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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My Study Plan

Concepts Covered:

  • Prenatal Concepts
  • Musculoskeletal Disorders
  • Respiratory Disorders
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Adulthood Growth and Development
  • Integumentary Disorders
  • Hematologic Disorders
  • Pregnancy Risks
  • Oncologic Disorders
  • Postpartum Complications
  • Fetal Development
  • Endocrine and Metabolic Disorders
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Labor Complications
  • EENT Disorders
  • EENT Disorders
  • Postpartum Care
  • Cardiovascular Disorders
  • Newborn Care
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Liver & Gallbladder Disorders
  • Microbiology
  • Infectious Disease Disorders

Study Plan Lessons

OB Course Introduction
Pediatrics Course Introduction
Care of the Pediatric Patient
Care of the Pediatric Patient
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vitals (VS) and Assessment
Overview of Childhood Growth & Development
Developmental Stages and Milestones
Growth & Development – Infants
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Growth & Development – School Age- Adolescent
Eczema
Gestation & Nägele’s Rule: Estimating Due Dates
Impetigo
Pediculosis Capitis
Burn Injuries
Burn Injuries
Fundal Height Assessment for Nurses
Physiological Changes
Sickle Cell Anemia
Sickle Cell Anemia
Discomforts of Pregnancy
Iron Deficiency Anemia
Hemophilia
Nutrition in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Pediatric Oncology Basics
Anemia in Pregnancy
Leukemia
Cardiac (Heart) Disease in Pregnancy
Nephroblastoma
Nephroblastoma
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
HELLP Syndrome
Fertilization and Implantation
Fever
Dehydration
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Leopold Maneuvers
Celiac Disease
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Appendicitis
Obstetrical Procedures
Intussusception
Umbilical Hernia
Constipation and Encopresis (Incontinence)
Constipation and Encopresis (Incontinence)
Strabismus
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Acute Bronchitis
Postpartum Interventions
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Postpartum Discomforts
Breastfeeding
Pneumonia
Asthma
Asthma
Cystic Fibrosis (CF)
Sudden Infant Death Syndrome (SIDS)
Congenital Heart Defects (CHD)
Congenital Heart Defects (CHD)
Postpartum Hematoma
Defects of Increased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Obstructive Heart (Cardiac) Defects
Subinvolution
Mixed (Cardiac) Heart Defects
Mixed (Cardiac) Heart Defects
Postpartum Thrombophlebitis
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Epispadias and Hypospadias
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Meningitis
Transient Tachypnea of Newborn
Retinopathy of Prematurity (ROP)
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Autism Spectrum Disorders
Erythroblastosis Fetalis
Addicted Newborn
Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Tocolytics
Betamethasone and Dexamethasone
Scoliosis
Magnesium Sulfate
Opioid Analgesics
Prostaglandins
Uterine Stimulants (Oxytocin, Pitocin)
Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
Phytonadione (Vitamin K)
Hb (Hepatitis) Vaccine
Rubeola – Measles
Rubeola – Measles
Mumps
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Influenza – Flu
Acute Otitis Media (AOM)
Antepartum Testing
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cerebral Palsy (CP)
Chorioamnionitis
Cleft Lip and Palate
Clubfoot
Conjunctivitis
Cystic Fibrosis (CF)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Eczema
Enuresis
Epiglottitis
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fever
Gestational Diabetes (GDM)
Gravidity and Parity (G&Ps, GTPAL)
Hemophilia
Hydrocephalus
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Imperforate Anus
Impetigo
Incompetent Cervix
Intussusception
Marfan Syndrome
Mastitis
Maternal Risk Factors
Meconium Aspiration
Meningitis
Menstrual Cycle
Omphalocele
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Postpartum Hemorrhage (PPH)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Reye’s Syndrome
Rheumatic Fever
Scoliosis
Signs of Pregnancy (Presumptive, Probable, Positive)
Spina Bifida – Neural Tube Defect (NTD)
Tonsillitis
Varicella – Chickenpox