Dermatological, Ophthalmic, and Otic Drugs

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?

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

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 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."

The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, "That eyedrop is making my eye sting! Is that normal?" Which is the best response by the nurse?

"Sometimes these eyedrops may cause burning or stinging, but it should go away soon."

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 patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?

"Take the Restasis first, and then wait 15 minutes before taking the artifical tears."

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?

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

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 debrided areas.

The nurse is preparing to give an earwax emulsifier to a patient and will assess the patient for which contraindication before administering the drops?

Drainage from the ear canal.

A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?

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 (Betadine)

The nurse is assessing a child with otitis media. Which statement about otitis media is correct?

Common symptoms include pain, fever, malaise, and a sensation of fullness in the ears.

A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipates that which drug will be used for this examination?

Fluorescein sodium

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?

Fungal infections often require prolonged therapy.

A patient has a new prescription for an antiglaucoma eyedrop. The next day, she calls the clinic and states, "The package insert says this medication might make my blue eyes turn brown! Is this true?" The nurse realizes that the patient has a prescription for which eye medication?

Latanoprost (Xalatan), a prostaglandin agonist

The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is given intravenously to reduce intraocular pressure when other medications are not successful?

Mannitol (Osmitrol)

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 nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?

Open-angle glaucoma

The nurse is preparing to administer a new order for eardrops. Which is a potential contraindication to the use of many otic preparations?

Perforated eardrum

A patient is about to undergo ocular surgery. The preoperative nurse anticipates that which drug will be used for local anesthesia?

Proparacaine

The nurse is teaching a patient's wife about administering eardrops to her husband. The nurse will use which technique when demonstrating the skill?

Pull the pinna of the ear up and back.

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?

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

The nurse is administrating eardrops that have been refrigerated. Which action by the nurse is correct before administering the drops?

Take the drops out of the refrigerator 1 hour before the dose is due.

The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in eardrops?

The corticosteroid reduces the inflammation and itching associated with ear infections.

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 sulfanomide drugs.

When reviewing a patient's medical record, the nurse notes an order for carbamide peroxide eardrops. Based on this information, the nurse interprets that these eardrops are being used for which purpose?

To loosen the cerumen for easier removal.

When teaching a patient about the proper application of timolol (Timoptic) eyedrops, the nurse will include which instruction?

a. "Apply the drops into the conjunctival sac instead of directly onto the eye."

The nurse is administering ophthalmic drops. Place the following administration steps in the correct order. (Select all that apply.)

a. Close the eye gently. b. Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute. c. Place drops into the conjunctival sac. d. Clean debris from the eye as needed. e. Have the patient tilt the head back and look up at the ceiling. f. Remove excess medication gently from around the eyes.

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 c. Altered skin pigmentation e. Red and edematous blisters

A child has been diagnosed with bacterial otitis externa and will be receiving eardrops. Which of these eardrops are appropriate for this infection? (Select all that apply.)`

a. Floxin Otic e. Cipro HC Otic

The nurse is reviewing the medical record of a patient and notes an order for ophthalmic dexamethasone (Decadron) solution. The nurse knows that indications for ophthalmic dexamethasone include which conditions? (Select all that apply.)

a. Uveitis b. Allergic conditions c. Removal of foreign bodies f. Conjunctival inflammation

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.)

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." e. "Apply this medication to the affected site twice daily." f. "You may have swelling, scaling, burning, and tenderness in the affected area."

The nurse is teaching a patient about proper administration of eardrops. Which statements are correct? (Select all that apply.)

c. Warm the eardrops the room temperature before instillation. d. The adult patient should pull the pinna of the ear up and back. e. Insert a dry cotton ball firmly into the ear canal after instillation.

A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?

d. Immunosuppression may take it more difficult to eliminate eye infection.