Nokea
The nurse is teaching a patient with contact dermatitis of the arms and lower legs about ways to decrease pruritus. Which of the following information would the nurse include in the teaching plan? (Select all that apply.)
- A. Cool, wet cloths or dressings can be used to reduce itching.
- B. Take cool or tepid baths several times daily to decrease itching.
- C. Add oil to your bath water to aid in moisturizing the affected skin.
- D. Rub yourself dry with a towel after bathing to prevent skin maceration
- E. Use of an over-the-counter (OTC) antihistamine with sedative effects can reduce scratching.
Correct Answer: A,B,E
Rationale: Cool or tepid baths, cool dressings, and OTC antihistamines all help reduce pruritus and scratching. Adding oil to bath water is not recommended because of the increased risk for falls. The patient should use the towel to pat (not rub) the skin dry.
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A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. Which of the findings by the nurse indicates a possible adverse effect of the medication?
- A. Thinning of the affected skin
- B. Alopecia of the affected areas
- C. Reddish-brown discoloration of the skin
- D. Dryness and scaling in the areas of treatment
Correct Answer: A
Rationale: Thinning of the skin indicates that atrophy, a possible adverse effect of topical corticosteroids, is occurring. The health care provider should be notified so that the medication can be changed or tapered. Alopecia, red-brown discoloration, and dryness or scaling of the skin are not adverse effects of topical corticosteroid use.
A patient who has severe refractory psoriasis on the face, neck, and extremities has quit working and withdrawn from social activities because of the appearance of the lesions.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 caring for a patient who has basal cell carcinoma (BCC) of the face. Which of the following information should the nurse include when teaching this patient?
- A. Treatment plans include watchful waiting.
- B. Screening for metastasis will be important.
- C. Low-dose systemic chemotherapy is used to treat BCC.
- D. Minimizing sun exposure will reduce risk for future BCC.
Correct Answer: D
Rationale: BCC is frequently associated with sun exposure. BCC spread locally, but do not metastasize to distant tissues. Since BCC can cause local tissue destruction, treatment is indicated. Local chemotherapy may be used to treat BCC.
Which of the following actions would the nurse take when applying a wet dressing to an inflamed and pruritic area of skin on a patient's ankle?
- A. Use a cool solution to wet the dressing.
- B. Change the dressing using sterile gloves.
- C. Soak the dressing in sterile normal saline.
- D. Apply the dressing from the knee to the foot.
Correct Answer: A
Rationale: Cool solutions are used when wet dressings are applied to inflamed areas. Wet dressings do not require sterile technique; tap water is the most common solution used. To avoid maceration of healthy skin, wet dressings should only be applied over the affected area.
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.