Baladji, Aisa A .

Otoalih, S u m a i y a H .
WHAT IS HERPES?
Herp es is a viral infection that c an cause blisters
or sores to develop around the mouth or genitals.
TWO TYPES HERPES SIMPLE VIRUS (HSV)

1. HERPES SIMPLE VIRUS TYPE 1 (HSV-1). It c au s es

oral herpes, which usually affects the mouth and
surrounding skin but c a n also affect the genital region.

2 . H ERP ES SIM P LE VIRU S TYP E 2 ( H SV-2) . It

c a u s e s g e n i t a l herpes, usu a lly se xu a lly transmitted but
can also affect in oral region.
... WHAT IS THE DIFFERENT BETWEEN
ORAL HERPES AND GENITALHERPES?
W h e n you g e t either H S V- 1 or H S V- 2 on or around your genitals (vulva,
v agi na, cer vix, anus, penis, sc rotum, butt, inner thighs), it’s called genital
herpes.

W h e n you g e t either H S V- 1 or H S V- 2 in or around your lips, mout h, an d

throat, it’s called oral herpes. O r a l herpes sores are sometimes called
cold sores or fever blisters.

H S V- 1 usually c a u s e s oral he rpe s, and H S V- 2 usually c a u s e s genital herpes

— e a c h strain prefers to live on its favorite a re a . B ut it’s totally possible for
both types of herpes simplex to infect either a re a .
 ORAL HERPES

GENITAL HERPES

...
PATHOPHYSIOLOGY

H S V infects epithelial cells in the mu co sa or skin. Infection of the skin

requires rupture of the keratin layer composed of dead cells. The virus
replicates lytically in epithelial cells producing new infectious viral
particles that rea c h ner ve endings of peripheral neurons, where H S V
establishes latency.
SYMPTOMS
M a n y people who g e t herpes never h ave symptoms. S o m e t i m e s the symptoms
are mild and are mistaken for another skin condition. S y m p t o m s m ay include:

Genital Herpes:

Painful sores in the genital a re a , anus, buttocks, or thighs

Itching
Painful urination
Vagi nal di sc harge
Tender lumps in the groin

Oral Herpes:

• A person with a n oral herpes outbreak m ay first feel itching, burning, or

tingling around the mouth, lips, or tongue. Lat e r, cold sores or small
blisters m ay develop in these are as or anywhere on the skin.
CAUSES
W h e n H S V is present on the skin, it c a n easily pass from person to person
through contact with the moist skin of the mouth and genitals, including
the anus.
T he virus m ay also spread through contact with other are as of the skin
an d the eye s.
T he virus is most contagious bet ween w he n symptoms first appear an d
before they he al. L e s s commonly, a person c a n transmit the virus w h e n
symptoms are not present.
If a person with genital herpes has sores while giving birth, the virus c a n
pass on to the b aby.

Infection can occur in the following ways:

h aving va g ina l or a na l se x without using ba rrie r prote c tion, su c h a s a
c on d om
sharing sex toys
having any other oral or genital contact with a person who has herpes
PREVENTION
The following stra te g ie s c a n re duc e the risk of deve loping or pa ssing on
herpes:

using barrier protection, s u c h as c ondoms, w he n having sex

avoiding sex while symptoms are present
avoiding kissing a nd ora l se x whe n th e re is a c old sore a rou nd the
mouth
wa shing th e ha nds thoroug hly, e spe c ia lly a fte r touc h ing th e a ffe c te d
a re a , during a n outbreak
DIAGNOSIS
T he primar y method of testing for the virus is:

T he herpes culture
H S V D N A testing (Polymerase C h a i n Reaction). T hou g h it is not as
sensitive .
H S V antibody testing c a n b e use d to help di agnose a n ac u t e H S V
infection. It is done by collecting the blood samples of the patient. Th e
convalescent blood sampl e is collected several wee ks after the a c u t e
sampl e , and H S V I g G antibody levels are c omp are d to se e if they h ave
risen significantly, indicating a current infection.
 NURSING INTERVENTIONS
1. Educate the client about the following measures:

W ear loose, nonrestrictive clothing made of cotton. C o n st r i c t ive , n o n b r e a t h i n g

g a r m e n t s m a y r u b l e s i o n s a n d a g g r a v a t e s k i n i rr it at io n. Cotton c l o t h i n g a l l o w s e v a p o r a t i o n of
moisture
Apply cool, moist dressings to pruritic lesions with or without Burrow’s solution several
times a day. Discontinue once the lesions have dried. T h i s p r o v i d e s r e l i e f a n d r e d u c e s t h e
r i s k for s e c o n d a r y i n f e c t i o n s .
Avoid temperature extremes, in both the air and bathwater. T e p i d w a t e r c a u s e s t h e l e a s t
itching and burning.
Avoid rubbing or scratching the skin or lesion. S c r a t c h i n g s t i m u l a t e s t h e s k i n , w h i c h i n t u r n
i n c r e a s e s i t c h i n e s s . I t c a n a l s o i n c r e a s e t h e p o s s i b i l i t y of s e c o n d a r y i n f e c t i o n .
Use topical steroids (anti-inflammatory effect), antihistamines (anti-itching effect,
particularly useful at bedtime), and analgesics. A v a r i e t y of m e d i c a t i o n s m a y b e r e q u i r e d to
provide relief.

