Introduction
Herpes Zoster (HZ), or Shingles, is a cutaneous disease, characterized by a unilateral, dermatomal, and often painful vesicular rash. Following the primary infection of varicella zoster virus (VZV), the virus remains latent in the dorsal or cranial sensory ganglia. The outbreak typically results from reactivation of latent VZV.1 Herpes zoster (HZ) arises years or decades after primary infection with VZV, which is known in clinical settings as varicella and, in many instances, as chicken pox.1 HZ is primarily a disease in older adults or individuals with a weakened immune system. VZV is responsible for an estimated four cases of herpes zoster infection per one thousand people per year, with approximately 50% of these cases affecting patients at least 50 years old.1, 2 The number of incidences tends to increase proportionally with advancing age. Approximately 10-20% of the United States population will develop HZ, and about 50% are predicted to develop HZ in their life by the time they are 85.1, 2 Even though the number of people in the United States who get chickenpox each year has declined dramatically due to vaccinations, clinicians need to be educated about preventative strategies along with the current treatment options. This paper addresses correlating signs and symptoms of HZ, as well as existing treatments of acute HZ and post-herpetic neuralgia. It outlines current treatment strategies, along with deficiency of newest drugs and procedure implementations.
Clinical Presentation
HZ patients typically present with a characteristic, distinguishing unilateral, localized, vesicular eruption in dermatome distribution, that is often followed by an intensive localized prodromal pain. In rare instances, it is acco...
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... provider experience, management is often insufficient. Enhanced application of available treatment options, use of updated resources, complex approach to PHN management may play a superior role in treatment. Primary care is on the front line of patient care, diagnoses, and treatment. It plays an essential and crucial role in the development and execution of the PHN treatment plan. Patient treatment might be affected by multiple factors, ranging from medication compliance and side effects to drug cost. Sufficient management should be achieved starting with single drug, titrating additional treatment options as needed. Severe cases of PHN should be followed up by the use of topical anesthetic agents and paravertebral injections, if other means of therapy fail. Systematized and thoughtful PHN therapy will ensure sufficient pain relief and decrease the risk for PHN.
Arch Dermatol. 2007;143(1):124–125. Puchenkova, S. G. (1996). "
Barone, Eugene J., Judson C. Jones, and Joann E. Schaefer. "Hidradenitis Suppurativa." Skin Disorders. Philadelphia: Lippincott Williams & Wilkins, 2000. 21-25. Print.
Alternatives would be prescription of different dose of PRN and regular pain medicines and alternative pain treatment such as implanted pain pumps, nerve block therapy, massage therapy, relaxation and guided imagery , chiropractic treatment and oncology rehabilitation so that level of pain can be minimized.
Acute paronychia is clinically characterised by rapid onset of erythema, oedema, and tenderness of the proximal...
The Shingles is an extremely painful condition. Patients who suffer from the Shingles face immense physical pain. For patient L, a 21-year-old female from Davis, California, it was no different. She characterized her experience with the Shingles as starting off with sharp pain traveling up her back through her spinal cord, causing massive headaches. While she was in a lot of physical pain, patient L, being the lackadaisical 21-year-old she is, choose to ignore her discomfort. However, as the pain grew exponentially worse, she began to develop a brick-red rash as well as “puss-filled bulbs” on her back. These bulbs were extremely painful, especially when they were opened. The pain grew worse and the bulbs continued to protrude on her back. She
Shingles, herpes zoster, is a very contagious and painful rash, or blister that appears on the skin. These rashes most commonly appear on the sides of the body in stripes. The stripes are made up of many very painful blisters caused by a certain type of virus. The varicella zoster, most commonly known as the chicken pox virus attacks the nerve roots in that area. The herpes zoster virus is in the herpes family, including HSV, herpes simple virus, which causes cold sores, fever blisters, and genital herpes. (WebMD, 2011) Most people are required to get the chicken pox shot when they are children although some do not. The chicken pox shot helps to keep out the virus by keeping it dormant in the nerves. The varicella zoster virus stays in a few cells; this is how shingles appear suddenly. It appears when the dormant cells become active in the later years of life.
and ears, and in the mouth and pharynx. The causative virus has been shown to be
Dr. Kinghorn, G. (2014, January 14). Dr. george kinghorn: "an update on herpes simplex". Retrieved from http://www.herpes.org.uk/art_kinghorn.html
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
Prunella Vulgaris is flavinoid rich, an anti-inflammatory, high in tannins, and used in many existing herpes treatments. Tea Tree Oil is also an anti-viral, though it has no effect on the herpes virus after it has penetrated the cell and can be irritating to mucous membranes. St. John’s Wort is a very old traditional treatment studied since the early 90’s with no definitive effect on the herpes virus. St John’s Wort also interacts with numerous drugs, including oral contraceptives, serotonin reuptake inhibitors and triptans (migrane medications). Aloe Vera has anti-viral qualities and helps soothe and speed healing of existing lesions. Geranium Maculatum was an addition to the ingredients that puzzled us, as this is an herbal remedy that was used in the 1800’s primarily to treat diarrhea, and has no known effect or benefit to treat herpes. Geranium Maculatum is also high in
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
Schepis, Carmelo, Donatella Greco, and Corrado Romano. "Cardiofaciocutaneous (CFC) Syndrome." Australasian Journal of Dermatology 40.2 (1999): 111-13. Print.
The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia