Tissue Integrity: Lilley Chapter 56

A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement is true regarding fungal infections of the skin? A. Fungal infections often require prolonged therapy. B. The patient has a new infection now. C. The patient needs to apply a dressing if the cream is too messy. D. This infection will probably never be cured.

A

A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin? A. "You will have to use two contraceptive methods while on this drug." B. "You must avoid sexual activity while on this drug." C. "You will have to avoid pregnancy for 2 weeks after taking this drug." D. "If you are taking an oral contraceptive, you may take this drug."

A

Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin (Retin-A)? (Select all that apply.) A. Crusted skin B. Itching C. Altered skin pigmentation D. Rosacea E. Red and edematous blisters

A, C, E

A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern to the nurse? A. "I am using two forms of contraception while on this drug." B. "I have been feeling rather down and lonely lately." C. "I wish I didn't have to be on this medication." D. "It's scary to know that this drug can cause birth defects."

B

A patient is considering taking oral aloe supplements and asks the nurse about potential problems with this therapy. Which statement by the nurse is correct? A. "Aloe is not taken orally; it is only used topically to aid in wound healing." B. "Aloe is used by some to treat constipation; it may cause diarrhea." C. "This is a safe herbal supplement, with no known drug interactions." D. "This is a safe herbal supplement, with no known adverse effects."

B

A teenage boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include in the teaching plan? A. "Avoid foods that are heavy in salt and oils." B. "This drug may cause increased redness of your skin." C. "Try using an abrasive cleanser to remove old skin layers." D. "Being out in the sunlight will help your skin heal."

B

The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates an order for which medication? A. Acyclovir (Zovirax) B. Mupirocin (Bactroban) C. Clindamycin (Cleocin T) D. Clotrimazole (Lotrimin)

B

The nurse is reviewing the medical record of a patient who is to receive wound care with topical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication? A. The patient has an open wound from a burn on her arm. B. The patient is allergic to sulfonamide drugs. C. The patient is allergic to shellfish. D. The patient's burn wound has been débrided.

B

The preoperative nurse is ready to perform a skin prep with povidone-iodine (Betadine) on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to the Betadine prep? A. Peanuts B. Shellfish C. Adhesives D. Latex

B

A patient has a prescription for topically applied 5% fluorouracil (Efudex) cream as part of treatment for basal cell carcinoma on her cheek. Which instructions will the nurse provide to the patient? (Select all that apply.) A. "You must use gloves to apply this medication." B. "You can use clean fingertips to apply the cream, but be sure to wash your hands afterward." C. "You will need to stay out of the sun during therapy with this medication." D. "Apply this medication to the affected site once a day in the evening." E. "Apply this medication to the affected site twice daily." F. "You may have swelling, scaling, burning, and tenderness in the affected area."

B, C, E, F

A child is being treated for head lice with spinosad (Natroba). Which of these statements about treatment with spinosad is true? (Select all that apply.) A. "You will need a prescription for a second product, malathion." B. "You will also need to decontaminate clothes and personal items." C. "Be sure to use a nit comb to remove nits from the hair shafts." D. "Try combing through the hair with mineral oil to loosen the lice from the hair shafts." E. "It is not necessary to comb the nits when using spinosad."

B, E

A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition? A. Spinosad (Natroba) B. Nystatin (Mycostatin) C. Acyclovir (Zovirax) D. Mupirocin (Bactroban)

D

A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate? A. The product is applied once daily in the morning. B. Systemic absorption of topically applied minoxidil is rare. C. Results may be seen as soon as 2 weeks after beginning therapy. D. Systemic absorption may cause tachycardia, fluid retention, and weight gain.

D

A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is open and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical débridement at this time. The nurse expects that which wound-care product will be used to treat the wound? A. Cadexomer iodine (Iodosorb) B. Biafine topical emulsion C. Povidone-iodine (Betadine) D. Collagenase (Santyl)

D

A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure? A. Gently patting a moderate amount over the burned area B. Massaging the cream completely into the wound C. Applying a thick layer over the burned area, and then leaving the area open D. Applying a thin layer with a sterile, gloved hand to clean and débrided areas

D