INTEGUMENTARY DISORDERS REVIEW

INTEGUMENTARY DISORDERS REVIEW

Chapter 50 integumentary disorders ( Linton Pg 1155-1156)
The skin regulates body temperature by dilating and constricting surface blood vessels
When inspecting the skin of older adult you observe flat pigmented spots on the backs of both hands. You should recognize these as LENTIGINES
Which interventions will help prevent scratching and skin injury in a patient with atopic dermatitis :wash new clothing before wearing it
Contact dermatitis is caused by an allergic response
Patient teaching related to psoriasis should include : In most people psoriasis affects only the skin.
An obese pt in LTC facility has had intertrigo in body folds ( axilla, beneath the breast) on several occasions. Which measure is most appropriate to reduce the risk of recurrence: keep body folds clean and dry
A female pt is being treated with isotretinoin ( acutance) at the clinic for severe acne after other treatments have failed. All of the following points should be included in the teaching plan. Which is most important: If sexually active, you must use reliable contraception.
A drug used to treat herpes simplex type 1: Acyclovir (Zovirax)
The best way to prevent skin cancer is to : avoid excessive sun exposure
Characteristics of melanoma include: irregular lesion with uneven coloration

CH 74 SKIN DISORDERS NCLEX -STYLE REVIEW QUESTIONS ( PG 1105)

On admission to the hospital, the client has a 10% body surface full thickness burn. The nurse should give highest priority to : obtaining vital sings
The nurse understands that the probable effect of a client’s choosing to continue to be exposed to UV radiation will be : increased risk of skin cancer.
Which statement by the client who has prutitus indicated that the client has understood teaching regarding the treatment of prutitus. : I can take a bath with baking soda added to it.
Which of the following conditions is best prevented by proper hand washing technique? Impetigo
Which of the following observations would the nurse expect to see with the client who has sustained a full thickness burn? Cherry red, white, or black color
A client with complaints of itching is prescribed diphenhydramine HCI ( Benadryl) by the healthcare provider. What client teaching should the nurse provides with regard to the use of antihistamines.: Avoid intake of alcohol
A 5yr old client is brought to the healthcare facility with complaints of head lice infestated . Which of the following characteristics of lice infestation should the nurse monitor this client for. :Presence of nits inhabiting the hair
Which of the following methods is to treat the removal of filiform warts. :Electrodessication
What teaching should the nurse impart to clients with eczema? Take starch baths daily.
A client with psoriasis is prescribed a topical application of Dovonex ( calcipotreine) which of the following is achieved through the use of Dovonex? : it slows the development of skin cells.
A client admitted to the healthcare facility with urinary has developed angioedema. Which of the following findings should the nurse notify healthcare provider of : respiratory distress, swelling around the eyes, extreme swelling of lips.
A nurse is caring for a client with severe burns who has developed skin ulcers. Which of the following are other complications associated with burn injury: hypostatic pneumonia, kidney failure, curling ulcers.
Which of the following are precautionary measures to be followed to prevent an accident when handling electric equipment? Keep water heaters’ thermostat set lower than 120 F
A client has a 2nd degree burns has been prescribed moist dressing application. Given below is a random order, are the steps undertaken during the application of moist dressing for a client with burn injury. Write a correct sequence:
Premedicate with analgesics and anxiolytics
Premoisten existing dressing with normal saline
Apply dressing according to specific protocol
Document the observation made during the procedure

Steps taken during manement of burn injury are:
Vital sings assessment, pain management,wound dressing, physical therapy

Davis NCLEX -PN REVIEW
(Pg 269 , 270, 273,
A clients entire posterior chest and buttocks have full- thickness burns. Using the rule of nines, the nurse would calculate the BSA burned as: 18%
The nurse knows the best place to assess for pallor in a very dark skinned person is: Mucous membrane
Which of the following is the best site for assessing skin turgor in an 80 year old client? Sternum
Which of the followings the best site to assess for edema in a client confined to bed : sacrum
Which of the following does the nurse recognize as being the only diagnostic parameter for cancer? Positive tissue biopsy
A client with aids indicates that more teaching about the condition is needed when the nursed hears the following statements. : I’m afraid to touch anyone; I might give them my disease.’’
A client is diagnosed if hepatitis A. The nurse would use which of the folowing precaution for preventing transmission of the disease to self and others: Universal precaution.
A client in a nursing home is at risk to develop pressure ulcers because of the immobility , incontinence, and low serum albumin. Which of the following would the nurse assess for a first sing of pressure ulcer? : erythematic of the skin.
A client with aids is unable to cough because of the weakness and fatigue. The client is at risk for : ineffective airway clearance
A male client has a diagnosis of herpes genitals infection. The nurse would instruct him to : avoid touching the blister like lesions
A nurse is conducting a physical assessment on a client. Which of the flowing characteristics of a mole on the skin warrants further evaluation by a physician. :irregular shape
A child sustains a burn injury when boiling a pot of water knocked oof the stove. The skin on the Childs chest appears sunburned and is dry. The nurse describes the burn injury as: superficial (first degree )burns
The nurse identifies which of the following as care of the client during the rehabilitation phase of the care? Applying pressure garments
A mother calls the clinic and tells the nurse that her 12 year old daughter has spilled hot grease on her foot and it has 2 blisters the size of quarters. The nurse initially advise her to : leave the blisters intact and open the air
An 80 year old client has 3rd degree burns on 25% of the body. The priority nursing diagnoses is : fluid volume deficit
A 38 year old client has chronic cirrhosis and is jaundiced. To decrease pouritus from the jaundice, the nurse should: keep the room temp below( 70.8 F - 21.18 C
Generalized edema is called anasarca
A client is receiving chemotherapy for treatment of breast cancer. She begun to experience alopecia( loss of hair). It is important to inform her that the alopecia is : temporary and hair will grow again soon after chemotherapy is discontinued
The physician has ordered topical corticosteroids for a clients atopic dermatitis. The nurse correctly identifies the purpose of applying topical corticosteroids to atopic dermatitis : to decrease inflammation
In preparing to apply a topical prepration over a burn, the nurse would question the application of which agent to a child allergic to sulfa : silver sulfadiazine ( silvadene)


