Chapter 56: Dermatologic Drugs

A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse

"I have been feeling rather down and lonely lately."

A patient has a prescription for topically applied 5% fluorouracil (Efudex) cream as part of treatment for basal cell carcinoma on her cheek. Which instructions will the nurse provide to the patient? (Select all that apply.) a. "You must use gloves to apply this medication." b. "You can use clean fingertips to apply the cream, but be sure to wash your hands afterward." c. "You will need to stay out of the sun during therapy with this medication." d. "Apply this medication to the affected site once a day in the evening." e. You will need to stay out of the sun during therapy with this medication." f. "You may have swelling, scaling, burning, and tenderness in the affected area."

"You can use clean fingertips to apply the cream, but be sure to wash your hands afterward." You will need to stay out of the sun during therapy with this medication." You will need to stay out of the sun during therapy with this medication." You may have swelling, scaling, burning, and tenderness in the affected area."

A father calls because his son has head lice. He reports that he used Kwell shampoo three times, but nothing happened." He wants to know what to do now. What will the nurse advise first?

Be sure to use a nit comb to remove nits from the hair shafts."

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."

Aloe is used by some to treat constipation; it may cause diarrhea

A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure?

Applying a thin layer with a sterile, gloved hand to clean and débrided areas

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 (Natroba) b. Nystatin (Mycostatin) c. Acyclovir (Zovirax) d. Bacitracin

Bacitracin

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 débridement at this time. The nurse expects that which wound-care product will be used to treat the wound?

Collagenase (Santyl)

Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin (Retin-A)? (Select all that apply.) a. Crusted skin b. Itching c. Altered skin pigmentation d. Rosacea e. Red and edematous blisters

Crusted skin Altered skin pigmentation Red and edematous blisters

A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin? a. Fungal infections often require prolonged therapy. b. The patient has a new infection now. c. The patient needs to apply a dressing if the cream is too messy. d. This infection will probably never be cured.

Fungal infections often require prolonged therapy.

The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates an order for which medication?

Mupirocin (Bactroban)

The preoperative nurse is ready to perform a skin prep with povidone-iodine (Betadine) on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to the Betadine prep?

Shellfish

A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate? a. The product is applied once daily in the morning. b. Systemic absorption of topically applied minoxidil is rare. c. Results may be seen as soon as 2 weeks after beginning therapy. d. Systemic absorption may cause tachycardia, fluid retention, and weight gain.

Systemic absorption may cause tachycardia, fluid retention, and weight gain.

The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?

The patient is allergic to sulfonamide drugs

A teenage boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include in the teaching plan?

This drug may cause increased redness of your skin."

A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin? a. "You will have to use two contraceptive methods while on this drug." b. "You must avoid sexual activity while on this drug." c. "You will have to avoid pregnancy for 2 weeks after taking this drug." d. "If you are taking an oral contraceptive, you may take this drug."

You will have to use two contraceptive methods while on this drug."