Chapter 45 Prep U

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? "We should avoid tight clothing and heat." "We should avoid using petroleum jelly." "We need to develop ways to prevent him from scratching." "We should keep his fingernails short and clean."

"We should avoid using petroleum jelly." It is important to apply moisture multiple times throughout the day. Petroleum jelly is a recommended moisturizer that is inexpensive and readily available. The other statements are correct.

The community nurse receives a call from a local day care center. One of the children in the center has been diagnosed with impetigo. Which information related to impetigo will the nurse provide to the day care center? Impetigo cannot be treated with medication and has to run its course. Impetigo is highly contagious and can spread quickly. Impetigo usually develops because of sensitivity to pollens and molds. The facility staff should wear masks until all children and adults are healthy.

Impetigo is highly contagious and can spread quickly. Impetigo is a highly contagious skin infection and can spread quickly. It usually appears as red sores on the face, especially around a child's nose and mouth, and may appear on the hands and feet. The sores burst and develop honey-colored crusts. It is spread by person-to-person contact, not droplet; therefore, masks are not indicated. It is treated with antibiotics, generally penicillin. The cause is not pollens or molds; it is bacterial.

A nurse is assessing a 6-month-old girl with an integumentary disorder. The nurse notes three virtually identically sized, round red circles with scaling that are symmetrically spaced on both of the girl's inner thighs. What should the nurse ask the mother? "Tell me about your family history of allergies." "Do you change her diapers regularly?" "Has she been exposed to poison ivy?" "Does she wear sleepers with metal snaps?"

"Does she wear sleepers with metal snaps?" Small round red circles with scaling, symmetrically located on the girl's inner thighs, point to nickel dermatitis that may occur from contact with jewelry, eyeglasses, belts, or clothing snaps. The nurse should inquire about any sleepers or clothing with metal snaps. The girl does not have a rash in her diaper area. It is unlikely that an infant this age would have her inner thighs exposed to a highly allergenic plant. Discussing family allergy history is important, but the nurse should first inquire about any clothing with metal that could have come into contact with the girl's skin when she displays a symmetrical rash.

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? "All children with atopic dermatitis develop both asthma and hay fever, so we will monitor your child for both conditions." "I can understand your concern. We will closely monitor your child for asthma development." "If your child starts having respiratory difficulties, be sure to let your health care provider know." "I am not sure why you think a skin disorder would lead to asthma?"

"I can understand your concern. We will closely monitor your child for asthma development." Atopic dermatitis (eczema) is one of the disorders in the atopy family (along with asthma and allergic rhinitis [hay fever]). About 30% to 35% of children who have atopic dermatitis will also develop allergic rhinitis (hay fever) and/or asthma. Therefore, the child will be monitored for the development of asthma

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? "I should use the highest-potency steroid cream I can find." "I should apply the medicine at bedtime and rinse it off in the morning." "I need to shake the preparation before using it." "I should not cover the area with plastic wrap after applying the cream."

"I should not cover the area with plastic wrap after applying the cream." An occlusive dressing such as plastic wrap over the area should not be used with topical corticosteroids. High-potency preparations should not be used. There is no need to shake topical corticosteroids. Benzoyl peroxide requires shaking before use. Applying the medication at night and rinsing off in the morning is used for coal tar preparations.

A nurse is providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? "We should use a mild soap for sensitive skin." "We should use soap to clean only dirty areas." "We should bathe our child in hot water, twice a day." "We need to avoid any skin product containing perfumes, dyes, or fragrances."

"We should bathe our child in hot water, twice a day." The nurse should emphasize that the parents should avoid hot water. The child should be bathed twice a day in warm water. The other statements are correct.

A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame? 24 hours 72 hours 1 week 5 days

1 week Once treatment is initiated for tinea capitis, the child can return to school or day care after 1 week.

A nurse is caring for a child with a wasp sting. Which nursing intervention is a priority? Remove jewelry or restrictive clothing. Administer diphenhydramine per protocol. Cleanse wound with mild soap and water. Apply ice intermittently.

