Varicella Chickenpox Nursing Diagnosis and Nursing Care Plan

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Varicella Chickenpox Nursing Care Plans Diagnosis and Interventions

Varicella Chickenpox NCLEX Review and Nursing Care Plans

Chickenpox, also known as varicella infection, is a common childhood illness caused by an infection from the varicella zoster virus. It is a highly contagious disease characterized by red, itchy rashes that turn into fluid-filled blisters.

It commonly affects children below 10 years of age.

The disease has an incubation period of 10 to 21 days, which means signs and symptoms will not appear immediately after exposure to the virus.

The person with the infection is contagious from 1 to 2 days prior to the onset of the rashes up until all the rashes crust.

People who have received chickenpox vaccine may develop lesions that do not crust. In these cases, they are deemed contagious until no new lesions appear for 24 hours.

After the disease takes its course, the virus lies dormant in the nerves where it will not cause any medical issues unless it is reactivated in the future.

Signs and Symptoms of Varicella Chickenpox

The characteristic rash associated with chickenpox typically occurs 10 to 12 days after exposure to the virus while the other signs and symptoms may show 1 to 2 days prior to the appearance of the rashes.

They may include the following:

  • Fever
  • Loss of appetite
  • Headache
  • Body malaise or a generalized feeling of tiredness

The chickenpox rashes go through three phases which are as follows:

  1. Rash or bumps – the appearance of maculopapular rashes or flat and raised red rashes occur over several days.
  2. Blisters – the raised rashes further turn into fluid-filled blisters within 1 to 2 days after they first appear. 
  3. Scabs – the formation of scabs is the last stage of the disease. The blisters dry off and form thick, brown-colored crusts that fall off after a few days.

Causes of Varicella Chickenpox

Chickenpox is caused by an infection from a virus called varicella zoster.

It is highly contagious and is often spread through direct contact with the rash or through contact with contaminated air droplets.

This can be via air droplets from somebody sneezing or coughing nearby or by contaminated inanimate objects such as doorknobs and surfaces.

The risk of getting chickenpox is higher in people who have not had the infection yet and those who did not receive the chickenpox vaccine.

It is unlikely for people who had chickenpox infection before to develop the condition again.

However, those who had the chickenpox vaccine can still acquire it with milder symptoms and fewer blisters. 

Complications of Varicella Chickenpox

  1. Bacterial infection of the skin – infection is the most common complication of chickenpox. It may start from the blisters and extend to the bones, tissues, and bloodstream.
  2. Reye’s syndrome. It is a condition that causes swelling of the liver and brain. It is known to be triggered by the intake of aspirin while recovering from a viral infection.
  3. Risks in pregnancy. It is known to cause low birth weight and limb abnormalities in babies born from women infected with the disease in the early stages of pregnancy. It can also cause life-threatening infections if the chickenpox occurs a few days prior to giving birth.
  4. Shingles. This is another infection caused by the varicella zoster virus. It occurs when the dormant virus from the chickenpox infection reactivates and causes painful clusters of blisters. It normally reappears in older adults with a low immune system.
  5. Dehydration
  6. Pneumonia
  7. Inflammation of the brain or encephalitis
  8. Toxic shock syndrome
  9. Death

** Pregnant women should any contact with anyone believed to have chickenpox. This can cause serious health risks to mother and baby.

Diagnosis of Varicella Chickenpox

  • Physical exam – laboratory tests are not usually required in diagnosing chickenpox. The characteristic rashes combined with mild fever are key in the diagnosis although the rashes can be confused with other conditions such as scabies and insect bites. In cases where a diagnosis is uncertain, laboratory tests including blood tests and culture of lesion samples can be performed.
  • Blood test – to identify the presence of antibodies to the disease. The presence of antibodies suggests that the body will naturally be protected from the infection. On the other hand, the absence of antibodies 

Treatment of Varicella Chickenpox

Chickenpox is self-limiting and treatment is not necessarily required to stop the disease.

However, there are ways to ease the discomfort caused by its symptoms and there are steps to take to stop the disease from spreading.

