NUR332:MEDICAL NURSINGIII

COURSE FACILITATOR: MRS. CHRISTIANA OKANTEY

GROUP PRESENTATION (GROUP 1B)

HERPES ZOSTER
CONTENT
 Introduction to herpes zoster

 Causes of herpes zoster

 Incidences of herpes zoster

 Pathophysiology of Sinusitis

 Clinical manifestations of herpes zoster

 Diagnostic measures for herpes zoster

 Medical and surgical managements of herpes zoster

 Patient and the family education

 Rehabilitation measures

 Coping strategies
OBJECTIVES
By the end of this presentation, pupils will be able to;

 Give an overview of herpes zoster

 List the causes of herpes zoster

 Know the incidences of herpes zoster

 Describe the pathophysiology of herpes zoster

 List the clinical manifestations of herpes zoster

 Know the diagnostic measures for herpes zoster

 Know the medical and surgical managements of herpes zoster

 Educate the patient and the family on herpes zoster

 OVERVIEW OF HERPES ZOSTER

 Herpes zoster, also known as shingles,

is caused by the reactivation of the
varicella-zoster virus (VZV), that is, the
virus that causes varicella (chickenpox).

 Herpes zoster is a viral infection that

causes an outbreak of a painful rash or
blisters on the skin.

 Primary infection with VZV causes

varicella. Once the illness resolves, the
virus remains latent in the dorsal root
ganglia.

 VZV can be reactive later in a person’s

life and cause a painful, maculopapular
rash called herpes zoster
 OVERVIEW OF HERPES ZOSTER

 When a child has

chickenpox, the body fights
off the varicella-zoster virus
and the physical signs of
chickenpox fade away, but
the virus always remains in
your body.

 In adulthood, sometimes the

virus becomes active again.
This time, the varicella-zoster
virus makes its second
appearance in the form of
shingles
 CAUSES OF HERPES ZOSTER

 Exposure to the virus.

 Emotional stress.

 Use of medications (immunosuppressant).

 Acute or chronic illness.

 INCIDENCE OF HERPES ZOSTER

 The incidence of herpes zoster can vary depending on

several factors including age, immunological status and
geographic location.

 Age: It is more common among older adults and the

elderly. This is primarily due to the decline in cellular
immunity and a decrease in VZV-specific immunity
that occurs with aging.

 Immunocompromised individuals: Their

compromised immune system allows the reactivation of
the latent VZV.

 Geographic variation: The incidence of herpes zoster

may vary across different regions or countries
 PATHOPHYSIOLOGY
The pathophysiology of herpes zoster involves several stages:

 Reactivation: This is usually due to a immunosuppression,

stress, and certain medical conditions can increase the risk.

 Viral replication: Once reactivated, the VZV travels along the

sensory nerve fibers and reaches the skin, causing
inflammation and damage along its path. The virus replicates
within the nerve cells and spreads to neighboring cells.

 Inflammatory response: As the virus replicates, the immune

system recognizes the presence of the virus and triggers an
inflammatory response in the affected nerve, causing pain,
itching, and other sensory disturbances.
 PATHOPHYSIOLOGY

 Vesicular rash: Within a few days of the onset of

symptoms, a characteristic rash appears. It consists
of clusters of fluid-filled blisters, which are usually
limited to a specific area of the skin corresponding to
the affected dermatome. The rash is often
accompanied by severe pain, burning, or tingling.

 Healing and complications: Over time, the blisters

crust over and eventually heal. In most cases, herpes
zoster resolves within 2-4 weeks. However, in some
individuals, especially older adults or those with
weakened immune systems, complications may arise
 CLINICAL MANIFESTATIONS
 Pain that is burning and tingling

