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Varicella exposure in a child at risk of being immunosuppressed
1Institute of Health Professions, MGH, Boston, MA, USA.
Insights
Pediatric nurse practitioners face complex decisions managing children with asthma and atopic conditions, especially when varicella risk arises during corticosteroid treatment. This case study details managing these dual threats to minimize health risks.
Area of Science:
- Pediatric Nursing
- Allergy and Immunology
- Infectious Disease Management
Background:
- Children with asthma and atopic symptoms present unique management challenges for pediatric nurse practitioners (PNPs).
- Managing concurrent asthma exacerbations and varicella (chickenpox) risk, particularly after parenteral corticosteroid use, poses significant clinical dilemmas.
Observation:
- A case example illustrates the complex decision-making process for PNPs.
- Decisions involve modifying asthma medications while addressing varicella prophylaxis and treatment.
Findings:
- Effective management requires balancing control of primary atopic illnesses with minimizing varicella-related health threats.
- PNPs must integrate current asthma guidelines with varicella management strategies.
Implications:
- This approach aids PNPs in navigating high-risk pediatric cases involving asthma and potential varicella exposure.
- Improved clinical decision-making can lead to better health outcomes for children and their families.
Abstract:
The child with asthma and other atopic symptoms presents many management problems to the pediatric nurse practitioner (PNP) responsible for his or her care. When such a child has an exacerbation of asthma while concomitantly being at risk for contracting varicella after having received parenteral corticosteroids, the consequences can be devastating. The many decisions the PNP must make include modifications to current medications to keep the primary illnesses under control while considering prophylactic and other therapeutic measures to make certain that the threats to the health of the child and the family from varicella are minimized. A case example is used to illustrate the decision-making process in such a situation. Guidelines are drawn from the recent literature, including the recent guidelines on asthma management from the National Heart, Lung and Blood Institute/National Asthma Education and Prevention Program.