nursing care of the child with an integumentary di
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Nursing Care of the Child With an Integumentary
Nursing Care of the Child With an Integumentary
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Voorbeeld van de inhoud
Nursing Care of the Child With an Integumentary Disorder
(and alteration in tissue integrity) Questions With Complete
Solutions
A 10-year-old has been bitten on the lower posterior arm by a
dog, requiring several stitches. The child was just admitted to
the hospital for 3 days of antibiotic therapy. When developing
the care plan, the nurse identifies which nursing diagnoses as
being the top 2 priorities? Correct Answer • Impaired skin
integrity
• Risk for infection
The wound was not a clean wound, such as a surgical wound, so
risk for infection would be a top priority. The child has impaired
skin integrity from the wound and from the IV. Since the wound
is new and on the arm the nursing diagnosis disturbed body
image would not be a top 2 priority at this time. It is unlikely
that a great deal of fluid has been lost from this wound.
Knowledge deficit of wound care would not be a top 2 priority
at this time, but would be an important nursing diagnosis to
address later.
A 14-year-old child is diagnosed with tinea versicolor. Which of
the following would the nurse expect the nurse practitioner to
order?
a) Topical nystatin
b) Diphenhydramine
c) Oral griseofulvin
d) Selenium sulfide Correct Answer Selenium sulfide
Correct
,Explanation:
Selenium sulfide is used to treat tinea versicolor. Topical
nystatin is used to treat monilial diaper rash. Griseofulvin is
used to treat tinea capitis. Diphenhydramine is an antihistamine
used to treat hypersensitivity reactions, atopic dermatitis, or
contact dermatitis that is highly pruritic.
A 6-year-old child is diagnosed with tinea capitis and treatment
is initiated. The nurse instructs the parents to have the child
return to school within which time frame?
a) 24 hours
b) 5 days
c) 1 week
d) 72 hours Correct Answer 1 week
Explanation:
Once treatment is initiated for tinea capitis, the child can return
to school or day care after 1 week.
A child has an order for an erythrocyte sedimentation rate
(ESR). The child's mother asks what the purpose of the test is.
What is the best response by the nurse? Correct Answer "This
test will tell if your child has an infection or inflammation
somewhere in their body."
Erythrocyte sedimentation rate (ESR) is a nonspecific test used
to detect the presence of infection or inflammation.
A child has been diagnosed with impetigo and the nurse is
performing discharge teaching to the parents. Which statements
by the parents indicate that additional teaching is necessary?
,Correct Answer • "Even though the lesions have crusted, the
infection is contagious and our child should stay home from
school."
• "Antifungal medications should be administered as ordered by
our physician."
• "We should soak impetiginous lesions with cool compresses to
remove crusts before applying topical medication."
Though impetigo is considered a contagious disorder among
vulnerable populations, removal from school or day care is not
necessary unless the condition is widespread or actively
weeping. Impetigo is a bacterial not a fungal infection, therefore
antibiotics will be ordered. Soaking and removing crusts is
necessary for the medication to penetrate the infection.
Antibiotics should be spread out evenly so a constant level
remains in the blood. Hand hygiene helps prevent spread of the
infection
A group of nursing students are reviewing information about
atopic dermatitis. Which of the following indicate that the
students understand the information? Select all that apply.
a) Changes in temperature can contribute to flare-ups.
b) The reaction occurs in response to specific allergens.
c) Scratching initiates the reaction, which then becomes
pruritic.
d) Excessively humid environments often lessen the severity of
the reaction.
e) The disorder is chronic with periods of remissions. Correct
Answer • The disorder is chronic with periods of remissions.
• The reaction occurs in response to specific allergens.
, • Changes in temperature can contribute to flare-ups.
Explanation:
Atopic dermatitis is a chronic disorder with a relapsing and
remitting nature. The skin reaction occurs in response to specific
allergens, usually foods, or environmental triggers. Changes in
ambient temperature can contribute to flare-ups. Excessively
humid or dry environments can cause the condition to worsen.
When a trigger occurs, antigen-presenting cells stimulate
interleukins to begin the inflammatory process. The skin begins
to feel pruritic and then the child starts to scratch. Itchiness
occurs first and then the rash appears.
A nurse assessing a 6-month-old girl with an integumentary
disorder. The nurse notes three virtually identically sized, round
red circles with scaling that are symmetrically spaced on both of
the girl's inner thighs. Which should the nurse ask the mother?
Correct Answer "Does she wear sleepers with metal snaps?"
Small round red circles with scaling, symmetrically located on
the girls' inner thighs point to nickel dermatitis that may occur
from contact with jewelry, eyeglasses, belts, or clothing snaps.
The nurse should inquire about any sleepers or clothing with
metal snaps. The girl does not have a rash in her diaper area. It is
unlikely that an infant this age would have her inner thighs
exposed to a highly allergenic plant. Discussing family allergy
history is important, but the nurse should first inquire about any
clothing with metal that could have come into contact with the
girl's skin when she displays a symmetrical rash.
A nurse is caring for a burn patient with second and third degree
burns on 15% of the body. The patient is complaining of severe
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