Nursing Care Plans for Chickenpox – Best Nursing Care Plans(2022)

is article discusses Nursing Care Plans for Chickenpox plus its causes, symptoms, preventions, treatments and interventions.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Introduction

Chickenpox is an infection caused by the varicella-zoster virus. It causes an itchy rash with small, fluid-filled blisters. Chickenpox is highly contagious to people who haven’t had the disease or been vaccinated against it. Today, a vaccine is available that protects children against chickenpox. Routine vaccination is recommended by the U.S. Centers for Disease Control and Prevention (CDC).

The chickenpox vaccine is a safe, effective way to prevent chickenpox and its possible complications.

Nursing Care Plans for Chickenpox – Symptoms of Chickenpox

The itchy blister rash caused by chickenpox infection appears 10 to 21 days after exposure to the virus and usually lasts about five to 10 days. Other signs and symptoms, which may occur one to two days before the rash, include:

• Fever
• Loss of appetite
• Headache
• Tiredness and a general feeling of being unwell (malaise)

Once the chickenpox rash appears, it goes through three phases:

1. Raised pink or red bumps (papules), which break out over several days
2. Small fluid-filled blisters (vesicles), which form in about one day and then break and leak
3. Crusts and scabs, which cover the broken blisters and take several more days to heal

New bumps continue to appear for several days, so a patient may have all three stages of the rash — bumps, blisters, and scabbed lesions — at the same time. A patient can spread the virus to other people for up to 48 hours before the rash appears, and the virus remains contagious until all broken blisters have crusted over.

The disease is generally mild in healthy children. In severe cases, the rash can cover the entire body, and lesions may form in the throat, eyes, and mucous membranes of the urethra, anus, and vagina.

Nursing Care Plans for Chickenpox – Causes of Chickenpox

The varicella-zoster virus causes chickenpox infection. It can spread through direct contact with the rash. It can also apply when a person with chickenpox coughs or sneezes and inhale the air droplets.

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Nursing Care Plans for Chickenpox – Transmission of Chickenpox

Chickenpox is one of the most infectious diseases. People who have never had chickenpox, have never been vaccinated, or have a compromised immune system are at the highest risk of infection.

Transmission happens through direct contact between people through coughing or sneezing or by air.

VZV can also cause another condition known as shingles or herpes zoster. A person can also get chickenpox if they come in contact with fluid either from someone’s chickenpox or shingles blister.

Nursing Care Plans for Chickenpox – Risk factors of Chickenpox

People are at risk of becoming infected with the varicella-zoster virus that causes chickenpox if they haven’t already had chickenpox or if they haven’t had the chickenpox vaccine. It’s essential for people who work in child care or school settings to be vaccinated.

Most people who have had chickenpox or have been vaccinated against chickenpox are immune to chickenpox. A few people can get chickenpox more than once, but this is rare. If you’ve been vaccinated and still get chickenpox, symptoms are often milder, with fewer blisters and mild or no fever.

Nursing Care Plans for Chickenpox – Complications of Chickenpox

Chickenpox is normally a mild disease. But it can be severe and can lead to complications, including:

• Bacterial infections of the skin, soft tissues, bones, joints, or bloodstream (sepsis)
• Dehydration
• Pneumonia
• Inflammation of the brain (encephalitis)
• Toxic shock syndrome
• Reye’s syndrome in children and teenagers who take aspirin during chickenpox
• Death

Chickenpox and Pregnancy

Low birth weight and limb abnormalities are more common among babies born to women who are infected with chickenpox early in their pregnancy. When a mother is infected with chickenpox in the week before birth or within a couple of days after giving birth, her baby has a higher risk of developing a severe and life-threatening infection.

Nursing Care Plans for Chickenpox – Prevention of Chickenpox

The chickenpox (varicella) vaccine is the best way to prevent chickenpox. Experts from the CDC estimate that the vaccine provides complete protection from the virus for nearly 98% of people who receive both of the recommended doses. When the vaccine doesn’t offer full protection, it significantly lessens the severity of chickenpox.

The chickenpox vaccine (Varivax) is recommended for:

1. Young children

In the United States, children receive two doses of the varicella vaccine — the first between ages 12 and 15 months and the second between ages 4 and 6 years — as part of the routine childhood vaccination schedule.

The vaccine can be combined with the measles, mumps, and rubella vaccine, but for some children between the ages of 12 and 23 months, the combination may increase the risk of fever and seizure from the vaccine.

