CHICKEN POX PPT Chickenpox is a common illness among kids, particularly those under age 12. An itchy rash of spots that look like blisters can appear all over the body and be accompanied by flu-like symptoms

Chickenpox is a common illness among kids, particularly those under age 12. An itchy rash of spots that look like blisters can appear all over the body and be accompanied by flu-like symptoms. Symptoms usually go away without treatment, but infection is very contagious. An infected child should stay home and take rest until the symptoms are gone.

1. welcomewelcome

2. C
HICKEN POX
C
HICKEN POX

3. INTRODUCTION
Chickenpox is a common illness among kids,
particularly those under age 12. An itchy rash of spots
that look like blisters can appear all over the body and
be accompanied by flu-like symptoms. Symptoms
usually go away without treatment, but infection is very
contagious. An infected child should stay home and
take rest until the symptoms are gone.

4. EPIDEMIOLOGYEPIDEMIOLOGY
The causative agent
Varicella-zoster(V-Z)
virus

5. EPIDEMIOLOGY EPIDEMIOLOGY con…,con…,
Source of infectionSource of infection

primary secretion of primary secretion of
respiratory tract of respiratory tract of
infected personsinfected persons

skin lesions.skin lesions.

6. Transmission
Direct contact,
Droplet ( airborne ) spread,
Contaminated objects.
EPIDEMIOLOGY con…,

7. Incubation period
2 -3 weeks,
usually 14 – 16 days.
EPIDEMIOLOGY con…,

8. Reservoir
 Man is the only reservoir
Prevalence
There is no age limit
for this illness,

Majority of the cases are
young children
of 5 to 10 years of age.
Second attacks of
chickenpox is rare.
EPIDEMIOLOGY con…,

9. Pre-eruptive or Pre
dromal stage
 Slight fever
 Malaise and anorexia
 Back pain,
 Shivering
CLINICAL MANIFESTATION

10. CLINICAL MANIFESTATION con…,
The eruptive stageThe eruptive stage

Rash is the Rash is the
first sign. first sign.

Mild to moderate Mild to moderate
fever,fever,
 Rarely Rarely Cough,Cough,
 Rhinitis, Rhinitis,
Abdominal pain,Abdominal pain,
Lethargy, Lethargy,

Malaise, nauseaMalaise, nausea

11. CLINICAL MANIFESTATION con…,
The eruptions pass The eruptions pass
through the stages i.e. through the stages i.e.
macule , papule, vesicle, macule , papule, vesicle,
pastule, and crusts.pastule, and crusts.
 The distribution of The distribution of
rash is symmetrical and rash is symmetrical and
first appears on the first appears on the
trunk and scalp; then on trunk and scalp; then on
the face, arms, and legs.the face, arms, and legs.

12. CLINICAL MANIFESTATION con…,
The trunk is covered The trunk is covered
profusely , whereas profusely , whereas
extremities and face are extremities and face are
having scanty rash . having scanty rash .
 Mucosal surface Mucosal surface
including buccal , including buccal ,
pharyngeal and pharyngeal and
conjunctiva are conjunctiva are
generally involved.generally involved.

13. PATHOPHYSIOLOGY

Pathological changes are limited to skin

and respiratory tract.



The skin lesions found as macules which
quickly develop into papules and vesicles
with scab and crust formation.

Degeneration of cells in the vesicles result in

multinucleated cells containing intra
nuclear inclsions.

14. The inclusion bodies and foci of necrosis may
be present in esophagus, pancreas, liver,
adrenal gland and genitourinary tract.
This may cause disseminated interstitial
pneumonia, encephalitis, perivascular
demyelination.
The V-Z virus may remain latent and can
use herpes-zoster in later life.
 
The virus has a potential for oncogenicity

17. DIAGNOSIS

Chickenpox is usually diagnosed by clinical
manifestations. It should be differentiated from
other skin lesions like
 Impetigo.
 Herpes urticaria,
It is differentiated from smallpox, which is
already eradicated.
 Virus isolation.
 Antibody test can be done.

18. INFECTION IN PREGNANCY AND INFECTION IN PREGNANCY AND
NEONANEONATESTES
For pregnant women, antibodies produced as a result For pregnant women, antibodies produced as a result
of immunization or previous infection are transferred of immunization or previous infection are transferred
via the placenta to the fetus.via the placenta to the fetus.
Women who are immune to chickenpox cannot Women who are immune to chickenpox cannot
become infected .become infected .
Varicella infection in pregnant women can lead to Varicella infection in pregnant women can lead to
viral transmission via the placenta and infection of the viral transmission via the placenta and infection of the
fetus.fetus.

