Nokea
A nurse is applying a topical agent that aids in the removal of dead soft tissue by hastening the reduction of proteins into simpler substances. Which of the following might the nurse be applying? Select all that apply.
- A. Bacitracin (Baci-Rx)
- B. Papain and urea (Accuzyme)
- C. Vidarabine (Ara-A)
- D. Collagenase (Santyl)
- E. Anthralin (Miconal)
Correct Answer: B,D
Rationale: Topical enzymes, like papain and urea (Accuzyme) and collagenase (Santyl), aid in the removal of dead soft tissue by hastening the reduction of proteins into simpler substances.
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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 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.
Which of the following would be most important to include in the preadministration assessment of a client who is receiving topical therapy for a skin disorder? Select all that apply.
- A. Size of the area affected
- B. Appearance of the lesions
- C. Report of pain or burning
- D. Client's weight
- E. Blood pressure
Correct Answer: A,B,C
Rationale: The preadministration assessment involves a visual inspection and palpation of the involved area(s). The areas of involvement, including the size, color, and appearance, are carefully measured and documented. The appearance of the skin lesions and reports of pain or burning are noted to establish an accurate baseline for treatment.
A client is diagnosed with psoriasis. Which of the following would the nurse expect the primary health care provider to prescribe as topical treatment? Select all that apply.
- A. Chlorhexidine (Hibiclens)
- B. Calcipotriene (Dovonex)
- C. Vidarabine (Ara-A)
- D. Imiquimod (Aldara)
- E. Anthralin (Miconal)
Correct Answer: B,E
Rationale: Anthralin (Miconal) and calcipotriene (Dovonex) are topical antipsoriatics used to treat psoriasis.
After conducting an in-service program for a group of nurses about topical drugs used to treat skin disorders, the presenter determines that the teaching was successful when the group identifies which of the following as an appropriate use for topical enzymes? Select all that apply.
- A. Widespread psoriasis
- B. Chronic dermal ulcers
- C. First-degree sunburn
- D. Severely burned areas
- E. Tinea pedis
Correct Answer: B,D
Rationale: A nurse may apply a topical enzyme to a client with chronic dermal ulcers or severely burned areas. Topical enzymes are not used for widespread psoriasis, first-degree sunburn, or tinea pedis.