Page 104 - LECTURE NOTES

or aching. In some patients the pain is absent and in some patients itching and

tenderness may occur over the area.
The lesions are grouped vesicles appear on the red and swollen skin following a

dermatone. The early vesicles contain serum and later, rupture and form crusts. The
inflammation is usually unilateral, involving the thoracic, cervical and cranial nerves.

The blisters are usually confined to narrow region of the face or trunk. The clinical
course varies from 1 to 3 weeks. If an ophthalmic branch of trigeminal nerve is involved

the patient may have painful eye. Inflammation and rash on the trunk may cause pain at

the slightest touch. In eye it causes keratitis, uveitis, ulceration and blindness. The
healing time varies between 7 and 26 days Herpes zoster in healthy adult is usually

localized and benign, however, in immuno suppressed patient, the disease may be

severe and the clinical course acutely disabling.

Management and Nursing intervention
The goal of treatment is to relieve the pain and reduce complication. These include

infection, scarring post herpetic nuralgia & eye complications.

1. The pain is controlled with analgesics and may require neurontin (gabapatin) for

pain conterol
2. Systemic corticosteroids given to patient over age of 50 to reduce the incidence

and duration of complication. Healing is usually more rapid in those who have
been treated with steroids.

3. started early antiviral drug such as systemic Acyclovir is effective in reducing the
pain and halting the progress of the disease and assess the discomfort and

response to medication on patient( try to get the patient in24 to 48 hours)

4. Apply wet dressing or medication to the lesion.
Wet dressing (Compresses) is usually used for acute, weeping inflammatory

lesion. This may be either sterile or non sterile.

5. Systemic antibiotic to control secondary infection.

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