The nurse is reviewing discharge teaching with the parent of a child with acute myelogenous leukemia who was admitted with varicella-zoster virus. The client has multiple lesions that have not crusted. Which of the following instructions should the nurse include? Select all that apply.

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11ecbb05_cadf_396f_b433_d98df0490644_MD0009_00 Varicella-zoster virus (VZV) infection (chickenpox) is characterized by lesions that begin as a maculopapular rash, progress to weeping vesicular lesions, and typically crust over within approximately 1 week. The lesions are often pruritic and/or painful, and clients frequently have an accompanying fever. In most cases, treatment is supportive in nature and includes: Cool oatmeal baths and topical antihistamines (eg, diphenhydramine) applied to lesions for itching (Option A) Acetaminophen as needed for fever or pain (Option C) Immunocompromised clients (eg, clients with acute myelogenous leukemia [AML]) are at risk for severe varicella (eg, disseminated, pneumonia) and require aggressive therapy, including an antiviral agent (eg, acyclovir). Antiviral therapy should be continued until all the lesions have crusted over (Option B). VZV is spread via airborne and contact transmission. Clients are most infectious in the days leading up to the rash and continue to be infectious until the entire rash reaches the crusting stage (Option E). (Option D) Immunocompromised clients should not receive live attenuated vaccines (eg, varicella virus vaccine). In addition, the vaccine is not indicated for a client who has already developed immunity after recovering from VZV infection. Educational objective: Treatment for clients with varicella-zoster virus infection (chickenpox) is supportive and includes acetaminophen for fever or pain, cool oatmeal baths, and topical antihistamines for itching. Immunocompromised clients are at risk for complications (eg, severe disseminated varicella) and should receive antiviral therapy. Clients are infectious until all lesions crust over.

The Nurse Is Reviewing Discharge Teaching with the Parent of a Child