Chapter 61: Drug Therapy for Disorders of the Skin, Inflammatory Disorders

A nurse has taught a client about sunscreen use. Which statement by the client suggests a need for additional instruction?

"A skin protection factor of 10 is recommended."

The nurse is performing the initial assessment of a client whose acne vulgaris causes considerable distress. The client tells the nurse, "Just so you know, I can't swallow pills so hopefully I don't get prescribed any." What is the nurse's most appropriate response?

"It's likely that your health care provider will prescribe an ointment, not tablets."

A male client is prescribed a combination of topical drugs to treat his atopic dermatitis. What statement by the client indicates that he requires further education regarding his medication regimen?

"Local drug therapy will not be absorbed systemically."

A client is diagnosed with herpes genitalis. Which medication is used for this condition?

Acyclovir

The nurse demonstrates appropriate understanding use when recommending which herbal preparation for the treatment of minor skin conditions?

Aloe

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

Benzoyl peroxide and erythromycin (Benzamycin)

The nurse uses special precautions to provide safe use of topical corticosteroids in which group of clients?

Children

The nurse recommends which of the following types of therapeutic baths for its antipruritic action?

Colloidal (Aveeno, oatmeal)

A nurse is preparing to administer lidocaine viscous to a client scheduled for minor surgery. Which instruction regarding the intake of food should the nurse give the client?

Do not eat food for 1 hour after use.

Which of the following topical anti-infective drugs is correctly paired with the infection it is used to treat? Select all that apply:

Erythromycin (Erygel) - acne vulgaris Ciclopirox (Loprox) - tinea pedis Acyclovir (Zovirax) - episodes of HSV

The nurse is performing an assessment for a client who has been taking isotretinoin for several weeks for the treatment of acne vulgaris. The client states, "I think it's working well, but my lips and face are terribly dry. What is the nurse's best action?

Explore strategies for managing this adverse effect with the client.

The nurse is conducting a class on skin care for adolescents and knows that special precautions are needed for safe use of oral retinoids in what client population?

Female clients of childbearing potential

The nurse is developing the plan of care for a client with a skin lesion requiring topical therapy. Which nursing diagnosis would the nurse most likely prioritize?

Impaired skin integrity

The nurse is giving discharge instructions to parents of an infant with a skin condition and knows that topical agents are used cautiously in infants for what reason?

Infant skin is more permeable

The nurse is counseling a client who will be taking isotretinoin for the treatment of acne. The nurse informs the client that the most common site for adverse effects is which system?

Integumentary

The Nurse Practitioner is seeing a 16-year-old male who has come to the dermatology clinic for treatment of nodular cystic acne. The Nurse Practitioner would know that the treatment would consist of which of the following medications?

Isotretinoin (Accutane)

Which of the following is an oral retinoid used in the treatment of acne?

Isotretinoin (Accutane)

A student nurse has completed a class presentation depicting the various topical drugs. The instructor determines the student has correctly illustrated which drug(s) that act by temporarily blocking the action of sensory nerve fibers? Select all that apply.

Lidocaine Dibucaine

The nurse knows that a pediatric client is at greater risk for systemic adverse reactions from a topical medication. Why?

Pediatric clients have a greater skin surface area to body mass ratio.

The nurse is assessing a teenage client with a history of acne vulgaris who was prescribed clindamycin and benzoyl peroxide three weeks ago. The client states, "My acne is as bad as it's ever been, and I don't think the medicine is working at all." What is the nurse's best response?

Reassure the client that the best results may take two or three months.

A client with acne vulgaris has been prescribed erythromycin and benzoyl peroxide. The client does not understand this approach to treatment, asking the nurse, "Why am I getting two different medications? Isn't the antibiotic enough?" The nurse should describe what potential benefits of this combination approach to treatment? Select all that apply.

Reduced risk of antibiotic resistance compared with antibiotics alone Increased effectiveness of acne treatment

The nurse is preparing to administer a topical medication to a client with a skin disorder. Which assessment(s) should the nurse prioritize on the assessment? Select all that apply.

Size of the area affected Appearance of the lesions Report of pain or burning

The health care provider has prescribed tacrolimus ointment for a client with severe atopic dermatitis because the client's condition has not improved with other medications. The nurse is aware that this medication carries a black box warning that this drug may increase the risk of the development of what condition?

Skin cancer

Bacitracin (Baciguent) interferes with the cell wall synthesis of which type of bacteria?

Staphylococcal

A client reports experiencing intense itching between the toes. Upon inspection, the nurse notes scaly red areas with open areas underneath the toes. Which condition does the nurse suspect?

Tinea pedis

Which of the following is the most common fungal infection?

Tinea pedis

The community health nurse provides care for a diverse group of clients, several of whom have acne vulgaris. For which client would the use of isotretinoin be most appropriate?

an adult client whose cystic acne has not responded to conservative treatment

Which medication can be applied to the lesions related to a bacterial skin infection?

bacitracin

Which of the following is the primary lesion associated with acne, caused by sebum blockage in hair follicles?

comedone

A nursing student identifies which drug class exerts a localized anti-inflammatory effect when applied topically?

corticosteroids

What nursing diagnosis is likely to be the priority for a teen whose acne is not responding to initial treatment?

disturbed body image related to visible skin lesions

A college student is distraught that facial acne has become more serious over the past several months and is requesting a prescription for isotretinoin. What assessment is the priority before the initiation of this treatment?

two consecutive pregnancy tests

The nurse understands the actions of keratolytics when salicylic acid is used to treat which of the following? (Select all that apply.)

warts calluses corns