Administer diphenhydramine per protocol. The nurse should administer diphenhydramine as soon as possible after the sting in an attempt to minimize a reaction. The other actions are important for an insect sting, but the priority intervention is to administer diphenhydramine.

A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform? Provide diversional activities. Administer diphenhydramine. Soak the child in a colloidal bath. Turn the child every 2 hours.

Administer diphenhydramine. As nerve endings heal they cause intense itching that can be relieved with the use of medications (e.g., diphenhydramine hydrochloride, loratadine) and by applying soothing lotions such as Nivea or Eucerin. Turning the child every two hours will not relieve the itching. Soaking in a colloidal bath is contraindicated with burn clients. Although diversional activities can help somewhat, they will not relieve the child's itching.

An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse recommend to relieve the itching? Bathe with a product that is oatmeal-based. Apply calamine lotion if the lesion is weeping. Keep the area covered with clothing. Use a fragrance-free moisturizer.

Bathe with a product that is oatmeal-based. Pruritis is a common problem associated with contact dermatitis. By healing the lesions, the itching will subside. Bathing with oatmeal-based products will accomplish this healing. If the area is too involved, then products like a topical corticosteroid can be used. Calamine lotion is a product that can help with itching, but it is primarily used to dry out weeping lesions. Moisturizers can be applied to the irritated skin, but they must be free of fragrances and dyes. The area should not be covered but allowed to be exposed to air to aid in healing.

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? Perform proper hand hygiene. Complete the prescribed antibiotics. Keep follow-up appointments. Monitor for signs of worsening condition.

Complete the prescribed antibiotics. The instruction that is most important for the nurse to convey is to complete the prescribed course of antibiotics. Many times, once the child feels better, the parent stops the medication; this action, though, can cause a rebound infection. Instructing the family to keep follow-up appointments, perform good hand hygiene, and look out for signs of worsening condition are all appropriate, but the most important instruction is to make sure the child completes the course of antibiotics.

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client? Risk for fluid volume deficit Disturbed body image Pain Altered nutrition

Disturbed body image Tinea versicolor is a superficial tan or hypopigmented oval scaly lesions, especially on upper back and chest and proximal arms. It may take several months for pigmentation to return to normal; therefore, disturbed body image is going to be a high priority for an adolescent client.

An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do? Use a fragrance-free, dye-free soap to clean the wound. Ensure that the temperature of the solution is 120°F (48.9°C). Premedicate the child before changing the dressing. Elevate the area after performing the dressing change.

Premedicate the child before changing the dressing. Premedicating the child before changing the dressing is crucial to providing atraumatic care. Elevating the area may or may not be appropriate depending on the problem and its location. A temperature of 120°F (48.9°C) is the recommended maximal hot water heater temperature. The solution for a wet dressing should not be this hot. There is no indication that the wound should be cleaned.

A teen has experienced a minor burn from a hair styling appliance. What interventions will be of benefit? Select all that apply. Apply ice intermittently. Cover with a clean nonadhesive bandage. Rinse the burned area in cool water. Apply a thin layer of butter on the burned area. Use aspirin for pain.

Rinse the burned area in cool water. Cover with a clean nonadhesive bandage. When caring for a minor burn at home the area may be rinsed with cool water. Ice should not be applied. Covering the burn with a clean nonadhesive bandage is recommended. Butter, creams and ointments should be avoided. Aspirin is not recommended. Acetaminophen or ibuprofen is recommended.

An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants? Staphylococcus aureus Escherichia coli Group A beta hemolytic strep Methicillin-resistant Staphylococcus aureus (MRSA)

Staphylococcus aureus Staphylococcus aureus is the most common cause of impetigo in infants. MRSA is a hospital-associated infection (HAI), group A beta hemolytic strep is seen in older children, and Escherichia coli is not frequently associated with impetigo.

An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? Select all that apply. flu-like symptoms headache burning photosensitivity dryness

burning photosensitivity dryness Adverse effects associated with topical retinoid therapy include burning, dryness, and photosensitivity. Flu-like symptoms and headache are associated with topical immune modulators.

