Nursing Care of the Child With an Alteration in Tissue Integrity/Integumentary Disorder - ML3
An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug?
"I have to make sure that I do not become pregnant while taking this drug."
A parent expresses a concern about white scales that have begun to flake off the 1-week-old infant's scalp. The parent asks, "What can I do to prevent this?" Which response by the nurse would be most appropriate?
"your child most likely has infantile seborrheic dermatitis, or cradle cap. you can care for it by cleansing the hair and scalp daily with baby shampoo. you can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes"
The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis?
I always tell my daughter to use her own hairbrush
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
The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take?
acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication
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?
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 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
The nurse is taking a health history of a 6-year-old girl with suspected Stevens-Johnson syndrome. During the physical examination, the nurse would expect to note which physical findings?
erythema multiforme with inflammatory bullae of at least two types of mucosa
The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first?
has the child ever eaten shellfish before now
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
A child is hospitalized with burns over 25% of the body. The nurse is preparing to perform a dressing change. What aspect of changing the child's dressings is most important for the nurse to consider?
infection prevention
An adolescent girl is going to be treated for a severe case of acne vulgaris. A pregnancy test should be done prior to the adolescent starting treatment with:
isotretinoin
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
The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction?
peanut butter and jelly sandwich
Which intervention is the most beneficial for a burn client undergoing a skin graft?
provide around-the-clock pain medication as soon as pain is reported
The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at:
reducing swelling and relieving itching
The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?
second-degree frostbite
A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer?
second-degree or partial-thickness burn
The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time?
tetanus toxoid vaccine
An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver?
that's not an uncommon reaction, although it's hard on you and your child
A newborn has a generalized rash on the skin, which the nurse identifies as erythema toxicum neonatorum. Which information would the nurse include when explaining the condition to the newborn's parent?
what you see on your newborn's skin is erythema toxicum neonatorum. it is a common newborn skin condition that typically resolves on its own in about 1 week. there is nothing special you will need to do for this
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
The nurse is caring for a 6-year-old child brought into the emergency department for burns from a house fire. The nurse notes burn areas surrounding the client's nose and mouth upon initial assessment. Which priority complication should the nurse be alert for?
airway obstruction related to 889 swelling
A nurse is working as part of a response team caring for children who have been involved in an elementary school fire. Which children would the nurse identify as needing a referral to a burn unit? Select all that apply.
- 8-year-old with an inhalation injury - 6-year-old with burns involving the knees and hips - 10-year-old with second-degree (partial-thickness) burns over 15% of the body - 9-year-old with asthma and burns to the face
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
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
The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education?
I guess my mom was right; she always put ice on our burns when we were kids
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 infants clothes
The wound care team has a need to improve the skin assessments in the pediatric population. What assessment(s) would be important for the nurses to implement in this multicultural community? Select all that apply.
-inspect the healing skin of a dark-skinned child for hypopigmentation - inspect the skin of young children for pressure breakdown due to friction - assess wound healing in dark-skinned children for hypertonic responses - monitor for increased vesicle production in dark-skinned children
The nurse is caring for a child with burns in a pediatric hospital. What would be an appropriate nursing diagnosis for this client?
acute pain related to thermal injuries and procedures
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 parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond?
your child most likely has cradle cap (seborrhea). you can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil
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 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 my child at least 1 hour before all meals
The nurse is caring for a client brought to a pediatric clinic for swelling in the lower extremities with reddened skin that has undefined borders and pits slightly when pressed. What is the most likely diagnosis of the client's skin alteration?
cellulitis
The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection?
impetigo
