This paper examines three interconnected healthcare topics: the management of varicella zoster (chickenpox) exposure in a pregnant registered nurse, including breakthrough varicella, immunoglobulin prophylaxis, and infection control protocols; the identification, treatment, and signs of methicillin-resistant Staphylococcus aureus (MRSA) infections; and core epidemiological concepts such as incidence, prevalence, endemic, epidemic, and pandemic disease patterns. Drawing on sources from the CDC, Immunization Action Coalition, and peer-reviewed literature, the paper provides a practical overview of how healthcare settings should respond to these infectious disease challenges.
As standard procedure warranted in this case, the patient's obstetrician injected her with varicella zoster-specific immunoglobulin. Although the injection occurred too late to be fully effective, it was administered as a prophylactic measure to protect the baby. A few days later, the registered nurse (RN) developed chickenpox regardless. The likely reason the vaccine did not take is that she had already been exposed; this situation is referred to as "breakthrough varicella" (National Centre for Immunisation, 2009, p. 3). Breakthrough varicella is a mild form of the infection, yet it remains contagious.
The varicella vaccine should not be given to the infant until it is twelve months of age, though it may not be necessary at all due to potential in utero exposure to the varicella zoster virus (VZV). Infants "should receive no specific treatment or vaccination after exposure to Varicella zoster virus (VZV) but can later receive acyclovir" (Immunization Action Coalition, 2014).
According to the Immunization Action Coalition (2014), "there has been only one published report of mother-to-child transmission of varicella vaccine virus." Moreover, "if the mother is at high risk of exposure to varicella, the benefits of vaccination probably outweigh the risk of transmission to the infant" (Immunization Action Coalition, 2014). If the mother contracts chickenpox during the first half of her pregnancy, there is a small chance the baby will experience serious effects, including scarring and birth defects (Children, Youth, and Women's Health Service, n.d.). The risk is considerably higher when the woman contracts chickenpox closer to the delivery date, which is why vaccination may be administered in these circumstances.
Six infection control issues raised by this case include the following. First, there is a clear need to monitor all healthcare staff for their exposure to specific infectious or contagious diseases; in this case, the nurse should have reported her chickenpox exposure earlier and should have been vaccinated. Second, chickenpox cannot be prevented solely through hand washing, so hand hygiene alone is insufficient in this scenario. Third, standard cleaning measures will also be ineffective — only nurses with proven immunity should care for potentially or actually infected patients. Fourth, the most important issue is exposure awareness and early reporting. Fifth, all pregnant nurses and healthcare workers should be required to report their pregnancy status. Finally, negative airflow rooms and patient isolation may be warranted (Centers for Disease Control and Prevention, 2014).
Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to many antibiotics. It can "cause severe problems such as bloodstream infections, pneumonia, and surgical site infections" (Centers for Disease Control and Prevention, 2014). Treatment of wounds must therefore be thorough and immediate. When a person is infected, wounds must be covered fully and bandages kept clean and dry until the wound has healed completely. Drainage must be performed professionally. Frequent hand washing is essential for the infected individual and all surrounding healthcare employees. The patient should not share personal items — such as towels or sheets — that may have come into contact with wound drainage during this period.
Treatment options for a patient with MRSA or similar infections include having healthcare professionals treat and drain the wound using proper procedures. In some cases, the healthcare provider may need to prescribe antibiotics for the infection, though the infection may not respond to treatment (Centers for Disease Control and Prevention, 2014). Keeping the patient relatively isolated, ensuring that the patient's linens are handled properly, and making sure the patient avoids contact with others when open wounds are present will all help, as will consistent and frequent wound care. It is important to coach patients regularly about proper wound care practices.
"Clinical presentation of MRSA from mild to severe"
"Definitions and distinctions between incidence and prevalence"
"Distinguishing endemic, epidemic, and pandemic disease spread"
You’re 53% through this paper. Sign up to read the remaining 3 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.