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Medsurg 6
| Question | Answer |
|---|---|
| The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about | Absent distal pulses, cool skin temperature in the affected limb, poor capillary refill |
| A patient scheduled for a lung scan, you know that lung scans use Radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for. | Iodine Allergy |
| The Purulent fluid during a Thoracentesis procedure indicates | Infection |
| The client has just had an invasive procedure to assess the respiratory system. What should be assessed on this patient? | Respiratory distress |
| What happens to Diaphragm during inspiration | It relaxes and flattens |
| You are studying for a physiology test over the respiratory system. What should you know about central chemoreceptors in the medulla | They respond to changes in C02 levels and hydrogen ion concentration (PH) the cerebrospinal fluid |
| What is the difference between respiration and ventilation | Ventilation is the movement of air in and out of the respiratory tract. |
| Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen | The two methods of perfusion are bronchial and pulmonary circulation |
| A nurse is caring for a client who has frequent upper respiratory infections. Which structure is most helpful in protecting against infection? | Tonsils and Adenoids |
| caring for a adolescent client injured in a snowboarding accident. has a head injury, a fractured right rib and various abrasions and contusions. The clients BP 142/88, P-102, RR 26. Which lab test provides data on potential impairment in ventilation. | Blood Gases |
| The nurse is providing health education on the body's ability to exchange oxygen and carbon dioxide through the alveolar capillary membrane. Which is correct about diffusion during aspiration. | During inspiration, oxygen is greater in the alveoli than in the capillaries |
| The nurse is caring for a client with decrease in airway diameter causing airway resistance. The client experiences cough and mucus production. Upon assessment, which adventitious breath sounds are anticipated | Wheezes |
| After a Bronchoscope what should be assessed before providing any food or fluids to the client | The gag reflex must be assessed. |
| The nurse is caring for a pt whose respiratory status has declined, Tachypnea, restless, and displays cyanosis. Which diagnostic test should be assessed first? | Pulse Oximetry |
| Diagnostic studies that the nurse would screen patient's for iodine allergy prior to test | Lung Scan Fluoroscopy Pulmonary Angiography |
| A client in immediate Post-thoracentesis, what position should the nurse place the patient | Lying on the unaffected side for at least 1 hr to promote expansion of the lung on the affected side |
| Which suggestion, offered by the nurse is helpful in producing sputum sample | Take deep breaths and cough forcefully |
| A patient upon assessment, the nurse notes that the client's sternum is depressed, especially on inspiration and crackles at the bases of the lung field. Base on inspection, what will the nurse document? | The client's has a funnel chest know as pectus excavatum |
| A patient diagnosed with Right middle lobe pneumonia, which sound over the chest wall when percussing is anticipated | Dull is indicative of little or no air movement in that area of the lung. |
| You are caring for a client diagnosed with enlarged adenoids. What condition is produced by enlarged adenoids | Noisy breathing |
| You are performing preoperative assessment on a client who is scheduled for a tonsillectomy. why would you ask a patient about the use of herbal supplement | They prolong bleeding |
| The nurse is caring for a patient with terminal cervical cancer. Which clinical manifestations would the nurse expect to observe based on this diagnosis? | Anemia Cachexia Weight Loss |
| Which manifestations may be seen in a 55-year-old nulliparous, menopausal female patient with a suspected endometrial cancer? | Pelvic pain vaginal bleeding pain with urination |
| A patient was recently diagnosed with early-stage resectable breast cancer and tells the nurse, “I do not want to have my entire breast removed!” How should the nurse respond? | “Have you discussed your treatment options with your health care provider? |
| The nurse is working with a patient who is actively engaged in breast cancer treatment. The patient reports feeling distant from her family over the past few weeks. How can the nurse provide support to the patient in this situation? | Discuss ways she can increase her communication with her family |
