pharm week 15

Which statements would the nurse include in a lecture while explaining about the various dosage forms of the dermatologic medications? Select all that apply.

"Aerosol sprays can be applied on burned areas." "Lotions can be applied on hairy areas of the skin." "Pastes provide better protective coverage than lotions." The correct dosage form should be selected for better absorption and delivery of the drugs to the site of action. The skin at the burned area becomes very tender and delicate. To prevent further damage, aerosols can be used because they can be applied without applying much pressure. Lotions contain water and alcohol. They are easily spread and thus can be applied on large areas and hairy surfaces of the skin. Pastes have protective properties. Because they are semisolid, they form a protective layer on the wound and prevent exposure of the wound to moisture and air. Pledget is a moisture pad that is used for wiping the affected area. Therefore, it does not help to dry the moistened area. Powders have absorbent properties and absorb moisture, so they cannot be applied on the dry lesions because they can worsen them.

A health care provider has prescribed lindane lotion to a patient with scabies. The nurse teaches the patient about the prescribed treatment. Which instruction would the nurse include in the teaching?

"All of your family members should use this medication for prophylaxis." Scabies can be transmitted from the patient to other family members by direct physical contact and by shared personal items even before the symptoms appear. Therefore the patient and his family members should be given a prophylaxis of lindane lotion. This helps to prevent transmission and recurrence and eradicates the disease. Unlike monoamine oxidase inhibitors (antidepressant medications), lindane lotion does not interact with foods containing tryptamine, such as cheese and yogurt. Most of the lotion gets absorbed immediately, and the patient can wash the medicated areas after 8 to 12 hours. Human scabies does not spread by animals. Therefore regularly vaccinating pet animals may not help to prevent the infection.

A patient is receiving two eyedrops for glaucoma, a beta blocker, and a carbonic anhydrase inhibitor. Which information does the nurse teach the patient about the rationale for these drugs?

"Both decrease aqueous humor in different ways." Beta blockers inhibit the production of aqueous humor formation, and carbonic anhydrase inhibitors block carbonic anhydrase, which in turn decreases aqueous humor. The two drugs decrease aqueous humor in different ways to decrease intraocular pressure. Carbonic anhydrase inhibitors can be given systemically to decrease intraocular pressure; however, beta blockers are administered topically for this purpose.

The nurse teaches a nursing student about earwax emulsifier. Which statement by the student indicates effective learning?

"Earwax emulsifier loosens impacted cerumen." Earwax emulsifiers are products that soften and help eliminate earwax. An earwax emulsifier loosens impacted cerumen and allows it to be flushed out of the ear canal. An earwax emulsifier does not have antiinfective or antifungal properties; therefore, it is not helpful for treating ear or fungal infections. Earwax emulsifiers have little or no effect on sweat glands. Therefore they do not decrease earwax secretion.

The nurse is teaching the parent of a 1-year-old patient how to instill eardrops for otitis externa. Which instructions on instillation does the nurse provide to the parent?

"Hold the pinna down and back."When administering eardrops to adults, hold the pinna up and back. In children younger than 3 years, hold the pinna down and back. Administration of solutions that are too cold may cause a vestibular-type reaction with vomiting and dizziness. Store eardrops, solutions, and ointments at room temperature before instillation. Allow a period of time for adequate coverage of the ear by the medication, rather than putting as many drops as possible into the ear. A cotton ball should not be placed in the ear.

Which statement made by a patient indicates the need for further teaching regarding proper administration of eyedrops?

"I will rinse the eyedropper with tap water after each use." Administer all ophthalmic preparations exactly as ordered. Always apply into the conjunctival sac. Safe and accurate application or instillation technique also includes avoiding contact of the eyedropper or tube with the eye to prevent contamination of the drug, and preventing the eyedropper from touching anything that is not sterile, such as tap water. It is important to maintain the sterility of the eyedrop container; therefore, it should not be rinsed, and the cap should immediately be put back on the container.

The nurse is providing education to a patient diagnosed with otitis externa. Which statement by the patient indicates an understanding of the otitis externa treatment plan?

"I will use the eardrops in the ear canal to treat this condition." The treatment for otitis externa is use of otic drops in the ear canal.

When teaching nursing students about topical medications to treat ear disorders, which statement is true?

"Topical medications are effective for treating disorders of the external ear." Disorders of the external ear are similar to general skin disorders like psoriasis and contact dermatitis. Symptoms are characterized by reddening of the skin, inflammation, and pain. Topical medications are recommended to treat such disorders. They generally involve ointments that contain the drug specified for targeted action for treating such disorders. Topical medications are not applicable in treating disorders of the inner, outer, or middle ear. Outer and middle ear disorders require antimicrobial agents or wax emulsifiers as part of a treatment plan. Disorders of the inner ear are complicated and are treated under the supervision of a primary health care provider.

The nurse is assessing a patient with angle-closure glaucoma who has been prescribed mydriatics. Which point is essential to include in teaching?

"Wear sunglasses after administering your eyedrops." Photosensitivity is an expected adverse effect of mydriatics; therefore, when these drugs are administered, encourage the patient to wear sunglasses to help minimize eye discomfort and/or headaches while in sunlight. Touching the eye with the tip of the dropper or container should be avoided to prevent contamination. Pressure should be applied to the inner canthus with a tissue or 2-inch gauze pad for 1 full minute. This helps remove any excess drug and prevents the outflow of the medication from the eye. Contact lenses may cause irritation, so these should be avoided after administering antiglaucoma drugs.

The nurse is assessing a patient with acne who has been prescribed isotretinoin. Which instruction would the nurse give to the patient to ensure safe administration of this medication?

"You should not become pregnant while using this drug."

Why are viral infections difficult to treat?

A virus has the ability to live in the body's healthy cells. Viral infections are difficult to treat because they invade healthy organisms and multiply in their cells. A few fungi produce keratinolytic enzymes, which allow them to survive on certain areas of the skin. Infections caused by yeast such as fungi favor moist, warm environments, which promote overgrowth of nonsusceptible organisms. Viruses reside in hosts and use host cell mechanisms to replicate and reproduce, thereby increasing their colonies.

A patient is started on olopatadine drops. What assessment finding indicates the medication is having a therapeutic effect?

Absence of itching Olopatadine is an ocular antihistamine used to treat symptoms of allergic conjunctivitis (hay fever), which can be seasonal or nonseasonal. It works by competing at the receptor sites for histamine. Histamine normally produces ocular symptoms such as itching and tearing. Olopatadine is not used to dilate pupils or reduce pain.

The nurse is caring for a patient who has a middle ear infection due to exposure to contaminated water. The laboratory reports confirm fungal infection. Which is the drug of choice for treating this condition?

Acetic acid and hydrocortisone solutionOtitis externa is a microbial infection of the ear canal or tympanum seen mostly in adults. The condition is caused by exposure to contaminated water and results in itching and inflammation of the external ear or auditory canal. Acetic acid and hydrocortisone solution is the choice of drug for treating otitis media related to fungal infections. The drug is composed of hydrocortisone (1%), acetic acid (2%), propylene glycol diacetate (3%), sodium acetate (0.015%), and benzethonium chloride (0.02%). Acetic acid and hydrocortisone solution is effective for treating itching and pain due to otitis externa, and it promotes comfort in patients. Carbamide peroxide, ofloxacin solution, and Neomycin, polymyxin B sulfates, and hydrocortisone solution are not used for treating fungus-related otitis externa. Carbamide peroxide is an earwax emulsifier used to soften earwax. Ofloxacin solution and Neomycin, polymyxin B sulfates, and hydrocortisone solution are the drugs used for treating bacterial-related otitis externa.

