With age, people may experience diseases differently due to their immune systems becoming weakened. Some types of skin wounds can develop into dangerous conditions that influence other healthcare problems and lead to complications. Shingles (herpes zoster) is a wound that appears more frequently in frail elders, and its challenging options for prevention make the condition a challenging problem for some individuals (National Institute of Aging, 2016). A care plan for a patient with shingles includes assessment and diagnosis based on physical examination, treatment of the virus, management of the symptoms, and patient education about wound hygiene and future prevention.
The Impact of Skin Wounds on Frail Elders
Frail elders often have many comorbidities, since environmental and patient factors heavily impact their immune system. Skin wounds can develop due to viruses (herpes zoster), bacterial infections, and the lack of mobility (Johnson et al., 2015). While some of them may be treated, such patients need to acknowledge that prevention is the best way to avoid complications. For example, a shingle is a condition that can pass without additional issues. On the other hand, the lack of preventive care results in long-term pain (postherpetic neuralgia), other infections, and various neurological problems (Kawai, Gebremeskel, & Acosta, 2014). Therefore, a frail elder who has developed shingles should be provided with timely treatment to lower the impact of the virus and avoid additional problems.
Patient Case
The discussed patient is a 67-year-old female who presented to the office with such complaints as pain on the right side of her chest and neck that had been persistent for three days. During the day of the appointment, the woman also noticed a rash in these areas. The assessment of the wound revealed that the patient has a skin rash characterized as a strip of red dots on the right part of the chest and neck (Kawai et al., 2014). Other symptoms included pain and tenderness in the area of the rash, light fever, and fatigue.
The diagnosis of the patient was based on the physical examination and the review of history which revealed that she had chickenpox as a child and did not have any varicella vaccinations. The treatment incorporated valacyclovir (antiviral drug) to reduce the impact of the virus and lidocaine topic applications to relieve pain (Johnson et al., 2015). The patient was advised to reduce stress, wear comfortable and loose-fitting clothes to avoid wound aggravations, and apply cool patches to the affected areas (National Institute of Aging, 2016).
Future Considerations
The patient’s care plan included treatment and management options that were not burdened to the patient. The proposed therapy was effective as the patient’s pain was reduced significantly, and the developed blisters cleared out in approximately two weeks. However, some preventative health options should have been recommended to the patient to reduce the risk of future infections and complications. The herpes zoster vaccine can be suggested to patients who are at risk of developing shingles multiple times (Johnson et al., 2015). Moreover, more information should be given to the patient about different health-related outcomes of shingles.
Conclusion
The health of frail elders is endangered by the combination of their personal and environmental factors. Shingle is a condition that occurs in older patients with a history of varicella virus and a weakened immune system. It can be diagnosed easily if the main symptom – a characteristic rash – is present. The management of this skin wound includes antiviral and pain relievers. The education should focus on future prevention of the virus’ reactivation and ways to avoid complications.
References
Johnson, R. W., Alvarez-Pasquin, M. J., Bijl, M., Franco, E., Gaillat, J., Clara, J. G.,… Weinke, T. (2015). Herpes zoster epidemiology, management, and disease and economic burden in Europe: A multidisciplinary perspective. Therapeutic Advances in Vaccines, 3(4), 109-120.
Kawai, K., Gebremeskel, B. G., & Acosta, C. J. (2014). Systematic review of incidence and complications of herpes zoster: Towards a global perspective. BMJ Open, 4(e004833), 1-18.
National Institute of Aging. (2016).Shingles. Web.