| The nurse is talking to a patient who is undergoing screening for ovarian cancer. The patient recently tested positive for BRCA-1. The patient has been prescribed an abdominal ultrasound and testing for CA-125. Why?? | |
| A patient is diagnosed with endometrial cancer and her health care provider recommends a hysterectomy. The patient asks the nurse, “How will they perform the hysterectomy?” | “The surgeon will likely complete the hysterectomy through an incision in the abdomen due to the necessity to remove the fallopian tubes, ovaries, and biopsy the lymph nodes.” |
| The nurse is providing reproductive education to a group of healthy young women. What information regarding cancer prevention and early detection should the nurse provide to this group? | Early detection can help improve the prognosis Routine cancer screening, Pap test, is an important part of self-care. Safer sex practices Healthy behaviors, such as regular physical activity and not smoking |
| The nurse is preparing to care for a patient who is two days postoperative after a pelvic exenteration surgery. Which intervention should the nurse include in the patient’s plan of care? | Extra time to allow the patient to express feelings and concerns |
| The main function of AAT, an α1-protease inhibitor, is to | protect normal lung tissue from attack by proteases during inflammation related to cigarette smoking and infections. |
| The main function of AAT, an α1-protease inhibitor, is to | protect normal lung tissue from attack by proteases during inflammation related to cigarette smoking and infections. |
| COPD is a chronic inflammation of the airways, respiratory bronchioles, alveoli, and pulmonary blood vessels associated with: | irreversible airflow limitation during forced exhalation caused by loss of elastic recoil and airflow obstruction from mucus hypersecretion.mucosal edema bronchospasm |
| COPD: Clinical Manifestations :anterior-posterior diameter of the chest is increased from 1:1 to 2:1 (barrel chest) from chronic air trapping. The patient may assume a tripod position and use pursed-lip breathing. | Cough- 1st symptom Dyspnea with exertion or late stage at rest Weight loss (advanced copd) or fatigue During PE, wheezes, or decreased breath sounds will be noted in all lung fields. hypoxemia may develop with hypercapnia. |
| Chronic Hypoxemia | The bluish-red color of the skin results from polycythemia and cyanosis. Polycythemia develops as a result of increased production of red blood cells as the body attempts to compensate for |
| COPD-Tripod Position | often, using a hard surface like a table to lean on, are at high risk for developing pressure ulcers on their elbows. Teach patients to use padding or other protection to prevent this from happening. |
| The nurse understands that patients working in which occupations may have an increased risk for developing chronic obstructive pulmonary disease (COPD)? | Exterminators City bus drivers Construction workers |
| The nurse is caring for a patient with new-onset chronic obstructive pulmonary disease (COPD). Which assessment findings would be expected? | Persistent cough Increased RBC count Weight loss of 10 lb in 1 month |
| Which nursing assessment findings would indicate that the patient has severe chronic obstructive pulmonary disease (COPD)? | Oxygen saturation of 82% (Hypoxemia) Forced expiratory volume in 1 second (FEV1) of 39% ( An FEV1 between 30% and 49% indicates severe COPD). |
| The main types of breathing exercises commonly taught to patient's with COPD | pursed-lip breathing and diaphragmatic breathing. Patients with moderate to severe COPD with marked hyperinflation may be poor candidates for diaphragmatic breathing. |
| To perform diaphragmatic breathing, the patient lies supine with the knees flexed. With the hands | resting on the abdomen, the patient should focus on filling the lungs completely using the diaphragm and should note the rise and fall of the abdomen with inhalation and exhalation. |
| COPD: Medications: Corticosteroids: Examples of combinations of ICSs with LABAs are fluticasone/salmeterol and budesonide/formoterol. | short-acting bronchodilators are albuterol and ipratropium. moderate stage of COPD, a long-acting bronchodilator-salmeterol and formoterol. Roflumilast to decrease the frequency of exacerbations |
| Roflumilast is an oral medication used to decrease the frequency of exacerbations in patients with severe COPD and chronic bronchitis. This drug is a phosphodiesterase inhibitor, which is an | anti-inflammatory agent that suppresses the release of cytokines and other inflammatory mediators and inhibits the production of reactive oxygen radicals. |
