SHINGLES (HERPES ZOSTER)

After chickenpox infection, the varicella zoster virus (VZV) lies dormant in the ganglia of the spinal nerve tracts. Shingles is an infectious viral condition caused by a reactivation of this latent VZV. Reactivation usually occurs in individuals with impaired inmunity; it is common among older adults. 

VZV produces painful vesicular eruptions along the peripheral distribution of nerves from posterior ganglia and is usually unilateral and characteristically occurs in a linear distribution, abruptly stopping at the midline both posteriorly and anteriorly. Although VZV typically affects the trunk of the body, the virus may also be noted on the buttocks or face. With facial involvement there is concern about involvement of the eye and cornea, potentially resulting in permanent loss of vision. Secondary infection resulting from scratching the lesions is common.

Shingles is characterized by burning, pain and neuralgia.

An individual with an outbreak of VZV is infectious for the 2 to 3 days after the eruption. The incubation period ranges from 7 to 21 days. The total course of the disease is 10 days to 5 weeks from onset to full recovery.

Some individuals may experience painful postherpetic neuralgia long after the lesions heal. 

Common risk factors:
-Skin lesions (papules, vesicles, pustules).
-Crusted-over lesions.
-Itching and scratching.
Common expected outcomes:
-Patient remains free of secondary infection, as evidenced by intact skin without redness or lesions.
-Risk for disease transmission is minimized through use of universal precautions.

Source: Nursing Care Plans Diagnoses, Interventions and Outcomes. Meg Gulanick, 8th Edition.