A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?
"Place a thick layer of the medication on open areas.”
“Rub the medication until it disappears.”
"Cover the area with an occlusive dressing.”
"Apply the medication to your infant's entire arm.”
The Correct Answer is B
A. "Place a thick layer of the medication on open areas." Topical corticosteroids like fluticasone should not be applied in thick layers or to open wounds, as excessive absorption can lead to systemic side effects such as adrenal suppression. A thin layer is sufficient to achieve the desired anti-inflammatory effects while minimizing adverse reactions.
B. “Rub the medication until it disappears.” Topical corticosteroids should be applied in a thin layer and gently rubbed into the skin until no visible residue remains. This ensures even absorption without excessive medication buildup, reducing the risk of local and systemic side effects, especially in infants who have a higher risk of absorption due to their thinner skin.
C. "Cover the area with an occlusive dressing." Occlusive dressings increase medication absorption, which can lead to systemic corticosteroid effects such as skin thinning, delayed wound healing, and adrenal suppression. Occlusion should only be used under medical supervision, especially in infants who are more susceptible to these effects.
D. "Apply the medication to your infant's entire arm." Fluticasone should be applied only to affected areas, not the entire limb. Applying it over a larger area than necessary increases the risk of systemic absorption and side effects. The medication should be used only as directed for targeted treatment of atopic dermatitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1"]
Explanation
Convert pounds to kilograms:
Conversion factor: 1 kg = 2.2 lb
=145 lb / 2.2 lb/kg
= 65.9 kg
Calculate the total daily dose:
Total daily dose (mg) = Weight (kg) × Dosage (mg/kg/day)
= 65.9 kg 3 mg/kg/day
= 197.7 mg/day
Calculate the dose per administration (divided into two doses):
Dose per administration (mg) = Total daily dose (mg) / Number of doses
=197.7 mg/day / 2 doses
= 98.85 mg/dose
Calculate the number of tablets per dose:
Number of tablets = Desired dose (mg) / Available dose (mg/tablet)
=98.85 mg/dose / 100 mg/tablet
= 0.9885 tablets
Round to the nearest whole number:
0.9885 tablets is 1 tablet
Correct Answer is D
Explanation
A. Anorexia. Anorexia is a common side effect of sulfasalazine and is usually mild. It occurs due to the drug’s gastrointestinal effects but does not require immediate intervention. Managing symptoms with dietary modifications or taking the medication with food can help alleviate discomfort.
B. Arthralgia. Joint pain (arthralgia) can develop as a side effect of sulfasalazine, sometimes due to a drug-induced lupus-like reaction. Although it can cause discomfort, it is not immediately life-threatening. Monitoring symptoms and adjusting treatment may help manage this condition.
C. Nausea. Nausea frequently occurs with sulfasalazine use and is typically mild. It is often dose-dependent and can be managed by taking the medication with meals. While persistent nausea may require adjustments, it is not a medical emergency.
D. Wheezing. Wheezing suggests a hypersensitivity reaction, which can lead to anaphylaxis, a life-threatening emergency. Sulfasalazine contains a sulfa component, which may trigger bronchospasm, angioedema, or respiratory distress. Immediate intervention, including discontinuing the drug and administering emergency treatment, is necessary.
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