| Which intervention is the priority for Mr. Sanchez to inhibit progression of chronic obstructive pulmonary disease (COPD)? | Encouraging smoking cessation |
| Mr. Sanchez reports thick sputum production with cough and difficulty breathing, which interferes with daily activities and sleep at night. Which collaborative care interventions would address the excess sputum production? | Postural drainage Chest wall oscillation therapy |
| generates a high-frequency pulse that vibrates the chest wall to mobilize secretions and clear the airway. | Chest wall oscillation therapy |
| Confusion and irritability are signs of | hypoxemia and should be treated with supplemental oxygen therapy. |
| Subjective: Exposure to irritants; recurrent respiratory tract infections Meds: oxygen, bronchodilators, corticosteroids, antibiotics, anticholinergics, (OTC) drugs, herbs, Smoking Family history of respiratory disease Anorexia, weight loss or gain | Increasing dyspnea, sputum volume or purulence Activity intolerance Respiratory symptoms Constipation, gas, bloating Insomnia, orthopnea, paroxysmal nocturnal dyspnea Headache, chest or abdominal soreness Anxiety, depression |
| objective; Debilitation, restlessness Cyanosis, pallor or ruddy color, poor skin turgor, thin skin, digital clubbing, easy bruising, peripheral edema Rapid, shallow breathing; inability to speak; prolonged expiration; pursed-lip breathing; wheezing; | rhonchi, crackles, or bronchial breath sounds; use of accessory muscles; hyperresonant or dull chest sounds on percussion, dysrhythmias, jugular venous distention, Ascites, hepatomegaly Muscle atrophy, (barrel chest) |
| COPD: Nursing Interventions and Evaluation : Monitor for signs of malnutrition and educate patients about proper nutrition and calorie intake. | Provide ventilation assistance to promote gas exchange, oxygenation, and perfusion. Teach cough enhancement techniques Provide 02, administer medication to prevent and treat Hypoxemia |
| Health promotion for patient with COPD | Influenza vaccine each year Pneumococcal vaccine Reduced exposure to household chemicals and outdoor air pollutants Frequent handwashing and other measures to minimize risk of infection |
| Lifestyle Modifications for patient with COPD | Good nutrition Reduction of risk factors, especially smoking cessation Exercise program of walking and arm strengthening Strategies to lose or gain weight, as appropriate Consultation with dietitian |
| Which patient education should the nurse provide Mrs. Strom to assist with long-term management of her symptoms? | Make sleep a priority. Seek social or group support. Use airway clearance techniques. Take scheduled breaks throughout the day. |
| A patient with (COPD) presents with a nonproductive cough, chest pressure, and dyspnea. The nurse notes an oxygen saturation of 86% on room air. Which action should the nurse take first? | Obtain an order to apply supplemental oxygen. |
| A patient with a history of long-term exposure to caustic fumes. Assessment reveals a forced expiratory volume (ratio of 65% and a functional oxygen saturation of 88%. increase in sputum production and a change in color from clear to green. | Provide supplemental oxygen. Teach diaphragmatic breathing. Administer intravenous corticosteroids. Obtain a sputum culture. |
| Place the physical manifestations of chronic obstructive pulmonary disease in the order in which they appear in the disease process. | Productive cough every few days for a month Decreased endurance during morning walks Difficulty breathing on awakening in the morning Altered chest expansion Bluish skin discoloration |
| A patient with (COPD) reports a chronic productive cough and an unintended weight loss of 15 lb over the previous month. Which recommendations should be made to this patient to address the current symptoms? | High protein diet Use of diaphragmatic breathing |
| A PT (COPD) presents with orthopnea and dyspnea that interferes with activities of daily living. On assessment, the forced expiratory volume 58%. Which medication would the nurse expect to administer as part of the maintenance treatment regimen? | Fluticasone/salmeterol |
| A patient diagnosed with (COPD) experiencing shortness of breath and a cough asks the nurse the best way to prevent exacerbations. Which recommendations should the nurse make? | Effective handwashing Preventative vaccination |
