Definition
June
M. Thomson defines varicella as a disease caused by the varicella-zoster (VZ
virus) is a highly contagious acute commonly put any child, which is
characterized by a sudden fever, malese, and maculopapular skin eruptions form
for a few hours and then turned into vesicles for 3 -4 days and can leave the
scab (Thomson, 1986, p. 1483).
Meanwhile,
according Adhi having Djuanda varicella or chickenpox chickenpox synonym is a
primary acute infection by the varicella-zoster virus that attacks the skin and
mucosa are clinically constitutional symptoms, skin disorders, especially in
the central body polimorfi (Djuanda, 1993).
Epidemiology
Spread
cosmopolitan, attacking mainly children but can also affect adults. The
transmission of this disease is aerogen. Period of communicability
approximately 7 liver was calculated from the onset of symptoms of the skin.
Etiology
The
cause of varicella is varicella-zoster virus. The naming of this virus gives
the sense that the primary infection with this virus causing varicella disease,
whereas reactivation (relapse state after recovering from varicella) zoster
causes herves.
Clinical
Manifestations
The
incubation period of this disease lasts 14-21 days. Clinical symptoms from the
prodromal symptoms, ie fever is not too high, malese and headache, followed by
the onset of skin eruption erythematous papules that form within a few hours
turned into vesicles. Vesicle shape typical of dew drops (tear drops). Vesicles
will turn into pustules and then to crusting. While this process arise again in
the new vesicles causing polimorfi picture.
The
distribution is mainly areas in the body and then spreads to the face and
extremities centrifuges, and can attack mucous membranes of the eyes, mouth and
upper respiratory tract. If there is a secondary infection is enlarged regional
lymph nodes (regional lymphadenopathy). The disease is usually accompanied by
intense itching.
Complication
Complications
in children are generally rare and arise more frequently in adults, such as
encephalitis, pneumonia, glumerulonephritis, carditis, hepatitis, keratitis,
konjunctivitis, otitis, arteritis, and several kinds of purpura.
Infections
that occur in the first trimester of pregnancy can cause abnormalities
konginetal, while the infections that occurred a few days before birth can
cause neonatal varicella konginetal.
Maid
Diagnosis
Tzanck
test can be done by making clear that preparations stained with Giemsa.
Material taken from the base vesicle scrapings and will be found many nucleated
cells Datia (multinukleated).
Differential
Diagnosis
Must
be distinguished from variola, the disease is more severe, giving an overview
monomorf, and spread starting from the body akral the palms and soles of the
feet.
Management
Treatment
is symptomatic with antipyretic and analgesic, to relieve itching can be given
sedatives. Locally supplied powder coupled with an anti itch (antipruritus)
such as menthol, camphor, etc., to prevent premature rupture of vesicles and
relieve itching. If there is a secondary infection can be given in the form of
ointment and oral antibiotics. Can also be given anti-viral drugs such as
acyclovir with dosisi 5 x 400 mg daily for 7 days with fairly good results.
Moreover, it can also be given as isoprinosin imunotimulator. One dose of 500
mg. The dose of 50 mg / kg of body weight a day, with a maximum of 3000 mg
daily dosisi. Generally the dosage for adults 6 x 4 x 1 tablet or 1 tablet a
day. Duration of treatment until the disease improves. The drug is administered
when the disease has been long over 3 days.
Prognosis
With
meticulous care, and always pay attention to cleanliness (hygiene) and the environment
provide a good prognosis and possible scarring, just a little, but if the
client did scratch / other acts that cause damage to the skin.
Assessment
•
Symptoms of subjective complaints such as headache, anorexia and malese.
•
In the skin and mucous membranes:
Lesions
in various stages of development: from erythematous macules appear for 4-5 days
and then quickly become vesicles and crusting that began in the body and spread
sentrifubal forward and extremities. Lesions may also occur on the mucosa,
palate and konjunctiva.
•
Temperature: fever can occur between 38 ° -39 ° C
Nursing
Diagnosis and Intervention
Actual
or potential disruption of skin integrity
•
Encourage bathe regularly
•
Avoid scratching the lesions
•
Use a soft clothes / soft
Impaired
sense of comfort: pain
•
Use of analgesics and powder antipruritus.
•
Keep the room temperature stays cool with adequate moisture.
Potential
transmission of infection
•
Perform isolation (strict isolation):
Strict
isolation procedures:
a.
Separate room; door should always be closed. Clients who become infected by the
same organism can be placed in the same room.
b.
Use masks, special clothing, and gloves for all those who enter the room.
c.
Always wash your hands after touching the client or objects that are likely
contaminated and before giving action to other clients.
d.
All contaminated objects discarded or put into a special place and labeled
prior to decontamination or reprocessing back
Lack
of knowledge
•
Teach the parents in the treatment of his son in ruamah on things above.
•
Explain that the fever d apat resolved by tepid sponge bath.
Jealskan
that the use of medication must be in accordance with the instructions dikter
Evaluation
Function
of the skin and mucous membranes well with minimal scarring.
•
crusting is reduced
•
skin temperature, moisture and color of skin and mucous membranes of normal
natural
No
complications and secondary infections
•
There were no neurologic abnormalities
•
Do not happening respiratory disorders.
Normal
body temperature.
Literature
1.
Adhi Djuanda (1993). Skin Disease and Gender Studies, Second Edition, FK
University of Indonesia, Jakarta, 1993.
2.
June M. Thomson, et. al. (1986). Clinical Nursing Practice, The C.V. Mosby
Company, Toronto.
