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:

Monitoring vital signs, fluid intake, and output is important for assessing the client's overall health and hydration status, but it does not specifically address preventing the transmission of the virus.

Choice B rationale:

Providing comfort measures like cool compresses and loose clothing can help alleviate symptoms and discomfort, but it does not directly address preventing the transmission of the virus.

Choice C rationale:

Encouraging oral hygiene and a soft diet is essential for managing the client's symptoms and promoting healing, but it does not focus on preventing the spread of the virus to others.

Choice D rationale:

Isolating the patient until all lesions are crusted over is a crucial nursing intervention to prevent transmission of the chickenpox virus. Chickenpox is highly contagious, primarily spread through respiratory droplets and contact with the fluid from the skin lesions. By isolating the patient until all lesions have crusted over, the risk of spreading the virus to others is significantly reduced.

Choice A rationale:

The primary infection of VZV occurs through respiratory droplets, not when a person comes into contact with them. The virus is highly contagious and spreads through respiratory secretions.

Choice B rationale:

Reactivation of VZV in the nerve cells leads to the onset of shingles, not chickenpox. Chickenpox is the primary infection, and after recovery, the virus remains dormant in nerve cells and can reactivate as shingles later in life.

Choice C rationale:

The incubation period of VZV for chickenpox ranges from 10 to 21 days, which is accurate information.

Choice D rationale:

The risk of transmission during reactivation (shingles) is higher than during primary infection (chickenpox) Shingles can cause the development of vesicles containing the virus, which can be contagious if someone comes into direct contact with the fluid from the vesicles. Primary chickenpox, on the other hand, spreads through respiratory droplets and is more widespread during the initial infection.