Peds Practice: Ch 45 (Integumentary)

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? 1. "I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out." 2. "I should not overdress the infant." 3. "I should only use ointments and creams as instructed by the health care provider." 4. "I should be certain to use fabric softener in the care of the infant's clothes."

"I should be certain to use fabric softener in the care of the infant's clothes."

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education? 1. "I will use a warm blow dryer on the rash area for a few minutes every time I change her diaper." 2. "I will use rubber pants over the cloth diapers in the future." 3. "I can still use fragrance fee diaper wipes." 4. "I can leave her diaper off when she naps each afternoon."

"I will use rubber pants over the cloth diapers in the future."

When reviewing bathing habits for a child with dermatitis, which statements by the child's mother indicates the need for further instruction? Select all that apply. a. "I should apply the topical ointments after bathing." b. "I should use the warmest water my child can tolerate during the bath." c. "It is important to avoid soaps with dyes and perfumes." d. "When drying the skin I should pat instead of rubbing it." e. "Antibacterial soap will be helpful in preventing infections at the site of the rash."

- "Antibacterial soap will be helpful in preventing infections at the site of the rash." - "I should use the warmest water my child can tolerate during the bath."

Treatment for diaper rash (Diaper candidiasis)

Topical nystatin with diaper changes for several days

An infant has a diaper rash. What should the parent or nurse do to limit further irritation? a. use baby powder b. use fragrant baby wipes c. let baby sleep with no diaper on d. promptly remove the soiled diaper

promptly remove the soiled diaper

signs and symptoms of severe tinea pedis

pruritus (itchy), peeling, fissures, and burning

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education? a) "I will need to make sure the dog gets a bath if he goes in the woods." b) "When he plays in the woods again, I will make sure he wears long pants and long sleeves." c) "I can buy a medicine to put on him before he goes out to prevent him from getting this again." d) "As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

"As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

The nurse is caring for a mom and her baby on a postpartum unit. The mom states she has received advice not to use baby powder on newborns. She asks the nurse if this is true, and if so, why. Which nurse response is correct?

"Baby powder should not be used on newborns due to the risk of aspiration upon application."

A nurse assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. Which should the nurse ask the mother?

"Does she wear sleepers with metal snaps?"

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? a. "That is an infection that you get under your fingernails." b. "I always tell my daughter to use her own hairbrush." c. "My son got that infection when he was at the swimming pool." d. "My husband had that once and his groin itched so much."

"I always tell my daughter to use her own hairbrush."

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? a) "I should not cover the area with plastic wrap after applying the cream." b) "I need to shake the preparation before using it." c) "I should use the highest-potency steroid cream I can find." d) "I should apply the medicine at bedtime and rinse it off in the morning."

"I should not cover the area with plastic wrap after applying the cream."

When doing teaching with a group of caregivers of infants, the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash. a. "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." b. "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash." c. "The formula she drinks sometimes causes her to have a diaper rash." d. "They told me to use baby powder every time I change her so she won't get diaper rash."

"My child gets diaper rash if I wash her clothes in the same detergent we use for the family."

A nurse providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? -"We should use soap to clean only dirty areas." -"We should use a mild soap for sensitive skin." -"We should bathe our child in hot water, twice a day." -"We need to avoid any skin product containing perfumes, dyes, or fragrances."

"We should bathe our child in hot water, twice a day."

Which of the following are treatments for tinea capitis? a. oral griseofulvin daily for 6 weeks b. Selenium sulfide shampoo twice/week for 2 weeks c. ketocanazole d. limisil

- oral griseofulvin daily for 6 weeks - Selenium sulfide shampoo twice/week for 2 weeks - ketocanazole - limisil

A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame? a) 24 hours b) 5 days c) 1 week d) 72 hours

1 week

Treatment for tinea versicolor

Apply selenium sulfide shampoo all over body (from face to knees) and allow to stay on skin overnight, rinsing in the morning,

A client comes in with inflamed, oozing wounds on his feet. What treatment do you give him to promote healing?

Burow's solution

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client?

Disturbed body image

When is tinea versicolor most common

During hot humid months (summer)

The nurse is caring for a child with a tinea corporis infection involving several sites. Which information would be the most important for the nurse to include in the teaching plan for the parents? a) Allowing the child to return to school after 3 days of treatment b) Keeping socks on before, during, and after athletic events c) Finishing all prescribed oral medication, even after lesions fade d) Applying oils and petroleum jelly to the affected areas

Finishing all prescribed oral medication, even after lesions fade

The term tinea is also called ringworm and it is applied to which of the following? a) Bacterial infections b) Sexually transmitted infections c) Fungal infections d) Contagious infections

Fungal infections

The nurse is providing education to a teen who has tinea pedis. What information should be included in the discussion? Select all that apply.

Keep feet clean and dry. Wear cotton socks.

The nurse is caring for a child with a suspected fungal infection. Which of the following tests would the nurse anticipate as being ordered? a) Potassium hydroxide (KOH) prep b) Patch or skin testing c) Culture of wound/drainage d) Erythrocyte sedimentation rate (ESR)

Potassium hydroxide (KOH)

A 5-year-old child has been diagnosed with tinea corporis. What is the recommendation for this child with regard to attending school? Recommendation to remain home from school until all lesions have healed. a. There is no reason to miss school for this child. b. Recommendation to remain home from school until medication therapy has been initiated. c. Recommendation to remain home from school until the regimen of prescribed medication has been completed d. Recommendation to remain home from school until all lesions have healed.

