PHARM chapter 11 Integumentary system Medications

Family members at a reunion on the beach return from a long walk with sunburn on their shoulders and feet. Which of the following recommendations will the nurse make? "Take oral antihistamines to help reduce the chance of blistering." "Apply butter to the area to stop the burn and allow healing." "Apply hydrocortisone cream to the area to reduce swelling and pain." "Apply cold cloths to the sunburn for 20 minutes, then apply aloe vera ointment."

"Apply cold cloths to the sunburn for 20 minutes, then apply aloe vera ointment." Correct. Nonpharmacologic treatment of sunburn includes cool water and aloe vera application.

A nurse working in a gynecology office is asked to assist in the treatment of a patient with condylomas. Which of the following actions should the nurse take? Make a list of the patient's sexual partners for the past 3 weeks. Ask the patient if there are any known allergies to iodine. Ask the patient to remove clothing below the waist. Prepare the patient for full-body phototherapy.

Ask the patient to remove clothing below the waist. Correct. Condylomas are genital warts and are treated with cryotherapy, salicylic acid, or liquid nitrogen applied directly to the wart. The genital area will need to be exposed to allow for treatment.

Rosacea is a type of skin cancer.

false;rosacea is Chronic skin disorder of the face with red inflamed areas appearing mostly on the nose and cheeks

A comedo is _______. A louse egg A nodule A form of acne Earwax

form of acne

acne

inflammatory disease of the skin involving the sebaceous glands and hair follicles

Nits

lice eggs

A school nurse is preparing a letter to parents to notify them of a recent case of head lice in a second-grade student. Which of the following statements should be included in the letter? (Select all that apply.) "Any child found to have lice during the school day will immediately be given oral antibiotic therapy." "Over-the-counter shampoo products are available for the treatment of lice." "Lice rarely spread from child to child, so no special precautions need to be taken." "Children's hair should be examined at home daily using a fine-toothed comb for small, round, white eggs or nits." "If your child is found to have lice, your health care provider should be seen to obtain a prescription for antifungal therapy."

"Over-the-counter shampoo products are available for the treatment of lice." "Children's hair should be examined at home daily using a fine-toothed comb for small, round, white eggs or nits." Correct. Lice are also called nits. The eggs are small, round, and attached to the hair shaft. A fine-toothed comb will assist in seeing the signs of a lice infestation. Shampoos can be obtained over the counter for management of lice infestations.

inflammatory conditions such as burns 1st 2nd and 3rd degree

1-lidocaine 2-silver 3-collagenase, becaplermin

While working in the hospital with patients who have been burned, the nurse prepares to apply the initial dressings to a patient with second- and third-degree burns. Place the following steps in order for this procedure: A. Apply silver sulfadiazine (Silvadene) to the burn area. B. Cover the burn with sterile dressing. C. Set up a sterile field and don sterile gloves. D. Assess and measure the wounds.

1. First ANS: D. The first step is to assess the wounds (nursing process) to determine the dressings that will be needed. 2. Second ANS: C. Sterile dressings are then used to prevent infection in the wounds. 3. Third ANS: A. Sulfadiazine is an antibiotic used for burns to prevent infections. 4. Fourth ANS: B. Finally, burns are covered with a sterile dressing to prevent infection and absorb any exudate leaking from the burns.

Which of the following patients would be instructed to avoid/discontinue using the noted treatment? A 34-year-old male with tinea infection who reports localized itching while using clotrimazole (Lotrimin) A 26-year-old female with psoriasis using fluorouracil (Efudex) who reports photosensitivity since starting the medication A 16-year-old male with acne prescribed tretinoin (Retin-A) who reports a history of asthma A 21-year-old female with eczema using hydrocortisone (Cortaid) who reports she is pregnant

A 21-year-old female with eczema using hydrocortisone (Cortaid) who reports she is pregnant Correct. This patient needs to stop using hydrocortisone cream due to the pregnancy; it is contraindicated.

While performing skin assessments during a local mall screening event, the nurse would be most concerned by which of the following findings? A 64-year-old patient with reddish, firm, dry, and peeling patches noted on his knuckles and elbows A 39-year-old patient with a purplish-black irregular shaped area on the shoulder blade A 47-year-old patient with a small tan, flat, scaly patch noted on his cheek A 55-year-old patient with multiple nevi across his back and shoulders

A 39-year-old patient with a purplish-black irregular shaped area on the shoulder blade Correct. This describes a possible malignant melanoma and needs referral to a physician immediately due to the potential for metastasis.

