While working in a pediatric clinic, you receive a telephone call from the parent of a 10-year-old who is receiving chemotherapy for leukemia. The client’s sibling has chickenpox. Which of these actions will you anticipate taking next?
A. Administer varicella-zoster immune globulin to the client
B. Educate the parent about the correct use of acyclovir (Zovirax)
C. Prepare the client for admission to a private room in the hospital
D. Teach the parents regarding contact and airborne precaution
Correct Answer: A. Administer varicella-zoster immune globulin to the client
Varicella-zoster immune globulin administration can prevent the development of chickenpox in high-risk clients and will typically be prescribed. The varicella-zoster immunoglobulin is used to manage patients who are immunocompromised. In addition, a live attenuated vaccine has been available since 1995. There is high seroconversion following the vaccine which is long-lasting. Adverse effects of the vaccine are rare.
Option B: In children, acyclovir decreases symptoms by one day if taken within 24 hours of the start of the rash, but it has no effect on complication rates, and it is not recommended for individuals with normal immune function.
Option C: Hospitalization may be required if the child develops a varicella-zoster virus infection. For most children who develop chickenpox, the outcome is excellent. However, in immunocompromised individuals, there is increased morbidity and mortality.
Option D: Contact and airborne precautions will be implemented to prevent the spread of infection to other children if the child develops varicella. It is acquired by inhalation of infected aerosolized droplets. This virus is highly contagious and can spread rapidly. The initial infection is in the mucosa of the upper airways.