Integumentary Ch 29 PrepU

The nurse is providing care to a 5-year-old child brought to the emergency department with a cat bite wound on the arm. While teaching the parents how to care for the wound, the child's mother asks the nurse, "Why isn't the bite being stitched closed?" Which response by the nurse would be appropriate?

"Bites from cats are likely to become infected, so it is better to leave the wound open and heal from the inside out."

The nurse is teaching the parents of a 9-year-old child about preventing contact dermatitis. What will the nurse include in the teaching? Select all that apply.

-Wash the clothes after exposure to a causative agent such as poison ivy. -Apply precontact solution to exposed areas of skin. -Read product labels to ensure that products do not contain offending ingredients. -Use fragrance- and dye-free products.

The nurse is preparing to administer acyclovir intravenously to a child with varicella infection who is immunocompromised. The nurse correctly administers the medication over which time frame?

60 minutes

A nurse is providing care to a 13-year-old client hospitalized with deep partial- and full-thickness (deep second-degree and third-degree) burns on the neck, torso and arms. The nurse attempts to begin a treatment, but the client refuses and angrily tells the nurse "What is the point in all this? I will never be the same again!" What action should the nurse take?

Acknowledge that the client is upset and offer to talk about feelings.

The nurse is caring for an immunocompromised child with a primary varicella zoster infection undergoing treatment with acyclovir. What is a nursing consideration(s) while administering this therapy? Select all that apply.

Administer 10 to 15 mg/kg. Infuse over 1 hour. Continue 48 hours after last new lesions appear.

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care?

Airway remains patent.

A school nurse has discovered that one of the children has acquired a case of head lice. The school principal asks the nurse to write a letter that will be sent to parents explaining about head lice and measures to prevent infestation. What information is important for the nurse to include in the letter? Select all that apply.

Children should avoid sharing personal items such as combs and hats. Parents should inspect their child's head for nits with a fine tooth comb. A second treatment one week after the first is recommended.

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform?

Observe infants respiratory effort

What is a true statement regarding varicella zoster virus infection?

Secondary bacterial infections of the skin can occur.

A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client?

The dog was unprovoked when he bit the girl

The nurse is performing an assessment of a child with a spider bite and documents the findings in the chart note above. Which finding(s) prompts the nurse to anticipate treatment for cellulitis? Select all that apply.

ever chills erythema

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?

"Does your child have any allergies to medications?"

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)." Since temp should be lower than 120.

A 4-year-old is brought to the urgent care center for evaluation of a burn on the forearm. On inspection, the burn is minor. After teaching the parents about how to care for this minor burn. the nurse determines that the teaching was successful based on which statement by the parents?

"If blisters form, we should leave them alone and not break them."

The nurse is assessing the skin of a 6-year-old child with urticaria. When interviewing the child and parents, which question would be most important for the nurse to ask?

"Is the child having any trouble breathing?"

A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate?

"The best thing to do is keep any infant under the age of 6 months out of the sun."

The nurse is inspecting the skin of a child with a rash on the lower legs and documents the above findings. Based on the findings, which question would the nurse most likely ask next?

"Was your child outside near some plants that could be poison ivy?"

The nurse is reviewing the use of malathion for the treatment of head lice in an 8-year-old child with the child's parents. What statement requires further follow up by the nurse?

"We should apply the medication to wet hair."

A child weighing 66 lb (30 kg) with deep partial thickness burns is receiving fluid resuscitation. The nurse is monitoring the child's urine output via Foley catheter every hour and documenting the findings on the flowsheet above. The nurse would notify the health care provider about which urine output?

56 ml

The nurse is teaching the parents of a 7-year-old child on preventing integumentary disorders. What will the nurse include in the teaching? Select all that apply.

Apply sunscreen to your child. Teach your child to recognize and avoid poison oak. Teach your child to not approach strange pets without permission. Learn to identify infestations such as lice, scabies, and bed bugs.

The nurse is caring for an 11-year-old child with a primary open skin lesion. What action(s) will the nurse include in the plan of care to prevent infection in the child? Select all that apply.

Assess for increased warmth around the wound. Teach hand hygiene to the child and parents. Advise the child not to scratch the affected area.

A child injured in a house fire is brought to the emergency department. What assessment(s) is a priority for the nurse to perform? Select all that apply.

