A nurse prepares to apply topical permethrin for a child with scabies.
What should be included in the instructions?

Choice A rationale

Asking if the child has eaten recently is important for understanding potential causes of elevated blood glucose and to consider the timing of insulin administration relative to meals. However, it does not directly ensure the medication being administered is correct for the right patient.

Choice B rationale

Verifying the child's identity using at least two identifiers and comparing the medication order to the prescription ensures that the right medication, dose, route, and time are being administered to the correct patient. This is a critical step in preventing medication errors and ensuring patient safety, especially with a high-risk medication like insulin.

Choice C rationale

Ensuring the child is comfortable and relaxed is beneficial for the child's overall well-being and can indirectly influence physiological parameters. However, it does not directly address the critical step of verifying the medication and patient identity before administration.

Choice D rationale

Preparing insulin without checking the expiration date is a medication error. Expired medications may have reduced potency or altered chemical properties, potentially leading to ineffective treatment or adverse effects. Checking the expiration date is a fundamental safety check.

Choice A rationale

A first-degree burn involves only the epidermis, the outermost layer of the skin. It is characterized by redness (erythema), pain, and dryness, without the formation of blisters. The superficial damage affects the outer layer of epithelial cells, causing vasodilation and inflammation, leading to the observed redness and discomfort.

Choice B rationale

A second-degree burn involves the epidermis and a portion of the dermis, the layer beneath the epidermis. These burns are characterized by blisters, significant pain, redness, and swelling. The damage extends deeper into the skin, affecting nerve endings and blood vessels, leading to fluid leakage and blister formation.

Choice C rationale

A third-degree burn involves the destruction of the epidermis and the entire dermis, potentially extending into the subcutaneous tissue. These burns appear white or charred, are often painless initially due to nerve damage, and lack blisters. The full thickness destruction of skin layers impairs sensation and requires significant medical intervention, often including skin grafting.

Choice D rationale

Full-thickness burn is another term for a third-degree burn, indicating that all layers of the skin have been destroyed. This type of burn extends through the epidermis and dermis and may involve underlying subcutaneous tissue, muscle, or bone. The appearance is typically dry, leathery, and may be white, charred, or waxy.