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 staphylococcal scalded skin syndrome impetigo cat scratch disease

cellulitis Cellulitis is characterized by reddened or lilac-colored swollen skin that pits when pressed by the fingertips. Impetigo has superficial lesions that can be bullous or nonbullous. Staphylococcal scalded skin syndrome involves bullae that enlarge and rupture, leaving a red, scalded-looking lesion. Cat scratch disease involves a benign, subacute, chronic course of lymphadenopathy that usually resolves spontaneously in 2 to 3 months.

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)? nonuniform pattern splash patterns stocking-glove pattern on hands or feet spattering pattern

stocking-glove pattern on hands or feet A stocking-glove pattern on the hands or feet or a circumferential ring appearing around the extremity points to the caregiver forcefully holding the child under extremely hot water. A nonuniform pattern and splash or spattering patterns are not typical indicators of child abuse (child maltreatment).

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? Haemophilus influenzae type B vaccine hepatitis A vaccine tetanus toxoid vaccine hepatitis B vaccine

tetanus toxoid vaccine If inoculations are up to date, a booster dose of tetanus toxoid is required to protect the child from infection introduced into the burn.

The nurse is caring for a child brought to the emergency department by the parents. Upon assessment the physician suspects the child has been bitten by a spider. While obtaining the nursing history of the present condition, which statement by the parent will require clarification from the nurse? "My child plays in our woods a lot so I need to be sure protective clothing and shoes are worn." "Since my child just has a rash around the area of the bite there is nothing to worry about." "I cleaned the wound with soap and water right away. I hope that's okay." "I put ice on the bite to try to keep the swelling down."

"Since my child just has a rash around the area of the bite there is nothing to worry about." A rash could be an indication of a systemic reaction and the child should be monitored closely for other signs of a systemic, or possible anaphylactic, reaction. Protective clothing for the prevention of insect or spider bites, cleansing the wound to help with infection control, and ice for prevention of swelling are all effective actions.

The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best? "Apply warm baby oil to your scalp once a day for a few days." "Wash your hair with a gentle shampoo daily." "Wash your hair vigorously twice a day for one week." "I will let your primary health care provider know you need prescription shampoo."

"Wash your hair with a gentle shampoo daily." In the older child and adolescent, a gentle shampoo should be used daily to control scaling caused by dandruff. A medicated shampoo may be indicated if shampooing with a gentle formula shampoo does not provide relief. Washing hair vigorously twice a day is not recommended. Warm baby oil is recommended for infants with cradle cap (seborrhea).

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? carrot and celery sticks peanut butter and jelly sandwich chicken nuggets tomato soup

peanut butter and jelly sandwich Atopic dermatitis is commonly associated with allergies to food. Common culprits may include peanuts, eggs, orange juice, and wheat-containing products.

The nursing diagnosis of risk for infection related to a disruption in the protective skin barrier is noted on a child's plan of care. Which action would be of greatest importance? using appropriate hand hygiene obtaining a culture of the impaired skin area assessing temperature every 4 hours urging adequate nutritional intake

using appropriate hand hygiene Hand hygiene would be the priority because the child's risk for infection is increased and hand hygiene is crucial to preventing the transmission of infectious organisms. Monitoring the child's temperature is important to evaluate for possible fever and infection, but this would not be the most important action. Although nutritional status can influence wound healing, urging adequate nutritional intake would not be the most important action. Although obtaining a culture provides information about the cause of an infection, the child is at risk for infection, so a culture would not provide any information about the risk.

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? The nurse follows contact precautions. The nurse soaks the skin with warm water. The nurse applies topical antibiotics to the lesions. The nurse applies elbow restraints to the infant.

The nurse follows contact precautions. Impetigo is highly contagious and can spread quickly. The nurse should follow contact (skin and wound) precautions, including wearing a cover gown and gloves. The nurse will soak the crusts with warm water, apply topical antibiotics, and apply elbow restraints, but these are not as high a priority as trying to prevent the spread of the infection by following contact precautions.