The nurse is caring for a patient who is experiencing peeling skin and regeneration of the epidermis due to drug treatment. For which dermatologic condition is the patient receiving treatment?

Acne vulgaris For the treatment of acne vulgaris, tretinoin can be used, which stimulates turnover of epidermal cells, causing the skin to peel. For the treatment of pruritus, antihistamines or corticosteroids are used. The adverse effects of corticosteroids are acne eruptions, allergic contact dermatitis, hirsutism, and alopecia. For the treatment of psoriasis, antipsoriatic drugs such as tazarotene are used, which play a role in skin cell differentiation and proliferation. Tinea pedis is a fungal infection of the foot. Drugs such as clotrimazole and miconazole are used. The common adverse effects of these drugs are burning, itching, pelvic cramps, and contact dermatitis.

The primary health care provider prescribes ofloxacin for a 10-year-old child to treat an ear infection. How will the nurse administer the medicine to the patient?

Administer a 5-drop dose twice daily to the patient. The nurse would administer a 5-drop dose twice daily to the patient. It is the standard dose of ofloxacin for children younger than 12 years of age. Administering a 10-drop dose to a 10-year-old child may result in adverse effects of the drug. The nurse would not heat the medicine because higher temperatures may degrade the medicine. The nurse would not massage the tragus area of the ear before instilling drops. The nurse massages the tragus area of the ear after administrating the medicine to increase coverage of the medication.

A patient who is taking an antifungal drug for ear infection reports severe ear pain. On examination, the nurse finds that the patient has a blockage in the ear canal. The nurse will notify the health care provider and will anticipate which order for this patient?

Administer a wax-emulsifier drug to the patient. Blockage of auditory canal is due to accumulation of earwax (cerumen), a natural secretion of modified sweat glands of the ear. The symptoms of wax accumulation are similar to those of infections, such as pain and diminished hearing. Wax emulsifiers are helpful for treating these conditions. Increasing drug dosage is preferred for treating chronic ear infections. Administering an analgesic with the antifungal drug is not useful because the analgesic drug would not help eliminate the cause of pain in this patient. Replacing the antifungal drug with an antibacterial drug or combining it with an analgesic may not be applicable for managing the condition. Replacing the antifungal drug with an antibacterial drug is not applicable, as few antifungal drugs are effective for controlling bacterial infections also.

A child has a fever and otitis media. Which drug does the nurse expect to act as the first line of treatment for the child?

Amoxicillin Amoxicillin is a systemic antibiotic that acts as the first line of treatment for conditions such as fever and otitis media, and it will likely be prescribed by a health care provider to children with these issues. Systemic fluoroquinolones such as ofloxacin are not indicated in children. Acetasol HC is a commonly used combination drug to treat infections of the outer ear and ear canal. Carbamide peroxide is used to remove ear wax.

The nurse is caring for a child who is experiencing severe discomfort and high fever. The health care provider diagnoses acute otitis media. Which first-line drug will be included as part of the treatment plan?

Amoxicillin Otitis media is a common disorder seen in infants and children. It is characterized by fever, discomfort (malaise), hearing defects, and sensation of fullness in the ears. However, it is also observed in adults, associated with bleeding of the tympanic membrane. Amoxicillin is the first-line drug for the treatment of otitis media. Thus the nurse would administer this drug to the patient. It is an antibiotic, and its action starts in 24 to 72 hours. Ofloxacin, ciprofloxacin, and carbamide peroxide are not the drugs given as first-line medication for treating otitis media. Ofloxacin and ciprofloxacin may be prescribed if the patient fails to respond to amoxicillin medication. Carbamide peroxide is the drug used to soften earwax.

Which drug acts by liberating active oxygen in the skin?

Benzoyl peroxide Benzoyl peroxide slowly and continuously liberates active oxygen in the skin, which results in antibacterial, antiseptic, drying, and keratolytic actions. Mupirocin is an antibacterial used for the treatment of staphylococcal and streptococcal impetigo. Clindamycin is a topical form of systemic antibiotic. Silver sulfadiazine is used in the prevention and treatment of infections related to burns.

The nurse is caring for a patient who has a circular red mark on the foot. Which drug would the nurse expect to be prescribed for this patient?

Butenafine The circular marks on the foot might be tinea pedis. Butenafine is indicated for the treatment of tinea pedis. Nystatin is used in the treatment of candidiasis. Butoconazole is a vaginal cream that is indicated for the treatment of candidiasis. Ciclopirox olamine is used in the treatment of tinea versicolor.

A patient who is prescribed the drug miconazole, a topical antifungal, has most likely been diagnosed with which condition?

Candidiasis Miconazole is used in the treatment of candidiasis, which is commonly known as a yeast infection. It is not used for the treatment of pruritus, eczema, or folliculitis.

A health care provider prescribes tazarotene for a patient with plaque psoriasis. Which action would the nurse follow while administering the medication to the patient?

Check the patient's pregnancy test before administering the drug. Tazarotene is prescribed for the treatment of plaque psoriasis. It is classified as a pregnancy category X drug. Therefore a negative pregnancy test 2 weeks before starting therapy is required for female patients because the drug can result in birth defects. Unlike minoxidil, tazarotene does not reduce blood pressure. Therefore blood pressure need not be monitored immediately after administering the medication. Tazarotene does not produce respiratory depression. Hence it is not mandatory to check the patient's respiratory rate before administering the medication. Before administering the drug, the nurse would check whether the patient is allergic to any of the drugs to help prevent a hypersensitive reaction.

A patient is administered echothiophate for the treatment of accommodative esotropia. Which mechanism is responsible for the therapeutic effect of echothiophate?

Cholinesterase inhibition Echothiophate is an indirect-acting cholinesterase inhibitor. Lysozyme is an enzyme in tears that has antiseptic action. Echothiophate does not inhibit the formation of lysozyme. The ciliary muscles are relaxed due to parasympathomimetic action exerted by the accumulated acetylcholine. Relaxed ciliary muscles would not be helpful in guiding the eye movement in a patient with accommodative esotropia. Acetylcholine increases the outflow of the aqueous humor; it does not increase its production.

Which drug is prescribed for a patient with tinea versicolor?

Ciclopiroxolamine Ciclopiroxolamine is indicated for tinea versicolor, dermatophytoses, and candidiasis. Nystatin is indicated for candidiasis. Butenafine is used in the treatment of tinea pedis. Terbinafine is used to treat patients with dermatophytoses.

A patient with athlete's foot who has been applying miconazole for 3 weeks reports rashes on the skin. After assessment, the nurse finds that the patient has developed an allergy. Which medication would the nurse expect to be added to the prescription?

Clotrimazole Athlete's foot is a common contagious fungal infection of the skin that causes scaling, flaking, and itching of the affected areas. Miconazole is used to treat athlete's foot, but it is contraindicated in patients with hypersensitivity and may result in severe allergic reactions. In these cases, clotrimazole can be added to the prescription. Nystatin and butoconazole are anesthetic, antipruritic, antipsoriatic, and other miscellaneous dermatologic drugs and are used in the treatment of candidiasis. Butenafine is used in the treatment of tinea pedis.

The nurse instructs the nursing student to avoid administering cold eardrop solution to the patient. Which are the reasons for this? Select all that apply.

