(Select all that apply) A nurse is providing care to a client diagnosed with shingles. Which of the following complications are associated with shingles?
Congestive heart failure.
Bell's palsy.
Chronic obstructive pulmonary disease.
Postherpetic neuralgia.
Acute pancreatitis.
Correct Answer : B,D
Choice B rationale:
Bell's palsy is a known complication of shingles (herpes zoster) The varicella-zoster virus (VZV), which causes chickenpox, remains dormant in the body and can reactivate as shingles later in life. Shingles can affect the facial nerve, leading to Bell's palsy, characterized by facial muscle weakness or paralysis on one side of the face.
Choice D rationale:
Postherpetic neuralgia is another complication associated with shingles. It is a persistent, severe pain that continues after the rash has healed, caused by nerve damage during the shingles infection. Choices A, C, and E rationales: Congestive heart failure (choice A), chronic obstructive pulmonary disease (choice C), and acute pancreatitis (choice E) are not directly related to shingles. These conditions are not commonly known as complications of shingles or the varicella-zoster virus infection.
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Correct Answer is B
Explanation
Choice A rationale:
The primary infection of VZV occurs through respiratory droplets, not when a person comes into contact with them. The virus is highly contagious and spreads through respiratory secretions.
Choice B rationale:
Reactivation of VZV in the nerve cells leads to the onset of shingles, not chickenpox. Chickenpox is the primary infection, and after recovery, the virus remains dormant in nerve cells and can reactivate as shingles later in life.
Choice C rationale:
The incubation period of VZV for chickenpox ranges from 10 to 21 days, which is accurate information.
Choice D rationale:
The risk of transmission during reactivation (shingles) is higher than during primary infection (chickenpox) Shingles can cause the development of vesicles containing the virus, which can be contagious if someone comes into direct contact with the fluid from the vesicles. Primary chickenpox, on the other hand, spreads through respiratory droplets and is more widespread during the initial infection.
Correct Answer is A
Explanation
Choice A rationale:
The nurse should recommend applying calamine lotion to soothe and dry the chickenpox lesions. Calamine lotion has a soothing effect on the skin and can help reduce the itching associated with chickenpox. It also helps to dry out the lesions, which may aid in the healing process. However, it is essential to advise the family not to apply calamine lotion on open sores or areas with broken skin to avoid potential irritation.
Choice B rationale:
Giving aspirin to a child with chickenpox is not recommended. Aspirin has been associated with an increased risk of Reye's syndrome in children with viral infections, including chickenpox. Reye's syndrome is a rare but potentially life-threatening condition that affects the brain and liver.
Choice C rationale:
Antiviral drugs, such as acyclovir, are often prescribed for severe cases of chickenpox or for individuals at high risk of complications. These drugs can help shorten the duration of the illness and reduce the severity of symptoms. They are not to be avoided to prevent side effects, as the benefits generally outweigh the potential risks.
Choice D rationale:
Allowing the child to play outside may not be the best approach to distract them from itching. It is crucial to prevent the child from scratching the rash to avoid secondary bacterial infections and scarring. Engaging the child in indoor activities and providing distractions that do not involve scratching would be a safer approach.
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