The nurse is caring for a child with suspected child abuse (child mistreatment)-induced burns. Which assessment findings would support this? splattered-looking, small burned areas to both legs consistent history given by all caregivers 911 called immediately after the burn occurred a burn to the entire right hand up to 2 cm above wrist with consistent edges

a burn to the entire right hand up to 2 cm above wrist with consistent edges A stocking/glove pattern on the hands or feet (circumferential ring appearing around the extremity, resulting from a caregiver forcefully holding the child under extremely hot water) is one sign of child abuse (child mistreatment)-induced burns. Inconsistent history given by caregivers, delay in seeking treatment by caregivers, and a lack of splattering of water burns are all indicators of child abuse (child mistreatment)-induced burns.

The nurse is caring for a mom and her baby on a postpartum unit. The mom states she has received advice not to use baby powder on newborns. She asks the nurse if this is true, and if so, why. Which nurse response is correct? "Baby powder should not be used on newborns due to the risk of aspiration upon application." "Baby powder can be used anytime with no concerns." "Baby powder may be used if sprinkled on your hand away from the baby to prevent aspiration." "Baby powder should not be used since so many people are allergic to the ingredients in it."

"Baby powder should not be used on newborns due to the risk of aspiration upon application." The use of baby powder containing "talc" (also known as "talcum powder") can cause accidental aspiration, pneumonia, and death. Aspiration is predominantly caused when the baby receives a "puff of smoke" when the powder is shaken from the container directly onto the baby's skin. In addition, the use of talcum powder is abrasive and is can contribute to the pathogenesis of diaper dermatitis.

The nurse is teaching parents about the care of diaper rash. The nurse would be concerned about the parents' level of understanding if they made which statement? "I should be certain to use fabric softener in the care of the infant's clothes." "I should not overdress the infant." "I need to wash and rinse clothes thoroughly to be sure all of the detergent is washed out." "I should only use ointments and creams as instructed by the health care provider."

"I should be certain to use fabric softener in the care of the infant's clothes." Fabric softeners should be avoided because their use can result in skin irritation in the infant. Clothing and other baby items should be washed and rinsed thoroughly. Overdressing should be avoided as sweating irritates the rash, and only ointments and creams that are recommended by health care personnel should be used on the infant.

The parent of a 4-year-old child with atopic dermatitis reports having difficulty keeping the child from scratching. What information can be provided by the nurse? Select all that apply. "Distract your child with activities when you notice scratching." "Give your child a small stuffed animal or ball to squeeze when the child itches instead of scratching." "Keep a diary of triggers for a week to see what patterns your child has related to this problem." "Consider flannel sheets for your child's bed." "Keep your child's finger nails trimmed and filed."

"Keep your child's finger nails trimmed and filed." "Distract your child with activities when you notice scratching." "Give your child a small stuffed animal or ball to squeeze when the child itches instead of scratching." "Keep a diary of triggers for a week to see what patterns your child has related to this problem." Itching is a chief concern with atopic dermatitis. Strategies should be employed to reduce scratching. Keeping the fingernails trimmed is helpful in preventing cuts to the skin and introducing bacteria to open wounds. Distracting the child with activities is helpful when the child is experiencing sensations of itching. A small ball or stuffed animal can be used to focus attention on something else when the urge to scratch is present. A diary can be useful when trying to identify patterns of behavior related to triggers of this condition. Flannel sheets may be irritating and should be avoided.

Which assessment finding by the nurse would warrant immediate action? A child with impetigo has honey-colored drainage noted on the skin area. A child with periorbital cellulitis reports changes in vision and pain with eye movement. A child with cellulitis has a temporal temperature of 101°F (38.3°C). A child has a red, warm, edematous area over an old spider bite.

A child with periorbital cellulitis reports changes in vision and pain with eye movement. In a child with periorbital cellulitis, the nurse musty notify the health care provider immediately if signs of progression to orbital cellulitis occur, such as conjunctival redness, change in vision, pain with eye movement, eye muscle weakness or paralysis, or proptosis. This assessment finding warrants immediate action. In nonbullous impetigo, a honey-colored exudate when the vesicles or pustules rupture may be noted on the skin. This assessment finding would be expected. A localized cellulitis will present with erythema, pain, edema, and warmth at the site of the skin disruption (such as a cut or spider bite). This assessment finding warrants further follow-up but not immediate attention. Fever may occur with bullous impetigo or cellulitis and is common with scalded skin syndrome; therefore, this assessment finding also warrants further, but not immediate, follow-up.

