Integumentary Conditions

Which statements support a diagnosis of contact dermatitis?

A six-year old patient received a new watch; lesions appeared under the watch. After helping prepare dinner, an eight-year old develops lesions on her hands. She helped by cutting limes and squeezing the juice from the fruit. A two-year old takes her mother's make-up on a daily basis to play dress up. After three days of play, her mother notices erythema around the child's lips after applying lipstick. A ten-month old has erythema in the perianal region; the mother states they just returned from a long car trip. The infant slept for most of the trip in the car seat and only had one diaper change.

A parent brings her kindergarten-aged child in for a check-up because the child has been complaining of pruritus, especially at night, and appears to have a rash on his wrist. After taking scrapings of the lesion and providing topical application of permethrin 5% as ordered, the nurse sends the child home with instructions for re-treatment in one week. At the two-week follow-up appointment, the child continues to complain of pruritus. Which statement best explains this finding?

After two rounds of proper treatment, the pruritus is likely not re-infestation but rather a normal response.

The parent of a patient describes a family history of sensitive skin and allergies. The patient presents with allergic rhinitis, pruritus, and multiple painful plaques. Which is the best description for the pathophysiology of this patient's skin?

An inflammatory response is generated by T-cell induced recruitment of mast cells and eosinophils to the skin. Histamine released from mast cells causes pruritus.

Two siblings were playing in a wooded area near the school. Both have several ticks that need to be removed. After removal, the nurse provides information to the parents regarding signs of infection. Which items should be included in the discussion with the parents?

Check skin for rashes and swollen lymph nodes. Keep the bite area clean and inspect for expanding redness. General fatigue, headache, and stiffness should be monitored.

An adolescent patient with acne vulgaris recently changed their skin cleansing regimen to include a topical antibacterial agent. Which finding does the nurse note determines that the expected outcome has been met?

Improvement of acne and prevention of secondary infection.

The presence of which type of birthmark is related to skin pigmentation?

Mongolian spots

The parents of a patient with molluscum contagiosum refuse treatment and insist the child will return to daycare tomorrow. What information should the nurse provide to the parents to prevent further spread of this viral infection?

Naptime mats, clothing, and other materials should not be shared. Transmission of molluscum contagiosum can occur from skin-to-skin, fomite-to-skin, and by sexual contact. Instruct the child not to touch the bumps and keep the bumps covered. If the bumps are visible it is contagious. Children with eczema or those who are immunocompromised are at an increased risk for generalized spread of the lesions.

The nurse provides discharge teaching to the parents of an infant and includes that good scalp and skin hygiene should be maintained to prevent which disorder?

Seborrheic dermatitis

A child comes to the clinic with multiple insect bites. The parent states that the child was playing soccer at dusk and was bitten by mosquitoes. What preventative measures would lead to a decrease in mosquito bites?

Stay away from areas of standing water where mosquitoes breed. Use an insect repellant; one that contains DEET can be used for older children. Limit outdoor activity during dawn and dusk when mosquitoes are most active.

A three-year old was running near a construction site and stepped on a rusty nail. At the emergency department, the nail was removed, the wound was cleaned, and the patient received Tetanus prophylaxis. Which statement best demonstrates how tetanus treatment promotes prevention of a secondary infection?

Tetanus is caused by soil-dwelling bacteria. Tetanus prophylaxis prevents the secondary infection and toxin release by the bacteria, C. tetani.

A patient with visible skin lesions presents with disturbed body image. After discussing ways to enhance appearance, the nurse should expect which desired patient outcome?

The patient should apply the techniques discussed which will help generate a positive self-image over time.

An adolescent is ashamed of her atopic dermatitis and refuses to join any outdoor family functions. What is the expected outcome, following nursing care involving discussion of skin care and hydration, for this patient?

This patient should see an improvement in the lesions as proper skin care and hydration are beneficial in atopic dermatitis.

When diagnosing a child with suspected pediculosis capitis, the father mentions that their older son was at summer camp last week. Which is the best statement associated with obtaining social history information for this patient?

To determine a possible origin for the infestation