  1. Painkillers. Painkillers are used for pain and mild fever. The use of aspirin and non-steroidal anti-inflammatory drugs are not recommended due to the complications they may cause such as Reye’s syndrome and adverse skin reactions.
  2. Proper hydration. Chickenpox can lead to dehydration. Maintaining proper hydration helps prevent sores from getting worse.
  3. Relieving pruritus. The blisters in chickenpox can be incredibly itchy. The following are the ways to prevent scratching of the spots:
    • Keep fingernails clean and short.
    • Use socks on hands or mittens at night.
    • Use cooling gels to prevent discomfort.
    • Use medications prescribed by doctors or recommended by pharmacists to stop or relieve itching.
  4. Wearing of cool clothing. Loose, smooth, cotton fabrics prevent the lesions from being irritated.
  5. Use of antiviral medicine. An antiviral medicine may be used to manage chickenpox. It does not cure chickenpox, but it helps manage the symptoms. It is commonly prescribed to the following population:
  6. Immunoglobulin treatment. Immunoglobulin is a drug containing solutions of antibodies for chickenpox from healthy donors. It is in the form of an injection that is given to people who are at higher risk of developing severe infection.

Nursing Diagnosis for Varicella Chickenpox

Varicella Chickenpox Nursing Care Plan 1

Nursing Diagnosis: Impaired Skin Integrity related to infection of the skin secondary to varicella chickenpox, as evidenced by maculopapular rashes, blisters, and/or scabs

Desired Outcome: The patient will re-establish healthy skin integrity by following treatment regimen for varicella chickenpox.

Varicella Chickenpox Nursing InterventionsRationale
Assess the patient’s skin on his/her whole body.To determine the severity of varicella chickenpox and any affected areas that require special attention or wound care.
Isolate the patient in his/her room ideally during the first 7 days since the appearance of rash, until after the blisters are completely dried up.Varicella chickenpox is an infectious/ communicable skin disease. It is also harmful for pregnant women as it can affect the unborn baby.
The affected area should be washed first in warm water, wet compresses may also be used. This is followed by the application of the prescribed antipruritic cream or ointment directly to the affected areas.Cleansing the skin and applying the topical antipruritic cream promotes relief of itchiness due to shingles.
Administer antiviral medication as prescribed. Ensure that the patient finishes the course of antibiotic prescribed by the physician.Varicella chickenpox can be treated through the use of antiviral therapy. If the rash leads to other skin breakdown which then gets bacterial infection, antibiotics is prescribed. Application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection. Even if the symptoms have already improved and healing is evident, it is still important to finish the course of antiviral therapy for at least 7 days.
Educate the patient and carer about proper skin care through washing the rash with soap and water. Advise the patient and carer to prevent scratching the affected areas.It is important to maintain the cleanliness of the affected areas by washing with mild soap and water. The rash may cause itching, but it is advisable to prevent the patient from scratching the affected areas to prevent worsening of the infection. a.     Use socks on hands or mittens at night. Use cooling gels to prevent discomfort.
Teach the patient/ carer the proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.Proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.

Varicella Chickenpox Nursing Care Plan 2

Risk for Infection related to contagious skin infection

Desired Outcome: The patient will prevent spread of infection to the rest of the body, as well as cross-contamination to other people by following treatment regimen for varicella chickenpox.

Varicella Chickenpox Nursing InterventionsRationale
Assess the patient’s skin on his/her whole body.To determine the severity of varicella chickenpox and any affected areas that require special attention or skin care.
Isolate the patient in his/her room ideally during the first 7 days since the appearance of rash.Varicella chickenpox is an infectious/ communicable skin disease. It is also harmful for pregnant women as it can affect the unborn baby.
Administer antiviral medication as prescribed. Ensure that the patient finishes the course of antibiotic prescribed by the physician.Varicella chickenpox is generally treated through the use of antiviral therapy. If the rash leads to other skin breakdown which then gets infected by bacteria, antibiotics is prescribed.
Administer immunoglobulin as prescribed for patients at high-risk group, such as pregnant women, newborns, and immunocompromised patients.Immunoglobulin is a drug containing solutions of antibodies for chickenpox from healthy donors. It is in the form of an injection that is given to people who are at higher risk of developing severe infection.
Educate the patient and carer about proper wound hygiene through washing the rash with soap and water.It is important to maintain the cleanliness of the affected areas by washing with mild soap and water. The rash may cause mild itching, but it is advisable to prevent the child from scratching the affected areas to prevent worsening and spread of the infection.
Trim the patient’s fingernails and ensure frequent hand hygiene. Advise the patient and carer to prevent scratching the affected areas.Long fingernails tend to harbor more bacteria. Scratching the infected skin areas will allow the bacteria to transfer into the fingernails and onto the fingerpads. When the patient touches other people or objects with infected hands, the infection will likely spread.
Teach the patient/ carer the proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.Proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.

More Varicella Chickenpox Nursing Diagnosis

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines and policies and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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