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse? "I had our plumber lower our water heater temperature to 130°F (53°C). "We made a song out of 'stop, drop and roll' to teach our children fire safety." "I always make sure the little ones stay out of the kitchen when I am cooking." "We installed smoke detectors on every floor in our home."

"I had our plumber lower our water heater temperature to 130°F (53°C). Water heater temperature should be 120°F (49°C) or lower to prevent significant burns. Installing smoke detectors on every floor of a home is recommended. Keeping young children out of the kitchen during food preparation is important. Teaching children to stop, drop, and roll is important for fire safety.

The nurse is caring for a child with a prescription for PO prednisone. Which statement by the child's mother would indicate a need for further education? "I will give it to ny child at least 1 hour before all meals." "Since my child has type 1 diabetes, I will need to monitor my child's blood sugar levels closely while on this medication. "My child should take the entire prescription as prescribed by the health care provider." "I will have to watch my child closely for signs of infection."

"I will give it to ny child at least 1 hour before all meals." Systemic corticosteroids such as prednisone should be administered with food to decrease gastrointestinal upset. These medications may mask signs of infection. This medication may increase blood sugar levels. Corticosteroid doses should be tapered and should not be stopped abruptly.

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system? "The integumentary system is not in place until after the child is born and then takes many years to mature." "The sebaceous and sweat glands are fully functional in the infant." "One role of the integumentary system is to distribute oxygen to the body cells." "The largest organ of the body helps regulate body temperature."

"The largest organ of the body helps regulate body temperature." The skin is the largest organ of the body. The skin helps regulate the body temperature by heating and cooling. The sebaceous and sweat glands are not fully functional until middle childhood. The major role of the skin is to protect the organs and structures of the body against bacteria, chemicals, and injury. Excretion in the form of perspiration is also a function of the skin glands, called the sweat glands. Sebaceous glands in the skin secrete oils to lubricate the skin and hair. The integumentary system is in place at birth, but the system is immature. A function of the respiratory system is to distribute oxygen to body cells.

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? "This is a normal newborn rash; do not be so worried." "What you see on your newborn's skin is erythema toxicum neonatorum. It is an extensive skin condition that is rare in newborns. You will need to treat the infant as soon as possible to prevent its spread." "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." "What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition. You will need to apply a topical cream twice a day until it disappears."

"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." Erythema toxicum neonatorum (ETN), or neonatal erythema, is one of the more well-known benign, self-limiting skin eruptions in the newborn period. Incidence estimates range from 50% to 70% of all healthy newborns. The rash usually remits within 1 week with no treatment. It is never appropriate to tell a mother not to be so worried.

A nurse is providing care to a child diagnosed with varicella zoster. The child has many lesions in various stages of healing, is irritable, and has a temperature of 100°F (37.8°C). The nurse and the child's parent constantly remind the child not to scratch the lesions. Which intervention is most important for the nurse to implement? Encourage oral fluids. Administer acetaminophen. Suggest distraction activities. Administer an oatmeal bath.

Administer an oatmeal bath. It is most important for the nurse to administer an oatmeal bath, which will result in less itching. Continued scratching could result in secondary infection of the lesions. Acetaminophen administration would be indicated if the child were in pain or if the child's temperature was above 100.4°F (38°C). Providing activities to distract the child would be more helpful once the child was made more comfortable.

The nurse is collecting data from a 14-year-old female and her mother who have come to the clinic for a check-up. The child's mother reports the teen has had hives intermittently for the past two months. What is the priority action for this client? Encourage the mother to purchase over-the-counter topical ointments to keep on hand in the event of another episode. Encourage the family to speak to the physician about prescribing topical steroids. Discuss home remedies to manage the skin condition. Determine the underlying cause.

