What is the appropriate technique for the application of a topical treatment for a child with eczema?
Apply skin lotions in a circular motion.
Apply prescribed ointments with a gloved hand.
Apply as much and as frequently as relieves the symptoms.
Choose lanolin-based ointments.
The Correct Answer is B
Choice A rationale
Applying topical medications in a circular motion can cause friction and irritate the compromised skin barrier in eczema. The goal of treatment is to protect the skin and reduce inflammation. Instead, a gentle, downward stroking motion in the direction of hair growth is recommended to avoid folliculitis and further skin damage.
Choice B rationale
Using a gloved hand during the application of topical treatments for a child with eczema prevents the transfer of microorganisms from the nurse's hands to the child's vulnerable skin, reducing the risk of secondary infection. It also protects the nurse from potential absorption of the medication, particularly if it's a steroid, through their own skin.
Choice C rationale
The frequent and liberal application of topical medications can lead to systemic absorption, especially with corticosteroids, due to the child's higher body surface area to weight ratio and thinner skin. This can cause adverse effects such as adrenal suppression and Cushing's syndrome. Medication application should strictly follow the prescribed dosage and frequency.
Choice D rationale
Lanolin is a common allergen and can exacerbate eczema symptoms in some individuals. It's an ingredient derived from sheep's wool and can trigger contact dermatitis in sensitive individuals. Therefore, lanolin-based ointments are not a universally recommended choice for eczema treatment and should be used with caution.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Wet-to-damp saline moistened gauze is a method of debridement and is not the most effective choice for a wound with copious exudate. This dressing type is less absorbent and would quickly become saturated, requiring frequent changes. Frequent changes and wetness can lead to periwound skin maceration and irritation, hindering the healing process.
Choice B rationale
Leaving a stage 3 pressure injury open to the air is contraindicated. A stage 3 pressure injury involves full-thickness skin loss and is susceptible to infection. Leaving the wound open would not manage the copious exudate, would expose the wound bed to pathogens, and would lead to dehydration of the wound bed, which impairs cellular migration and proliferation necessary for healing.
Choice C rationale
A transparent film is a moisture-retaining dressing that is inappropriate for a wound with copious exudate. This dressing is designed for superficial wounds with minimal exudate. Applying a transparent film to a heavily draining wound would lead to the accumulation of exudate underneath the dressing, causing maceration of the surrounding skin and potential for infection.
Choice D rationale
A multi-fiber superabsorbent dressing is the most appropriate choice for a stage 3 pressure injury with copious exudate. These dressings are designed to absorb large volumes of fluid, wicking it away from the wound bed and periwound skin. This action helps to manage moisture, protect the surrounding skin from maceration, and maintain a moist environment ideal for wound healing.
Correct Answer is A
Explanation
Choice A rationale
A blood pressure of 98/58 mm Hg in a client who needs a beta blocker is a significant safety concern. Beta blockers work by blocking the effects of epinephrine, which can cause a decrease in heart rate and blood pressure. Administering a beta blocker to a client with a pre-existing low blood pressure (normotensive range is 120/80 mm Hg) could cause a profound and dangerous drop in blood pressure, leading to hypotension, syncope, and inadequate organ perfusion. This client needs immediate assessment before medication administration.
Choice B rationale
A client needing to use the bathroom after taking captopril is not an immediate priority. While captopril can cause hypotension, the primary concern is the potential for a first-dose hypotensive effect. However, a client's need to void is a common and expected request and does not indicate an acute, life-threatening crisis requiring immediate intervention before other clients.
Choice C rationale
A blood pressure of 188/92 mm Hg, while elevated, is not an immediate life-threatening emergency unless there are signs of end-organ damage (e.g., chest pain, neurological changes). This is considered a hypertensive urgency, which requires a prompt but not immediate intervention to lower the blood pressure gradually. This client is stable and can be assessed after the client in Choice A, who is at risk for a profound hypotensive event.
Choice D rationale
A client needing pain medication before a dressing change is not the highest priority. Pain management is an important aspect of care, but it is not an acute physiological emergency. Delaying pain medication for a short time to address a life-threatening physiological instability in another client is an appropriate triage decision. The client in Choice A is at higher risk for a critical physiological event. .
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