Cold solution may cause vomiting. Cold solution may cause dizziness. Administration of eardrops that are too cold may cause a vestibular type of reaction with vomiting and dizziness. If the solution has been refrigerated, allow it to warm to room temperature. Exposure of the drug to high temperatures may destabilize the drug. Cooling does not affect the stability of eardrop solution. Cooling the medication does not affect its coverage. Gentle massage to the tragus area of the ear may increase coverage of the medication. The eardrop medication may lose its potency at higher temperatures.

Which type of glaucoma occurs in infants?

Congenital glaucoma An infant may be born with congenital glaucoma. Infants do not typically have pigmentary, open-angle, or angle-closure glaucoma.

Which information is essential for the nurse to teach the patient about glaucoma?

Damages the optic nerve Glaucoma is characterized by increased intraocular pressure that damages the optic nerve due to accumulation of aqueous humor. The patient needs to understand that without treatment, the optic nerve is damaged, and blindness can result. The lens, cones, and lacrimal ducts are not involved in glaucoma. Loss of transparency of lenses is caused by cataract. Destruction of cone cells affects central vision and causes color blindness. Lacrimal ducts are the channels arising from lacrimal glands; they drain tears. Impaired functioning of lacrimal ducts does not cause glaucoma.

Which assessment finding indicates flurbiprofen is having the desired effect for the patient?

Decreased inflammation Flurbiprofen is a nonsteroidal antiinflammatory drug used to treat inflammatory ophthalmic conditions such as postoperative inflammation after cataract extraction. It is also used to inhibit intraoperative miosis that may be induced by operative trauma and tissue injury. Flurbiprofen is not used to dilate pupils, decrease pain, or increase lacrimation.

The nurse was instructed to administer apraclonidine drops. Which medication effects would the nurse teach the patient about the apraclonidine drops?

Decreased ocular pressure Apraclonidine is structurally and pharmacologically related to the alpha2 stimulant clonidine. It reduces intraocular pressure by stimulating alpha2 and beta2 receptors. It also prevents ocular vasoconstriction, which reduces ocular blood pressure as well as aqueous humor formation. Apraclonidine is primarily used to inhibit perioperative intraocular pressure increases, rather than to treat glaucoma. Brimonidine is a similar drug but is used primarily for glaucoma. Apraclonidine does not increase heart rate, constrict pupils, or vasoconstrict blood vessels in the eye.

A patient with psoriasis has been prescribed corticosteroids. Which side effects may occur with this medication? Select all that apply.

Dermatitis Folliculitis The adverse effects of topical antiinflammatory drugs that contain corticosteroids include a variety of skin reactions such as dermatitis and folliculitis. Dermatitis is an inflammation of the skin, and folliculitis is the inflammation of hair follicles. Candidiasis is not an adverse effect caused by the administration of corticosteroids; it is a fungal infection. Dermatoses are a disorder involving lesions on the skin. Corticosteroids do not cause dermatoses; rather, these drugs relieve inflammatory and pruritic dermatoses. Dermatophytoses is a superficial fungal infection of the skin, hair, or nails caused by dermatophytes.

In a patient admitted with an ocular problem, the nurse performs an assessment of extraocular eye movement. Which purpose does this assessment serve?

Determines if the patient has the ability to move eyes in all directions Each eye is held in place and moved by six muscles that are controlled by cranial nerves. These muscles include the rectus and oblique muscles. There are four types of rectus muscles: inferior, superior, medial, and lateral. There are two types of oblique muscles: inferior and superior. The nurse would assess a patient with ocular problems by asking him or her to follow an object as the patient moves the eye. This assessment allows the nurse to determine if the patient has any deficits in muscle movement. This assessment does not show if the patient is in pain or sensitive to stimuli. This assessment is not used to determine if eye movement causes accommodation.

Which structure causes mydriasis?

Dilator muscle The pupil is opened (called mydriasis) by a radial smooth muscle called the dilator muscle. It is composed of radiating fibers, like spokes of a wheel, which converge from the circumference of the iris toward its center. Sympathetic nervous system impulses control this muscle. Ciliary muscles are the circular muscles between the anterior and the posterior chambers of the eye behind the iris. They control the curvature of the lens. Lacrimal caruncle is a small, red, rounded elevation covered by modified skin at the medial angle of the eye. The sphincter papillae muscle is a smooth muscle controlled by the parasympathetic nervous system. It constricts the diameter of the pupil.

Which drug is used to treat accommodative esotropia?

Echothiophate Echothiophate is used to treat accommodative esotropia. Carbachol is used to treat open-angle glaucoma. Pilocarpine is used to treat secondary glaucoma after iridectomy. Acetylcholine is used for rapid miosis after cataract lens extraction.

Which effects are expected from therapy with direct- and indirect-acting miotics? Select all that apply.

Enhanced aqueous humor drainage Ciliary muscle contraction Both direct- and indirect-acting miotics have effects similar to those of acetylcholine, but their actions are more prolonged. The direct-acting miotics can directly stimulate ocular cholinergic receptors and mimic acetylcholine. Indirect-acting miotics work by binding to and inactivating the cholinesterases acetylcholinesterase and pseudocholinesterase, the enzymes that break down acetylcholine. As a result, acetylcholine accumulates and acts longer at the cholinergic receptor sites. This leads to drug effects that include miosis, enhanced aqueous humor drainage, ciliary muscle contraction, and reduced intraocular pressure by an average of 20% to 30%. Drug-induced miotic effects may be less pronounced in individuals with dark eyes (e.g., brown or hazel). Miotics are not used to numb the eye.

Which drug is prescribed to newborns for preventing ocular infections caused by Neisseria gonorrhoeae?

Erythromycin Erythromycin

Which drug is used to identify corneal defects?

Fluorescein Fluorescein is an ophthalmic diagnostic dye used to identify corneal defects. Atropine sulfate is a mydriatic and cycloplegic drug used to assist eye examination and to treat uveal tract inflammation. Cromolyn sodium is an antiallergic drug used in the treatment of vernal (spring time) keratoconjunctivitis. Cyclopentolate solution is used in diagnostics as a mydriatic and cycloplegic drug.

Which ocular infection is characterized by the formation of a single cyst at the follicles of the eyelashes?

Hordeolum (sty) Hordeolum (sty) is an acute localized ocular infection that is characterized by the formation of a small cyst at the eyelash follicles. It usually affects the eyelash follicles and glands of the anterior lid. Keratitis is caused by bacterial and viral infections, and its symptoms are intense pain and inflammation of the cornea. Blepharitis is the inflammation of both eyelids where the eyelashes grow. Conjunctivitis is the inflammation of the conjunctiva, the mucous membrane lining the back of the eyelids and the front of the eye except the cornea.

In which part of the ear is the eustachian tube located?

Middle The eustachian tube is in the middle part of the ear. The middle ear also contains the tympanic cavity and three bony structures of the mastoid bone, namely the incus, stapes, and malleus. The eustachian tube is not in the inner, outer, or external part of the ear. The cochlea and semicircular canals are in the inner part of the ear. The external auditory canal is in the outer part of the ear. The pinna is part of the external ear.

The nurse is caring for a patient with anogenital warts who has a history of skin cancer. Which medication will the nurse expect to be prescribed?