While performing an admission history with a patient who has extensive eczema, the nurse should anticipate the patient will report a history of which other conditions? (Select all that apply.) Allergic rhinitis Frequent/severe sunburn Asthma Recurrent urinary tract infections Cardiomyopathy

Allergic rhinitis Asthma Correct. Eczema is an allergic condition associated with other allergic conditions such as asthma. Eczema is an allergic condition associated with other allergic conditions, such as allergic rhinitis.

The nurse is caring for a patient with extensive third-degree burns scattered across the left leg and hip. Orders for chemical debridement using collagenase (Santyl) are noted. The nurse will take which of the following actions? Apply the collagenase to the blackened, dead tissue within the burned area. Apply the collagenase to the pink, open areas within the burned area. Mix the collagenase with sterile normal saline and apply soaked dressing to entire wound bed. Work the collagenase into sterile dressings and apply these uniformly across the burned area.

Apply the collagenase to the blackened, dead tissue within the burned area. Correct. Collagenase will remove dead tissue; the blackened color of the tissue indicates it is dead and needs to be removed. The collagenase should be used on this.

Rosacea

Chronic skin disorder of the face with red inflamed areas appearing mostly on the nose and cheeks

While performing a skin assessment for a newly admitted 82-year-old patient, the nurse notes the patient has reddened, peeling areas between his toes and around the soles of his feet. Which of the following medications would the nurse request? Nystatin Lidocaine Clotrimazole Calcipotriene

Clotrimazole Correct. Clotrimazole is an antifungal medication used in the treatment of fungal infections on the feet, trunk, extremities, and groin.

(Inflammatory) Atopic dermatitis

Eczema. Allergic disorder causing cutaneous inflammation- Treatment: Topical corticosteroids, oral antihistamines, and avoidance of allergens.

The nurse is admitting a 22-year-old patient to the hospital with suspected fractures of the right arm after a bicycle accident. The patient reports taking vitamin A daily. Which of the following would the nurse expect to see during the physical examination? Flushed nose and cheeks Genital warts Oral fever blisters in various stages of healing Dry, patchy, reddened areas on the hands and elbows

Flushed nose and cheeks for rosacea

Antiviral medications can be used to treat which of the following conditions? (Select all that apply.) Herpes zoster HPV Thrush HSV-2 Scabies

Herpes zoster HPV HSV-2 Correct. HPV is an example of a viral infection that is treated with antiviral medication. Herpes zoster is an example of a viral infection that is treated with antiviral medication. HSV-2 is an example of a viral infection that is treated with antiviral medication.

While playing at the park with her children, the nurse notes a toddler who has honey-colored crusts and open areas on the lips and nose. Which of the following actions should the nurse take first? No action is required, as the child is exhibiting symptoms of a common cold, and medications will not alter the child's symptoms. Inform the child's parent the child may have a common bacterial infection and should be seen by a physician for topical or systemic antibiotics. Ask the child's parent if the child has food allergies and suggest the use of an antihistamine. Suggest the child's parent seek treatment for suspected thrush with an oral antifungal agent.

Inform the child's parent the child may have a common bacterial infection and should be seen by a physician for topical or systemic antibiotics. Correct. The honey-colored crusts are a sign of impetigo, a contagious bacterial infection common in children, which can be treated with topical or systemic antibiotics.

A nursing instructor informs a nursing student that the assigned patient has been prescribed a pediculicide medication. The student recognizes the patient has been diagnosed with which of the following? Lice Eczema Impetigo Psoriasis

Lice

A nurse at a dermatologist's office is working with a patient with suspected basal cell carcinoma. The nurse would most likely prepare for which of the following? Liquid nitrogen cryotherapy Radiation therapy Chemotherapy Topical treatment with corticosteroids

Liquid nitrogen cryotherapy Correct. Liquid nitrogen cryotherapy is a common treatment for basal cell carcinoma, and the nurse should be prepared to assist with the procedure.

A nurse working with adolescents recognizes that which of the following could be used to help treat acne? (Select all that apply.) Topical immunomodulators Salicylic acid Oral contraceptives Sulfur Systemic antibiotics

Salicylic acid Oral contraceptives Sulfur Systemic antibiotics Correct. Oral contraceptives can be helpful in managing acne and have been prescribed for this purpose. Systemic antibiotics are used to manage extreme cases of acne. Salicylic acid ointments or creams can be used to manage acne. Sulfur can be used topically to manage severe acne.

