Nokea
Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin? (Select all that apply.)
- A. Crusted skin
- B. Itching
- C. Altered skin pigmentation
- D. Rosacea
- E. Red and edematous blisters
Correct Answer: A,C,E
Rationale: Some of the most common adverse effects of tretinoin are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation.
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A teenage boy is taking tretinoin for acne. Which statement will the nurse include in the teaching plan?
- A. Avoid foods that are heavy in salt and oils.
- B. This drug may cause increased redness of your skin.
- C. Try using an abrasive cleanser to remove old skin layers.
- D. Being out in the sunlight will help your skin heal.
Correct Answer: B
Rationale: Tretinoin may cause increased redness and drying, and the patient needs to avoid weather extremes, ultraviolet light, and abrasive cleansers. Certain foods do not need to be avoided.
The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine. Which finding, if noted, would be a potential contraindication?
- A. The patient has an open wound from a burn on her arm.
- B. The patient is allergic to sulfonamide drugs.
- C. The patient is allergic to shellfish.
- D. The patient's burn wound has been debrided.
Correct Answer: B
Rationale: Patients with allergies to sulfonamide drugs must not receive silver sulfadiazine.
A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
- A. Spinosad
- B. Nystatin
- C. Acyclovir
- D. Mupirocin
Correct Answer: D
Rationale: Mupirocin is used on the skin for treatment of staphylococcal and streptococcal impetigo. Spinosad is used for pediculosis; nystatin is an antifungal drug; and acyclovir is an antiviral drug.
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical debridement at this time. The nurse expects that which wound-care product will be used to treat the wound?
- A. Cadexomer iodine
- B. Biafine topical emulsion
- C. Povidone-iodine
- D. Collagenase
Correct Answer: D
Rationale: Because this patient has an elevated PT/INR, he cannot receive surgical debridement because of concerns about excessive bleeding. Collagenase is useful for patients taking anticoagulants and for those in whom surgery is contraindicated; it selectively removes necrotic tissue but does not harm normal tissue.
A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct?
- A. Aloe is not taken orally; it is only used topically to aid in wound healing.
- B. Aloe is used by some to treat constipation; it may cause diarrhea.
- C. This is a safe herbal supplement, with no known drug interactions.
- D. This is a safe herbal supplement, with no known adverse effects.
Correct Answer: B
Rationale: The dried juice of the leaves of the aloe plant contains anthranoids, which give aloe a laxative effect when taken orally. The topical application of the plant juice has been known for years to help the healing of wounds. Common adverse effects include diarrhea, nephritis, abdominal pain, and dermatitis when used topically.