Pediatric Nursing Demystified

Nursing Intervention

Monitor vital signs.

Increase fluids to reduce secretion viscosity.

Provide cool mist from a vaporizer for inflamed mucous membranes.

Place the child on droplet isolation if hospitalized.

Report the diagnoses to local health officials according to policy.

Explain the disorder and treatment to the family.

Nursing alert The patient is contagious beginning several days before a

rash appears and until 5 days after the rash disappears.

Varicella

What Went Wrong?

Varicella, commonly called chickenpox, is a viral infection caused by the vari-

cella zoster virus (VZV) that is transmitted by airborne droplets and by contact

with lesions. The VZV is latent in the dorsal root ganglia and can become reac-

tivated later in life as a herpes zoster infection, commonly called shingles. The

incubation period is between 10 and 21 days before the symptoms appear. Chil-

dren should receive the varicella vaccination beginning at 12 months of age.

Nursing alert Only the nonpregnant should come in contact with the

patient. Assume that a female who is of childbearing age is pregnant because

a woman in very early pregnancy may not know she is pregnant. Women of child-

bearing age should receive the rubella vaccine.

Signs and Symptoms

Early signs:

• Malaise


• Fever


• Anorexia
  Late signs:


• Itchy rash of red maculesbegins on the face, scalp, or trunk.


• Macules transform into small solid (not pus containing) elevation of
  the skin (papules).


• Papules develop into clear sacs (vesicles) with a red base.


• Vesicles break and scabs form a lesion.


• Lesions are crusted over.

Test Results

VZV antibody test: Positive

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