While working in a dermatologist's office, the nurse welcomes a new patient who is 15 years old. The patient has notable facial acne, and a quick examination reveals scattered areas of keratinization and multiple pustules and comedones across the patient's shoulders and back. The nurse anticipates that which of the following medications will be recommended? Salicylic acid (Stri-Dex) Anthralin (Psoriatec) Etanercept (Enbrel) Lindane (Rid-X)

Salicylic acid (Stri-Dex) Correct. This medication is appropriate to treat severe cases of acne as described in the scenario. It is used to slough the infected skin to resolve the acne.

Keratinization

The process by which cells form fibrils of keratin and harden

The layer of skin involved in a second-degree burn is the _______. Dermis Epidermis Hypodermis A and B All of the above None of the above

a and b dermis and epidermis

Nodule

a small lump

HPV is an example of a _______. Bacterial infection Viral infection Parasitic infection Fungal infection

viral infections

bacterial medications for acne/rosacea

vitamin A (retinoids) benzoyl peroxide salicic acid tetracyclines sulfu resorcinol oral contraceptives

virsus medications for HPV

warts-cryotherapy with liquid nitrogen

A nurse working for a family practice physician sees a 48-year-old patient who reports severe itching of his hands and underarms. Examination reveals redness and irritation in the webbing of both hands and axillae. The physician orders permethrin (Elimite) cream, a scabicide. The nurse recognizes that teaching has been effective by which of the following statements? "Applying this cream between my fingers and arm pits will kill the mites and eggs." "Scabies only live on top of the skin, so the itch should disappear within a day." "I can't believe I have lice. I wonder if I got it from my niece." "I will need to use a fine-tooth comb to go through my hair daily for the next full week."

"Applying this cream between my fingers and arm pits will kill the mites and eggs."

The nurse is providing instructions for a patient who will begin taking docosanol 10% (Abreva) for HSV-1 infection. Which of the following indicates that further teaching is necessary? "Side effects of this medication could include headache." "The medication helps block the spread of the virus." "I should apply this medication once daily." "I don't need a prescription for this medication."

"I should apply this medication once daily." Correct. This medication should be applied at the first sign of a cold sore and repeated up to five times daily.

The nurse is educating a patient who is to start a prescription for tacrolimus (Protopic) for the treatment of atopic dermatitis. The nurse knows further teaching is necessary when the patient states which of the following? "I will have to take this medication by mouth at least three times a day." "This medication alters the local immune response on my skin but won't increase my risk for other infections." "This medication will help reduce the swelling and redness on my skin." "I should notice a big improvement in the constant itch I've been having."

"I will have to take this medication by mouth at least three times a day." Correct. Further teaching is needed because this medication is a topical preparation for the skin.

A nurse caring for a patient with psoriasis recognizes the patient is very knowledgeable about his disease by which of the following statements? (Select all that apply.) "I've used topical steroids and antihistamine creams, but they haven't helped much lately." "My skin peels because the cells underneath are damaged and don't replace themselves fast enough to maintain a protective barrier." "The doctor said if the anthralin (Psoriatec) cream doesn't help, I may need to take methotrexate." "I keep hoping the doctor will find the medication that cures this so it will go away for good." "I traveled to Argentina and soaked in a hot spring—it was wonderful and did help my skin."

"I've used topical steroids and antihistamine creams, but they haven't helped much lately." "The doctor said if the anthralin (Psoriatec) cream doesn't help, I may need to take methotrexate." "I traveled to Argentina and soaked in a hot spring—it was wonderful and did help my skin." Correct. Several countries claim to have hot springs that are helpful to people and provide healing for their condition. The topical steroids and antihistamines are commonly used to manage psoriasis, and sometimes the effectiveness decreases over time. Anthralin cream is used to manage psoriasis, and when it is not effective the next level of medication can be used.

While working with a patient who has extensive third-degree burns, the nurse applies becaplermin (Regranex) gel to the patient's wound bed. The patient asks, "What will that do?" Which of the following responses is best? "By stimulating phagocytosis, the gel reduces the amount of fluid loss within your burns." "The gel helps slow tissue growth to prevent scarring that may cause contractures." "The gel helps new tissue grow within the wound bed and increase healing." "This will kill topical bacteria and help reduce the risk of infection."

"The gel helps new tissue grow within the wound bed and increase healing."

