A nurse is assessing a client who presents with a prodrome of fever, headache, malaise, anorexia, and pharyngitis. The nurse observes a generalized pruritic rash that progresses from macules to papules to vesicles to pustules to crusts, starting on the face and trunk and spreading to the extremities. The number of lesions varies from a few to hundreds. Which of the following complications should the nurse be aware of?

Choice A rationale:

Stating that "chickenpox is not contagious once the fever is gone" is incorrect information. Chickenpox is still contagious until all the lesions are crusted over.

Choice B rationale:

The statement "You can spread the virus by scratching the lesions" is accurate. Scratching the chickenpox lesions can cause the fluid from the blisters to be released, and this fluid contains the varicella-zoster virus, which can then infect others.

Choice C rationale:

Stating that "chickenpox can only be transmitted through respiratory droplets" is incorrect. While respiratory droplets are a common mode of transmission, direct contact with the fluid from the lesions is also a significant mode of transmission.

Choice D rationale:

Saying that "the virus can survive on surfaces for up to 24 hours" is incorrect. The varicella-zoster virus is relatively fragile and cannot survive for extended periods on surfaces outside the body. It is primarily transmitted through direct contact or respiratory droplets.

Choice A rationale:

Topical corticosteroids can help reduce inflammation in various skin conditions, but they are not the best option for managing pain associated with shingles (herpes zoster) Corticosteroids primarily target inflammation and do not provide effective pain relief in neuropathic pain, which is characteristic of shingles.

Choice B rationale:

Antibiotics are not useful for managing the pain caused by shingles. Shingles is a viral infection, not a bacterial one, so antibiotics would not be effective in reducing pain or preventing secondary infection.

Choice C rationale:

Starting antiviral drugs, such as acyclovir, valacyclovir, or famciclovir, within 72 hours of rash onset is essential for managing shingles. These medications can help reduce the severity and duration of the illness and may also decrease the risk of developing complications like postherpetic neuralgia.

Choice D rationale:

Topical capsaicin is an appropriate option for neuropathic pain relief in shingles. Capsaicin, derived from chili peppers, works by desensitizing the nerve endings and reducing pain signals. However, it may cause a burning sensation initially, and the client should be advised on proper application and hand hygiene afterward.