The 74-year-old otherwise healthy patient presents to the clinic complaining of severe pain and burning of the skin over the right flank. Upon assessment, the nurse notes two lines of vesicles that curve laterally away from the spine on the right side. The nurse provides which instruction to the patient regarding treatment?

“You will need to perform meticulous oral hygiene.”. Shingles in the adult older than 60 is treated with oral corticosteroids, which places the patient at risk for oral candidiasis, or thrush. Meticulous oral hygiene is necessary to prevent this complication. An allergic reaction may occur with varicella-zoster immune globulin (VZIG), which may present with signs of anaphylaxis such as lip swelling and difficulty breathing. However, the otherwise healthy older adult with only two dermatomes affected does not require VZIG; this is reserved for severe cases in patients who are immunocompromised. Individuals with shingles are only contagious if the vesicles are open; therefore, the statement about fluid-filled or crusted over lesions is true. However, this instruction relates to disease course, not treatment, and is therefore not the right answer. Additionally, it is important to tell the patient to go to the emergency department if the shingles spreads to the face; however, this is disease education, not treatment education.

The 74-year-old otherwise healthy patient presents to the clinic ...

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Pharmacological and Parenteral Therapies
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Category: Pharmacological and Parenteral Therapies
Difficulty: 10

Topics: Communication & Documentation Immunity Infection Inflammation Patient Education Tissue Integrity Disease Prevention Health Promotion Medication and Blood Products Routes of Administration

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