Medications

A 17 year old client was diagnosed with herpes genitilia. The physician ordered acyclovir ( zovirax) 200 mg every 4 hours while awake times 5 days ( 8am noon, 4 pm and 8 pm). The nurse instructed the client to have on hand how many 200 mg tablets? 20 tablets
The client was having pruritus secondary to severe anxiety. The physician ordered diphenhydramine (benadryl) 75 mg . Avaailable is benadryl injection 25 mg/ml in a 10 ml multiple dose vial. How many milliliters should be administered to the client? 3
A client was to be given morphine sulfate 3-5 mg IV for pain. The physician ordered the morphine to be titrated. The morphine was supplied in a 10-mg/mL single-dose vial. The nurse needed to titrate the morphine with how much saline in order to deliver 1 mg/ml? : 9mL


DR HUNT’S REVIEW QUESTIONS

You have a pt burned in a burn unit pt was burned lower back and posterior: 27% burns
What part of the skin is thinnest : epidermis
What part of the skin produced new cells : stratum germination
Full thickness burns: silvidine creams for wounds
Burn in a wound pt is using excessive silvidine( toxic when used in excess) : monitor CVC
If a burn give: tetanus shot
You have burn patient 50 year old good source of protein is : fortified milk, skim powdered milk.
Older client burn may be more severe than younger : old people skin is thinner; less subcutaneous fat
Thermal in jury what you going to worry about ( always airway before fluid) pt who has 3rd degree burn ( supposed on the hair) dressing change at 2:00 clock: give them analgesic for pain before you change the dressing
Thermal injury is: hot liquid and smoke inhalation
Intermediate phase : ensure milk
Bulky dressing : absorb clean to clean
Hematuria a s result of : massive RBC destruction
2nd degree burns : epidermis and dermis
Calorie intake is inadequate : weigh the patient
Major patient calorie intake do consume 90to 100% of food: weigh them.
Treatment procedures : germicidal soap scrubs
Nurse completed a assessment on 2nd degree burns partial thickness: epidermis, dermis, showing edema with blisters no vesicles.
full thickness: brown/black and lack sensation
Patient receiving silvidine :monitor CBC
Pilo reaction to tissue : No capacity and no pain
First thing to notice if not a respiratory burn: fluid and electrolyte

Atopic dermatitis is a genetic condition. Those who suffer from this in childhood tend to have a more dry skin when they grew up. Asthma and fever are all considered atopic and if you get one condition your chance of getting another one increases. Some foods can trigger atop c dermatitis ex dairy products.
Eczema (atopic dermatitis) will itch and if you scratch it will form rashes. It is affected by stress. It’s not caused by allergy.
Herpes simplex virus cannot be eliminated once you get it. It can be transmitted even if there is no visible outbreak or symptom of any outbreak. It may trigger if you are stressed and tired.
In psoriasis , the skin cells travel upward much faster. Normally what takes about month time, is finished in 3-4 days. That causes it because fresh cells keep accumulating on the skin surface and the skin fails to replace old cells effectively. Most of the patients who get this does not get eczema. Sunburns and other injuries trigger this. People can get this during winter time because the dry air causes dry skin and itching.
Scabies is associated with heavy itching during nighttime. Anyone can get scabies as the scabies mites is transferred by body contact.
Warts are caused by virus called human papiloma virus (HPV). It’s better to treat warts as in grows in size. Warts grow on the top layer of the skin the epidermis. It may can grow again in the same place.
Keloids are difficult to treat. Any small injuries causes more keloids to form. Lasers are commonly used to treat scars.