Nokea
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.
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The nurse is assessing a patient who has just arrived in the postanesthesia recovery area (PACU) after a blepharoplasty. Which of the following assessment data is a priority?
- A. The patient complains of incisional pain.
- B. The patient 's heart rate is 110 beats/minute.
- C. The patient is unable to detect when the eyelids are touched
- D. The skin around the incision is pale and cold when palpated.
Correct Answer: D
Rationale: Pale, cool skin indicates a possible decrease in circulation, so the surgeon should be notified immediately. Warm, pink skin that blanches with pressure indicates that adequate circulation is present in the surgical area. The other assessment data indicate a need for ongoing assessment or nursing action. A heart rate of 110 may be related to the stress associated with surgery, assessment of other vital signs and continued monitoring are appropriate. Because local anaesthesia would be used for the procedure, numbness of the incisional area is expected immediately after surgery. The nurse should monitor for return of feeling.
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.
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.
The nurse is caring for a patient in the dermatology clinic who has a small, slow-growing papule with ulceration and a depression in the centre of the lesion on the right cheek. Which of the following nursing interventions will the nurse anticipate performing for this patient?
- A. Prepare the patient for a biopsy.
- B. Teach about the use of corticosteroid creams.
- C. Educate the patient about use of tretinion (Retin-A).
- D. Discuss the need for topical application of antibiotics.
Correct Answer: A
Rationale: Because the appearance of the lesion is consistent with a possible basal cell carcinoma (BCC), the appropriate treatment would be excision and biopsy. Over-the-counter (OTC) corticosteroids, topical antibiotics, and Retin-A would not be used for this lesion unless the biopsy indicated that the lesion was nonmalignant.
A patient with atopic dermatitis has a new prescription for tacrolimus. After teaching the patient about the medication, which statement by the patient indicates that further teaching is needed?
- A. After I apply the medication, I can go ahead and get dressed as usual.
- B. I will rub the medication gently onto the skin every morning and night.
- C. I will need to minimize my time in the sun while I am using the tacrolimus.
- D. If the medication burns when I apply it, I will wipe it off and call the doctor.
Correct Answer: D
Rationale: The patient should be taught that transient burning at the application site is an expected effect of tacrolimus and that the medication should be left in place. The other statements by the patient are accurate and indicate that patient teaching has been effective.