• Unvaccinated older children

Children ages 7 to 12 years who haven’t been vaccinated should receive two catch-up doses of the varicella vaccine, given at least three months apart. Children age 13 or older who haven’t been vaccinated should also receive two catch-up doses of the vaccine, given at least four weeks apart.

• Unvaccinated adults who’ve never had chickenpox are at high risk of exposure. This includes health care workers, teachers, child care employees, international travelers, military personnel, adults who live with young children, and all women of childbearing age.
• Adults who’ve never had chickenpox or been vaccinated usually receive two doses of the vaccine, four to eight weeks apart. If you don’t remember whether you’ve had chickenpox or the vaccine, a blood test can determine your immunity.

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The chickenpox vaccine isn’t approved for:

• Pregnant women
• People who have weakened immune systems, such as those who are infected with HIV or people who are taking immune-suppressing medications
• People who are allergic to gelatin or the antibiotic neomycin

Nursing Care Plans for Chickenpox – Diagnosis of Chickenpox

Physical exam – laboratory tests are not usually required in diagnosing chickenpox. The characteristic rashes combined with mild fever are critical in the diagnosis, although the rashes can be confused with other conditions such as scabies and insect bites. Laboratory tests, including blood tests and culture of lesion samples, can be performed in cases where a diagnosis is uncertain.

Blood test – to identify the presence of antibodies to the disease. The presence of antibodies suggests that the body will naturally be protected from the infection. On the other hand, the absence of antibodies.

Nursing Care Plans for Chickenpox – Treatment of Chickenpox

Chickenpox is self-limiting, and treatment is not necessarily required to stop the disease.

However, there are ways to ease the discomfort caused by its symptoms, and there are steps to take to stop the disease from spreading.

Painkillers. Painkillers are used for pain and mild fever. The use of aspirin and non-steroidal anti-inflammatory drugs are not recommended due to the complications they may cause, such as Reye’s syndrome and adverse skin reactions.

Proper hydration. Chickenpox can lead to dehydration. Maintaining adequate hydration helps prevent sores from getting worse.

Relieving pruritus. The blisters in chickenpox can be incredibly itchy. The following are the ways to prevent scratching of the spots:

• Keep fingernails clean and short.
• Use socks on hands or mittens at night.
• Use cooling gels to avoid discomfort.
• Use medications prescribed by doctors or recommended by pharmacists to stop or relieve itching.

Wearing cool clothing. Loose, smooth cotton fabrics prevent the lesions from being irritated.

Use of antiviral medicine. An antiviral medicine may be used to manage chickenpox. It does not cure chickenpox, but it helps manage the symptoms. It is commonly prescribed to the following population:

• Pregnant women
• Newborn babies
• People with a weak immune system

Immunoglobulin treatment. Immunoglobulin is a drug containing solutions of antibodies for chickenpox from healthy donors. It is in the form of an injection given to people at higher risk of developing severe infection.

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Nursing Care Plans for Chickenpox – Nursing Assessment for Chickenpox

Assessment of a child with chickenpox includes the following:

History taking. The history should elicit if a recent outbreak of chickenpox in the community has occurred and if any exposure to varicella at school, daycare, or among family members has occurred.

Immunizations. It should also be noted whether the child has previously received varicella vaccine or if the child is immunocompromised (including recent systemic steroid use) to help guide management.

Immunocompromised child. Immunocompromised children often have severe and complicated varicella, and their mortality rate is higher than that in immunocompetent children.

Nursing Care Plans for Chickenpox Based on Diagnosis

Nursing Care Plans for Chickenpox – Care Plan 1: Diagnosis – Impaired Skin Integrity related to infection of the skin secondary to varicella chickenpox

Evidenced by:

• Maculopapular rashes
• Blisters
• Scabs

Desired Outcome

The patient will re-establish healthy skin integrity by following a treatment regimen for varicella chickenpox.

