Primary Nursing Diagnosis

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Anxiety related to a knowledge deficit of cause, treatment, and prevention of HSV

OUTCOMES. Anxiety control; Coping; Social interaction skills; Acceptance: Health status; Symptom control behavior

INTERVENTIONS. Anxiety reduction; Coping enhancement; Presence; Teaching: Individual; Counseling; Support group; Medication prescribing

H PLANNING AND IMPLEMENTATION Collaborative

Since HSV is not curable, treatment focuses on relieving the symptoms. The drug of choice to treat a primary infection of HSV-1 and -2 is acyclovir.

Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Valacyclovir

Famciclovir

Depends on the drug and if the outbreak is primary or recurrent

Antiviral

Relief of symptoms, decreases viral shedding (acyclovir is contraindicated during pregnancy); daily dosage for primary episodes is slightly lower than that used for recurrent infections. Some physicians may order chronic suppressive drug therapy, where acyclovir is taken for up to 6 mo.

Other Drugs: Antipyretics, analgesics, viscous lidocaine.

Independent

Instruct the patient to take all medication ordered, even if symptoms recede before the medication is used up. For comfort during the outbreak, patients may take prescribed analgesics or use warm soaks with Epsom salts or sitz baths. Lesions can be cleaned with Betadine. Encourage patients to wear loose clothing and cotton underwear and to avoid ointments that contain cortisone and petroleum because they slow healing and promote the growth of the virus. Encourage exercise, good nutrition, and stress reduction to decrease the number of recurrent outbreaks (Box 1).

Inform patients that the risk of acquiring human immunodeficiency virus (HIV) is double that for HSV-2-infected persons. Help the patient understand that this is a minor problem with which she or he will be inconvenienced from time to time. Adherence to strict guidelines when active lesions are present allows the patient to have a normal sexual relationship. Healthcare workers with active herpes are prohibited from working with immunosuppressed patients or in a nursery setting because of the complications that result in the neonate if HSV transmission occurs.

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Getting to Know Anxiety

Getting to Know Anxiety

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