| The nurse is preparing to discharge a patient with COPD) who reports weight loss of 10 lb in the past month, fatigue, and dyspnea at rest. Which recommendations should the nurse include in discharge teaching? | Adequate sleep high calorie diet oxygen supplement |
| Community-Acquired Pneumonia (CAP) | an acute infection of the lung in patients who have not been in the hospital or long-term care facility within 14 days of onset. |
| Hospital-Acquired Pneumonia (HAP), | formally known as nosocomial pneumonia is pneumonia in the non-intubated or ventilator patient that begins within 48 hours of hospital admission and exhibits symptoms that were not present upon admission. |
| Health Care-Associated Pneumonia (HCAP) | a type of pneumonia caught in another health care setting apart from a hospital such as a nursing home, primary care office, urgent care clinic, or dialysis center. |
| The most common presenting manifestations of pneumonia are | cough, fever, shaking chills, dyspnea, tachypnea, and pleuritic chest pain. Sputum may appear green, yellow, or rust colored (bloody). |
| Pathological process of pneumonia in order | Release of cytokines, histamines, and prostaglandins Obstruction of the airway with mucus Impaired CO2 and O2 exchange Mucus and debris removed by alveolar macrophages Lung tissue functioning normally |
| Which patient conditions increase the risk of contracting pneumonia? | AIDS Coma Congenital heart defect |
| A family member of a patient asks the nurse how a person develops pneumonia. What is the best response by the nurse? | “Pneumonia develops when bacteria invade the lower airways. |
| A patient with pneumonia is ordered an arterial blood gas (ABG). A family member asks about the purpose of this test. Which response by the nurse is best? | To determine the oxygenation status of the patient.” |
| A patient arrives at the emergency department reporting flu-like symptoms that have progressively worsened over the past two to three days. The nurse bases the plan of care on which likely cause of the patient’s symptoms? | Viral infection Viral pneumonia presents with flu-like symptoms with worsening respiratory symptoms over two to three days. |
| A patient with pneumonia reports a loss of appetite and a weight loss of six pounds over the last week. Which interventions by the nurse are most appropriate for this patient? | Instruct the patient to eat small, frequent mealsInstruct the patient to choose their favorite foods at mealtime. |
| A 22-year-old patient with cystic fibrosis is receiving a pneumonia vaccine. The patient asks the nurse why it is necessary to have the vaccine at such a young age. What is the best response by the nurse? | “Because of your health history, you should receive the vaccine even though you are not 65 years old.” |
| A patient reports severe flu-like symptoms worsened over the past 36 hrs. The patient is coughing intensely and has temperature of 101.7 °F. The patient questions why she has not received any antibiotics. Which response by the nurse is appropriate? | “Antibiotics treat bacterial infections. Your infection is viral in nature.” |
| A patient calls the clinic and reports upper respiratory symptoms. Which statement is most appropriate by the nurse? | “When did your symptoms begin?” |
| A nurse is caring for a patient in the medical unit with altered consciousness. Which nursing interventions should be included in the plan of care to prevent this patient from getting pneumonia? Correct | Raise the patient’s head of bed to 30 degrees.Reposition patient every two hours while in bed. Perform hand hygiene before and after providing patient care. |
| A patient with Mycoplasma pneumonia is being discharged to the home. Which statements should the nurse include in the teaching plan for this patient? | “You should get a yearly influenza vaccination.” You need to drink six to ten glasses of clear liquids per day.” “You must take your antibiotic until it is gone regardless of how well you are feeling. |
| A nurse is caring for a severely burned client who now has elevated HCT and blood cell count, what consequences should the nurse expect in this client | Kidney stones and blood clots |
| Client taking antineoplastic agents. What adverse effects should the nurse monitor? | symptoms of gout |
| Client teaching for a client undergoing chemotherapy. What dietary modification should be advised | Avoid spicy and fatty foods |
| Warning signals of cancer: persistent indigestion or difficulty swallowing. Change in a wart or mole. Persistent nagging cough or hoarseness | Change in bowel habits or bladder function unusual bleeding or discharge sores that do not heal thickening or lump in breast or other body parts |