Imiquimod A health care provider would prescribe imiquimod for the treatment of anogenital warts. Because the patient has a history of skin cancer, this antineoplastic drug would be effective. Minoxidil is prescribed for the treatment of hypertension (systemic) and to stimulate hair growth (topical). Collagenase is used to clean wounds. It is not prescribed for the treatment of anogenital warts. Fluorouracil is prescribed for the treatment of skin cancer such as basal cell carcinoma but not for the treatment of anogenital warts.

The nurse is caring for a patient who has been prescribed clotrimazole for the treatment of vaginal trichomoniasis. How will this drug be administered?`

Insert 100- and 500-mg vaginal tablets. The primary health care provider instructs the nurse to insert 100- and 500-mg vaginal tablets into the vagina for the treatment of vaginal trichomoniasis. A 10-mg oral topical lozenge should be administered to infants who have oropharyngeal candidiasis. This medication is not used to treat vaginal trichomoniasis in adults. Both 100- and 200-mg vaginal suppositories must be inserted into the vagina to treat yeast infections such as vulvovaginal candidiasis. A formulation of 2% topical aerosol spray can be prescribed to treat topical vaginal infections; however, it is not used to treat systemic vaginal infections.

Which information does the nurse teach the patient about the administration of pilocarpine gel?

Instill the gel into the lower conjunctival sac.

Which antibiotic is used to treat acne vulgaris by acting on the dermal layer of the skin?

Isotretinoin Isotretinoin is prescribed for the treatment of acne vulgaris; it acts by inhibiting the activity of the sebaceous glands in the dermal layer of the skin. Tretinoin treats acne vulgaris by stimulating turnover of epidermal cells. It also reduces the levels of free fatty acid in the skin and of horny cells in the outer epidermis. Clindamycin treats acne vulgaris through its bacteriostatic activity. Benzoyl peroxide has keratolytic actions and acts on epidermal layers of the skin.

The nurse tells a patient who is being treated for acne to report if any signs of depression occur. Which drug is part of the patient's prescription?

Isotretinoin There have been reports of suicide and suicide attempts in patients receiving isotretinoin treatment; therefore the nurse would instruct the patient to report any signs and symptoms of depression to the health care provider. Tretinoin is not associated with suicide. The main adverse effect of tretinoin is a local inflammatory reaction. Clindamycin is a topical formulation of a systemic antibiotic used in the treatment of acne. The adverse effects are minor local skin reactions. Clotrimazole is an antifungal drug used in the treatment of candidiasis and tinea versicolor.

Which information would the nurse teach the patient prescribed glycerin therapy for an ocular problem?

It will cause you to urinate more frequently. Glycerin is an osmotic diuretic given orally to lower intraocular pressure or topically to reduce superficial corneal edema. The patient should be taught that the medication is a diuretic that causes increased urination. Osmotic diuretics include glycerin, mannitol, urea, and isosorbide. These drugs are normally reserved for acute reduction of intraocular pressure during glaucoma crises and perioperative reduction of intraocular pressure in ophthalmic surgery. Another use is before iridectomy in individuals with acute narrow-angle glaucoma. It is also used preoperatively and/or postoperatively in procedures such as treatment of congenital glaucoma, repair of retinal detachment, cataract extraction, and keratoplasty (corneal transplant). It may also be used in the management of secondary glaucoma. It is not an antibiotic and does not cure eye infections. It is administered orally, not by eyedrops.

Antiglaucoma beta blockers have which side effects? Select all that apply.

Keratitis Blepharitis Photophobia The adverse effects of antiglaucoma beta blockers are primarily limited to ocular effects. The most common ocular effects are transient burning and discomfort. Other effects include keratitis (inflammation of the cornea), blepharitis, photophobia, blurred vision, pain, lacrimation, and decreased corneal sensitivity. Because these drugs are administered topically, few, if any, systemic effects such as faintness or tachycardia are expected.

The nurse is teaching a patient with angle-closure glaucoma. Which information about the treatment is included?

Medication therapy will help to decrease intraocular pressure. Angle-closure glaucoma is a condition in which the intraocular pressure increases due to the accumulation of aqueous humor. Medication therapy is used to decrease the production of aqueous humor or to increase the outflow of aqueous humor to decrease intraocular pressure. Medication therapy is usually successful without surgery. Primarily, eyedrops are utilized.

Which medication will the nurse anticipate will be prescribed for a patient diagnosed with impetigo?

Mupirocin Impetigo is a skin disorder caused by bacteria; it is treated with a topical antibacterial agent, mupirocin. Isotretinoin, retinoic acid, and benzoyl peroxide are used to treat acne rather than impetigo.

The nurse is caring for a patient with minor wounds on the hand who has been prescribed an antibacterial medication for preventing infections. Which medication would the nurse expect to find in the patient's prescription?

Neomycin, polymyxin B, and bacitracin The primary health care provider would prescribe Neosporin ointment, which is a triple antibiotic combination of neomycin, polymyxin B, and bacitracin. This has a faster therapeutic effect. Tretinoin is used for the treatment of acne and hyperpigmentation, which is caused by sunburns. Miconazole is an antifungal medication that is prescribed for the treatment of dermatophytoses. Silver sulfadiazine cream is used for the treatment of major wounds such as second- and third-degree burns, but not for the treatment of minor skin burns.

Which otic preparations are recommended for a patient who has a perforated eardrum? Select all that apply.

Ofloxacin Ciprofloxacin Ofloxacin and ciprofloxacin are recommended for the patient with a perforated eardrum. These medicines are safe for the patient with a perforated eardrum. Neomycin, polymyxin B, and hydrocortisone are contraindicated in patients with a perforated eardrum because these drugs may cause permanent damage to the ear.

A 14-year-old patient is diagnosed with perforated tympanic membrane, otitis externa, and otitis media. Which does the nurse anticipate the health care provider will prescribe?

Otic and oral antimicrobials The patient will need a topical/local otic antimicrobial for the otitis externa and perforated tympanic membrane in addition to a systemic (oral) antimicrobial to treat the otitis media. Otic antifungals are the treatment of choice in otomycosis.

Which drug will decrease postoperative intraocular hypertension?P

Pilocarpine Pilocarpine is a direct-acting cholinergic drug used to treat postoperative intraocular hypertension. Dipivefrin is used to treat chronic open-angle glaucoma. Acetylcholine is used for surgical miosis. Brimonidine is used primarily for glaucoma.

Which skin preparations are effective for preventing and treating bacterial, viral, and fungal infections? Select all that apply.

Povidone-iodine Isopropyl alcohol Povidone-iodine and isopropyl alcohol are the skin preparations that are effective for preventing and treating bacterial, viral, and fungal infections. Collagenase is used for cleaning wounds with granulation. Chlorhexidine and benzalkonium chloride are effective for preventing and treating bacterial and fungal infections.

Which medication is useful in the prevention and treatment of topical infections caused by burns and surgery?

Povidone-iodine Povidone-iodine is an antiseptic medication. It is useful for the treatment and prevention of bacterial, viral, and fungal infections that are caused by burns and surgeries. Lindane is useful for the treatment of pediculosis and scabies. Imiquimod has an immunomodulating effect. It is used for the treatment of basal cell carcinoma. Calcipotriene is a synthetic vitamin D3 analog that helps to regulate the growth and reproduction of keratinocytes.

The nurse is assessing a patient with acne who has been prescribed benzoyl peroxide. Which bacterial infection would the nurse suspect in the patient?

