Chapter 56 - Management of Patients with Dermatologic Disorders

A 30-year-old client has just returned from the operating room after having a "flap" done following a motorcycle accident. The client's spouse asks the nurse about the major complications following this type of surgery. What would be the nurse's best response?

"The major complication is when the blood supply falls and the tissue in the flap dies."

A nurse is providing self-care education to a client who has been receiving treatment for acne vulgaris. What instruction should the nurse provide to the client?

"Wash your face with water and gentle soap each morning and evening."

A 65-year-old man presents at the clinic reporting nodules on both legs. The man tells the nurse that his son, who is in medical school, encouraged him to seek prompt care and told him that the nodules are related to the fact that he is Jewish. What health problem should the nurse suspect?

Classic Kaposi sarcoma

An older adult client, who is bedridden, is admitted to the unit because of a pressure injury that can no longer be treated in a community setting. During assessment, the nurse finds that the ulcer extends into the muscle and bone. At what stage should the nurse document this injury?

IV

A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?

nits may have to be manually removed from the child's hair shafts

A client diagnosed with a stasis ulcer has been hospitalized. There is an order to change the dressing and provide wound care. Which activity should the nurse first perform when providing wound care?

perform hand hygiene

A patient with a chronic diabetic wound is being discharged after receiving a skin graft to aid wound healing. What direction should the nurse include in home care instructions?

protect the graft from direct sunlight and temperature extremes

A client's blistering disorder has resulted in the formation of multiple lesions in the client's mouth. What intervention should be included in the client's plan of care?

provide chlorhexidine solution for rinsing the client's mouth

A client is admitted to the intensive care unit with what is thought to be toxic epidermal necrolysis (TEN). When assessing the health history of the client, the nurse would be alert to what precipitating factor?

recent administration of new medications

A nurse is caring for a client whose chemical injury has necessitated a skin graft to the client's left hand. Which statement is true regarding skin graft use?

skin is transferred from a distant site to the graft site

A client with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?

surgical excision

A nurse is caring for a client whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?

teach the client about self-care after treatment

A nurse is working with a family whose 5-year-old child has been diagnosed with impetigo. What educational intervention should the nurse include in this family's care?

teaching about the importance of maintaining high standards of hygiene

A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants' risks of basal cell carcinoma (BCC)?

teaching participants to limit their sun exposure

A client who has sustained third-degree facial burns and a facial fracture is undergoing reconstructive surgery and implantation of a prosthesis. The nurse has identified a nursing diagnosis of Low Self Esteem related to use of facial prosthetic secondary to reconstructive surgery. Which nursing intervention would be appropriate for this diagnosis?

teaching the client how to use and care for the prosthesis

A client presents at the free clinic with a black, wart-like lesion on his face, stating, "I've done some research, and I'm pretty sure I have malignant melanoma." Subsequent diagnostic testing results in a diagnosis of seborrheic keratosis. The nurse should recognize what significance of this diagnosis?

the client requires no treatment unless he finds the lesion to be cosmetically unacceptable

A client has just been told that he has deep malignant melanoma. The nurse caring for this client should anticipate that the client will undergo what treatment?

wide excision

A 55-year-old woman is scheduled to have a chemical face peel. The nurse is aware that the client is likely seeking treatment for which of the following?

wrinkles near the lips and eyes

A nurse is planning the care of a client with herpes zoster. What medication, if given within the first 24 hours of the initial eruption, can arrest herpes zoster?

acyclovir (Zovirax)

A nurse educator is teaching a group of nurses about Kaposi sarcoma. What would the educator identify as characteristics of endemic Kaposi sarcoma? Select all that apply.

affects people predominantly in the eastern half of Africa, affects men more than women, can progress to lymphadenopathic forms

A client requires a full-thickness graft to cover a chronic wound. How is the donor site selected?

an area matching the color and texture of the skin at the surgical site is selected

A client has just undergone surgery for malignant melanoma. Which of the following nursing actions should be prioritized?

