Management and Reflection on Herpes Simplex Virus (HSV) Case Presentation
This case presentation focuses on the assessment, diagnosis, and management of a patient with Herpes Simplex Virus (HSV) infection. It includes subjective and objective findings, differential diagnosis, treatment plan, and a reflection on pain management strategies for HSV. Education on virus transmission and chronic illness management are also highlighted.
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Presentation Transcript
Week 2 Case Presentation (Herpes Simplex I) Bari Berger NSG-5590 Ron and Kathy Assaf College of Nursing, Nova Southern University January 17, 2023
Subjective Chief Complaint F/U for care of Herpes Simplex Virus with infection HPI DX with Herpes outbreak with infection Medication Acyclovir, Augmentin, Mirtazipine, Lamotrigine, Levothyroxine NKDA PmHx: Downs Syndrome, Hypothyroidism, Seizures, non-verbal PSH/SH/FH: None
Objective VS BP-132/53, P-98, RR-18, T-97.5, O2-99%, Wt. 98.8 lbs., BMI-22.96 General- Alert and follows simple commands, non-verbal. Oral Cavity mucosa moist and pink, scabbed blisters around mouth without drainage. Heart- S1, S2 RRR, no rubs, no murmurs. Lungs- All lobes clear bilat.
Assessment DX: Herpes Simplex B00.9, lip infection (K13.0) Encounter for general examination with abnormal findings Z00.01 Differential DX Bachet s Syndrome (M35. 2), squamous cell carcinoma (C44.02), Apthous ulcers (K12.0) Status of chronic conditions Stable on current medication
Plan Continue current treatment-Acyclovir, Augment Education on transmission of virus Vaseline to lips to keep moist Tyelenol 650 mg every 6 hrs as needed for pain Continue chronic illness medication CPT code 99213
Reflection Pain Herpes Simplex Virus (HSV) can cause painful ulcers or vesicles on the lips or in the oral cavity. For pain relief a local anesthetic such as lidocaine can be utilized. Keeping out of the sun and keeping the area moist can also decrease pain. The best course of action is treatment with an antiviral as soon as prodromal symptoms are felt. (Wiley Blackwell, 2023, Chapter 14)
Reference Wiley Blackwell. (2023). Sexually transmissible oral diseases (1st ed.). Wiley-Blackwell.