An 18-year-old male seen routinely in the dermatology clinic has recently been given a prescription for tretinoin (Retin-A). Which of the following statements will the nurse include in the patient teaching? (Select all that apply.) "I'm so glad the doctor started this medication for you; it will make your psoriasis clear right up." "This medication may increase the risk of sun burn, so be sure to wear a hat and sunscreen." "This medication acts by reducing oil production by the glands in your skin." "Be sure you drink at least ten glasses of water each day, as this medication can damage your kidneys." "It will be particularly important for you to immediately report any thoughts of suicide while you are taking this medication."

"This medication may increase the risk of sun burn, so be sure to wear a hat and sunscreen." "This medication acts by reducing oil production by the glands in your skin." "It will be particularly important for you to immediately report any thoughts of suicide while you are taking this medication." Correct. The tretinoin can cause increased sensitivity to the sun, and protection from the sun is important to teach the patient. A serious side effect of tretinoin is suicide, so any thoughts of suicide need to be reported immediately. Tretinoin does reduce oil production in the skin to reduce acne in the patient.

Ultraviolet therapy will be most helpful for which of the following patients? A 55-year-old with squamous cell carcinoma A 15-year-old with atopic dermatitis A 28-year-old with basal cell carcinoma A 41-year-old with psoriasis

A 41-year-old with psoriasis Correct. This is the appropriate treatment for patients with psoriasis. It is combined with other antipsoriatic agents.

Which of the following individuals will need a referral to determine the potential need for systemic chemotherapy? A 48-year-old patient with basal cell carcinoma who is being treated with topical fluorouracil A 54-year-old patient with basal cell carcinoma on the nose who is being treated with a topical immunomodulator A 66-year-old patient with squamous cell carcinoma who is receiving radiation after surgical excision of the primary lesion A 61-year-old patient with malignant melanoma who had a wide surgical excision with clear margins

A 61-year-old patient with malignant melanoma who had a wide surgical excision with clear margins Correct. Malignant melanoma can metastasize easily and is unpredictable in its course; therefore, chemotherapy is often used in the treatment of the condition.

A nurse's teenage daughter tearfully states, "I keep getting pimples on my face even though I wash it every day and I'm not eating any chips or cookies. What can I do?" While considering over-the-counter treatment options, what common ingredient will the nurse most likely find in topical creams and lotions? Clotrimazole Benzoyl peroxide Hydrocortisone Lidocaine

Benzoyl peroxide

seborrhea

overactivity of the sebaceous glands that results in the production of an excessive amount of sebum/oil

Rosacea includes skin irritations called _______. Comedones Papules Verruca Nevus

papules

An example of a pediculicide is _______. Compound W Nystatin Rid-X Decadron

rid-x

parasitic medications for scabies and lice

scabicides/pedicilicides

Which of the following is NOT a type of skin cancer? Basal cell carcinoma Squamous cell carcinoma Small cell barceloma Melanoma

small cell barceloma

Skin cancers

surgery fluorouracil imiquimod liquid nitrogen cryotherapy

Metastasize

the process by which cancer spreads from one place to another

inflammatory psoriases

topical corticoids antihistamine salici acid phototherapy antralin,calcipotriene (specific) severe-methotrexate

Comedones

also called blackheads; masses of sebum trapped in the hair follicles

bacterial medications for impetigo

antibiotics

fungi medications for tinea and candidiases

antifungals- clotrimazole, terbinafine, nystatin

A nevus is a mole.

true

Oral contraceptive drugs can treat acne.

true

Pediculicides kill nits and lice.

true

Psoriasis occurs when a shortened life cycle of skin occurs.

true

The topical antibiotic used for burns is called Silvadene.

true

Vitamin A is used to treat acne.

true

Thrush is caused by _______. HSV-1 HSV-2 Candida albicans Sarcoptes scabiei

candida albicans

Psoriasis

chronic skin condition producing red lesions covered with silvery scales

Atopic dermatitis is also called _______. Eczema Psoriasis Basal cell carcinoma None of the above

eczema

Antifungals are used to treat impetigo.

false, antibacterial medications

Thrush is a bacterial infection.

false, fungal infection

Malignant melanoma is easily treatable with topical creams.

false; sugery and chemotherpay/radiation

Impetigo

inflammatory skin disease with pustules that rupture and become crusted

Scabies is caused by this parasite. Itch mite Body lice Head lice Pubic lice

itch mite

Nevus

mole/birthmark

Eczema

noninfectious, inflammatory skin disease characterized by redness, blisters, scabs, and itching

Thrush is treated with what medication? Nystatin Ampicillin Acyclovir Any of the above

nystatin

virus medications for HSV 1 and 2

oral antiviruls

Thrush

oral candidiasis in the newborn