Nokea
A client is prescribed a topical corticosteroid. The nurse understands that this drug would be contraindicated in which of the following circumstances? Select all that apply.
- A. Monotherapy for bacterial skin infections
- B. Ophthalmic use
- C. Otic use
- D. Monotherapy for widespread plaque psoriasis
- E. Low-potency corticosteroids on the face, groin, or axilla
Correct Answer: A,B,D
Rationale: The use of topical corticosteroids is contraindicated in the following circumstances: known hypersensitivity to the drug or any component of the drug; as monotherapy for bacterial skin infections; high-potency corticosteroids for use on the face, groin, or axilla; for ophthalmic use; and as monotherapy in widespread plaque psoriasis.
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When developing the plan of care for a client with a skin lesion requiring topical therapy, which nursing diagnosis would the nurse most likely identify?
- A. Acute Pain
- B. Risk for Infection
- C. Impaired Skin Integrity
- D. Disturbed Body Image
Correct Answer: C
Rationale: Impaired Skin Integrity is the most likely nursing diagnosis due to the presence of a skin lesion requiring topical therapy, as it directly addresses the compromised skin condition.
The nurse might suspect a hypersensitivity reaction has occurred in a client using azelaic acid (Azelex) if the client experiences a combination of which of the following? Select all that apply.
- A. Pruritus
- B. Urticaria
- C. Vomiting
- D. Erythema
- E. Mental status changes
Correct Answer: A,B,D
Rationale: Topical anti-infectives, like azelaic acid (Azelex), result in a rash, pruritus, urticaria, dermatitis, irritation, and erythema, which may indicate a hypersensitivity reaction to the drug.
A client is prescribed topical clindamycin therapy. The nurse instructs the client and family about possible systemic effects. The nurse determines that the teaching was successful when they state that they should contact the primary health care provider immediately if which of the following occur? Select all that apply.
- A. Stomach cramps
- B. Severe diarrhea
- C. Bloody stools
- D. Burning
- E. Pruritus
Correct Answer: A,B,C
Rationale: Topical clindamycin can be absorbed in sufficient amounts to cause systemic effects. Severe diarrhea, stomach cramps, or bloody stools indicate potential systemic complications, such as pseudomembranous colitis, requiring immediate medical attention.
A nurse is providing care to two clients, one with a Staphylococcus aureus skin infection and another with a Streptococcus pyogenes infection. Which of the following would the nurse expect the primary health care provider to prescribe? Select all that apply.
- A. Mupirocin (Bactroban)
- B. Acyclovir (Zovirax)
- C. Ketoconazole (Nizoral)
- D. Metronidazole (Metro-Gel)
- E. Retapamulin (Altabax)
Correct Answer: A,E
Rationale: Mupirocin (Bactroban) and retapamulin (Altabax) are topical anti-infectives that can be used to treat Staphylococcus aureus and Streptococcus pyogenes infections of the skin.
After teaching a group of nursing students about topical drugs for skin disorders, the instructor determines that the teaching was successful when the students identify which of the following as used to prevent institutional outbreaks of methicillin-resistant Staphylococcus aureus (MRSA)?
- A. Bacitracin
- B. Mupirocin
- C. Retapamulin
- D. Clindamycin
Correct Answer: B
Rationale: Mupirocin is applied to the nasal mucosa to reduce the risk of institutional outbreaks of MRSA, as it effectively targets nasal colonization of the bacteria.