19. INFECTION IN PREGNANCY AND INFECTION IN PREGNANCY AND
NEONATES con…,NEONATES con…,

If infection occurs during
the first 28 weeks of
gestation this can lead to
fetal varicella syndrome
 Effects on the fetus can
range in severity from
underdeveloped toes and
fingers, severe anal and
bladder malformation.

20. Possible problems includePossible problems include
Damage to the eyeDamage to the eye

 Optic stalkOptic stalk
 Optic capOptic cap
 MicrophthalmiaMicrophthalmia
 CataractCataract
 optic atophyoptic atophy
Damage to brain
Encephalitis
MicrocephalyMicrocephaly
Hydrocephaly

21. Possible problems Possible problems con…,con…,
Neurological disorder:Neurological disorder:

Damage to cervical Damage to cervical
and lumbo sacral and lumbo sacral
spinal cordspinal cord
Motor/sensory Motor/sensory
deficits, absent deep deficits, absent deep
tendon reflexestendon reflexes
Damage to body: Damage to body:

Hypoplasia

of upper/lower
extremities,
 Anal and bladder
sphincter dysfunction

22. Skin disorders:
skinlesions,
hypo pigmentation

23. NEONATAL VARICELLANEONATAL VARICELLA

If the child gets chicken pox following birth is referred to If the child gets chicken pox following birth is referred to
as “ neonatal Varicella”as “ neonatal Varicella”

Maternal infection is associated with premature delivery. Maternal infection is associated with premature delivery.

The risk of the baby developing the disease is greatest The risk of the baby developing the disease is greatest
following exposure to infection in the period 7 days prior to following exposure to infection in the period 7 days prior to
delivery and up to 7 days following the birth.delivery and up to 7 days following the birth.

24. NEONATAL VARICELLA NEONATAL VARICELLA con…,con…,

The baby may also be exposed to the virus via The baby may also be exposed to the virus via
infectious siblings or other contacts, but this is infectious siblings or other contacts, but this is
of less concern if the mother is immune. of less concern if the mother is immune.

Newborns who develop symptoms are at a high Newborns who develop symptoms are at a high
risk of pneumonia and other serious risk of pneumonia and other serious
complications of the disease.complications of the disease.

25. TREATMENTTREATMENT

The antiviral The antiviral
medicine medicine acycloviracyclovir
may be prescribed may be prescribed
for people with for people with
chickenpox who are chickenpox who are
at risk for at risk for
complications.complications.

26. TREATMENT con…,
The drug, which can make the infection less
severe, must be given within the first 24
hours after the rash appears.
 Acyclovir can have significant side effects, so
it is only given when necessary.

27. TREATMENT con…,TREATMENT con…,

A topical barrier A topical barrier
preparation containing preparation containing zinc zinc
oxideoxide is one of the most is one of the most
commonly used commonly used
interventions, it has an interventions, it has an
excellent safety profile.excellent safety profile.
To relieve the symptoms of To relieve the symptoms of
chicken pox, people chicken pox, people
commonly use anti-itching commonly use anti-itching
creams and lotions like creams and lotions like
calamine lotion.calamine lotion.

28. TREATMENT con…,
 These lotions are not to be used on the face or
close to the eyes.
Pain killers could be taken to prevent feeling
itching.
Bath also might help to reduce the discomfort.

29. TREATMENT con…,

It is important to maintain good hygiene
and daily cleaning of skin with warm water
to avoid secondary bacterial infection.
 Scratching may also increase the risk of
secondary infection, so cut short the nails.
 Addition of a small quantity of vinegar to
the water is sometimes advocated.

30. PREVENTION & CONTROl PREVENTION & CONTROl

Isolation of the patientIsolation of the patient

Disinfection of oro nasal Disinfection of oro nasal
discharge and solid discharge and solid
articlesarticles
Terminal disinfection of Terminal disinfection of
roomroom

31. Prevention & control Prevention & control con…, con…,
Passive immunization Passive immunization
with normal human with normal human
immunoglobin ( VZIG - immunoglobin ( VZIG -
Varicella zoster Ig ) given Varicella zoster Ig ) given
with 72 hours exposure with 72 hours exposure
dose in 0.4 cc to 1.2 cc / dose in 0.4 cc to 1.2 cc /
kg body weight.kg body weight.

