Varicella – Chickenpox

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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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Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Community Health Overview
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Emotions and Motivation
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Labor Complications
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Cardiac Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Shock
  • Infectious Disease Disorders
  • Nervous System
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Epidemiology
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Legal Considerations
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Fundal Height Assessment for Nurses
Injectable Medications
Somatoform
Technology & Informatics
Fall and Injury Prevention
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
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
Overview of the Nursing Process
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Proton Pump Inhibitors
Schizophrenia