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NURS 623 ADULT HEALTH FNP EXAM 1 WORKSHEET REVIEW MARY VILLE UNIVERSITY
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NURS 623 ADULT HEALTH FNP EXAM 1 WORKSHEET REVIEW MARY VILLE UNIVERSITY
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NURS 623 ADULT HEALTH FNP EXAM 1WORKSHEET REVIEW MARY VILLE
UNIVERSITY
, Worksheet for Exam 1
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?
a. Scabies
b. Lice (Pediculosis) – close contact, reside and reproduce on human host. Lay eggs in
patients’ clothes. Initial infection for up to 2 weeks w/ no Sx. Itching r/t lice saliva
injected in skin. Re-infection Sx return w/i 12-48 hrs. Blood sucking
2. What is the clinical presentation for each of the parasitic skin problems?
Scabies – itching (worse at night), with rash in 50%, scratch marks. Burrows in skin
Lice - itching (worse at night), excoriation marks with crusting or scaling, can be on
scalp, facial or pubic hair (a STD and should test for other STDs), armpits.
3. What are the commonly prescribed medications for the various parasitic skin problems?
Treat patient and close contacts and secondary complications (impetigo/dermatitis- used
antib’s).
Scabies – Permethrin or Lindane (monitor for toxicity in children, preg, elderly) –
scabicides
- Histamine
- Topical steroids
Lice – Lotions, shampoos, creams with benzyl alcohol, permethrin, ivermectin,
etc. and Lindane 2nd line d/t CNS toxicity.
- Manual picking of nits or Electronic comb to electrocute lice. Consider
for patients with asthma, allergies, immune suppression.
- Vasoline, mayo, tea tree oil or olive oil can suffocate
- Nits in eyelashes in children suspect sexual abuse.
4. What should you include in the patient education to prevent spreading of the various parasitic
skin problems?
*F/up in 1 week for both if Sx’s persist after treatment. Warn itching may last up to a
week
, * Wash bedding, clothing in hot soapy water and dry in hot dryer. Vacuum rugs, seating
and carpets.
* Monitor for toxicity with Lindane (2nd line Tx) w/ no use in children under 12 y, preg or
lactating and cover eyes and mouth to prevent pesticide exposure and ingesting.
Lice: do not share comb, scarves, headsets, towels, bedding. Wash them in hot soapy
water. Screen scalp once a week after treatment and can return to school/work after Tx.
Scabies: Trim nails low to prevent reinfecting. Monitor medication. Treat all family
members, avoid scratching as it aids in spreading the mites.
Fungal skin problems
4. What is the clinical presentation of each of the fungal skin problems?
a. Candidiasis – increase risk w/ immune suppression (HIV, Diab, Antib therapy)
and can be
i. oral thrush (sore throat and dysphagia espec. w/ acidic foods), diaper
dermatitis. Obj.: creamy patches on top of red rash on buccal mucosa,
lips, tongue, & angle of mouth.
ii. vulvovaginitis (albican – burning, itchy, thick cottage cheese discharge,
dyspareunia and dysuria, red & irritated. Curdlike patches in vag wall),
iii. balanitis (penis – itchy, burning after sex, red rash. Small red, eroded
tender patches. Some small white round w/ red base),
iv. skinfolds (armpits, pelvic creases, groin, hands/feet, perianal, mammary
folds) – red itchy rash w/ weeping and burning. Skin the rubs [maceration]
w/ increased heat and moisture, tender to touch.
v. nail (painful fingertip w/ red, hot swelling, sometimes an abscess may
drain; Subungual – discolored, yellow nails, usually w/ excessive water
contact. Obj: deformed, partial or total separated nail from bed; usually no
pain). Tx: With warm compress, may drain abscess, but subungual treat
with systemic antib’s.
b. Dermatophyses – superficial infection d/t metabolizing of keratin (tineas).
Complications: Occurs inside (endothrix -more severe w/ kerion, Staph -2ary
infection or drainage) or outside (ectothrix) hair shaft; Scarring & alopecia
can occur when healed. Risk factors: Diab, heat, moist, poor circulation, age
broken skin or hair shaft, African American.
i. Capitis “scalp” – most contagious and common in children to puberty.
Painless bald spot w/ black dot or gray-white scaly patch(es) of thick
keratinized skin (in children) or no redness, pain, nodule w/ kerion
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