NURSING MSN 571 REVIEW AND SOLUTIONS
2026
◉ Secondary Skin Lesions-Lichenification. Answer: thickening of the
epidermis with exaggeration of normal skin due to chronic skin
itching (eczema)
◉ Secondary skin lesions- Scale. Answer: flaking skin (psoriasis)
◉ Secondary skin condition-crust. Answer: dried exudate (impetigo)
◉ Secondary skin condition-ulceration. Answer: eroding of
epidermis and dermis (if deep can involve subcutaneous tissue)
◉ Secondary skin condition-scar. Answer: permanent fibrotic
change following damage to dermis (surgical scars)
◉ Secondary skin condition-keloids/hypertrophic scars. Answer:
overgrowth of scar tissue (more common in Black and Asian
descent)
◉ Rule of 9's. Answer: Head and neck = 9%
Upper Ex = 9% each
,Lower Ex = 9% each
Front trunk = 18%
Back trunk = 18%
◉ Rule of 9's =-child leg. Answer: Chlid one leg=13.5%
One leg adult =18%
◉ Rule of 9's =child head. Answer: Child head- 18% (half of adult %)
◉ First degree (superficial):. Answer: Red to bright red skin and
tenderness/pain
◉ second-degree (partial-thickness) burns. Answer: Painful red
skin, bullae (blisters), reddened/weepy skin
--> BLISTERS START AT SECOND DEGREE
◉ third-degree (full-thickness) burns. Answer: Pain sensation
absent. Pale/white color, charred skin, leather-like texture
◉ Criteria for Burn Center Referral:. Answer: Face, hands, feet,
genitals, major joints
Electrical burns, lightning burns
Partial thickness burns >10% of total body surface area
,Third degree burns in any age group
◉ If pt. has a Sulfa allergy and can't use Silvadene what is the
alternative?. Answer: Bacitracin, Polysporin/Triple antibiotic cream
or ointment
◉ Cellulitis. Answer: Bacteria (Gram Positive):
Streptococcus (beta hemolytic strep), Staph aureus (MRSA)
◉ Cellulitis Symptoms:. Answer: Diffused pink to red colored skin,
warm to touch, and may become abscessed
If red streaks radiating from infection it has spread to lymph nodes
(lymphangitis)
Usually within the deep dermis and is poorly demarcated (poor
boundaries)
Most common location is the lower legs
-->If pt. has DM and develops cellulitis watch for osteomyelitis
◉ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D
(if <5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours
for 5-10 days
, Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim
BS BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found
on the cheeks and shins
◉ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs
• If fever and chills present pt. is septic (hospitalization is
recommended)
◉ Erysipelas: Treatment. Answer: If treating facial erysipelas
assume MRSA is present.
Use appropriate antibiotics or refer to ER if septic
Dicloxacillin QID, Cephalexin or Clindamycin x 10 days
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ MRSA: Treatment. Answer: Bactrim
Doxycycline
Minocycline
2026
◉ Secondary Skin Lesions-Lichenification. Answer: thickening of the
epidermis with exaggeration of normal skin due to chronic skin
itching (eczema)
◉ Secondary skin lesions- Scale. Answer: flaking skin (psoriasis)
◉ Secondary skin condition-crust. Answer: dried exudate (impetigo)
◉ Secondary skin condition-ulceration. Answer: eroding of
epidermis and dermis (if deep can involve subcutaneous tissue)
◉ Secondary skin condition-scar. Answer: permanent fibrotic
change following damage to dermis (surgical scars)
◉ Secondary skin condition-keloids/hypertrophic scars. Answer:
overgrowth of scar tissue (more common in Black and Asian
descent)
◉ Rule of 9's. Answer: Head and neck = 9%
Upper Ex = 9% each
,Lower Ex = 9% each
Front trunk = 18%
Back trunk = 18%
◉ Rule of 9's =-child leg. Answer: Chlid one leg=13.5%
One leg adult =18%
◉ Rule of 9's =child head. Answer: Child head- 18% (half of adult %)
◉ First degree (superficial):. Answer: Red to bright red skin and
tenderness/pain
◉ second-degree (partial-thickness) burns. Answer: Painful red
skin, bullae (blisters), reddened/weepy skin
--> BLISTERS START AT SECOND DEGREE
◉ third-degree (full-thickness) burns. Answer: Pain sensation
absent. Pale/white color, charred skin, leather-like texture
◉ Criteria for Burn Center Referral:. Answer: Face, hands, feet,
genitals, major joints
Electrical burns, lightning burns
Partial thickness burns >10% of total body surface area
,Third degree burns in any age group
◉ If pt. has a Sulfa allergy and can't use Silvadene what is the
alternative?. Answer: Bacitracin, Polysporin/Triple antibiotic cream
or ointment
◉ Cellulitis. Answer: Bacteria (Gram Positive):
Streptococcus (beta hemolytic strep), Staph aureus (MRSA)
◉ Cellulitis Symptoms:. Answer: Diffused pink to red colored skin,
warm to touch, and may become abscessed
If red streaks radiating from infection it has spread to lymph nodes
(lymphangitis)
Usually within the deep dermis and is poorly demarcated (poor
boundaries)
Most common location is the lower legs
-->If pt. has DM and develops cellulitis watch for osteomyelitis
◉ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D
(if <5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours
for 5-10 days
, Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim
BS BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found
on the cheeks and shins
◉ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs
• If fever and chills present pt. is septic (hospitalization is
recommended)
◉ Erysipelas: Treatment. Answer: If treating facial erysipelas
assume MRSA is present.
Use appropriate antibiotics or refer to ER if septic
Dicloxacillin QID, Cephalexin or Clindamycin x 10 days
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
◉ MRSA: Treatment. Answer: Bactrim
Doxycycline
Minocycline
