NURS 623 Worksheet for Exam 1 Q&A

NURS 623 Worksheet for Exam 1 Q&A The following list is meant to serve as a study guide and may not be inclusive of every component of the exam. You are responsible for the required readings and the Kaltura presentations. Be prepared to identify diagnosis (or treatment) when given a picture with the description of the various skin problems. Working through the questions should help point out areas you need to spend more time further reviewing. Also, please look over the review guide in the module section. Parasitic skin problems 1. What is the mode of transmission? Contaminated food, water, soil, blood, and can be transmitted through sexual contact. 2. What is the clinical presentation for each of the parasitic skin problems? Small insects or worms that burrow into the skin to live and lay their eggs. SUBJECTIVE: intense itching worse at night.OBJECTIVE: 1-2 mm red papules intense itching excoriations may be present with crusting from itching. 3. What are the commonly prescribed medications for the various parasitic skin problems? Permethrin cream (scabies) Permethrin rinse (lice) Ivermectin, lindane 4. What should you include in the patient education to prevent spreading of the various parasitic skin problems? Good hygiene, don’t share combs/hats/ wash bedding in hot water, clothing hot water too. Fungal skin problems 5. What is the clinical presentation of each of the fungal skin problems? Thrive warm moist environments, folds of skin. Feet / goin. Scaly rash, discoloration of the skin, red, cracked peeling and biggest thing ITCHES. OBJECTIVE: bright red rash with macules or satellite lesions seen on the borders, a cardinal symptom is pruritus’ and sometimes burning. 6. How are fungal infections usually diagnosed? By scrapping off the skin and looking under a microscope Is there a difference if the fungal infection is resistant to treatment? Many of these cases are completely resistant to one form of another class of antifungal. So combo of antifungal treatment is commonly used. 7. What are the commonly prescribed medications end in ZOLE or FINE for the various fungal skin problems? Clotrimazole (Canesten), Econazole (Ecoza), Ketoconazole (Nizoral), Desenex Miconazole 8. What should you include in the patient education regarding the various fungal skin problems? Wash, dry thoroughly, wear socks, wash shoes Bacterial skin infections 9. Which bacterial skin infection is considered highly contagious? Impetigo What is the “classic” presentation?Vesicles moist HONEY-Crusts 10. What is the clinical presentation of each of the bacterial skin infections? Induration and erythema of the affected area with pain out of proportion to overlying skin changes. 11. What is the management of a minor case of folliculitis (non-pharmacologic)? Antibacterial soap and warm wather, good hand washing, good hygiene, avoid old razors, gentle cleansing bid with antibacterial soap 12. What are the commonly prescribed medications for folliculitis? Mupirocin (Bactroba) 2% ointment or cream tid for 5-14days . Retapamulin (Altabax) bid for 5 days. Clindamycin 1% solution gel, pledget bid until lesions are clear. EES 2% solution lotion or gel bid 13. What is the difference between a carbuncle and furuncle? FURuncle is BOIL. Carbuncle are multiple boils. Does the treatment differ? Have to be drained, warm compress help if not I & D, Can use topical abx, systemic not necessary unless cellulitis, or immunocompromised, elderly etc. 14. What are the considerations when determining treatment for cellulitis? Severity of the infection, site of the infection, presence of underlying disease, and virulence of the pathogen. For example, DM2 high risk, pts on corticosteroids higher risk, previous surgeries or surgical site, Hands feet and face needs aggressive treatment. 15. What are the pharmacologic recommendations for management of skin and soft tissue infections in primary care? The following are good choices for cellulitis NOT associated by human or animal bites: Pen VK, dicloxacillin, clindamycin, or cephalexin for 5 days. If allergic to PCN, clindamycin, azithromycin, or clarithromycin. Infected with human or animal bite then augmentin for 2 weeks.