SHINGLES
• Painful skin lesions that can recur when the dormant
virus is activated by trauma, stress, or another
illness; caused by the chicken pox virus after
childhood infection.
• Commonly affects thoracic or trigeminal dermatomes
CAUSE
• Reactivation of varicella-zoster virus (VZV)
RISK FACTORS
• Aging (especially >50 years)
• Weakened immunity – HIV, cancer, organ transplant
• Immunosuppressive drugs – steroids, chemotherapy
• Physical or emotional stress
• History of chickenpox infection
• Family history of shingles
ASSESSMENT
Signs/Symptoms: Pain, burning or tingling
Sensitivity to touch, red rash, Fluid-filled blisters,
Itching, Fever, Headache
Lab Tests: Polymerase chain reaction (PCR) test,
Direct fluorescent antibody (DFA) test, Serologic Test,
Tzanck Smear
NURSING DIAGNOSIS
Acute pain rt inflammatory response of viral infection and
irritation of affected dermatomes, aeb verbalization of
burning and stabbing pain rated 8/10 on pain scale.
Impaired Skin Integrity rt epidermal and dermal tissue
damage from viral vesicle eruption, aeb open fluid-filled
vesicles, crusted lesions on affected area, patient
verbalizing discomfort during dressing change, presence
of excoriation from scratching, and delayed wound healing
observed during assessment.
Risk for Situational Low Self Esteem rt visible skin
lesions caused by reactivation of the varicella-zoster
virus, which may lead to negative body image and social
withdrawal.
MANAGEMENT
MEDICAL
1. Antiviral therapy
2. Analgesics
3. Topical agent
4. Vaccination
SURGICAL
1. No specific surgical intervention.
NURSING MANAGEMENT AND HEALTH TEACHING
1. Assess the characteristics of the rash.
2. Monitor for signs of secondary bacterial infection.
3. Encourage to maintain skin integrity and proper hygiene.
4. Educate to avoid scratching or rupturing blisters.
5. Teach about the infection control precautions.
6. Educate about disease treatment and vaccination.
REFERENCES
VanPutte, C. et al, (2019). Seley's Essential of Anatomy &
Physiology. Tenth edition. ISBN: 978-1-260-09256-8.
Seed, S. (2024). Shingles: Everything You Need to Know.
WebMD. Accessed on June 12, 2025.