A teenager with a history of recurring atopic dermatitis (eczema) tells the school nurse of a desire to play high school sports.
Which action should the nurse take?

Answer and explanation

The correct answer is Choice B.

Choice A rationale

Rechecking the client’s vital signs in 30 minutes may not be the most appropriate action in this situation. The client is showing signs of possible complications such as infection (elevated

temperature, malaise) and referred pain in the shoulder, which could indicate diaphragmatic irritation. These symptoms, along with the client’s recent surgery, suggest that immediate medical attention may be necessary.

Choice B rationale

Having the client transported via ambulance to the hospital is the most appropriate action. The client’s symptoms suggest possible complications that require immediate medical attention.

Abdominal tenderness and shoulder pain could indicate a serious condition such as a perforation or infection. The elevated heart rate and low blood pressure could suggest sepsis or shock. Immediate medical evaluation and treatment are necessary.

Choice C rationale

Determining the client’s current oxygen saturation rate is important, but it is not the most immediate need. While this information could provide additional data about the client’s condition, it does not address the potential seriousness of the client’s symptoms. The client needs immediate medical attention.

Choice D rationale

Instructing the client to drive to the hospital for admission is not the best choice. Given the client’s symptoms and recent surgery, it would be safer for the client to be transported by ambulance. This would ensure that the client receives immediate medical attention and that the client’s condition can be monitored during transport.

Answer and explanation

The correct answer is Choice A.

Choice A rationale

Showering with non-perfumed soaps immediately after practice is a good practice for a teenager with a history of recurring atopic dermatitis (eczema) who wants to play high school sports. Heat and humidity can cause perspiration, which intensifies itching with atopic dermatitis (eczema), so the client should be encouraged to shower, using non-perfumed soaps, as soon as possible after physical activity to remove perspiration.

Choice B rationale

Informing the parents of problems associated with perspiration for those with eczema is also important. However, this does not directly address the teenager’s desire to play sports. It’s more of a secondary action that supports the primary action of managing the condition.

Choice C rationale

Informing the athletic coach of the teenager’s skin condition and its manifestations could be helpful in ensuring that the coach understands the teenager’s needs and can support them appropriately. However, this is not the most direct action that the nurse can take to help the teenager manage their condition while playing sports.

Choice D rationale

Encouraging the teenager to join the swim team instead of an outdoor sport could potentially reduce exposure to triggers for eczema flares, such as sweat and heat. However, chlorine in swimming pools can also be a trigger for some people with eczema. Therefore, this option might not be the best for everyone and should be considered on an individual basis.