A toddler is diagnosed with streptococcal based impetigo.
After teaching the parents about this condition and its treatment, the nurse determines that the teaching was successful based on which statement?
"The steroids should treat the sores pretty well.”.
"We need to make sure we finish up the entire antibiotic prescription.”.
"We should change the dressing on the sores every day.”.
"We need to stop our child from sucking their thumb.”.
The Correct Answer is B
Choice A rationale
Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. Steroids have immunosuppressive properties and can exacerbate bacterial infections by hindering the body’s ability to fight off the pathogens. Therefore, steroid creams are contraindicated and would not effectively treat the sores, as they would likely worsen the condition and delay healing.
Choice B rationale
The statement indicates an understanding of the importance of completing the full course of antibiotics to eradicate all of the bacteria. Discontinuing the medication prematurely can lead to antibiotic resistance and a recurrence of the infection, as some of the bacteria may survive and proliferate. Finishing the entire prescription ensures complete elimination of the pathogens.
Choice C rationale
Impetigo sores should not be covered with a tight dressing, as this can trap moisture and heat, creating an ideal environment for bacterial growth and proliferation. While the sores should be kept clean and dry, covering them daily with an occlusive dressing is generally not recommended. This can worsen the infection and hinder the drying and healing process.
Choice D rationale
Impetigo is highly contagious, but it is primarily spread through direct contact with the sores. While thumb sucking could potentially transfer bacteria from the hands to the face, it is not the primary route of transmission or a specific treatment concern. The focus should be on proper hand hygiene and avoiding scratching or picking at the lesions, which is the main way the infection spreads.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While positioning the client is a crucial step for the procedure, it is not the first priority. The client is positioned after the preliminary steps, such as administering the fluid bolus, are completed. The fetal position is used to open the intervertebral spaces, allowing for easier needle insertion. However, the first priority is to prevent a known and common complication.
Choice B rationale
Preparing a sterile field is a necessary step for any invasive procedure to prevent infection. The supplies are prepared while the client is getting ready for the procedure. However, the priority intervention is focused on the client's physiological safety and preventing a known and common complication, which takes precedence over setting up the sterile field.
Choice C rationale
Reviewing the client's medical history and lab results is part of the initial admission process and is necessary to ensure the client is a suitable candidate for the procedure. This is done before the decision is made to proceed with the epidural. However, the priority intervention immediately before the procedure is a physiological intervention to prevent a potential complication.
Choice D rationale
Epidural anesthesia can cause vasodilation and a rapid drop in blood pressure due to the blockade of sympathetic nerves. A fluid bolus, typically 500-1000 mL of an isotonic solution, is administered to increase intravascular volume and preload, which helps to counteract this potential hypotensive effect. Preventing maternal hypotension is a priority because it can lead to decreased placental perfusion and fetal distress.
Correct Answer is D
Explanation
Choice A rationale
Chronic anemia is not a primary complication of Kawasaki syndrome. The disease process is a vasculitis that primarily affects medium-sized arteries, leading to inflammation and damage. The acute inflammatory state can cause temporary anemia, but it is not a chronic sequela prevented by IVIG and aspirin.
Choice B rationale
Cardiac arrhythmias are not the primary long-term complication targeted by IVIG and aspirin therapy. The main concern is the weakening of the coronary artery walls due to inflammation, which can lead to the formation of aneurysms. Arrhythmias can occur but are not the main focus of this specific treatment.
Choice C rationale
Acute respiratory distress is not a typical complication of Kawasaki syndrome. The syndrome is a systemic vasculitis, not a primary pulmonary disease. Respiratory symptoms like cough or runny nose are part of the initial presentation but are not the serious, life-threatening complication that IVIG and aspirin are given to prevent.
Choice D rationale
Coronary artery aneurysms are the most serious long-term complication of Kawasaki syndrome. The intense inflammation of the blood vessel walls, known as vasculitis, can lead to weakening and bulging of the coronary arteries. High-dose aspirin and IVIG reduce this systemic inflammation, thereby preventing the formation of these aneurysms.
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