Propionibacterium acnes infection The microorganism Propionibacterium acnes, which causes acne, is an anaerobic bacterium. It needs an environment poor in oxygen to grow. Benzoyl peroxide is effective in combating such infection because it releases active oxygen slowly and continuously into the skin. This creates an environment that is unfavorable for the continued growth of the P. acnes bacteria, thus leading to their death. Clostridium is the bacteria that causes local skin infections. Staphylococcus aureus and Streptococcus pyogenes are the bacteria that cause common skin disorders such as folliculitis, impetigo, furuncles, carbuncles, papules, pustules, vesicles, and cellulitis.

The nurse is teaching the patient to utilize cromolyn for keratitis. What instruction is correct?

Put 1 to 2 drops in affected eye 4 to 6 times daily. Cromolyn is utilized as eyedrops to treat keratitis. The correct dose is to put 1 to 2 drops in the affected eye only 4 to 6 times daily. The other administrations are incorrect.

The nurse is caring for a patient who is on isotretinoin treatment. Which cautionary factor does the nurse warn the patient about while using this medication?

Risk to the fetus in pregnancy Isotretinoin is a pregnancy category X drug, which is proven to be a human teratogen. Female patients should be warned not to get pregnant while using this drug. Patients who are on clindamycin may experience oiliness of the skin. Patients on benzoyl peroxide treatment may experience swelling or blistering of the skin, which is an allergic reaction to the drug and is an indication that the treatment should be stopped. Patients on tretinoin treatment may experience temporary alterations in skin pigmentation.

When planning care for a burn patient, the nurse would anticipate applying which topical medication?

Silver sulfadiazine Silver sulfadiazine is a topical antiinfective drug used to treat and prevent infection in second- and third-degree burns. Lindane is effective in treating both scabies and pediculosis. Minoxidil is applied to the scalp to stimulate hair growth. Erythromycin is an antiacne drug.

The nurse instructs a nursing student to administer eardrops to a patient. The nursing student finds that the medication bottle has been stored in the refrigerator. Which is the appropriate action for the nursing student to follow?

Take the bottle out of the refrigerator for an hour before administration The nurse would remove the bottle from the refrigerator 1 hour before administering the drug so that it may warm up to room temperature. The nurse would not place the bottle in hot water because heating affects the potency of medicine. Placing the bottle in water may also damage the label of the drug, thus rendering the directions unreadable. The nurse would not administer cold eardrop medication to the patient because it can cause nausea and vomiting. The nurse would not heat the eardrops because heating affects the potency of the medication.

Which mechanism causes the eye to dilate?

The iris dilator muscle constricts the iris to cause pupil dilation. The pupillary size changes in response to the light due to the constriction and dilation of the pupil. To achieve better vision in low light, the iris dilator muscles constrict the iris and increase the size of the pupil (dilatation). The sympathetic nervous system dilates the pupil by sending impulses to the dilator muscles to contract. This increases the size of the pupil. The parasympathetic nervous system causes constriction of the pupil by sending impulses to the sphincter pupillae muscle. This expands the iris and decreases the pupil size.

The nurse learns that a patient who has an eye infection is taking ciprofloxacin for otitis media. The patient is also prescribed ophthalmic ciprofloxacin to treat the eye infection. Which necessary precautio

The nurse administers the drugs with a time gap.The Institute for Safe Medication Practices (ISMP) has formulated several ethical practices regarding care for patients with eye and ear infections. The nurse would administer the medication to the patient with a time gap to prevent the inadvertent use of eyedrops in the ears and vice versa. The drugs should not be stored in a single carton because these drugs appear similar and can be mixed up. Formulations for otic drugs differ from those for optic drugs; patients will experience inflammation and reddening of the eye if given the wrong medication. The eyedrops should be administered via the conjunctival route, and the eardrops should be administered via the auricular route. Alternate routes of drug administration will not be effective in treating the conditions.

The nurse is caring for a patient who has a deep cut on the auricle of the ear. After 1 week, the nurse finds that the wound has turned into a boil. The patient's culture reports do not reveal any infection. Which is a possible reason for this reaction?

The patient has a disorder of the external ear. Symptoms like cuts (lacerations), localized reaction, and boils are common skin disorders of the external ear. The symptoms are short-lived and can be cured quickly. The symptoms respond to topical medications. Localized reactions with boil formation are not observed in disorders of the outer ear, middle ear, or inner ear. Otitis externa is a disorder of the outer ear, and otitis media is a disorder of the middle ear. Otitis externa and otitis media are characterized by microbial infections and can be cured by administration of antibacterial and antifungal agents. Disorders of the inner ear can be fatal; they require complicated treatment procedures under the supervision of a medical professional.

A teenage female patient is going to be prescribed isotretinoin for acne. Which information is important for the nurse to include in the education of the patient?

The patient must use at least two forms of contraception while taking this medication. The most important teaching mandated by the U.S. Food and Drug Administration (FDA) is the requirement to use two different forms of contraception if the patient is female and of childbearing age.

The nursing student assesses a patient who has otitis media for whom a combination therapy of antibacterial otic drugs and steroids is prescribed. The nursing student asks the instructor why steroids are prescribed to the patient. Which response from the instructor is appropriate?

The steroids are prescribed to reduce inflammation." The steroids are antiinflammatory drugs prescribed in combination with antiinfective drugs for a patient who has otitis media. The steroids help reduce inflammatory symptoms such as itching. Steroids do not soften the cerumen. Steroids do not have antifungal properties and are thus not helpful in reducing fungal infection. Steroids do not have antibacterial properties; therefore steroids do not prevent bacterial infection of the ear.

A patient is receiving a miotic. Which information is essential for the nurse to teach the patient?

This medication may cause blurred vision. Tearing (lacrimation), inflammation in the eye, and blurred vision are the adverse effects of miotics. The medication should not cause pain, headaches, or constant lacrimation.

Which medication decreases the production of aqueous humor and increases its outflow?

Timolol Timolol is a beta-adrenergic blocker class of drug used for treating disorders like open-angle glaucoma. Timolol is the only beta blocker that reduces the intraocular pressure by decreasing the production of aqueous humor and increasing its outflow. It is available in formulations that are devoid of benzalkonium chloride (preservative) to prevent allergic reactions in patients sensitive to this preservative. Betaxolol, metipranolol, and levobetaxolol do not have an effect on the outflow of aqueous humor. These medications also contain benzalkonium chloride as a preservative. Therefore to avoid hypersensitive reactions, these medications cannot be prescribed for the patient.

A male patient has been ordered clotrimazole after a diagnosis of jock itch. Which technical name would the nurse use to document the diagnosis on the chart (and the reason the patient has been prescribed this medication)?

Tinea cruris Infections caused by dermatophytes are called tinea, or ringworm, infections. Tinea infections are identified by the body location where they occur: tinea cruris (groin), tinea pedis (foot), tinea capitis (scalp), and tinea corporis (body). Tinea infections of the foot are also known as athlete's foot and those of the groin as jock itch.

Which drug stimulates the turnover of epidermal cells resulting in skin peeling?

Tretinoin Tretinoin stimulates the turnover of epidermal cells, which results in skin peeling. This decreases the free fatty acid levels of the skin, which means that the horny cells of the outer epidermis cannot adhere to one another. Bacitracin is a polypeptide antibiotic that inhibits bacterial cell wall synthesis, leading to cell death. Isotretinoin inhibits sebaceous gland activity. Clindamycin is an antibiotic.

Which eye component is the jelly-like fluid in the large chamber behind the lens of the eye?