Determine the underlying cause. Urticaria, commonly called hives, is a type I hypersensitivity reaction caused by an immunologically mediated antigen-antibody response of histamine release from mast cells. Urticaria usually begins rapidly and may disappear in a few days or may take up to 6 to 8 weeks to resolve. The most common causes of this reaction are foods, drugs, animal stings, infections, environmental stimuli (e.g., heat, cold, sun, tight clothes), and stress. The priority is to determine the underlying cause. Over-the-counter topical agents, prescription strength medications, and home remedies may be discussed and employed but are not of greatest importance.

A 10-year-old has been bitten on the lower posterior arm by a dog, requiring several stitches. The child was just admitted to the hospital for 3 days of antibiotic therapy. When developing the care plan, the nurse identifies which nursing diagnoses as being the top 2 priorities? Knowledge deficit regarding care of wound Risk for infection Impaired skin integrity Disturbed body image Risk for fluid volume deficit

Impaired skin integrity Risk for infection The wound was not a clean wound, such as a surgical wound, so risk for infection would be a top priority. The child has impaired skin integrity from the wound and from the IV. Since the wound is new and on the arm the nursing diagnosis disturbed body image would not be a top 2 priority at this time. It is unlikely that a great deal of fluid has been lost from this wound. Knowledge deficit of wound care would not be a top 2 priority at this time, but would be an important nursing diagnosis to address later.

The nurse is caring for a child on the burn unit weighing 100 lb (45.5 kg) who has second-degree (partial-thickness) burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse? Urine output of 15 ml per hour over the last 4 hours Refused dinner due to nausea Pain at a 7 on a 0 to 10 scale Weight gain of 0.9 kg over the last 2 days

Urine output of 15 ml per hour over the last 4 hours Fluid and electrolyte imbalance is a primary concern when caring for the client with burns. The urine output should be a minimum of 1 ml/kg/hour. The client weighs 45.5 kg, so output should equal approximately 45 ml/hour. Pain is a major concern, but the higher priority at this time is the decreased output. Refusal of one meal is not a high priority. Weight gain of 0.9 kg over 2 days is not a concern at this time.

The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest? Pop the pimples to make them go away. Avoid chocolate and greasy foods. Wash the face twice a day with a mild soap then pat dry. Wash the face with abrasive soaps three times a day.

Wash the face twice a day with a mild soap then pat dry. The face should be washed twice per day with a mild soap and lukewarm water then patted dry. Avoiding certain foods will not prevent acne. Popping pimples does not make acne go away and can cause scarring. Washing the face with abrasive soaps can aggravate the acne and cause more flare-ups.

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: graft placement. hypovolemic shock. wound care. curling ulcer.

hypovolemic shock. In severe burns the increased capillary permeability results in vasodilation. This increases hydrostatic pressure in the capillaries, causing water and electrolytes to leak out of the vasculature and resulting in edema. Around 48 to 72 hours, the capillary permeability returns to normal causing severe diuresis. Hypovolemic shock is the major manifestation in the first 48 hours in massive burns. As extracellular fluid pours into the burned area, it collects in enormous quantities, dehydrating the body. Wound care and graft placements are part of burn care, but they are not the priority in the first 48 hours after the burn. A curling ulcer is an acute gastric erosion from complications of severe burns causing ischemia and cell necrosis of the gastric mucosa.

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

impetigo Impetigo is a superficial bacterial skin infection. Impetigo in the newborn is usually bullous (blister-like, fluid filled); in the older child, the lesions are nonbullous and have a honey-colored, crusted appearance.

The nurse is caring for a client who suffered burn injuries to the arms. The arms have blisters, moist red skin, blanching, and sensation is intact. What type(s) of treatment plan is expected for this type of burn injury? Select all that apply. intravenous morphine use of moisturizers application of cool, damp cloths skin grafting surgical debridement

use of moisturizers application of cool, damp cloths The description of the burn matches a partial-thickness (second-degree) burn. Treatment for a partial-thickness burn includes application of cool damp cloths, moisturizers, and ibuprofen. Treatment lasts 14 days or less. Skin grafting and surgical debridement are indicated for full-thickness (third-degree) burns. Morphine is not specified as a treatment for any type of burn.

