Nokea
The health care provider diagnoses impetigo for a patient who has crusty vesicopustular lesions on the lower face. Which of the following topics would the nurse include in the teaching plan for this patient?
- A. Avoidance of antibiotic ointments on the lesions
- B. How to clean the infected areas with soap and water
- C. Use of petroleum jelly (Vaseline) to soften crusty areas
- D. Appropriate use of alcohol-based cleansers on the lesions
Correct Answer: B
Rationale: The treatment for impetigo includes softening of the crusts with warm saline soaks and then soap-and-water removal. Alcohol-based cleansers and use of petroleum jelly are not recommended for impetigo. Antibiotic ointments may be applied to the lesions.
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To decrease the risk for sun damage to the skin, which information should the nurse include when teaching patients?
- A. Waterproof sunscreens will provide good protection when swimming.
- B. Use a sunscreen with an SPF of at least 8-10 for adequate protection.
- C. Try to stay out of the sun between the hours of 10:00 and 16:00.
- D. Increase sun exposure by no more than 10 minutes a day to avoid skin damage.
Correct Answer: C
Rationale: The risk for skin damage from the sun is highest with exposure between 10:00 and 15:00 during regular time and 11:00-16:00 during daylight savings time. The term waterproof is misleading; no sunscreen is completely waterproof. Sunscreen with an SPF of at least 15 is recommended for people at normal risk for skin cancer. Although gradually increasing sun exposure may decrease the risk for burning, the risk for skin cancer is not decreased.
Which of the following information would the nurse include when teaching an older-adult patient about skin care?
- A. Dry the skin thoroughly before applying lotons.
- B. Bathe and shampoo daily with soap and shampoo.
- C. Use warm water and a moisturizing soap when bathing.
- D. Use antibacterial soaps when bathing to avoid infection.
Correct Answer: C
Rationale: Warm water and moisturizing soap will avoid overdrying of the skin. Since older patients have dryer skin, daily bathing and shampooing are not necessary and may dry the skin unnecessarily. Antibacterial soaps are not necessary. Lotions should be applied while the skin is still damp to seal moisture in.
A patient who has severe refractory psoriasis on the face, neck, and extremities has quit working and withdrawn from social activities because of the appearance of the lesions. Which of the following actions should the nurse take first?
- A. Discuss the possibility of enrolling in a worker-retraining program.
- B. Encourage the patient to volunteer to work on community projects.
- C. Suggest that the patient use cosmetics to cover the psoriatic lesions
- D. Ask the patient to describe the impact of psoriasis on quality of life.
Correct Answer: D
Rationale: The nurse's initial actions should be to assess the impact of the disease on the patient's life and to allow the patient to verbalize feelings about the psoriasis. Depending on the assessment findings, other actions may be appropriate.
The nurse is teaching a patient about the use of a wet dressing to reduce pruritus. Which of the following time frames would the nurse instruct the patient to leave the dressing on for?
- A. 5-15 minutes
- B. 10-30 minutes
- C. 30-45 minutes
- D. 45-60 minutes
Correct Answer: B
Rationale: Wet dressings can be used effectively to relieve pruritus. Thin cotton sheets or thermal underwear is placed in warm water, wrung out, and placed over the pruritic area. After 10-30 minutes, the dressing is removed and the skin is patted dry (not rubbed) and a lubricant or medication applied. This can be done two to four times per day.
The nurse is teaching the patient how to use wet compresses at home for treatment of poison ivy. Which of the following instructions would the nurse include in the teaching plan?
- A. Use only sterile water as the solution for the dressing.
- B. The material for the compress is to be 4-8 layers thick.
- C. The compress should meet the edge of the area that is to be treated.
- D. Use abdominal pads (gauze sponges) when covering odd-shaped body parts.
Correct Answer: B
Rationale: The material for wet compresses should be 4-8 layers thick and slightly larger than the area that is being treated. Abdominal pads are to be avoided as they hold too much fluid as well as fibres may be left in the wound if the skin is not intact. It is not necessary to use sterile water; tap water at room temperature is acceptable.