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.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is A
Explanation
Choice A rationale
Wool fibers have a rough, coarse texture that can mechanically irritate the delicate skin of an infant with eczema. This physical abrasion can trigger an inflammatory response and exacerbate the itching and rash associated with the condition. The goal is to use smooth, breathable fabrics like cotton to minimize skin friction.
Choice B rationale
Fragrances and dyes in laundry detergents are common chemical irritants and allergens that can cause contact dermatitis and worsen eczema symptoms. Avoiding these additives is crucial for minimizing exposure to potential triggers and reducing inflammation and itching in sensitive skin.
Choice C rationale
Putting cotton gloves or socks on an infant's hands is a practical strategy to prevent the infant from scratching their skin. The mechanical trauma from scratching can break the skin barrier, leading to secondary infections and worsening the eczema flare-up.
Choice D rationale
Keeping fingernails short is a fundamental measure to prevent the skin damage caused by scratching. Long, sharp nails can tear the skin, creating entry points for bacteria and increasing the risk of infection, a common complication of poorly controlled eczema.
Correct Answer is B
Explanation
Choice A rationale
Ambulation is contraindicated for a client with a confirmed deep vein thrombosis due to the significant risk of dislodging the thrombus. This could lead to a pulmonary embolism, a life-threatening complication. The nurse must ensure the client remains on bed rest to prevent this from occurring, thus this is not a delegated task for the AP.
Choice B rationale
Applying a warm moist pack is a safe and effective comfort measure for a client with a deep vein thrombosis. The warmth helps to promote vasodilation, which can reduce pain and inflammation associated with the DVT. This task is within the scope of practice for an assistive personnel to perform under the direct supervision of the nurse.
Choice C rationale
Massaging the leg of a client with a deep vein thrombosis is strictly contraindicated. This action can physically dislodge the thrombus from the vein wall, causing it to travel through the bloodstream. If the thrombus reaches the lungs, it becomes a pulmonary embolism, which is a medical emergency.
Choice D rationale
Applying an ice pack is not an appropriate comfort measure for a client with a deep vein thrombosis. Cold can cause vasoconstriction, which may worsen the pain and swelling associated with the DVT. It could also potentially increase the risk of thrombus formation by slowing blood flow.
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