A patient previously treated for herpes zoster now reports trunk pain at the site of prior lesions. What is the nurse’s first step?

• A. Review the medication administration record to determine when the last analgesic was given.
• B. Notify the physician of the pain.
• C. Change the analgesic prescription.
• D. Observe for new lesions.

Answer: (A)

When a patient who had shingles reports pain at the site, the immediate priority is to ensure appropriate pain control by checking what analgesia has already been given. Reviewing the medication administration record reveals the last analgesic dose, its dose and timing, and whether another dose is due or if adjustments are needed. This step helps prevent under-treating pain or duplicating therapy and guides the next action—whether to administer a PRN dose per order, document inadequate relief, or escalate if pain persists despite appropriate dosing. While postherpetic neuralgia is a possible cause of ongoing pain after herpes zoster, the first action is to verify current analgesia status before changing prescriptions or contacting the physician. Observing for new lesions is important if there are signs suggesting a new outbreak, but it follows after confirming the patient’s pain management plan.