My patient is a patient that is leaving the E.R. after being diagnosed with the shingles virus. The patient came into the E.R. with a rash on the right side of the trunk. The rash presented as clear blisters and was painful to the touch. The physician diagnosed the patient with shingles and it is now my job to explain to the patient about the shingles virus. I would start by explaining that the painful rash is called the shingles virus. It is caused by the same virus that causes chicken pox and it is called herpes zoster. If they had the chicken pox as a child the virus has been in there body since they had them. It is an infection of the nerve. The virus presents usually on the trunk or side of the body but can present in other areas but that the rash they are experiencing is in the most common place. I would give the patient an overview of the symptoms. I would explain that the virus can cause clear blisters that are filled with liquid. These blisters will eventually burst and the skin will be red and sore and will scab or crust over. The rash will go from being itchy to painful to the touch. In some cases a low fever can occur. I want to make sure the patient knows these symptoms are normal. I want the patient to know that the actual length of time for these sores to go away can vary. Typically it takes 1-4 weeks to get better. This is just the average time frame some people have it for much longer it just depends on the patient. Some patients have symptoms for months. The next step will be to explain what to do to help with pain relief. I will tell the patient that there are going to be several different medications that ae going to be prescribed. One will be an antiviral. This medicine is used to speed the healing process of the shingles virus. There will also be pain medicine in topical and oral form. I will make sure to tell the patient that they need to take and use the medicine as prescribed. The pain can get out of control if they do not follow the doctor’s orders. I will also explain that a luke warm bath with oatmeal can calm the affected nerves. These oatmeal baths can be purchased at the drug store. Wearing clothing that is loose can help to keep from irritating the sores. I will then explain that there are some things they can do to keep infections at bay. Not touching the sores will help keep them clean. It will be hard at first to not scratch when they are having the itching sensations but it is important to touch the area as little as possible to keep any infectious agents out of the area. Not touching will keep it clean and keep the pain down as much as possible. They need to make sure they wash their hands any time they touch the areas because they can spread the virus. They need to stay away from people who have not had the chicken pox or the vaccine. People who are immune suppressed and the unborn child of a pregnant women. This virus can be life threating to all of these people. I would end by making sure the patient is clear on all of my explanations. I would make sure they understood the medications that were prescribed and how to take them. I would give them the orders that the doctor had written about when to call him. For example if the temp got above a certain point. I would make sure they were clear on all orders. I would also make sure if they had any questions they could call back to E.R. at any time. I would now send them home and wish them the best of luck.
