Aging:shingles-exam2

herpes zoster
-shingles
-reactivation of the varicella virus

shingles affects ____ people per year. You must have a history of ____ to get it.
50,000; chicken pox

shingles mostly affects _____. why?
older adults; vulnerable because have a history of chicken pox and most have a depressed immune system

Zostavax
-vaccine approved in 2006
-is 3 times booster sot of varicella vaccine
-for adults aged 60+

Zostavax: evidence for? $$?
-it can prevent shingles in about 1/2 of injected pts.
-not covered by medicare; only partially by insurance; usually $100-$150

What are some other risk factors for shingles?
-immunocompromised: vaccine not recommended
-post-trauma or stress
-post-op
-cancer: radiation therapy

clinical manifestations of shingles
1. prodrome (3-5 days prior to outbreak of rash)
2. eruption of vesicles atop inflamed skin (rash 2-4 wks)
3. blister like elevations containing serous fluid
4. vesicles rupture and crust in 10 days – 3 weeks

prodrome of shingles SS
itching, tingling, aching or sharp pain

the rash follows the path of _______. 50% are ____ and 15% are near ____.
-a unilateral nerve root- does not cross the midline
-around the waist, near the eye (refer to ophthalmologist b/c can cause corneal scarring or blindness)

When is the communicable stage of shingles?
when there are blister-like elevations containing serous fluid; only if have no immunity to chickenpox

average duration of herpes zoster
3 weeks

3 complications of shingles
1. bacterial skin infection when vesicles rupture
2. post-herpatic neuralgia
3. dissemination- occurring in 2-5% of cases

post-herpatic neuralgia
-occurs 1 to 3 months after crusting
-incidence: 10-15% of pts
-deep burning, stabbing, shock-like pain (often treated w/ neurontin- gabapentin)
-can last weeks, months, or indefinately
-very difficult to control
-often accompanied by depression

dissemination
systemic spread of herpes z infection

7 interventions for shingles
1. admin meds as ordered
2. keep skin lesions clean to prevent infection
3. local treatment usually ordered by MD
4. cool compress may help pain
5. enhance restful sleep
6. pain may interfere with sleep- treat this
7. acupuncture helps some

5 medications for shingles
1. acyclovir: anti-viral med given po or IV; should be started within 72 hours to decr. severity and communicability
2. corticosteroid therapy: decr. inflamm & pain, po or topical, topical cream may be combined w/ local anesthetic
3. analgesics prn- narcotics often needed
4. nerve block may be done
5. anti-depressant may also be helpful

etiology (Chickenpox and Shingles) Varicella-zoster virus (causes chicken pox)- enveloped dsDNA virus (HHV3) Shingles is local. transmission (Chickenpox and Shingles) Transmitted by the respiratory route, ~2 wks incubation, highly contagious WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC …

Dermatomes area of skin in which sensory nerves derive from a single spinal nerve root Shingles Painful blistering skin rash, caused by same virus as chicken pox, dormant and lives in Nervous System, affects where virus is residing, not contagious …

Chicken pox is caused by the ___ virus. varicella-zoster Varicella zoster is a member of the ___ family. herpes WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample The chicken …

Causative agent Varicella – Zoster Virus (VZV) Characteristics enveloped DNA virus related to Herpes simplex virus and Epstein – Barr virus WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample …

Snake Cinnabar (Shingles) AKA Herpes Zoster, this is a skin disease characterized by the eruption of vesicles running together like a string of beads associated with excruciating pain. It often occurs around the waist or on the chest and fact …

pathogen human herpesvirus 3 (varicella-zoster virus) -icosahedral, enveloped, DNA virus related to herpes simplex virus and Epstein-Barr virus latent virus in the nerve cells – does not cross the midline, follows a nerve path pathogenesis – 1st wave infection begins …

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