 Rash manifests as erythema and macules, followed by papules

 Lesions that tend to cluster at contagious nerve branches

 Sensitivity to light

 Sensitivity to touch

 Fatigue

 Fluid-filled blisters that break open and crust over

 Itching

 Headache

 Fever
 DIAGNOSTIC MEASURES
 Physical Examination: A
doctor examines the affected
area to visually confirm the
presence of herpes zoster
blisters or rash.
 Polymerase Chain Reaction
(Pcr) Test: This test is used
to detect the DNA of the
Varicella-Zoster Virus (VZV)
in blood, fluid or tissue
samples.
 Serologic Tests: Blood tests
can detect the presence of
VZV antibodies, which the
body produces in response to
a herpes zoster infection.
 Tzanck Smear: This test involves
taking a fluid sample from the
blisters and testing it under a
microscope to find herpes zoster
virus particles.
 Skin Biopsy: A small sample of
the affected skin is taken and
examined under a microscope to
confirm the presence of herpes
zoster virus.
 Magnetic Resonance Imaging
(MRI): In severe cases, MRI may
be used to detect nerve damage
caused by herpes zoster.
 NURSES RESPONSIBILITIES DURING
DIAGNOSTIC PROCEDURE

 Educate the patient about the procedure

 Obtain informed consent

 Prepare the patient

 Assist the physician or other healthcare provider

 Monitor the patient's vital signs

 Document the procedure

 MEDICAL MANAGEMENT

 Administer antiviral medication. eg Acyclovir,

Famciclovir or valcyclovir.

 Non-steroidal anti-inflammatory drugs can also be

prescribed to reduce the pain and swelling.

 Applying a medicated anti-itch lotion (Benadryl,

Caladryl) to the blaster might reduce the pain and
itching.

 Vaccination can be recommended to prevent

complications in adult and those with weakened
immune system.
 SURGICAL MANAGEMENT
Peripheral nerve surgery
An incision is made over the involved nerve area to
access and remove painful nerves. In most cases the
excised involved sensory nerves would result in
numbness along affected skin area, while no motor
deficits are expected. The skin is closed in anatomical
layers.
 PSYCHOLOGICAL MANAGEMENT

 Seek professional help

 Practice relaxation techniques

 Connect with support groups

 Engage in enjoyable activities

 PATIENT AND FAMILY EDUCATION

 Practice good hygiene

 Manage pain

 Get plenty of rest

 PREVENTIVE MEASURES

 Get vaccinated

 Maintain a healthy lifestyle

 Manage stress

 Avoid contact with people who have shingles

 Wash your hands regularly

 COMPLICATIONS
 Post Herpetic Neuralgia (Phn)

 Vision loss

 Bacterial skin infections

 Neurological complications

 Ramsay Hunt syndrome

 REHABILITATION
 Pain management: Shingles can cause intense pain, and effective
pain management is crucial. Non-steroidal anti-inflammatory
drugs (NSAIDs)

 Wound care: Proper wound care is essential to prevent secondary

infections. Keep the affected area clean and dry, and avoid
scratching the rash to prevent further complications.

 Rest and self-care

 Psychological support: Dealing with the physical and emotional

impact of shingles can be challenging. If needed, consider
counseling or therapy to help cope with any emotional distress or
anxiety related to the condition.

 Physical therapy: In some cases, shingles can cause weakness,

limited mobility. Physical therapy may be beneficial to regain
strength, improve flexibility, and reduce pain
COPING STRATEGIES FOR THE PATIENT AND
FAMILY

 Follow the treatment plan

 Provide emotional support

 Maintain a healthy lifestyle

 Practice self-care
 CONCLUSION

In conclusion, Herpes zoster, also known as shingles, is

caused by the reactivation of the varicella-zoster virus
(VZV), that is, the virus that causes varicella
(chickenpox). When a child has chickenpox, the body
fights off the varicella-zoster virus and the physical signs
of chickenpox fade away, but the virus always remains
in your body which reactivates later in adulthood as
shingles.
INDEX NUMBERS NAMES
SN/NUS/20/0015 RACHEAL YAWSON

SN/NUS/20/0008 LINDA OPOKU

SN/NUS/20/0001 OSBORN AYISI

SN/NUS/20/0011 CYNTHIA JACKSON

SN/NUS/20/0005 MARTHA SEKYIWAH

SN/NUS/20/0003 BRIGHT HAGAN

SN/NUS/20/0133 SAMUEL KINGSLEY KOOSOM

SN/NUS/20/0004 MARIAM AMOATENG

THANK YOU