A nurse is caring for a patient with a diagnosis of Herpes Zoster. The nurse knows that the patient is likely to experience: (Check all that apply) Multiple options may be correct

A. Only have one blister near the oral cavity: Herpes zoster (shingles) typically presents as a unilateral vesicular rash along a single dermatome, not limited to a single blister near the oral cavity. The lesions usually follow the distribution of the affected sensory nerve and can be more extensive than a single blister. Limiting the expectation to one blister is inaccurate for shingles. B. Pruritus: Shingles lesions often cause itching due to inflammation of the skin and involvement of sensory nerves. Pruritus can accompany the vesicular rash and contribute to discomfort, and it may persist during healing, sometimes complicating care if scratching leads to skin breakdown. C. Increased chance of secondary infection: Open vesicles and crusting lesions in herpes zoster compromise the skin barrier, increasing the risk of bacterial colonization and secondary infection. Proper hygiene, lesion care, and sometimes topical antiseptics are important to prevent superimposed infection. D. Pain: Pain is a hallmark symptom of herpes zoster, often preceding the rash. It can be severe, burning, or tingling, and may persist as postherpetic neuralgia even after lesions heal. Pain management is a key component of nursing care for shingles. E. Bilateral rash: Herpes zoster typically presents as a unilateral rash restricted to a single dermatome. Bilateral rashes are uncommon and may indicate another dermatologic condition. The distribution pattern is important in distinguishing shingles from other rashes.