Vitreous body The vitreous body is the jelly-like fluid that fills the large chamber behind the lens of the eye. The uvea is a structure in the eye consisting of the iris, ciliary body, and choroid. Lysozyme is an enzyme that destroys foreign organisms; it is present in the tears, saliva, sweat, and breast milk. Aqueous humor is a clear, watery fluid produced by the ciliary body. It circulates in the anterior and posterior chambers of the eye.

The nurse bases the plan of care regarding administration of eardrops on which knowledge?

Warming the eardrops to room temperature before administration helps reduce a vestibular-type reaction. Eardrops that are administered too cold may cause vomiting and dizziness by stimulating a vestibular-type reaction. Eardrops in adults should be administered by holding the pinna up and out; in children under 3 years of age, the pinna is held down and back. The eardrops should not be warmed in the microwave because too high a temperature can destroy the effectiveness of the medication. Room air temperature is sufficient.

The nurse is assessing a patient who has been prescribed an antibacterial otic drug for otitis media. The nurse finds that the patient is also taking oral antibiotics for a throat infection. Which advice will the nurse give to the patient in this situation?

You should take both of the drugs regularly as per the dosing regimen." Otic drugs are applied topically in the ear canal and thus, generally do not interact with drugs that are given orally. Therefore the nurse would tell the patient to take both medications as per the dosing regimen. If the patient stops taking oral antibiotics, the throat infection would worsen. Therefore this suggestion would not be appropriate. If the patient does not start taking the otic drug in the early stages of otitis media, the patient will develop chronic otitis media, which is a more serious condition. Otitis media is treated only with a topical antibacterial drug (otic drug). Thus the nurse would not inform the patient that the oral antibiotic will suffice for treating otitis media.

Which phrase describes the main function of melanin?

absorb radiation Melanin is a color pigment in the skin that is produced by melanocytes and absorbs radiation, thus giving protection. Connective tissue strengthens the skin. Eccrine glands regulate body temperature. Melanin has no role in growth, so it does not increase the amount of blood vessels.

Isotretinoin and tretinoin are common dermatologic drugs used to treat which condition?

acne Isotretinoin and tretinoin are effective topical treatments for acne vulgaris, not keloid scarring, fungal infections, or male pattern baldness. Isotretinoin inhibits sebaceous gland activity, and tretinoin stimulates the turnover of epidermal cells, resulting in skin peeling.

Which patient finding may be a contraindication to receiving dorzolamide ophthalmic drops?

allergy to sulfa drugs Ophthalmic carbonic anhydrase inhibitors include brinzolamide and dorzolamide. Both drugs are also sulfonamides and are chemically related to the sulfonamide antibiotics. They are to be used with caution in patients who are allergic to sulfa antibiotics. A penicillin allergy, erythromycin allergy, and a history of HIV/AIDS are not contraindications for a patient receiving dorzolamide ophthalmic drops.

Which medication is an example of an ocular sympathomimetic drug?

apraclonidine Apraclonidine is a direct-acting ocular sympathomimetic drug. It is used as short-term adjunctive therapy for glaucoma. Latanoprost is a prostaglandin agonist. Dorzolamide is a carbonic anhydrase inhibitor. Levobetaxolol is an ophthalmic beta-blocking drug.

A patient is prescribed bacitracin topical ointment. Which condition does the nurse suspect as the possible diagnosis based on the medication prescribed?

bacterial infection Bacitracin is a polypeptide antibiotic that is applied topically for the treatment or prevention of local skin infections caused by susceptible aerobic and anaerobic gram-positive organisms such as staphylococci, streptococci, anaerobic cocci, corynebacteria, and clostridia.It would not be prescribed for a viral, fungal, or parasitic infection.

Which dermatologic disorder is characterized by the presence of abnormal lesions and nodules in the epidermal layer of the skin?

basal cell carcinoma Basal cell carcinomas are characterized by abnormal, uncontrolled growths or lesions that arise in the skin's basal cells. These cells line the deepest layer of the epidermis (the outermost layer of the skin). They are usually caused by a combination of cumulative ultraviolet exposure and are rarely metastatic. Actinic keratosis is formed by the gradual development and localized thickening of the outer layers of the skin and results from long-term and prolonged exposure to the sun. Malignant melanoma is a type of cancer arising from the melanocyte cells of the skin. It is caused by uncontrolled division of melanocytes. Squamous cell carcinomas arise from squamous cells, which are flat cells lining many areas of the body. They begin as a small nodule and enlarge to turn into an ulcer.

Information about which adverse effects would the nurse include in the teaching about indirect-acting miotic eyedrops? Select all that apply.

blurred vision stinging on instillation decreased night time vision Adverse effects are more likely to occur with indirect-acting miotics because they have longer-lasting effects. Adverse effects include blurred vision, temporary stinging upon drug instillation, reduced night time or low-light vision, drug-induced myopia (near sightedness), and accommodative spasms. Such effects are secondary to contraction of the ciliary muscle. Miotic drugs also cause vasodilation of blood vessels supplying the conjunctiva, iris, and ciliary body, which may lead to vascular congestion and ocular inflammation. Other undesirable effects include conjunctivitis, lacrimation (tearing), twitching of the eyelids (blepharospasm), and eye or brow pain. Prolonged use can result in iris cysts, lens opacities, and, rarely, retinal detachment.

The nurse assesses a patient who has been prescribed an ocular beta-adrenergic blocker for the treatment of ocular hypertension. For which adverse effects would the nurse monitor in the patient? Select all that apply.

blurred vision transient burning The adverse effects of antiglaucoma beta blockers are primarily limited to ocular effects. The most common ocular effects are transient burning and discomfort. Other effects include blurred vision, pain, photophobia, lacrimation, blepharitis, keratitis (inflammation of the cornea), and decreased corneal sensitivity. Because these drugs are administered topically, systemic effects such as dizziness, nausea, and nervousness are not expected.

The nurse is caring for a patient who is receiving clindamycin treatment for acne. Which is an adverse reaction of the drug that the nurse would expect?

burning and itching of the skin The adverse reactions to clindamycin include minor local skin reactions, such as burning and itching. Crusted skin is a common adverse reaction of tretinoin. A patient might experience blistering of the skin if the patient is allergic to benzoyl peroxide. Local inflammatory reactions are adverse reactions of tretinoin.

Which phrase describes the characteristics of the aerosol foam formulation?

can cover a large area Aerosol foams can cover a large area and are useful for delivering a drug into body cavities such as the vagina and rectum, as well as on areas covered by hair. Ointments are desirable for dry lesions because of their occlusiveness. Powders promote the drying of areas where they are applied. Aerosol sprays are used when the skin is tender to touch.

A patient is complaining of excessive earwax, leading to diminished hearing ability. The nurse will expect to teach the patient to administer which medication to correct this problem?

carbamide peroxide Carbamide peroxide works to soften earwax for easy removal while providing a weak antibacterial action to prevent infection. Pramoxine, acetic acid, and hydrocortisone are not used for excessive ear wax.

Which drug has dexamethasone as a steroidal component?

ciprodex Antibacterial drugs are commonly combined with steroids to treat ear disorders. Ciprodex is the drug that has dexamethasone as a steroidal component. It consists of ciprofloxacin (3 mg/mL) in combination with dexamethasone. Floxin Otic, Cipro HT Otic, and Cortisporin Otic do not contain dexamethasone as a steroidal component. Floxin Otic contains only antibiotic ofloxacin (3 mg/mL). Cipro HT Otic contains ciprofloxacin (2 mg/mL) in combination with hydrocortisone (1%). Cortisporin Otic contains neomycin (5 mg) and polymyxin B (10,000 units) in combination with hydrocortisone (1%).

