1. The client/caregiver can define herpes zoster (shingles).
   1. It is caused by the varicella-zoster virus, the same virus that causes the chicken pox.
   2. After you have had chicken pox, the virus lies dormant (not active) in your nerves. Years later, the virus may reactivate in the form of shingles.
   3. Pain from this disease can be severe.
   4. Risk factors are aging, stress, and an impaired immune system.
2. The client/caregiver can describe the symptoms of herpes zoster.
   1. It spreads along the nerve tract and causes pain and/or a burning sensation.
   2. Symptoms appear on one side of the body or face.
   3. A red rash appears with fluid-filled blisters that begin a few days after the pain.
   4. Fever appears.
   5. Headaches occur.
   6. Upset stomach occurs.
3. The client/caregiver can list measures to prevent the spread of shingles and how to manage the symptoms.
   1. Measures to prevent spread
      1. Until blisters dry and have scabs, avoid contact with anyone who has never had chicken pox, has a weak immune system, newborns, and pregnant women.
      2. Varivax was approved in 1995 as immunization for prevention of shingles. Children got immunized between the ages 12 and 18 months. Older children and adults who have never had chicken pox can receive this vaccine.
      3. The Zostavax vaccine was approved in 2006 for use to prevent shingles. It is recommended for adults over 60 years of age who have had chicken pox but not shingles.
   2. Measures to manage disease
      1. Physician may order pain medication, antidepressants, or anticonvulsant medication for relief of pain.
      2. Keep the affected area clean.
      3. Apply cool, wet compresses to affected areas.
      4. Soak in a tub of lukewarm water or use calamine lotion to relieve itching and discomfort.
      5. Get plenty of rest.
      6. Maintain a healthy diet.
      7. Consult the physician regarding the use of over-the-counter pain relievers.
4. The client/caregiver can describe possible complications.
   1. Postherpetic neuralgia, which occurs when the skin remains painful and sensitive to the touch for months or even years
   2. Inflammation of the brain (encephalitis)
   3. Hearing problems
   4. Temporary or permanent blindness
   5. Loss of facial movement
   6. Secondary skin infections

Resources

National Institute of Neurologic Disorders and Stroke
www.ninds.nih.gov

National Institute of Health for Seniors
www.nihseniorhealth.gov

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care.
Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott
Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com