A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care? "How long has the child had the infection?" "Is there anything else you think we should know about your family?" "Do you have any concerns about filling the prescriptions?" "Does your child have any allergies to medications?"

"Does your child have any allergies to medications?" Since the child is hospitalized with a severe case of impetigo, the child will likely need intravenous antibiotics, so asking about medication allergies is the question that will have the greatest impact on care. Asking how long the child has had the infection, if the parent has concerns about filling prescriptions, or if there is anything the health care team should know about the family are all appropriate questions that should be asked during an admission interview. However, due to the severity of the infection, asking about medication allergies will impact care the most.

The nurse is evaluating the parents' understanding of atopic dermatitis. Which statement shows their understanding? "Atopic dermatitis follows a streptococcal infection." "Hydrocortisone cream may lead to kidney disease." "Atopic dermatitis turns to asthma later in life." "Flare-ups of lesions are not uncommon following therapy."

"Flare-ups of lesions are not uncommon following therapy." Atopic dermatitis is relapsing and remitting. It may recur when the child is re-exposed to the substance to which he or she is allergic, even following treatment. Approximately 30% of children with atopic dermatitis develop allergic rhinitis and asthma. It does not occur as a result of a strep infection. It is caused by an inflammatory process. The use of periodic hydrocortisone cream will not lead to kidney disease.

The nurse is caring for an infant with diaper dermatitis. Which statement by the child's parent would indicate a need for further education? "I will use rubber pants over the cloth diapers in the future." "I will use a warm blow dryer on the rash area for a few minutes every time I change her diaper." "I can still use fragrance-free diaper wipes." "I can leave her diaper off when she naps each afternoon."

"I will use rubber pants over the cloth diapers in the future." Prevention and management of diaper dermatitis include avoiding rubber pants, avoiding diaper wipes with fragrance or preservatives. Treatment of a rash includes allowing the child to go diaperless for a period of time each day and using a warm blow dryer on the area for 3 to 5 minutes.

An adolescent is diagnosed with psoriasis. After speaking with the nurse about treatment options suggested by the primary health care provider, the adolescent states, "Since ultraviolet rays help, I am going to buy a tanning package so I can tan year round." How will the nurse respond? "Be sure to not get burned while you are tanning. Sunburns can significantly increase your chances of getting skin cancer." "I do not think the health care provider meant for you to tan year round. Is that exactly what your health care provider said to you?" "I know it must be tempting, especially at your age. However, please understand that a tanning salon is not a good option for your health." "Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems."

"Year round tanning is not what your health care provider intended. Tanning puts you at high risk for skin cancer and other problems." Acknowledging that ultraviolet therapy is an option while clarifying what is meant by ultraviolet therapy and the risks of tanning year round addresses all concerns. Asking if that is what the doctor said may lead the adolescent to think year-round tanning is a viable option. Advising the adolescent to not get burned is giving approval for tanning. Simply telling the adolescent it is not a good option will be ineffective.

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 dandruff. You can treat it with daily with antiseborrheic shampoo, like Head and Shoulders." "How often do you bathe your infant? The infant should have a thorough shampooing every day to prevent things like this." "Your child most likely has infantile seborrheic dermatitis, or cradle cap. There is no intervention needed and it should resolve in 1 week." "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."

"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." Infantile seborrheic dermatitis usually responds well to cleansing the scalp with a mild shampoo. The thick, scaling lesions on the child's scalp can be treated by applying baby oil, salicylic acid in mineral oil, or a corticosteroid gel on the scalp for 10 to 15 minutes. The area is gently massaged with a soft toothbrush; then the scales can be rinsed away. A fine-toothed comb helps rid the hair of scale debris. Antiseborrheic shampoo is not recommended for infants. Accusing a parent of poor hygiene is inappropriate. Infantile seborrheic dermatitis is not a result of poor hygiene.