The rash may also occur on the face, if it appears near the eye it can permanently affect vision. The pain of shingles can be mild to severe, and generally has a sharp, stabbing, or burning quality. Usually the pain is localized to the skin affected by the rash. Older adults compared to younger people generally experience more pain. Within three to four days, shingles blisters can become open sores. These sores may become infected with bacteria. The rash generally goes away within three to four weeks.
Scarring and skin color changes may be permanent. Most people recover from shingles without any lasting problems. Postherpetic Neuralgia PHN is a complication of shingles. PHN is a condition in which damage to sensory nerves, causes severe neuropathic pain. This pain can be continuous or intermittent. The pain can occur without external stimuli. However it may also be caused by external stimuli, light touch, the brush of clothing, and even wind can cause extreme pain.
The amount of pain from PHN greatly increases with age. PHN is defined as pain that last at least 3 months after all shingles lesions have went away.
Varicella-Zoster Virus Infection in Children and Adolescents
PHN is treated with:. These medications may all be used concurrently. Shingles can be diagnosed in the prodromal stage, before lesions appear but this is difficult as the symptoms in this stage can mimic many other illnesses. Virology of skin scrapings once the lesions have appeared is usually the only way to achieve a proper diagnosis. This is done by isolating the Varicella Zoster Virus Chickenpox in tissue culture cell lines. These two tests are also the most sensitive. Also contact dermatitis is pruritic and shingles is painful.
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If lesions of herpes simplex are not differentiated from shingles, doses of antibiotics appropriate for shingles should be used. However herpes simplex and shingles are differentiated by the staining of antibodies from vesicular fluid and identified under fluorescent light. Usually the lesions of these two disorders occur in different places. Shingles is usually treated with prescription oral antiviral drugs to significantly reduce the healing time of the infection.
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Anti inflammatory drugs are used to reduce inflammation, these may be prescription or OTC. Analgesic medication is also used to lower pain level; these may also be prescription or OTC. Antivirals used to treat shingles are:. Immunocompromised patients should be treated with IV Acyclovir at a dose of Glucocorticoid treatment should not be used unless there is concomitant antiviral therapy.
Analgesics usually used for shingles include: gabapentin, amitriptyline hydrochloride, lidocane patches, codeine, aspirin, acetaminophen, and, fluphenazine hydrochloride. Topical antipruritics such as calamine lotion can be used to reduce pruritis. The following nursing interventions should be applied to patients with shingles.
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Apply calamine lotion as liberally as directed by physician. Apply silver sulfadiazine to soften and debride lesions that are infected. Administer pain medication as prescribed. Patients with severe pain should be referred to a pain specialist. Maintain hygiene to prevent the infection from spreading to other parts of the body. If the patient has open lesions follow contact isolation to avoid spreading the infection to immunocompromised patients.
Patient should be reassured that the pain will eventually subside. Also cool wet compresses can be applied to the lesions for 20 minutes several times a day. Domeboro and Betadine soaks may be utilized to reduce crusting. The patient should be encouraged to wear loose fitting clothing to reduce irritation caused from clothing rubbing the lesions. New research regarding shingles has been in the area of prevention. Researchers have developed a preventive vaccine, Zostavax, marketed by Merck. Zostavax is a stronger version of the vaccine given to children to prevent chickenpox.
Even though an individual may still get shingles after vaccination, the vaccination reduces the risk of complications of shingles. The vaccine has not been utilized by many people because shingles is not a life threatening disease and there have not been many new vaccines for adults, so many people are not aware of this vaccination.
Is it shingles? Pictures and symptoms
Also the vaccine is not covered by insurance so many older adults that are on fixed incomes cannot afford it. Public education about shingles and the extremely painful complications associated with it are presumed to increase the use of this groundbreaking new vaccine. In conclusion shingles is a disease that can affect people that have had chickenpox at any age. However it affects mainly the elderly population.
Shingles usually presents with pain, numbness, tingling, burning, shooting pain, itching, fever, headache, chills, and, nausea. Shingles is treated with antivirals, analgesics, and antiinflammatories.
Usually a person can only have shingles but there have been rare occasions of people having it more than once. From a nursing stand point relieving pain and starting antiviral therapy are the highest priority interventions. Lastly with patient education about vaccines now available to prevent shingles. The incidence of people getting shingles, or having painful complications if they do get shingles is greatly reduced.
If you are the original writer of this essay and no longer wish to have the essay published on the UK Essays website then please:. Essays Health And Social Care. Essays, UK. November All Answers Ltd. Copy to Clipboard Reference Copied to Clipboard. She still maintained normal breathing sounds though. Abnormal red and mucous membrane erythematous rash and vesicles were observed around her left upper extremity. It was located around the C5 to C7 dermatomes, around the top of the left forearm.
During the examination many physical aliments were found.
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There was a weakness in the left deltoids and biceps muscles. Also there was a diminished left biceps reflex. Spiral CT scan of the chest with intravenous contrast and radionuclide pulmonary ventilation-perfusion scans were normal.
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