MS-1: Management of Patients with Dermatologic Disorders

History of severe sunburn **Ultraviolet rays are strongly suspected as the etiology of malignant melanoma. Fair-skinned, blue-eyed, light-haired people of Celtic or Scandinavian origin are at a higher risk for developing malignant melanoma. People who burn and do not tan are at higher risk. Elderly individuals who retire to the southwestern US seem to have a higher incidence of developing malignant melanoma

Development of malignant melanoma is associated with which risk factor?

honey-yellow crusted lesions on an erythematous base

The classic lesions of impetigo manifest as

Use hot water throughout wash cycle. **Using hot water kills the scabies and infectious agents on the laundry

The home health nurse is caring for a client with scabies. When instructing on the proper procedure to wash preworn contaminated clothing, which nursing instructions is essential?

Lift the client, do not slide them

The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair?

Kaposi sarcoma **kaposi sarcoma is a cancer that causes lesions in the soft tissues, such as the GI tract, mouth, and anus. It often affects people with AIDS or HIV, or another immune deficiency.

The nurse assesses the client and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which condition?

Avoid cosmetics with fragrance **contact dermatitis, also called contact eczema is an itchy rash caused by a direct contact with a substance or an allergic reaction to it

The nurse caring for a client with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which information should the nurse include?

"It is characterized by patches of redness covered with silvery scales." **psoriasis is usually on the extensor surfaces of the elbows, knees, trunk, and scalp. It is a chronic non-infectious inflammatory disease. There is no cure. the onset is in young and middle adulthood

A client asks the nurse what psoriasis is. What is the best answer?

A Wood's light examination **A Wood's light is known as a black light and is a handheld device that can identify certain fungal infections that fluoresce under long-wave ultraviolet light. When the nurse aims the light at a lesion caused by a fungus that fluoresces, the lesion emits a blue-green color.

A client has a rash on the arm that has been treated with an antibiotic w/out eradicating the rash. What type of exam can be used to determine if the rash is a fungal rash using ultraviolet light?

Antiviral **Oral acyclovir (Zovirax), when taken w/in 48 hours of the appearance of symptoms, reduces their severity, and prevents the development of additional lesions

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions?

Don't touch the treated area

A client has undergone dermabrasion to decrease scarring from severe acne endured as a teen. After completion of the procedure, the nurse reviews the client's home care instructions. Which instructions is appropriate for this client?

Use gloves with application **benzoyl peroxide is an oxidizing agent and may remove the color from clothing, rugs, and furniture

A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide?

Overproduction of sebum **the follicle becomes further distended and irritated, causing a raised papule in the skin

A client is treated for acne vulgaris. What contributes to follicular irritation?

Psoriasis

A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have?

Preventing infection ** Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the skin. This disorder can be caused by a drug reaction—often antibiotics or anticonvulsives. The major cause of death from toxic epidermal necrolysis is from sepsis. Monitoring vital signs closely and noticing changes in respiratory, kidney, and GI function may help the nurse to quickly detect the beginning of an infection. Strict asepsis is always maintained during routine skin care measures. Visitors should wear protective garments and wash their hands before and after coming into contact with the patient. people with any infections or infectious disease should not visit the patient until they are no longer a danger to the patient.

A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis?

Behind the ears **adult lice usually bite the scalp behind the ears and along the back of the neck. Because such lice are tiny (1 to 2 mm) with grayish white bodies, they are hard to see. Bites are less common on the temporal area, top of the head, and middle area

A nurse is examining a client's scalp for evidence of lice. The nurse should pay particular attention in which part of the scalp?

Nodular melanoma **a nodular melanoma is a spherical, blueberry-like nodule with a relatively smooth surface and a relatively uniform, blue-black color.

A patient is diagnosed with malignant melanoma that directly invades the adjacent dermis (vertical growth). The nurse knows that this type of melanoma has a poor prognosis. Which of the following is most likely the type of melanoma described in this scenario?

Frequently inspect the oral cavity

The nurse is developing a plan of care for a client with toxic epidermal necrolysis (TEN) or Stevens-Johnson Syndrome. Which action should the nurse include?

Chocolate, Ice cream **The nurse should promote avoidance of foods associated with flare-up of acne, particularly those high in refined sugars, including chocolate, cola, and ice cream.

The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply

Perform push-ups, Move from side to side, Shift weight in the chair, Complete half-push ups

The nurse notes that a client who uses a wheelchair for long periods after recovering from an amputation has a reddened area over the coccyx. Which teaching will the nurse provide to the client to relieve the pressure? Select all that apply

the infection results from reactivation of the chickenpox virus **it is believed that the varicella zoster virus lies dominant inside nerve cells near the brain and spinal cord and is reactivated with weakened immune systems and cancers. A person who has had chickenpox is immune and therefore not at risk of infection after exposure to a client with herpes zoster.

The nurse teaches the client who demonstrates herpes zoster (shingles) that

Impaired Skin Integrity, Related to Scaly Lesions

When writing a plan of care for a client with psoriasis, the nurse would know that an appropriate nursing diagnosis for this client would be what?

Itch mite

Which infecting agent causes scabies?

Corticosteroids

Which medication classification may be used for contact dermatitis?

Fexofenadine (Allegra)

Which of the following nonsedating antihistamines is appropriate for daytime pruritus?

Autograft **Autografts of full-thickness and pedicle flaps are commonly used for reconstructive surgery months or years after the initial injury. Allografts and homografts are grafts transferred from one human (living or cadaveric) to another human. A heterograft is a graft obtained from an animal of a species other than that of the recipient

Which term refers to a graft derived from one part of a client's body and used on another part of the same client's body?

Secondary bacterial infection

With repeated reactions of contact dermatitis, which of the following can occur?