| The clients reports during a breast exam findings of a firm, non-movable lump in the upper outer quadrant of the right breast that was not there 3 wks ago. What does this finding suggest: | Malignant Tumor |
| The topic with the greatest value for decreasing cancer risk | sun safety and use of sunscreen |
| The nurse knows that which bacteria are responsible for primary and secondary skin infections? | Staphylococcus aureus Group A β-hemolytic streptococci |
| A patient recently diagnosed with a bacterial skin infection exclaims, “I’ve never had so much as a cold!” Which statement by the nurse is the most appropriate? | “Good hygiene practices can help prevent skin infections.” |
| Verruca vulgaris, | Painful, hypertrophic, flesh-colored papules on the epidermis |
| Pruritic vesicles with honey-colored crusts surrounded by erythema | Impetigo |
| Painful, itchy, single or grouped vesicles on an erythematous base | Herpes simplex virus |
| Linear rash with red pustules itching and/or burning pain on the trunk, face, and lumbosacral areas. | Shingles (herpes zoster) |
| treats psoriasis, atopic dermatitis, vitiligo, and pruritus. | Phototherapy (UV light) |
| Psoralen is administered two to four times a week before UV exposure (PUVA therapy). What should be monitored by the nurse? | Monitor patient frequently (erythema, nausea and vomiting, sunburn, and persistent pruritus). Use psoralen with extreme caution in patients with liver or renal disease. All patients should be taught to wear eyewear that blocks UV light 100%. |
| used to treat acne scars, pigmented nevi, and psoriasis. | Laser technology: Lasers cut, coagulate, and vaporize some tissues. |
| Most common laser is the carbon dioxide (CO2) laser; applications include | vaporizing and cutting most tissues. |
| Argon lasers emit light absorbed by hemoglobin and are useful in | the treatment of vascular and other pigmented lesions. |
| Skin infections such as acne vulgaris, rosacea, erysipelas, cellulitis, carbuncles, and severe infected eczema Examples Topical antibiotics include | Bacitracin Mupirocin Gentamicin Erythromycin |
| Bacitracin-neomycin-polymyxin Mupirocin (for superficial Staphylococcus infections) Gentamicin (for Staphylococcus and most gram-negative infections) Erythromycin for | used for gram-positive cocci [staphylococci and streptococci] and gram-negative cocci and bacilli) |
| Systemic antibiotics include | Penicillin Minocycline Erythromycin Tetracycline Vancomycin |
| Corticosteroids Common in the treatment of psoriasis, alopecia areata, cystic acne, hypertrophic scars, and keloids. Accurate and adequate dosing leads to successful outcomes; prolonged use and use of high-potency forms can lead | to skin atrophy, adrenal suppression, weight gain, and high blood glucose levels. |
| Examples of Corticosteroids | Topical: Ointments and creams, thinly applied, have local anti-inflammatory and antipruritic effects. Intralesional: Triamcinolone acetonide is the most common and is injected directly into or just beneath a lesion; effects last several weeks to months. |
| Therapy of choice for immune-mediated dermatoses such as atopic dermatitis, alopecia areata, allergic dermatitis, psoriasis, and lupus erythematosus. | Topical Immunomodulators; example-Topical: Ointment usually applied twice daily. The most common side effects are burning, feeling of warmth, and itching. |
| Herpes zoster (shingles) topical tx Wet compresses, silver sulfadiazine applied to ruptured vesicles | Systemic: Antiviral agents to prevent postherpetic neuralgia given within 72 hours Zoster vaccine to prevent shingles for adults ≥50 years |
| Impetigo (topical tx) Warm saline soaks, followed by soap-and-water removal of crusts and application of antibiotic cream or ointment systemic tx are | Intravenous (IV) antibiotics |
| Folliculitis (topical tx) | Cleanse with antistaphylococcal soap and water Apply antibiotics or warm compresses No systemic treatment |
| Furuncle (topical tx) Incision and drainage with possible packing Apply antibiotics with frequent warm, moist compress application. Systemic treatment are | Antibiotics effective against MRSA pending culture and sensitivity |
| Cellulitis (topical treatment) Moist heat, immobilization, and elevation systemic treatment are | IV antibiotics and hospitalization if severe |
| Erysipelas (topical treat N/A) Systemic treatment only | Hospitalization and systemic antibiotics may be required |