Recommendation to remain home from school until medication therapy has been initiated.

A nurse is caring for a child with tinea pedis. Which assessment finding should the nurse expect?

Red scaling rash on soles and between the toes

A 14-year-old child is diagnosed with tinea versicolor. Which of the following would the nurse expect the nurse practitioner to order? a) Topical nystatin b) Diphenhydramine c) Oral griseofulvin d) Selenium sulfide

Selenium sulfide

The client is scheduled to have potassium hydroxide (KOH) testing performed. What will be needed to complete this test? a. A urine specimen b. A strand of hair with the root attached c. A blood specimen d. Skin scrapings

Skin scrapings

Which medication is most effective on tinea pedis?

Sporanox

A teen experiencing contact dermatitis reports that he is experiencing pruritis. What recommendation may reduce this occurrence?

Take tepid/ oatmeal baths.

The nurse is caring for a 10-year-old male patient in a pediatric clinic with presenting symptoms of small circular patches of hair loss on the scalp. Which of the following skin conditions does the patient most likely have? a) Tinea corporis b) Tinea capitis c) Tinea cruris d) Tinea versicolor

Tinea capitis

The nurse is caring for a 6-year-old male patient in a pediatric clinic with presenting symptoms of pink papules and scales in his inner thighs, groin, scrotum, and buttocks. The infected areas were also very inflamed and itchy. Which of the following skin conditions does the patient most likely have? a) Tinea corporis b) Tinea capitis c) Tinea cruris d) Tinea versicolor

Tinea cruris

The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? 1. administer griseofulvin with a fatty meal 2. institute contact isolation precautions 3. apply topical antibiotic cream 4. apply topical antifungal cream

apply topical antifungal cream

Which of the following are nursing interventions for tinea corporis? a. wear loose clothes b. avoid contact with infected pets c. change towels daily d. antifungals bid for 4 weeks

avoid contact with infected pets, antifungals bid for 4 weeks

The nurse is discussing the use of over-the-counter ointments to manage a mild case of diaper rash. What ingredients should the nurse instruct the parents to look for in a compound? Select all that apply. a) Vitamin D b) Vitamin A c) Vitamin B12 d) Vitamin B6 e) Zinc

b)Vitamin A e)Zinc a)Vitamin D

When is tinea corporis considered contagious? a. before treatment b. a few days after treatment c. until treatment is completed d. never; it's not contagious

before treatment

What are causes of contact dermatitis

clothing dyes, nickel, soap, lotion, wool clothes, plants (poison ivy), diaper rash from moisture and friction

Tinea corporis can be transmitted by what? a. human b. sharing brushes/towels c. dogs/cats d. airborne

humans, dogs/cats

Treatment for severe tinea pedis

oral griseofulvin, flucanazole for 1 month

Treatment for tinea pedis

topical clotrimazole, miconazole, oxiconazole bid for 1 week or until lesions are cleared; sporanox

signs and symptoms of tinea pedis

vesiculopustular or scaly lesions of soles, feet, between toes, and under nails

A 6-year-old comes into contact with poison ivy. What should he do? a. play in it b. wash affected area vigorously with soap and water within 10 mins of contact c. hot compress d. make sure affected area is dry

wash affected area vigorously with soap and water within 10 mins of contact

Which of the following are nursing interventions for tinea cruris? a. wear loose clothes b. ventilated shoe c. change towels daily d. tropical antifungals for 4 to 6 weeks

wear loose clothes, change towels daily, tropical antifungals for 4 to 6 weeks

The nurse is caring for a child who has a severe case of contact dermatitis following exposure to Toxicodendron radicans (poison ivy). The nurse adds the nursing diagnosis, "Knowledge deficit regarding disease process and care of the client," to the care plan. What nursing interventions should the nurse add to the care plan for this nursing diagnosis? a• Teach the client and parents that even contact with dormant plants or plants perceived to be dead may cause an allergic response. b• Inform the client that itching is very common for contact dermatitis. c• Notify the client and parents that the rash may last for 2 to 4 weeks. d• Encourage the client to not scratch the skin since this can cause a secondary infection.

• Teach the client and parents that even contact with dormant plants or plants perceived to be dead may cause an allergic response. • Inform the client that itching is very common for contact dermatitis. • Notify the client and parents that the rash may last for 2 to 4 weeks. • Encourage the client to not scratch the skin since this can cause a secondary infection.

The nurse is caring for a 16-year-old male patient in a pediatric clinic with presenting symptoms of pruritus and peeling on his feet. Which of the following skin conditions does the patient most likely have? a) Tinea corporis b) Tinea capitis c) Tinea pedis d) Tinea versicolor

Tinea pedis

The nurse is caring for a 12-year-old female patient in a pediatric clinic with presenting symptoms of hypopigmented oval scaly lesions on her back and chest. Which of the following skin conditions does the patient most likely have? a) Tinea corporis b) Tinea capitis c) Tinea pedis d) Tinea versicolor

Tinea versicolor