Maryville NURS 623 Exam
1. Mode of transmission for parasitic skin infections
Close direct skin contact.
2. Clinical presentation for Scabies
Intense itching, worse at night. Burrows noted between webs of fingers.
3. Commonly prescribed medications for Scabies
Permethrin Cream 5% (Elimite) is the first-line treatment. Safe in 2 months and older. Apply to
all areas from neck down and leave on for 8-12 hours. Repeat application in 1 week. May
repeat a third time in another week. Follow up in 1 week.
Antihistamines and topical steroids if the pruritis is bad.
4. What should you include in the patient education to prevent spreading of the various parasitic
skin problems?
Avoid close contact. Wash all bedding, clothing, cloth items, and stuffed animals in hot water.
All close contacts family members, people you live with and sexual partners need to be
treated as well.
5. Which bacterial skin infection is considered highly contagious?
Impetigo
6. What is the "classic" presentation of impetigo?
Honey crusted lesions
7. What is the management of a minor case of folliculitis (non-pharmacologic)?
Gentle cleansing by washing the skin twice a day with antibacterial soap.
8. What are the commonly prescribed medications for folliculitis?
Mupirocin (Bactroban) 2% ointment or cream, TID, 5-14 days, for secondarily infected skin
lesions.
Mupirocin (Bactroban) twice daily for 5 days in the nose for people with recurrent folliculitis
to clear the colonization of S. Aureus.
9. Furuncles
Initially appear small (0.5-1 cm), red, tender, indurated nodule. As it grows it develops a
central yellow plug. They eventually rupture spontaneously. Fluctuant or larger furuncles
should be treated with I&D and covered with a simple dry sterile dressing. Patients should be
instructed to use warm compresses twice daily to encourage drainage of pus.
10. Carbuncles
Initially appear as multiple furuncles and develops into a large, erythematous lump and must
be drained before healing will take place and this typically occurs spontaneously within 2
, weeks. Carbuncles frequently require I&D and need systemic antibiotics and a referral.
Antibiotics include: TMP-SMX (MRSA converage), dicloxacillin, cephalexin, or doxycycline.
A gram stain is recommended to check for MRSA strains.
11. What are the considerations when determining treatment for cellulitis?
Severe infections, infections around the eyes, or systemic involvement (fever & chills),
immunocompromised should be sent to the ED for inpatient IV treatment.
Mild cases can be treated with PO antibiotics that should show improvement within 48-72
hours. Penicillin VK, dicloxacillin, clindamycin, or cephalexin for 5 days.
Infected human & animal bites need to be treated with amoxicillin-clavulanic acid
(Augmentin) for 2 weeks. Prophylaxis treatment for human & animal bites (within 6 hours)
amoxicillin-clavulanic acid (Augmentin) for 3-5 days.
12. HSV
grouped vesicles on an erythematous base, followed by ulcers or erosions that crust over
with honey color. Lesions typically heal in 7-10 days. Mouth, face, or genitals.
13. Diagnostic tests for HSV
Viral Culture Gold Standard & PCR tests are standard for diagnosis. Vesicle fluid can be
cultured with 72 hours of outbreak. Tzanck smear. HIV testing is advisable in HSV-2 patients.
Herpetic keratoconjunctivitis
requires immediate referral to an ophthalmologist.
14. HSV-2 Genital lesion treatment
Treated with oral antivirals Valacyclovir or famciclovir. Warm compresses and oatmeal sitz
baths can help promote comfort and healing. Urinate into a warm bath. Increase fluid intake
and rest.
15. HSV-1 oral lesion treatment
Acetaminophen to control pain. Ice or lip ointments like Blistex. OTC docosanol (abreva) 10%
cream applied 5 times a day. For more extensive lesions, penciclovir (Denavir) 1% cream
applied every 2 hours while awake. Extensive oral lesions may require lidocaine, and
acyclovier oral suspension 200mg/5mL, rinse mouth with 1 teaspoon and swallow five times a
day.
16. HSV Patient education
Begin antiviral at the first sign of tingling or burning.
No sharing of towels, silverware, or glasses. Wash hands frequently.
Avoid sex until lesions are healed, Use condoms every time to avoid viral spread.
17. Which dermatitis is an inherited skin reaction that begins in infancy
Atopic dermatitis
18. What is the "atopic triad?"
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