Intervention	Rationale
Assess the patient’s skin on his/her whole body.	To determine the severity of varicella chickenpox and any affected areas that require special attention or wound care.
Isolate the patient in his/her room ideally during the first 7 days since the appearance of the rash, until after the blisters are completely dried up.	Varicella chickenpox is an infectious/contagious skin disease. It is also harmful for pregnant women as it can affect the unborn baby.
The affected area should be washed first in warm water, wet compresses may also be used. This is followed by the application of the prescribed antipruritic cream or ointment directly to the affected areas.	Cleansing the skin and applying the topical antipruritic cream promotes relief of itchiness due to shingles.
Administer antiviral medication as prescribed. Ensure that the patient finishes the course of antibiotics prescribed by the physician.	Varicella chickenpox can be treated through the use of antiviral therapy. If the rash leads to other skin breakdowns, which then gets a bacterial infection, antibiotics are prescribed. Application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection. Even if the symptoms have already improved and healing is evident, it is still important to finish the course of antiviral therapy for at least 7 days.
Educate the patient and carer about proper skincare through washing the rash with soap and water. Advise the patient and carer to prevent scratching the affected areas.	It is important to maintain the cleanliness of the affected areas by washing with mild soap and water. The rash may cause itching, but it is advisable to prevent the patient from scratching the affected areas to prevent worsening of the infection. a.     Use socks on hands or mittens at night. Use cooling gels to prevent discomfort.
Teaching the patient/ carer the proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.	Proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.

Nursing Care Plans for Chickenpox – Care Plan 2: Diagnosis – Risk for Infection related to a contagious skin infection

Desired Outcome

The patient will prevent the spread of infection to the rest of the body, as well as cross-contamination to other people by following a treatment regimen for varicella chickenpox.

Intervention	Rationale
Assess the patient’s skin on his/her whole body.	To determine the severity of varicella chickenpox and any affected areas that require special attention or skincare.
Isolate the patient in his/her room ideally during the first 7 days since the appearance of the rash.	Varicella Chickenpox is an infectious/ communicable skin disease. It is also harmful for pregnant women as it can affect the unborn baby.
Administer antiviral medication as prescribed. Ensure that the patient finishes the course of antibiotics prescribed by the physician.	Varicella chickenpox is generally treated through the use of antiviral therapy. If the rash leads to other skin breakdowns, which then gets infected by bacteria, antibiotics are prescribed.
Administer immunoglobulin as prescribed for patients in high-risk groups, such as pregnant women, newborns, and immunocompromised patients.	Immunoglobulin is a drug containing solutions of antibodies for chickenpox from healthy donors. It is in the form of an injection given to people at higher risk of developing severe infection.
Educate the patient and carer about proper wound hygiene through washing the rash with soap and water.	It is important to maintain the cleanliness of the affected areas by washing with mild soap and water. The rash may cause mild itching, but it is advisable to prevent the child from scratching the affected areas to prevent the worsening and spread of the infection.
Trim the patient’s fingernails and ensure frequent hand hygiene. Advise the patient and carer to prevent scratching the affected areas.	Long fingernails tend to harbor more bacteria. Scratching the infected skin areas will allow the bacteria to transfer into the fingernails and onto the fingerpads. When the patient touches other people or objects with infected hands, the infection will likely spread.
Teaching the patient/ carer the proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.	Proper application of non-stick bandages over the affected areas can also help prevent the spread of rash and further infection.

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Nursing Care Plans for Chickenpox – Summary

Chickenpox is a contagious illness caused by the varicella-zoster virus (VZV) that causes a highly itchy rash. Historically, most people have gotten it in childhood. If people get it as adults, they may be at risk for more serious symptoms and complications.

Since 1995, most people in the U.S. have received a vaccine for chickenpox. There are two types of chickenpox vaccines, which usually are administered twice in a person’s childhood.

The vaccine prevents about 90% of infections in the U.S. Some infections may still occur among unvaccinated or immunocompromised people.

Related FAQs

1. What is the nursing management for chickenpox?

Nursing Management

Treatment approaches include supportive measures, antiviral therapy, administration of varicella zoster immune globulin (VZIG), and management of secondary bacterial infection.

2. What interventions are required for patients with chickenpox or shingles?

Work restriction and isolation precautions

All patients with varicella or disseminated zoster should be placed on airborne and contact precautions until all lesions are crusted. For immunocompetent patients with dermatomal herpes zoster, standard precautions and complete covering of the skin lesions are recommended.

3. What are the 3 stages of chickenpox?

New bumps continue to appear for several days, so you may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time. You can spread the virus to other people for up to 48 hours before the rash appears, and the virus remains contagious until all broken blisters have crusted over.

4. Where do chickenpox usually start?

The rash may first show up on the chest, back, and face, and then spread over the entire body, including inside the mouth, eyelids, or genital area. It usually takes about one week for all of the blisters to become scabs. Other typical symptoms that may begin to appear one to two days before rash include: fever.

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