PAEDIATRIC NURSING CARE IN CHILDREN WITH
CHICKENPOX INFECTION
Li Sze Man
Paediatric Infectious Diseases Unit (PIDU), Princess Margaret
Hospital, Hong Kong Special Administrative Region, China
Chickenpox
is a common infection in children and most parents thought of chickenpox as
a relatively trivial illness.
In fact, it involve considerable medical, economical and societal
costs in the community. A
live-attenuated vaccine is now available and its development raised
questions regarding its universal use in our children population. In order to document the incidence
of this vaccine preventable disease and also to evaluate the usefulness of
vaccination, chickenpox was included as a notifiable disease since 1st
February 1999 in Hong Kong the SAR.
As a tertiary
referral centre for paediatric infectious diseases, we admitted 230
children presented with chickenpox infection in year 2000 ( the number of
children notified in Hong Kong SAR during the same period was 8557 ). All of these children suffered from
complications arising from chickenpox infection.
The most
common complications include secondary bacterial infection with cellulitis
and abscess formation.
Secondary bacterial infection by the group A streptococcus often
resulted in scarlet fever or streptococcus toxic shock syndrome. In most severe cases, it can lead
to necrotizing fasciitis resulting in devastating muscle and tendon
injury. Chickenpox can also resulted
in hepatitis, pneumonitis or encephalitis although these are more commonly
seen in immunocompromised children.
Nursing care
of children with chickenpox infection should focus on adequate hydration
either by enteral or intravenous route. Personal hygiene must be maintained so as to minimize
the chance of secondary bacterial infection. Monitoring of blood pressure and vital signs are
importance especially in children with scarlet fever and toxic shock
syndrome. Areas of tenderness
underneath normal looking skin may be early sign of necrotizing
fasciitis. Subtle signs like
unexplained headache, chest, abdominal and back pain may indicate the
development of disseminated varicella infection.
Apart
from routine nursing care, attention should also paid to the psychological
suffering of the children and their parents. A child, apart from their physical suffering, suffers
from loss of school, being isolated from peers and worry about future
cosmetic appearance. There was
considerable disruption to family organization and routines and great
stress was imposed on the parents.
Parents also suffered from extra financial burden because they are
often missed work to care for their children with chickenpox, they also
have many questions concerning this “trivial illness” during their hospital
stay. These problems can be
solved by patience listening, detailed counseling, explanation and
reassurance. The paediatric
infectious diseases nurses serve a vital role in these aspects.