2 . Administer medications as indicated.

Oral opioid analgesics (codeine, hydrocodone) are typically prescribed during the acute
phase.
MEDICAL MANAGEMENT
Th e re i s n o w a y to e ra d i c a te h e rp e s v i ru s f rom th e b od y, b u t a n ti v i ra l
m e d i c a t i o n s c a n r e d u c e t h e f r e q u e n c y, d u r a t i o n , a n d s e ve r i t y of o u t b re a k s .
P a i n k i l l e r s l i ke ibuprofen c a n r e d u c e p a i n a n d f e ve r
.
Anti v i r a l d r u g s l i ke acyclovir, valacyclovir, famciclovir, and
penciclovir. I f u s e d c orre c t ly, t h e y m a y s p e e d u p t h e h e a l i n g t i m e of a
re c u r re n t i n fe c t i o n .

To p i c a l a p p l i c a t i o n of antiviral creams c a n a l s o h e l p i n h e a l i n g
o u t b re a k of i n fe c t i o n . T h e y do not g e t r i d of t h e h e r p e s s i m p l e x v i r u s or
p re v e n t f u t u re o u t b re a k s of c o l d s o re s o c c u r r i n g .
COMPLICATION
Dehydration: D e hy d r a t i o n i s a l a c k of w a t e r i n t h e b o d y a n d it c a n
s o m e t i m e s o c c u r a s a re s u l t of t h e p a i n t h a t i s c a u s e d b y a b l i s t e r.

Herpetic whitlow (whitlow finger): S o m e t i m e t h e v i r u s m a y s p r e a d

to ot he r p a r t s of t h e b o d y.

Herpetic keratoconjunctivitis: Herpetic ke r a t o c o n j u n c t i v i t i s is a

s e c o n d a r y i n f e c t i o n of t h e c o l d sore v i r u s t h a t a f f e c t s t h e e y e s .

Encephalitis: E n c e p h a l i t i s i s a c on d i t i o n w h e r e t h e b r a i n b e c o m e s
i n f l a m e d a n d s wo l l e n . T h i s c a n b e ve r y s e r i o u s a n d it c a n c a u s e b r a i n
d a m a g e a n d even death.
 MECHANISIM OF
DRUGDATA
ACTION
GENERIC NAME: • Acyclovir (9-[2-
ACYCLOVIR hydroxymethyl]guanine)
is a nucleoside analog
BRAND NAME: that selectively inhibits
ZOVIRAX the replication of herpes
simplex virus types 1
and 2 (HSV-1, HSV-2)
CLASSIFICATION: and varicella-zoster
ANTIVIRAL,
TROPICAL
virus (VZV). After
intracellular uptake, it is
converted to acyclovir
DOSAGE: 200 mg monophosphate by
(one 200 mg tablet virally-encoded
or one teaspoonful thymidine kinase.
of suspension [5
• Acyclovir triphosphate
mL]) every 4 hours. competitively inhibits
viral DNA polymerase by
ROUTE OF acting as an analog to
ADMINISTRATION: deoxyguanosine
ORAL OR triphosphate (dGTP).
INTRAVENOUS Incorporation of
acyclovir triphosphate
PHARMACOLOGIC:
into DNA results in chain
termination since the
PURINE absence of a 3' hydroxyl
ANALOGUES
group prevents the
attachment of additional
nucleosides.
• Acyclovir triphosphate
has a much higher
affinity for viral DNA
polymerase than for the
cellular homolog,
yielding a high
therapeutic ratio.
INDICATION CONTRAINDICATION ADVERSE REACTION NURSING RESPONSIBILITIES
•Assess underlying disease, history
• The treatment of • Contraindicated •nausea,
allergies before therapy
initial episodes of in patient
•vomiting, • Monitor rashes or other skin reactions
herpes genitalis. hypersensitivity
(hives, acne, abnormal sweating,
to acyclovir. •diarrhea, exfoliation). Notify physician immediately
• The suppression
•loss of appetite, • Assess dizziness or trembling that might
of unusually
affect gait, balance, or other functional
frequent activities.
•stomach pain,
recurrences of
herpes genitalis •Assess skin and mucosal lesions to help
•headache, determine if drug therapy is successful in
(6 or more controlling infection.
episodes per •lightheadedness,
year). •Monitor signs of renal failure, including
•swelling in your decreased urine output, increased blood
hands and feet, pressure, muscle cramps/twitching,
• The acute and feeling unwell edema/weight gain from fluid retention,
treatment of yellowish brown skin, and confusion that
(malaise).
progresses to seizures and coma. Report
herpes zoster these signs to the physician immediately.
•Serious side
(shingles) and
effects of Zovirax Client teaching :
varicella include renal
• Clients who are being treated with
(chickenpox). function problem. antiviral therapy should be instructed
about the importance of medication
compliance.
• Advice the clients to take this medication
by mouth with or without food as directed
by your doctor, usually 2 to 5 times a day.
THA NK
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