptom of chickenpox is an itchy rash that goes through three stages. Pustule, vesicle and then it crusts over.

Treatment should focus on skin care to prevent secondary skin infections. And in severe cases acyclovir may be given.

Complications that can happen are varicella pneumonia and cellulitis.
That’s it for our lesson on caring for pediatric patients with chickenpox. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!

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S25 Week 4 Study Plan (Community Health, OB, Peds)

Concepts Covered:

  • Respiratory Disorders
  • Prenatal Concepts
  • Community Health Overview
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Oncologic Disorders
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Labor Complications
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders

Study Plan Lessons

Care of the Pediatric Patient
Menstrual Cycle
Family Planning & Contraception
Vitals (VS) and Assessment
Epidemiology
Growth & Development – Infants
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Environmental Health
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Pediculosis Capitis
Burn Injuries
Fundal Height Assessment for Nurses
Technology & Informatics
Maternal Risk Factors
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Nephroblastoma
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Postpartum Discomforts
Breastfeeding
Asthma
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Eczema