Question

Sara is a 79-year-old patient who is seen in the clinic today for a painful rash that runs in a half-circle along her rib line. The rash is composed of raised, fluid-filled lesions. The patient describes the pain as the most severe pain she has ever experienced. The physician makes a diagnosis of shingles and gives the patient a prescription for acyclovir (Zovirax®). The patient has some questions for the nurse regarding the disease and the medication.

1. The patient asks the nurse why she has developed shingles. How will the nurse respond?

Answer:

Rationale:

2. Sara asks what adverse effects she can expect. How will the nurse respond?

Answer:

Rationale:

3. Sara returns to the clinic in 4 weeks, stating that she still has severe pain where the blisters once were. What would the nurse instruct Sara?

Answer:

Rationale:

4. How could Sara have prevented shingles? What would you tell other adults about the prevention of shingles?

Answer 1

Q. No 1. Answer :

Shingles : these are the viral infections, due to chickenpox virus. It is a painful and acute inflammation of the nerve ganglia, so that the skin eruption and blister formation on the body or middle of the body.

Why this shingles develop : means the nurse may respond to client like, it is a viral infection.

* caused by varicella zoster. Which is the causative organism for chickenpox also.

* after the developing of chickenpox, or after the cured from chickenpox, after some years there is a chance to develop this shingles.

* because one of the cause is weak immune system.

* and direct communication or contact with who are suffering chickenpox and if not immunized for chickenpox vaccine. These are the causes to get shingles.

Like this the nurse may respond to client.

Rationale :

After suffered from chickenpox, the virus will be stay in inactive state at the spinal cord nerve endings, when the person is have low immune power the virus may get active stage and it will cause the shingles or fluid filled rashes on the body.

Q. No 2. Answer :

Sever single may cause some of adverse effects on some major organs like eyes, nervous system, lungs, liver, and brain.

* some of the internal shingles may cause severe pain, redness, rash and abdominal pain, cough and fever and headache.

* first sign is tingling and numbness and burning sensation may develops then itching and rashes may come .

* so the nurse will respond to her these type of adverse effects may come so, the medical treatment is very important and necessary like that she will explain.

Rationale :

If not vaccinated or suffered from varicella virus it is in inactive state then come to activate, if not treated immediately through nervous system and poor immune system, it may spread to the vital organs.

Q. No 3. Answer :

* After the treatment it may take time at least 8 to 12 weeks, to recover from pain or to come down pain.

* some peoples may be recover from pain 3 to 5 weeks, it is depending on immune system of the body. And also age factor.

* educate the client to apply cold cloth or compress on rashes to reduce pain.

Rationale :

* Here the client age is 79 years old. Old-age people may have less immunity and less coping mechanism to the diseases.

* so the Time should be need to reduce from pain.

* so pain killers may help to reduce from pain.

Q. No 4. Answer :

Prevention of shingles :

* Shingles mainly prevented by taking vaccine of shingrix.

* so by vaccines given by after 50 years it may act like a preventative measurement for shingles.

* the patients may use cold compress to get reduce from their pain.

* by covering the rashes by cold clean clothes we may reduces the spreading of the shingles.

* there are availablility of two vaccines those are Shingrix, 0.5 ml, intramuscularly. Two doses, 0 dose and second dose on

2 - 6 months. For 50 years and older.

* one more Zostavax ,as a single dose subcutaneous, 50 to 60 years, and older.

* educate about adequate and good nutritious diet.

So like this we can provide as a nurse can educate the prevention of shingles.