Varicella

Definition

Varicella (chickenpox) is a highly contagious infection caused by the varicella-zoster virus (VZV). It produces fever and a characteristic pruritic vesicular rash that progresses through macule, papule, vesicle, and crust stages. VZV remains latent after primary infection and may reactivate as shingles (herpes zoster).

Transmission and Isolation

Spread by respiratory droplets and contact with vesicle fluid. AIRBORNE + CONTACT precautions. N95 respirator and negative-pressure room. Contagious from 1 to 2 days before rash until all lesions crusted.

Nursing Interventions

• Antipyretics (NO ASPIRIN; reye syndrome risk); acetaminophen or ibuprofen
• Oatmeal baths, calamine lotion for itching
• Diphenhydramine for severe itching
• Antivirals (acyclovir) for high-risk patients
• Keep fingernails short to prevent skin breakdown and infection
• Varivax vaccine for prevention

NCLEX Relevance

Airborne + contact precautions (no aspirin).