Maryville University NURS 623 Exam 1
Mode of transmission for parasitic skin infections - answer Close direct skin contact.
Clinical presentation for Scabies - answer Intense itching, worse at night. Burrows noted
between webs of fingers.
Commonly prescribed medications for Scabies – answer Permethrin Cream 5%
(Elimite) is the first-line treatment. Safe in 2 months and older. Apply to all areas from
neck down and leave on for 8-12 hours. Repeat application in 1 week. May repeat a
third time in another week. Follow up in 1 week.
Antihistamines and topical steroids if the pruritis is bad.
What should you include in the patient education to prevent spreading of the various
parasitic skin problems? - answer Avoid close contact. Wash all bedding, clothing, cloth
items, and stuffed animals in hot water. All close contacts family members, people you
live with and sexual partners need to be treated as well.
Which bacterial skin infection is considered highly contagious? - answerImpetigo
What is the "classic" presentation of impetigo? - answerHoney crusted lesions
What is the management of a minor case of folliculitis (non-pharmacologic)? -
answerGentle cleansing by washing the skin twice a day with antibacterial soap.
What are the commonly prescribed medications for folliculitis? - answerMupirocin
(Bactroban) 2% ointment or cream, TID, 5-14 days, for secondarily infected skin lesions.
Mupirocin (Bactroban) twice daily for 5 days in the nose for people with recurrent
folliculitis to clear the colonization of S. Aureus.
Furuncles - answerInitially appear small (0.5-1 cm), red, tender, indurated nodule. As it
grows it develops a central yellow plug. They eventually rupture spontaneously.
Fluctuant or larger furuncles should be treated with I&D and covered with a simple dry
sterile dressing. Patients should be instructed to use warm compresses twice daily to
encourage drainage of pus.
Carbuncles - answerInitially appear as multiple furuncles and develops into a large,
erythematous lump and must be drained before healing will take place and this typically
occurs spontaneously within 2 weeks. Carbuncles frequently require I&D and need
systemic antibiotics and a referral. Antibiotics include: TMP-SMX (MRSA converage),
dicloxacillin, cephalexin, or doxycycline.
A gram stain is recommended to check for MRSA strains.
, What are the considerations when determining treatment for cellulitis? - answerSevere
infections, infections around the eyes, or systemic involvement (fever & chills),
immunocompromised should be sent to the ED for inpatient IV treatment.
Mild cases can be treated with PO antibiotics that should show improvement within 48-
72 hours. Penicillin VK, dicloxacillin, clindamycin, or cephalexin for 5 days.
Infected human & animal bites need to be treated with amoxicillin-clavulanic acid
(Augmentin) for 2 weeks. Prophylaxis treatment for human & animal bites (within 6
hours) amoxicillin-clavulanic acid (Augmentin) for 3-5 days.
HSV - answergrouped vesicles on an erythematous base, followed by ulcers or erosions
that crust over with honey color. Lesions typically heal in 7-10 days. Mouth, face, or
genitals.
Diagnostic tests for HSV - answerViral Culture Gold Standard & PCR tests are standard
for diagnosis. Vesicle fluid can be cultured with 72 hours of outbreak. Tzanck smear.
HIV testing is advisable in HSV-2 patients.
Herpetic keratoconjunctivitis - answerrequires immediate referral to an ophthalmologist.
HSV-2 Genital lesion treatment - answerTreated with oral antivirals Valacyclovir or
famciclovir. Warm compresses and oatmeal sitz baths can help promote comfort and
healing. Urinate into a warm bath. Increase fluid intake and rest.
HSV-1 oral lesion treatment - answerAcetaminophen to control pain. Ice or lip ointments
like Blistex. OTC docosanol (abreva) 10% cream applied 5 times a day. For more
extensive lesions, penciclovir (Denavir) 1% cream applied every 2 hours while awake.
Extensive oral lesions may require lidocaine, and acyclovier oral suspension
200mg/5mL, rinse mouth with 1 teaspoon and swallow five times a day.
HSV Patient education - answerBegin antiviral at the first sign of tingling or burning.
No sharing of towels, silverware, or glasses. Wash hands frequently.
Avoid sex until lesions are healed, Use condoms every time to avoid viral spread.
Which dermatitis is an inherited skin reaction that begins in infancy - answerAtopic
dermatitis
What is the "atopic triad?" - answerAtopic eczema, asthma, and allergies
What dermatitis is associated with the expression "the itch that rashes?" - answerAtopic
dermatitis
What is the objective finding with atopic dermatitis? - answerBegins in infancy on
cheeks, face, and upper extremities. Erythema is often seen before pruritis. Flexural
eczema seen between 4-10 antecubital fossa, popliteal fossa, and neck. Adults: face,
neck, upper chest, genital area and hands. Excoriated maculopapular lesions. Oozing
and crusting.