Which epidermal layer of skin consists of flat cells?

clear layer The stratum lucidum, also called the clear layer, is the translucent layer of the skin that contains flat cells. The stratum corneum, also called the horny layer, consists of keratin cells. The stratum granulosum, also called the granular layer, consists of granulated cells. The stratum germinativum, also called the germinative layer, consists of melanocytes.

Which structure(s) located in the eye play(s) a majorrole in central vision and enable(s) a person to perceive colors?

cones Cones are the photoreceptive cells located in the retina of the eye. These cells play a major role in central vision and enable the perception of colors. The lens is the biconvex transparent crystalline structure of the eye, located directly behind the iris and the pupil. Rods are the photoreceptive cells in the retina and are responsible for light vision. The pupil is a circular opening in the iris of the eye that allows light to enter the eyeball when the eyelids are open.

Which structure covers the exposed anterior surface of the eyeball?

conjunctiva The conjunctiva is the mucous membrane that lines the eyelids and covers the exposed anterior surface of the eyeball. The pupil is a circular opening in the iris of the eye that allows the light to enter the eyeball when the eyelids are open. Sclera is a tough, white coat of fibrous tissue that surrounds the entire eyeball except the cornea. It helps maintain the shape of the eye. Lacrimal caruncle is a small, red, rounded elevation covered by modified skin at the medial angle of the eye.

Which statement(s) describe the advantages of dermatologic medications available in cream form over other dosage forms? Select all that apply.

creams are nongreasy in nature creams are nonocclusive in nature creams can easily be removed by water Creams as dermatologic formulations are nongreasy and nonocclusive in nature. As a result, they allow the skin to breathe, and they evaporate; hence they can be applied to moist areas to allow for the evaporation of fluid. Creams contain water or an alcohol base in their formulations and can be removed easily by washing with water. Creams should not be applied on broken tissue because they can cause necrosis and tissue damage. Creams are suitable for application on moist areas, whereas ointments are suitable for application on dry areas because of their occlusiveness. Ointments are occlusive and do not let the skin breathe; hence they are limited to application on dry areas.

Which sympathomimetic drugs are used in the treatment of glaucoma? Select all that apply.

dipivefrin epinephryl Dipivefrin and epinephryl are sympathomimetic drugs used in the treatment of glaucoma. Carbachol and pilocarpine are direct-acting cholinergic drugs used in the treatment of open- and closed-angle glaucoma. Acetylcholine is a direct-acting cholinergic drug used in producing miosis during ophthalmic surgery.

Which assessment finding is expected in a patient admitted with a cataract? Select all that apply.

diplopia blurred vision gray-white color within the lens A cataract is a gray-white opacity that can be seen within the lens. If cataracts are untreated, sight may eventually be completely lost. Diplopia, or double vision, may also develop. At the onset of a cataract, vision is blurred and may be further worsened by the glare of bright lights. The patient with a cataract does not typically have severe pain or photosensitivity.

At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism?

n. gonorrhoeae Erythromycin eye ointment is indicated for the treatment of neonatal conjunctivitis caused by C. trachomatis and for the prevention of eye infections in newborns that may be caused by N. gonorrhoeae or other susceptible organisms. It is not used for prophylaxis against C. albicans, M. furfur, or A. fumigatus.

The nurse is teaching a group of nursing students about the anatomy of the ear. Arrange the order of structures from external to internal.

ear pinna eardrum eustachian tube cochlea The structure of the ear is divided into four regions: external, outer, middle, and inner. The external auditory meatus, or the pinna, is the external projection of the ear. The middle ear is composed of the eardrum (tympanic membrane) and three bones, namely the incus (anvil), malleus (hammer), and stapes (stirrup). These structures are connected to the eustachian tube. The middle ear is followed by the inner ear, which contains the cochlea and semicircular canals.

Which exocrine glands are present in the layers of the skin? Select all that apply.

eccrine gland apocrine glands sebaceous glands The dermis of the skin consists of exocrine glands, which include eccrine glands. These glands help to regulate body temperature and prevent skin dryness. The apocrine glands secrete substances that emit an odor. Sebaceous glands secrete substances that lubricate and protect the skin. The salivary glands are located in the buccal cavity and secrete saliva. Mammary glands are located in the breast.

The nurse is assessing a patient with moderate acne vulgaris. The patient reports excessive pimples during menstruation. Which other skin disease normally exacerbates during menstruation?

eczema Acne vulgaris usually exacerbates during menstruation. The other skin condition that exacerbates during menstruation is eczema. Hormonal changes before the menstrual cycle in women worsen eczema as a result of reactions caused by endogenous and exogenous agents. Eczema is characterized by an inflammatory infiltrate of the dermis accompanied by oozing, crusting, and scaling. Scabies is a contagious infection caused by itch mite. It does not exacerbate during menstruation. Psoriasis is chronic squamous cell dermatosis with polygenic (multigene) inheritance and a fluctuating pattern of recurrence and remission. It is not influenced by hormonal changes before menstruation. Unlike anogenital pruritus, anogenital warts would not worsen during menstruation.

Which information would the nurse teach the patient about the advantage of a prostaglandin agonist for glaucoma compared to other medications used?

has longer duration of action A single dose of a prostaglandin agonist lowers intraocular pressure for 20 to 24 hours, which allows a single daily dosing regimen. This drug is not given orally. Prostaglandin agonists are no easier or harder to administer than other drugs through the ocular route. Adverse effects include foreign body sensation, punctate epithelial keratopathy (dotted appearance of the cornea), stinging, conjunctival hyperemia ("bloodshot" eyes), blurred vision, itching, and burning.

Which bony structures are located in the middle ear? Select all that apply.

incus stapes malleus The middle ear consists of three bony structures of the mastoid bone: the incus, stapes, and malleus. The cochlea is not a bony structure; it is the auditory portion of the inner ear. The temporal bone is not in the middle ear; it is part of the skull.

The nurse is assessing a patient with plaque psoriasis who has been prescribed ustekinumab. The nurse will teach this patient about which increased risk associated with this drug?

infections Ustekinumab increases the risk of infections by lowering immunity. Ustekinumab does not cause seizures or neurotoxicity. Patients who are administered lindane have a risk of seizures and neurotoxicity because of the prolonged application or overusage of the drug. Folliculitis is the most serious side effect of calcipotriene, which is used to treat plaque psoriasis.

Which ocular drugs belong to the category of nonsteroidal antiinflammatory drugs (NSAIDs)? Select all that apply.

ketolorac diclofenac Ketorolac and diclofenac belong to the category of NSAIDs. They act by inhibiting the enzyme cyclooxygenase, which helps reduce inflammation. Natamycin is an antifungal drug that binds to sterols in the fungal cell membrane and causes cell death. Sulfacetamide is a sulfonamide antibacterial drug that blocks folic acid synthesis in susceptible bacteria. Dexamethasone is a synthetic corticosteroid. It reduces inflammation by inhibiting the expression of phospholipases.

Which assessment finding will the nurse determine is consistent with cycloplegia?

lack of accommodation Cycloplegia is paralysis of the ciliary muscles preventing the accommodation of the lens for variations in distance. Cycloplegia is not pupil dilation, constriction, or absence of lacrimation.

