HERPES ZOSTER I. Synonym V. Incubation period 1.

Shingles is not transmitted from exposure to another infected person so there is no applicable incubation period. Anyone who has recovered from varicella may develop shingles. VI. Signs and Symptoms 1. Pain 2. Itching 3. Tingling in the area where the rash develops prior to blistering. 4. Headache 5. Fever 6. Malaise 7. Chills VII. Pathognomonic sign 1. Regional Painful Rash 2. Lesions follow peripheral nerve pathway of CN V and CN VII. VIII. Diagnostic test 1. Tzanck testing can be used to diagnose viral disease, such as herpes simplex and herpes zoster, and is done when active intact vesicles are present. Tzanck testing cannot distinguish between herpes simplex and herpes zoster infections. An intact blister is the preferred lesion for examination. The blister roof is removed with a sharp blade, and the base of the unroofed vesicle is scraped with a #15 scalpel blade. The scrapings are transferred to a

1. Shingles II. Definition

Herpes zoster, also Shingles, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body. Initially, red patches of rash develop into blisters. Because the virus travels along the nerve to the skin, it can damage the nerve and cause it to become inflamed. This condition can be very painful. If the pain persists long after the rash disappears, it is known as postherpetic neuralgia.

III. Etiologic Agents 1. The virus that causes chickenpox, the Varicella Zoster Virus (VSV), can become dormant in nerve cells after an episode of chickenpox and later reemerge as shingles. IV. Mode of transmission Transmission of the virus occurs through direct contact with the rash or fluid from the lesions. If the person exposed has not previously had chicken pox, that person would develop chicken pox, not shingles. Therefore, shingles cannot be passed from one individual to another.

slide and stained with Wright's stain or Giemsa stain. Multinucleated giant cells are a sign of herpes infection. 2. Culture of Wound Secretions IX. Drug of choice 1. Acyclovir hasten the healing and decreases the pain if started within 72 hours of vesicle appearance X. Immunization 1. The varicella vaccine is a live (attenuated) vaccine that protects against the viral disease commonly known as chickenpox, Herpes zoster, and Postherpetic neuralgia. XI. Prevention and control 1. People with shingles should keep the rash covered and not touch or scratch the rash. 2. Wash hands properly and often. 3. There is no shingles vaccine available for children; however, administration of the varicella vaccine will prevent infection if contact with a shingles case occurs. XII. Nursing management 1. Wear a clean cotton undershirt each day. 2. Trim the fingernails short, and keep the hands clean. 3. Wash the hands each time the area is touched. 4. Wash any soiled clothes or linens in hot water and soap. 5. Do not allow other family members to use your towels.

6. Take medications as prescribed for itching and pain. 7. Wash the sores and the skin around them very gently with a soft washcloth and a mild soap. XIII. Possible nursing diagnosis 1. Risk For Infection r/t to disease process 2. Acute pain related to the presence of lesions and pruritus 3. Deficient knowledge of the cause of the skin disorder and recommended.

Submitted by: Peter Francis O. Gonzaga 3 NRS-2 Group #4 Submitted to: Mr. Armando Delos Santos RN, MAN, Clinical Instructor