| Verruca vulgaris Liquid nitrogen therapy Blistering agent Keratolytic agent (salicylic acid; CO2 laser destruction) | No systemic treat applicable for Verruca vulgaris |
| Plantar warts: topical treatment only which is | Topical immunotherapy, cryotherapy, salicylic acid, duct tape |
| Candidiasis Azole antifungals (suppository or oral lozenge) Nursing teaching | Sexual abstinence or condom use Skin hygiene Topical powder |
| Tinea corporis treatment | Cool compresses Topical antifungals |
| Tinea cruris treatment | Topical antifungal cream, gel, solution, spray, or powder |
| Tinea pedis treatment | Topical antifungal cream, gel, solution, spray, or powder |
| Tinea unguium treatment | Topical antifungal cream Systemic antifungal medications Nail avulsion is an option if needed |
| Treatments for bug bites and infestations include medications, | cool compresses, laundering of clothing and linens, and screening those in close contact with affected individuals. |
| Bees and wasps topical treatment | Cool compresses Local application of antipruritic lotion and antihistamines, if indicated |
| Bedbugs topical treatment | Lesions usually require no treatment Severe itching may require antihistamines or topical corticosteroids |
| Pediculosis topical treatment | Topical treatments to scalp and hair and other parts of the body Anyone in close contact with an infected individual should be screened and treated Systemic treatment N/A |
| Scabies 5% permethrin, one application overnight with second application 1 week later to yield 95% eradication. Systemic treatments are | Antibiotics if secondary infections present Treat all household members and sexual partners Launder all clothes and linens with bleach |
| Ticks: topical treatment N/A Systemic treatment only | Oral antibiotics IV antibiotics for arthritic, neurologic, and cardiac symptoms Rest and healthy diet |
| Treatment for Allergic Contact Dermatitis | Topical or oral corticosteroids Antihistamines (Non-drowsy antihistamines include cetirizine, loratadine, fexofenadine.) |
| Treatment for Atopic Dermatitis | Lubrication of dry skin and/or stress reduction Topical immunomodulators Corticosteroids, phototherapy, and/or antibiotics |
| Treatment for Urticaria | Removal of triggering agent; administration of oral antihistamine and possibly systemic corticosteroids |
| Treatment for Drug Reactions | Withdraw offending drug Antihistamines, topical or systemic corticosteroids depending on symptom severity |
| Acne vulgaris Topical treatment Removal with extractor Topical benzoyl peroxide, retinoids, or antimicrobials such as clindamycin, erythromycin and systemic treatment are | Antibiotics Isotretinoin for severe nodulocystic acne Spontaneous remission possible Improvement possible with exposure to sun |
| Nevi treatment | No treatment necessary unless for cosmetic purpose Skin biopsy for suspicious nevi |
| Psoriasis treatment: Corticosteroids, tar, salicylic acid Intralesional injection of corticosteroids for chronic plaques Oral: Ibuprofen Systemic: Natural or artificial UV light, methotrexate, immunosuppressant, biologic therapy | No cure, but control is possible The goal is to reduce inflammation and suppress rapid turnover of epidermal cells |
| Seborrheic keratosis treatment | Biopsy if unable to distinguish and remove by curettage; cryosurgery for cosmetic reasons or because of irritation |
| Treatment of Acrochordons | No treatment necessary Surgical snipping without anesthesia when needed |
| Treatment of Lipomas | No treatment necessary; excision when indicated Biopsy to differentiate from liposarcoma |
| Lentigo treatment | Evaluate for progression Treat only for cosmetic purposes and use liquid nitrogen or laser resurfacing Biopsy for suspicious melanoma May recur |
| Skin scraping is done with a scalpel blade to obtain samples of surface cells for microscopic inspection and diagnosis. Surgical therapy options after diagnosis may include: | Electrodessication (superficial) and electrocoagulation (deep) Curettage Cryosurgery Punch biopsy |
| A patient presents to the emergency department with a small, plaque-like lesion on the right arm. The patient states, “I don’t know what this is, but I want it removed.” Which order by the health care provider should the nurse anticipate? | A skin scraping should be performed first to obtain samples of surface cells for microscopic inspection and diagnosis. |
| A patient with psoriasis of the upper arms is being treated while in the hospital with a diagnosis of lupus. Which medication order should the nurse anticipate? | Ibuprofen Salicylic acid Hydrocortisone |
