A nurse is reinforcing teaching with a client who has herpes zoster about the order of occurrence of findings associated with this disorder. In what order should the nurse identify the typical occurrence of findings? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
Explanation & Rationale
A. Weeping blisters: Vesicles that rupture and release fluid typically occur after the initial appearance of vesicles. This stage can be associated with pain and increased risk of infection, occurring before lesions begin to crust over. B. Crusted lesions: Crusting is the final stage of herpes zoster lesions, indicating that the vesicles have dried and begun to heal. This occurs after the weeping stage and signals that the acute infection is resolving. C. Redness and swelling: Erythema and localized swelling generally appear after the initial sensory changes (paresthesia) and precede vesicle formation. This inflammation indicates viral activity in the affected dermatome. D. Paresthesia: Tingling, burning, or numbness in the affected dermatome usually occurs first, often before visible skin changes. This sensory disturbance is an early indicator of impending herpes zoster lesions. E. Appearance of vesicles: Vesicles develop on the reddened, inflamed skin following paresthesia and swelling. These fluid-filled blisters are characteristic of the active stage of herpes zoster before they rupture and crust.