Assess the child's respiratory effort. Examine the face for signs of soot. Remove the clothing to inspect burned areas.

An adolescent is brought to the urgent care clinic for evaluation of the hands. The adolescent had been out snowboarding for the past several hours in 20°F (-6.7°C) temperatures. The adolescent was wearing gloves but took them off because they were wet and causing problems with holding onto the snowboard. The nurse completes an assessment and documents the findings. Based on the assessment findings above, which action would be appropriate as part of the plan of care?

Place the hands in warm water for 30 minutes.

What information should be included in the teaching plan for a child with varicella?

Remind the child not to scratch the lesions.

The nurse is conducting a presentation for a group of parents at the local pediatric community health center. The nurse is describing the importance of immunizations to prevent common viral infections such as rubeola and rubella. As part of the presentation, the nurse describes the development of rubeola and explains the progression of signs and symptoms. Place the signs and symptoms listed below in the order that the nurse would describe them. Use all options.

fever rash Koplik spots desquamation

The appearance of which hallmark clinical manifestation occurs in measles?

koplik spots

koplik spots

small, blue-white spots with red halo over oral mucosa; early sign of measles

The nurse is caring for a child presenting with plaques around the nose and mouth that have a honey-crusted appearance. What treatment does the nurse anticipate for the child?

topical mupirocin for 10 to 14 days

The parents of a child diagnosed with varicella are concerned about their other children getting it. The nurse instructs the parents that their child is contagious for how much longer now that the rash has appeared?

until there are no more new lesions and lesions have crusted over

The nurse is teaching the parents of a child diagnosed with erythema multiforme about the condition. The nurse determines that the teaching was successful based on which statement by the parents?

"The rash should go away in about 2 weeks."

A nurse is conducting a parenting class on infant skin care. What information should the nurse include when preparing materials on the characteristics of the skin of infants? Select all that apply.

it is thinner and more fragile than an adult's Substances are easily absorbed.

The nurse is teaching the parents of a 5-year-old child diagnosed with head lice about using permethrin. The nurse determines that the teaching was successful based on which statement by the parents?

leave on for 10 mins before rinsing off

A 5-year-old child is brought to the pediatric health clinic for evaluation. The nurse completes the assessment and documents the findings. Based on the assessment findings above, which condition would the nurse suspect?

measles

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child?

mumps

A nurse is providing care to a 3-year-old child hospitalized with second-degree (partial-thickness) and deep partial-thickness burns to the dorsal portion of both legs. The nurse is preparing to change the child's dressings. Which action(s) should the nurse take to elicit the child's cooperation in the dressing change? Select all that apply.

Allow the child to decide which leg's dressing to change first. Permit the child to choose a method of distraction. Encourage the parent to hold the child's hand during the dressing change.

The nurse is caring for a 2-month-old infant. What action(s) will the nurse take to help prevent skin breakdown? Select all that apply.

Assess the skin at regular intervals. Perform frequent diaper changes as appropriate. Note areas of redness on the skin.

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?

Complete the prescribed antibiotics.

The nurse is providing care to a 6-year-old child who was stung by a honey bee. Inspection reveals that the stinger is still present. Which action by the nurse would be appropriate?

Remove the stinger by scraping the skin.

A 10-year-old child is brought to the clinic by the parents for evaluation of swelling of the foot. The child tells the nurse, "I wore new soccer shoes and got a blister. The blister broke and is red." Further inspection reveals an edematous third toe on the right foot. The area is reddened and warm and tender to the touch. A diagnosis of cellulitis is made and medication is prescribed for the child. The nurse would most likely educate the child and parents about which medication?

cephalexin

A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults?

herpes zoster (shingles)

A 7-year-old child is brought to the emergency department after suffering a burn injury. The nurse would expect the child to be transferred and admitted to the burn center based on which finding(s)? Select all that apply.

history of type 1 diabetes since age 3 burns affecting the child's face and hands evidence of smoke inhalation injury demonstration of full-thickness (third-degree) burns on trunk

A nurse is preparing a presentation for a group of parents of toddlers at the local community center. The topic of the presentation is burn prevention. When describing burns in toddlers, which situation would the nurse likely identify as the most common cause of thermal burns?

scalding from pulling a hot pan off the stove