32. Prevention & control Prevention & control con…, con…,

Active immunization with Active immunization with
line alternated Varicella line alternated Varicella
vaccinationvaccination
Other air born illness Other air born illness
control measurescontrol measures
Use personal protective Use personal protective
equipment in hospitalequipment in hospital

33. Prevention & control Prevention & control con…, con…,

Frequent hand washing.Frequent hand washing.

Follow aseptic technique Follow aseptic technique

wash the clothe with wash the clothe with
antiseptic solution. antiseptic solution.

Dry the clothes under Dry the clothes under
sun light. sun light.
  

34. PROGNOSIS
Chicken pox is usually a self limiting disease
with good prognosis.
In case of serious complications like
encephalitis especially in immune compromised
children the prognosis may be worsen.

35. COMPLICATIONS
In most cases chickenpox is mild and self-
limiting . the mortality rate is less than one
percent in complicated cases . though rare , the
following complications may be found .

36. Superadded skin infection( cellulites , abscess)
 Septicemia
 Bronchopneumonia
 Encephalitis and
 Neurological problems , like cerebellar
ataxia optic neuritis,
 Facial nerve palsy
COMPLICATIONS con…,

37. Other complications include
Appendicitis, Appendicitis,

Myocitis, Myocitis,
 Thrombocytopenia, Thrombocytopenia,
 Purpura fulminants,Purpura fulminants,

Reye’s syndrome and Reye’s syndrome and
 Herpes zoster.Herpes zoster.
Supportive arthritis,Supportive arthritis,

Osteomyelitis,Osteomyelitis,
 Myocarditis ,Myocarditis ,
 Hepatitis,Hepatitis,

Glomerulonephritis, Glomerulonephritis,

38. NURSING DIAGNOSIS NURSING DIAGNOSIS

39. 1.Increased body temperature
hyperthermia related to infectious process.
 Assess the physiological status, skin
temperature, vital signs and environment
for heat and cold.
 Provide stable environmental
temperature and adequate clothing.
 Provide more amount of oral fluids.
 Provide proper ventilation.
 Give sponge bath.
 Give more fruit juices.

40. 2. pain related to skin lesions, malaise
 Assess the level of pain.
 Use cool mist vaporizer, to keep mucous membranes
moist.
 Apply Vaseline to the dry lips.
 Keep skin clean.
 Change the bed cloth and linen at least daily.
 Give cool bath because overheating increasing
itching.
 Assess the need for pain medication.
 Administer antipyretic, analgesic, anti purities as
needed.

41. 3. Impaired skin integrity related to scratching
from purities
 Keep nails short and clean to minimize trauma
and secondary infection.
 Apply mittens or elbow restrains to prevent
scratching.
 Dress in light weight, loose and non irritating
clothes.

42.  Bath in cool water with no soap or apply
cool compress.
 Apply soothing lotions to decrease purities .
 Cover affected areas ( long sleeves, pants, ) to
prevent scratching.
 Avoid exposure to heat or sun, which can
aggravate rash.

43. 4. Imbalanced nutrition less than body
requirement related to poor intake of food.
Assess the nutritional status of the child.
Give more amount of liquid food like fruit
juices.
Maintain intake and out put chart.

44.  Check body weight daily.
 Serve foods that are cold, soft, and bland diet.
 Avoid feeding the child anything highly acidic
especially like orange juice, and salty foods.
 Provide small frequent liquid diet.

45. 5. Risk for infection related to susceptible
host and infectious agent
 Isolate the child in separate room.
 Follow aseptic technique.
 Use clean linen for bed.
 Use clean clothe after washing it with antiseptic
solution.
 Dry the clothe under sun light.

46. Avoid more visitors .
Proper preparation and handling of food and
water supplies.
Identify close contact who may require
prophylactic treatment.
Maintain good body hygiene.

47.  Inform parents of treatment option, especially
acyclovir for Varicella.
 Reinforce family’s effort to carry out the plan of care.
 Provide assistance when necessary, such as visiting
nursing to help to home care.
 Keep family aware of recovery in most cases to
decrease anxiety.
6. Altered family process related to child with
an acute illness

48. Thank you
Thank you
T
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