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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.
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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.
The primary health care provider has prescribed dexamethasone sodium phosphate for a client being treated for immunologic skin disorder. Assessment of which of the following would lead the nurse to suspect that the client is experiencing an adverse reaction to the drug?
- A. Redness or mild scaling
- B. Allergic contact dermatitis
- C. Dermatitis and irritation
- D. Photosensitivity
Correct Answer: B
Rationale: The nurse should monitor for allergic contact dermatitis as an adverse reaction to dexamethasone sodium phosphate. Redness or mild scaling and photosensitivity are adverse reactions to hexachlorophene. Dermatitis and irritation are adverse reactions to povidone-iodine.
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.
Chlorhexidine gluconate is being used in a client for preoperative skin preparation. Which of the following if noted would alert the nurse to a possible adverse reaction?
- A. Taste perversion
- B. Headache
- C. Deafness
- D. Mild erythema
Correct Answer: C
Rationale: The nurse should monitor for deafness as an adverse reaction to the use of chlorhexidine gluconate. Taste perversion, headache, and mild erythema are adverse reactions to penciclovir.
A nurse is caring for a client who has been prescribed lidocaine viscous to be used for pain control of the oral mucosa. Which of the following instructions regarding the intake of food should the nurse give the client?
- A. Drink plenty of water along with food.
- B. Avoid intake of heavy and fibrous food.
- C. Ensure the food is not too hot or cold.
- D. Do not eat food for 1 hour after use.
Correct Answer: D
Rationale: When lidocaine viscous is used for oral anesthesia to control pain, the nurse instructs the client not to eat food for 1 hour after use because local anesthesia of the mouth or throat may impair swallowing and increase the possibility of aspiration.