Mode of transmission for parasitic skin infections - answer Close direct skin contact.
Clinical presentation for Scabies - answer Intense itching, worse at night. Burrows noted
between webs of fingers.
Commonly prescribed medications for Scabies – answer Permethrin Cream 5%
(Elimite) is the first-line treatment. Safe in 2 months and older. Apply to all areas from
neck down and leave on for 8-12 hours. Repeat application in 1 week. May repeat a
third time in another week. Follow up in 1 week.
Antihistamines and topical steroids if the pruritis is bad.
What should you include in the patient education to prevent spreading of the various
parasitic skin problems? - answer Avoid close contact. Wash all bedding, clothing, cloth
items, and stuffed animals in hot water. All close contacts family members, people you
live with and sexual partners need to be treated as well.
Which bacterial skin infection is considered highly contagious? - answerImpetigo
What is the "classic" presentation of impetigo? - answerHoney crusted lesions
What is the management of a minor case of folliculitis (non-pharmacologic)? -
answerGentle cleansing by washing the skin twice a day with antibacterial soap.
What are the commonly prescribed medications for folliculitis? - answerMupirocin
(Bactroban) 2% ointment or cream, TID, 5-14 days, for secondarily infected skin lesions.
Mupirocin (Bactroban) twice daily for 5 days in the nose for people with recurrent
folliculitis to clear the colonization of S. Aureus.
Furuncles - answerInitially appear small (0.5-1 cm), red, tender, indurated nodule. As it
grows it develops a central yellow plug. They eventually rupture spontaneously.
Fluctuant or larger furuncles should be treated with I&D and covered with a simple dry
sterile dressing. Patients should be instructed to use warm compresses twice daily to
encourage drainage of pus.
Carbuncles - answerInitially appear as multiple furuncles and develops into a large,
erythematous lump and must be drained before healing will take place and this typically
occurs spontaneously within 2 weeks. Carbuncles frequently require I&D and need
systemic antibiotics and a referral. Antibiotics include: TMP-SMX (MRSA converage),
dicloxacillin, cephalexin, or doxycycline.
A gram stain is recommended to check for MRSA strains.
, What are the considerations when determining treatment for cellulitis? - answerSevere
infections, infections around the eyes, or systemic involvement (fever & chills),
immunocompromised should be sent to the ED for inpatient IV treatment.
Mild cases can be treated with PO antibiotics that should show improvement within 48-
72 hours. Penicillin VK, dicloxacillin, clindamycin, or cephalexin for 5 days.
Infected human & animal bites need to be treated with amoxicillin-clavulanic acid
(Augmentin) for 2 weeks. Prophylaxis treatment for human & animal bites (within 6
hours) amoxicillin-clavulanic acid (Augmentin) for 3-5 days.
HSV - answergrouped vesicles on an erythematous base, followed by ulcers or erosions
that crust over with honey color. Lesions typically heal in 7-10 days. Mouth, face, or
genitals.
Diagnostic tests for HSV - answerViral Culture Gold Standard & PCR tests are standard
for diagnosis. Vesicle fluid can be cultured with 72 hours of outbreak. Tzanck smear.
HIV testing is advisable in HSV-2 patients.
Herpetic keratoconjunctivitis - answerrequires immediate referral to an ophthalmologist.
HSV-2 Genital lesion treatment - answerTreated with oral antivirals Valacyclovir or
famciclovir. Warm compresses and oatmeal sitz baths can help promote comfort and
healing. Urinate into a warm bath. Increase fluid intake and rest.
HSV-1 oral lesion treatment - answerAcetaminophen to control pain. Ice or lip ointments
like Blistex. OTC docosanol (abreva) 10% cream applied 5 times a day. For more
extensive lesions, penciclovir (Denavir) 1% cream applied every 2 hours while awake.
Extensive oral lesions may require lidocaine, and acyclovier oral suspension
200mg/5mL, rinse mouth with 1 teaspoon and swallow five times a day.
HSV Patient education - answerBegin antiviral at the first sign of tingling or burning.
No sharing of towels, silverware, or glasses. Wash hands frequently.
Avoid sex until lesions are healed, Use condoms every time to avoid viral spread.
Which dermatitis is an inherited skin reaction that begins in infancy - answerAtopic
dermatitis
What is the "atopic triad?" - answerAtopic eczema, asthma, and allergies
What dermatitis is associated with the expression "the itch that rashes?" - answerAtopic
dermatitis
What is the objective finding with atopic dermatitis? - answerBegins in infancy on
cheeks, face, and upper extremities. Erythema is often seen before pruritis. Flexural
eczema seen between 4-10 antecubital fossa, popliteal fossa, and neck. Adults: face,
neck, upper chest, genital area and hands. Excoriated maculopapular lesions. Oozing
and crusting.
