NUR 236 PrepU Chapter 45: Nursing Care of the Child With an Alteration in Tissue Integrity/Integumentary Disorder

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 is 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. What should the nurse ask the mother?

"Does she wear sleepers with metal snaps?"

A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care?

"Does your child have any allergies to medications?"

A child has been diagnosed with impetigo and the nurse is performing discharge teaching to the parents. Which statements by the parents indicate that additional teaching is necessary? Select all that apply.

"Even though the lesions have crusted, the infection is contagious and our child should stay home from school." "Antifungal medications should be administered as ordered by our physician." "We should soak impetiginous lesions with cool compresses to remove crusts before applying topical medication."

The parents of a child recently diagnosed with atopic dermatitis voice concern to the nurse that their child may develop asthma at some point. How should the nurse respond?

"I can understand your concern. We will closely monitor your child for asthma development."

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse?

"I had our plumber lower our water heater temperature to 130°F (53°C).

An adolescent with acne vulgaris who last week was prescribed tretinoin cream reports to the nurse, "The medicine has not helped my acne at all." What is an appropriate response(s) by the nurse? Select all that apply.

"I know it must be hard waiting for improvement, but it may take 4 to 6 weeks for the medication to begin working." "Be sure to avoid oil-based cosmetics and hair products because their use may block pores and worsen your acne." "Tell me about your daily regimen. While it takes some time for the medicine to work, there may be something in your routine that needs adjusting."

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?

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

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful?

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

The nurse is caring for a child with a prescription for PO prednisone. Which statement by the child's mother would indicate a need for further education?

"I will give it to ny child at least 1 hour before all meals."

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply.

"If I am sexually active I need to let my doctor know." "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." "It's important I get my CBC blood test when my doctor orders it."

An adolescent client with seborrhea asks the nurse, "Why is my seborrhea so bad? Will it always be like this?" What is the best response by the nurse?

"Seborrhea tends to be worse during your teen years because of hormone levels."

The nurse is caring for a 2-month-old in a pediatric clinic. The mom states she is going on vacation in Florida in a month and she is concerned about sunburn. She asks if it is okay to use a sunscreen lotion made for children. What is the correct nursing response?

"Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system?

"The largest organ of the body helps regulate body temperature."

A nurse is 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 bathe our child in hot water, twice a day."

An adolescent is diagnosed with psoriasis. After speaking with the nurse about treatment options suggested by the primary health care provider, the adolescent states, "Since ultraviolet rays help, I am going to buy a tanning package so I can tan year round." How will the nurse respond?

"Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems."

A school-aged child diagnosed with atopic dermatitis is having difficulty in school, and school performance is declining. The parent asks the nurse for interventions that can help improve the situation. How should the nurse respond? Select all that apply.

"You can help your child sleep better at night by giving the prescribed antihistamines." "The school nurse can apply skin moisturizers during the school day." "Talk with the child's teacher about work the child can do at home until flare-ups resolve." "Obtain an order from the health care provider for the child to rest in the nurse's office if too stressed."

The nurse is developing the plan of care for a child who has suffered a major burn and has just been admitted to the acute care facility. Which nursing diagnosis would be most appropriate?

Acute pain related to thermal injuries and procedures

A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform?

Administer diphenhydramine.

An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse recommend to relieve the itching?

Bathe with a product that is oatmeal-based.

The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is most characteristic of this type of burn?

Blisters appear.

A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family?

Complete the prescribed antibiotics.

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform?

Observe the infant's respiratory effort.

An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do?

Premedicate the child before changing the dressing.

A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take?

Provide instruction on how to care for a diaper rash.

An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants?

Staphylococcus aureus

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority?

The nurse follows contact precautions.

The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest?

Wash the face twice a day with a mild soap then pat dry.

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder?

asthma

The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect?

cellulitis

The nurse is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to:

hypovolemic shock.

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to:

impetigo.

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

The nurse is caring for a 10-year-old male in a pediatric clinic with presenting symptoms of small circular patches of hair loss on the scalp. Which skin condition does the child most likely have?

tinea capitis

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?

finishing all prescribed oral medication, even after lesions fade

The nurse is monitoring the intake and output of a client with deep partial-thickness or second-degree burns. The child weighs 75 lb (34 kg). The nurse will contact the physician if the child's urine output drops below how many milliliters per hour? (Round you answer to the nearest whole number.)

34

The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child?

Apply ice to the affected area.

The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris?

"Sometimes I get acne when I use my sister's makeup."