4 Herpes Zoster (Shingles) Nursing Care Plans

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Herpes zoster, also called shingles, is an infectious condition caused by varicella zoster virus (VZV), the same virus that causes varicella zoster (chickenpox). After a case of chickenpox run its course, the virus lies dormant in the ganglia of the spinal nerve tracts. Then the virus reactivates and travels along the peripheral nerves to the skin, where the viruses multiply and produce painful vesicular eruptions. It is most common in older adults and people who have weak immune systems.

Although VZV typically affects the trunk of the body, the virus may also be noted on the buttocks or face. If an ophthalmic nerve is involved, the client may potentially experience keratitis, ulceration and possibly blindness. Secondary infection resulting from scratching the lesions is common.

An individual with an outbreak of VZV is infectious for the first 2 to 3 days after the eruption. The incubation period ranges from 7 to 21 days. The total course of the disease is 10 days to 5 weeks from onset to full recovery. Some individuals may develop painful postherpetic neuralgia long after the lesions heal.

Shingles is characterized initially by a burning, tingling, numbness or itchiness of the skin in the affected area. VZV infection can lead to central nervous system (CNS) involvement; pneumonia develops in about 15% of cases. Approximately 20% of people who have had chickenpox will develop herpes zoster.

Nursing Care Plans

Major nursing goals for a client with shingles may include increased understanding of the disease condition and treatment regimen, relief of discomfort from the lesions, emphasis on strict contact isolation, development of self-acceptance, and absence of complications.

Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for patients with herpes zoster (shingles):

  1. Acute/Chronic Pain
  2. Deficient Knowledge
  3. Risk for Infection
  4. Risk for Disturbed Body Image
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Risk for Disturbed Body Image

Nursing Diagnosis

May be related to

  • Preoccupation with changed body part
  • Visible skin lesions

Possibly evidenced by

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  • [not applicable]

Desired Outcomes

  • Client will verbalize feelings about lesions and continues daily activities.
  • Client will demonstrate positive body image, as evidenced by the ability to look at, talk about, and care for lesions.
Nursing Interventions Rationale
Assess the client’s perception of his or her changed appearance. Because the course of an outbreak may span several weeks, clients typically need to work or carry out their usual routine; they may require assistance coping with changes in appearance.
Note verbal references to skin lesions. Scarring may occur with repeated outbreaks or if lesions are infected. This may cause a preoccupation with appearance.
Discuss reasons for infectious isolation and procedures when indicated. Taking time to sit down and talk/listen to the client in the room decreases the feeling of isolation and loneliness.
Assist the client in articulating responses to questions from others regarding lesions and infectious risk. Clients may need some guidance in determining what to say to people who comment on the appearance of their skin. The rehearsal of set responses to anticipated questions may provide some reassurance.
Suggest the use of concealing clothing when lesions can be easily covered. This approach may help the client who is having problems adjusting to body image changes.

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See Also

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Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.

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