NURSING CARE PLAN:

INTEGUMENTARY
DISODER
(HERPES ZOSTER)

PREPARED BY:
OCUBILLO, FRANCISE ELYN B.
BSN-III
ASSESSMENT DIAGNOSIS SCIENTIFIC BASE PLANNING IMPLEMENTATION RATIONALE EVALUATIO
N
SUBJECTIVE : Risk for Although VZV After 8 hours 1. Assess for - Secondary After 8 hours
of nurse-client
“mag katol siya maong infection as typically affects the of nurse-client pruritus or infection can occur interaction
paniguruon nko ug manifested by trunk of the body, the interaction irritations from because scratching patient
kawt.” itching and virus may also be noted patient will the lesions, and opens pustules demonstrate
- As verbalized scratching of on the buttocks or face. demonstrate the amount of introduces bacteria. measures to
by the patient. the infected If an ophthalmic nerve measures to scratching. decrease the
area(neck) . is involved, the client decrease the Assess for the risk for
OBJECTIVE: may potentially risk for signs of infection.
- Scratching of experience keratitis, infection. localized
the infected ulceration and possibly infection:
area blindness. Secondary redness and
- Skin around infection resulting from drainage from
the lesions is scratching the lesions is the lesions.
red and common. 2. Suggest the use
inflamed of gauze to - This reduces
- Lesions An individual with an separate the irritation, itching,
present outbreak of VZV is lesions in skin and cross-
infectious for the first 2 folds. contamination.
VITAL SIGNS: to 3 days after the 3. Discourage the
T: 37.2°C eruption. The scratching of - These measures
PR: 78 bpm incubation period lesions. prevent the
RR: 23 cpm ranges from 7 to 21 Encourage the inadvertent
BP: 130 / 80 days. The total course client to trim opening of lesions,
of the disease is 10 days fingernails. cross-
to 5 weeks from onset 4. Use universal contamination, and
to full recovery. Some precautions in bacterial infection.
individuals may caring for the
develop painful client to - VZV can be
postherpetic neuralgia prevent transmitted to
long after the lesions transmission of others and cause
heal. disease to self chickenpox in the
or other clients. person who has not
- nurseslabs. previously had the
com/herpes- disease.
zoster-shingles
5. Obtain - Viral cultures,
additional Tzanck smear, or
cultures and viral smear may be
blood work as required for
indicated. diagnosis.
Serological
diagnoses also may
be obtained.
 - Antiviral agents are
most effective
6. Instruct the during the first 72
client in the use hours of an
of antiviral outbreak when
medications, as viruses are
prescribed. proliferating.
Drugs of choice are
acyclovir,
famciclovir, or
valacyclovir.

- The use of steroids