| The nurse suspects a patient receiving topical immunomodulatory therapy is experiencing a side effect of the treatment if which finding is noted? | Itching, burning, or feeling of warmth |
| Wet compresses help relieve superficial skin problems such as | inflammation, itching, and infection. They are appropriate for crusting, damaged, or oozing skin. |
| Baths are appropriate for large areas of skin needing treatment. They can be relaxing; decrease | itching, irritation, and inflammation; and provide moisture. |
| Topical medications are used to treat skin problems. By providing relief from | pruritus, they prevent the thickening of the epidermis with exaggerated markings caused by scratching. |
| Not all infected drainage is purulent; however, careful hand washing and | proper disposal of soiled dressings are the best means of preventing the spread of infections and/or infestations. |
| Open lesions, excoriations, scratches, and dry, itchy skin are susceptible to invasion by | viral, bacterial, or fungal organisms. |
| Meticulous hygiene, nail trimming, and handwashing for both the HCP and patient are important in minimizing | the risk for secondary infections. |
| Some inflammation is normal; however, redness that persists longer than a week, fever above 101° F, or | increased pain, swelling, and purulent drainage indicate a possible infection and should be reported immediately to the HCP. The patient should then be examined in the office. |
| A patient just underwent a surgical dermatologic procedure. Which statements indicate the nurse fully understands the foundations of proper healing when providing patient teaching? | Your sutures will be removed in 4 to 14 days.” “Topical antibiotics will help prevent infection while promoting healing.” “Be sure to let me know if you are having pain or discomfort, and I can give you some ibuprofen.” |
| A patient with eczema is admitted to the unit for intravenous antibiotic therapy for a severe skin infection. The patient states, “Make sure you wear gloves. I don’t want you to catch what I have.” Which response by the nurse is appropriate? | “The gloves are for your safety to prevent any organisms spreading from me to you because your skin is compromised.” |
| A patient shares with the nurse a concern about a skin tag on the inner thigh. The patient is becoming worried that the skin tag is cancerous. How should the nurse respond? | “Most skin tags are harmless and won’t require any treatment, unless they are irritating and you want them removed.” |
| Which practice should the nurse emphasize as being the single most important means of preventing secondary skin infections? | Handwashing |
| A female was recently prescribed oral birth control pills. The patient states that since she started taking the pills, her skin has become “problematic.” The nurse understands that which skin disorder is a common side effect of oral contraceptives? | Acne vulgaris Flare-ups of acne vulgaris can occur with corticosteroid and birth control pill use. |
| The nurse is concerned that a patient is experiencing complications of long-term oral corticosteroid use. Which finding indicates a possible complication? | High Glucose |
| Phototherapy for a patient with atopic dermatitis has been effective when the nurse notes which assessment finding? | Phototherapy treats psoriasis, atopic dermatitis, vitiligo, and pruritus. Itching is reduced when treatment is effective. |
| A patient presents to the clinic with welts b/l arms and itchy, watery eyes, diagnosed with allergic contact dermatitis. Receives a prescription, few days later complains of feeling drowsy. Which medications would be appropriate for the patient? | Cetirizine Loratadine Fexofenadine Hydrocortisone |
| The nurse is taking care of a patient with impetigo. Which methods are appropriate for management of the skin lesions and discomfort? | Topical antibiotics Warm saline soak |
| Which statement indicates the nurse is performing proper patient teaching during discharge of a patient who has recently undergone a dermatologic procedure? | “Check the site for any type of pus or drainage and call the health care provider immediately if you see it.” |
| The nurse notes that a patient appears very withdrawn and depressed. Patient states, “I’ll never look the same again with all these skin issues and treatments. I don’t even want to leave this room.” How should the nurse respond? | “Cosmetics can be helpful in situations like this. Would you like to discuss this more?” |
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