Which class of drugs is used to treat pain due to infection in the auditory canal?

local analgesics Pain is a common symptom for most of the otic conditions. Local analgesics are the class of drugs used to treat pain due to infection in the ear canal. Antihistamines, corticosteroids, and wax emulsifiers are not used to treat pain due to infection in the auditory canal. Antihistamines are used to treat allergic reactions. Corticosteroids are used to treat symptoms like reddening and edema. Wax emulsifiers are used to treat cerumen accumulation.

Which medication is administered intravenously to decrease intraocular pressure prior to surgery when other medications have been unsuccessful?

mannitol Mannitol is administered by intravenous infusion to reduce elevated intraocular pressure when the pressure cannot be lowered by other methods. It is effective in lowering intraocular pressure before intraocular surgery. It is also used in treating acute episodes of angle-closure, absolute, or secondary glaucoma. Mannitol does not penetrate the eye and, unlike some of the other osmotic drugs, may be used when irritation is present, such as urea.

Which type of cells comprises the germinative layer of the epidermis?

melanin cells The germinative layer of the epidermis is composed of melanin cells, which are new skin cells that are germinated from this layer. These cells determine the skin's color. Flat cells are translucent and located in the clear layer of the epidermis. Keratin cells are dead skin cells present in the horny layer of the epidermis, which helps in protection. Granulated cells are located in the granular layer of the epidermis.

Which antifungal drug would the nurse expect to be prescribed for an infant showing signs of thrush?

nyastatin Oropharyngeal candidiasis, commonly known as thrush, is common in infants because of fungal infections. An infant who shows signs of thrush should be prescribed nystatin for treatment. Azole anesthetic, antipruritic, antipsoriatic, and other miscellaneous dermatologic drugs such as miconazole, ketoconazole, or butoconazole may be prescribed only for adults who report other types of candidiasis, such as vulvovaginal candidiasis or cutaneous candidiasis.

Which option is an example of sebaceous glands?

oil glands Sebaceous glands contain large lipid cells that produce oil that covers the epidermis of the skin; therefore these are oil glands. Apocrine glands are located in the genital organs; they produce scent or odors, and they are known as sex glands. Sweat glands are located throughout the skin's surface. These glands regulate the body temperature and prevent dryness of the skin. Apocrine glands located in the breasts help in lactation and are known as mammary glands.

Which disorder can likely cause damage to the eustachian canal?

otitis media Otitis media is a common disorder in infants. The disease is characterized by fever and pain in the ear, and in chronic conditions, severe infection in the ear cavity. The condition commonly damages the eustachian canal because the initial stage of infection is confined to the middle ear. Psoriasis, seborrhea, and otitis externa are not conditions observed in the eustachian tube. Psoriasis and seborrhea are skin disorders that affect the external ear. Otitis externa is a common disorder of the outer ear.

Which roles are the sensory functions of the skin? Select all that apply.

pain pressure temperature The nerve endings of the skin have the ability to sense the intensity of pain and changes in the applied pressure. They also have the ability to sense temperature such as heat and cold. Excretory functions, absorption, and metabolism are regulated by skin without any sensations but by diffusion of various gases and nutrients.

Which response indicates a therapeutic effect from administering atropine sulfate eyedrops to a patient with uveitis?

pupil dilation Atropine sulfate solution and ointment are used as mydriatic and cycloplegic drugs. The drug dilates the pupil (mydriasis) and paralyzes the ciliary muscle (cycloplegic refraction), which prevents accommodation. It is used to assist with eye examinations or to treat uveal tract inflammatory states. The usual dosage for uveitis (inflammation of the choroid, iris, or ciliary body) in children and adults is 1 to 2 drops of the solution, or 0.3 to 0.5 cm of ointment, two to three times daily. The dosage for eye examination is 1 drop of solution, ideally 1 hour before the procedure. It is classified as a pregnancy category C drug. Atropine sulfate is not used to change the color of the iris.

Which roles are the physiologic functions of the skin? Select all that apply.

sensation absorption protection The major physiologic functions of skin are sensation, protection, and absorption. The skin is supplied by many nerves. This helps in sensation by sending impulses from heat, cold, touch, pressure, vibration, and tissue injury. The skin acts as a protective barrier for the internal organs and protects against harmful external agents such as microorganisms and chemicals. Exchange of gases such as oxygen, nitrogen, and carbon dioxide takes place through the pores present on the skin. Medications that are applied on the skin enter into the body through the pores by diffusion. Therefore the skin has a significant role in absorption. The skin does not have any role in digestion because it does not secrete digestive enzymes. The skin has no role in promoting circulation.

Which role is the main function of the eccrine glands?

thermal regulation Thermal regulation is the main function of eccrine glands, where sweat is excreted through the pores of the skin. Perspiration is the process through which fluids are secreted by the sweat glands; thus sweating allows thermal regulation in the body. Sensation of pain is the primary function of the skin but not of eccrine glands in the dermal layer. Thermal insulation is the function of the hypodermis, which creates an insulating layer against heat loss.

Which information would the nurse teach the patient about trifluridine?

this medication is used for 21 days Trifluridine is an antiviral drug that is used to treat keratoconjunctivitis caused by a herpes simplex virus type 1 infection. It is used for 21 days per episode. It is not taken at bedtime, and there is no need to increase fluids while on the eyedrops.

The nurse finds that a patient is unwilling to take medications for otitis media. Which complication over a period of time does the nurse anticipate in the patient if the patient will not accept treatment for otitis media?

tinnitus Otitis media is inflammation or infection of the middle ear. Untreated otitis media leads to tinnitus, which is ringing in the ears. The untreated condition also causes nausea, vertigo, and mastoiditis, and temporary or permanent hearing deficits may occur. It does not have any effect on the throat, so it does not cause throat infection. Otitis media is inflammation of the middle ear; it does not cause fungal ear infection or hardening of cerumen.

The nurse is caring for a child who reports pain resulting from an insect bite. Which class of drug should be included in the treatment plan?

topical anesthetics

The nurse is caring for a patient with actinic keratosis who has been prescribed fluorouracil. Which instruction would the nurse include in the discharge instructions for this patient?

use sunscreen and protective clothing when going outside Photosensitivity is an adverse effect of fluorouracil, and exposure to the sun can cause severe burns. Therefore the patient should be instructed to use sunscreen and wear protective clothing when going outdoors. Fluorouracil causes adverse effects such as stomatitis and inflammation in the mouth, which occur because of a dietary protein deficiency. Therefore the patient should eat high-protein foods such as legumes and meat. Dermatitis is caused by the adverse effect of the drug fluorouracil. It causes inflammation of the skin that is characterized by itching and can be treated by applying moisturizers. Fluorouracil cream can be applied with a nonmetallic applicator, clean fingertips, or fingered gloves. Metallic applicators must not be used because the metals may interact with the ingredients in the cream and cause adverse effects through drug interaction.

A patient asks, "What should I expect after administering dipivefrin?" How would the nurse respond?

your pupils will increase in size Sympathomimetic drugs mimic the sympathetic neurotransmitters norepinephrine and epinephrine. They stimulate the dilator muscle to contract by means of alpha- and/or beta-receptor interaction. This stimulation results in increased pupil size or mydriasis. Dilation is seen within minutes of instillation of the ophthalmic drops and lasts for several hours, during which time the intraocular pressure is reduced. Dipivefrin may cause lacrimation, not dry eye. A change in pulse rate is not typically seen with dipivefrin. Dipivefrin may cause redness in the eyes.