anticipate the need for, and administer, appropriate analgesic medications

A nurse is caring for a patient who has a diagnosis of bullous pemphigoid and who is being treated on the medical unit. When providing hygiene for this patient, the nurse should perform which of the following actions?

apply cornstarch to the patient's skin after bathing to facilitate mobility

A nurse is providing care for a client who has psoriasis. Following the appearance of skin lesions, the nurse should prioritize what assessment?

assessment of the client's joints for pain and decreased range of motion

The nurse is caring for a client who developed a pressure injury as a result of decreased mobility. The nurse on the previous shift has provided client teaching about pressure injuries and healing promotion. The nurse determines that the client has understood the teaching by observing the client:

avoid placing body weight on the healing site

An older adult resident of a long-term care facility has been experiencing generalized pruritus that has become more severe in recent weeks. What intervention should the nurse add to this resident's plan of care?

avoid using hot water during the client's baths

A public health nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?

educating participants about the early signs and symptoms of skin cancer

A nurse is providing care for a client who has developed Kaposi sarcoma secondary to HIV infection. The nurse should be aware that this form of malignancy originates in what part of the body?

endothelial cells lining small blood vessels

When caring for a client with toxic epidermal necrolysis (TEN), the critical care nurse assesses frequently for high fever, tachycardia, and extreme weakness and fatigue. The nurse is aware that these findings are potential indicators of what condition(s)? Select all that apply.

epidermal necrosis, increased metabolic needs, possible gastrointestinal mucosal sloughing

A client comes to the clinic reporting a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with this diagnosis?

grouped vesicles in linear patches along a dermatome

A client has received a diagnosis of irritant contact dermatitis. What action should the nurse prioritize in the client's subsequent care?

helping the client identify and avoid the offending agent

A 35-year-old kidney transplant client comes to the clinic exhibiting new skin lesions. The diagnosis is Kaposi sarcoma. The nurse caring for this client recognizes that this is what type of Kaposi sarcoma?

iatrogenic or immunosuppression-related

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

impaired skin integrity related to scaly lesions

A client comes to the dermatology clinic requesting the removal of epidermal nevi on the client's right cheek. The nurse knows that the procedure especially useful in treating such lesions is what?

laser treatment

A nurse is caring for a client who has been diagnosed with psoriasis. The nurse is creating an education plan for the client. What information should be included in this plan?

lifelong management is likely needed and use caution when taking nonprescription medications

While performing an initial assessment of a client admitted with appendicitis, the nurse observes an elevated blue-black lesion on the client's ear. The nurse knows that this lesion is consistent with what type of skin cancer?

malignant melanoma

A nurse is assessing a teenage client with acne vulgaris. The client's mother states, "I keep telling him that this is what happens when you eat as many french fries as he does." What aspect of the pathophysiology of acne should inform the nurse's response?

diet is thought to play a minimal role in the development of acne

A client has a diagnosis of seborrhea and has been referred to the dermatology clinic, where the nurse contributes to care. When planning this client's care, the nurse should include what nursing diagnosis?

disturbed body image related to excess sebum production

A nurse practitioner is seeing a 16-year-old client who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?

benzoyl peroxide and erythromycin (Benzamycin)

A client has just been diagnosed with psoriasis and frequently has lesions around his right eye. What should the nurse teach the client about topical corticosteroid use on these lesions?

cataract development is possible

A nurse is caring for a client who has a diagnosis of bullous pemphigoid and who is being treated on the medical unit. The nurse knows that systemic treatment will most likely include which element?

corticosteroid therapy

A patient has recently been diagnosed with advanced malignant melanoma and is scheduled for a wide excision of the tumor on her chest. In writing the plan of care for this patient, what major nursing diagnosis should the nurse include?

deficient knowledge about early signs of melanoma

A nurse is preparing to assist a surgeon in a skin grafting procedure. What can a skin graft can be used for?

denuded skin after burns