A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects?

Increased pigmentation

Localized hair loss

Thinning of the skin

Increased sensitivity to the sun

Answer and Explanation

The Correct Answer is C

Rationale:
A. Increased pigmentation: Triamcinolone, a topical corticosteroid, is not known to cause increased skin pigmentation. In some cases, prolonged use can lead to hypopigmentation, especially in clients with darker skin tones.

B. Localized hair loss: Hair loss is not commonly associated with triamcinolone use. In fact, some corticosteroids may lead to localized hair growth due to their effects on the skin and follicles.

C. Thinning of the skin: Prolonged use of topical corticosteroids like triamcinolone can lead to skin atrophy. This manifests as thinning of the skin, increased fragility, and a higher risk of bruising or tearing with minimal trauma.

D. Increased sensitivity to the sun: Photosensitivity is not a typical side effect of triamcinolone. Sun protection is generally recommended for healthy skin care, but triamcinolone does not specifically increase sun sensitivity.

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Correct Answer is D

Explanation

Rationale:
A. Hypotension: Circulatory overload typically causes hypertension rather than hypotension due to increased blood volume and pressure. Hypotension would be more consistent with a different transfusion reaction such as anaphylaxis or septic shock.

B. Flattened jugular veins: Jugular vein distention, not flattening, is a classic sign of circulatory overload. Distended neck veins indicate elevated central venous pressure from fluid excess.

C. Lethargy: While lethargy may occur with various conditions, it is not a specific or early sign of circulatory overload. More immediate symptoms include respiratory distress and cardiovascular changes.

D. Bounding pulse: A bounding pulse is a key sign of circulatory overload, reflecting increased stroke volume and elevated intravascular volume. It often occurs alongside hypertension, dyspnea, and jugular vein distention, especially in older adults with compromised cardiac function.

A. "I will have to move out of my family's home until I am no longer contagious." B. "I will place my used tissues in a plastic bag." C. "I will cover my mouth with my hands when I have to cough." D. "I will not go in public areas until I am cured."

Correct Answer is B

Explanation

Rationale:
A. "I will have to move out of my family's home until I am no longer contagious.": It is not necessary for the client to move out of the home, but precautions such as proper ventilation, wearing a mask, and isolating in a separate room can reduce the risk of transmission to household members during the contagious period.

B. "I will place my used tissues in a plastic bag.": Disposing of used tissues in a sealed plastic bag helps contain respiratory secretions and prevent the spread of Mycobacterium tuberculosis. This is an appropriate infection control practice that demonstrates understanding of proper hygiene.

C. "I will cover my mouth with my hands when I have to cough.": Covering the mouth is essential, but using the hands increases the risk of spreading bacteria through contact with surfaces. The client should be instructed to use a tissue or the inside of the elbow to minimize contamination.

D. "I will not go in public areas until I am cured.": Total avoidance of public areas is not necessary, but the client should avoid crowded places and public transport during the initial phase of treatment, typically the first few weeks, when they are still contagious.

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A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects?

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