While bathing an elderly client, the nurse observes the presence of various age-related skin changes. Which skin change should be of concern to the nurse?
1. Senile lentigines
2. Actinic keratosis
3. Seborrheic keratosis
4. Skin tags
Answer: 2
1. Senile lentigines (liver spots) are normal with aging, and benign.
2. Actinic keratoses are reddish, raised plaques that can become malignant and should be checked frequently.
3. Seborrheic keratosis (dark, raised lesions) is normal with aging, and benign.
4. Skin tags (excess flaps of skin) are normal with aging, and benign.
You might also like to view...
A client has sat in stony silence in the day room for 20 minutes after her appointment with her
psychiatrist. She appears tense and vigilant. The nurse sees the client abruptly stand up and pace back and forth across the day room, clenching and unclenching her fists, then stop and stare intently into the face of the psychiatric technician seated at a table. The assessment that can be made is that the client is a. working off angry feelings. b. attempting to use relaxation strategies. c. exhibiting clues to potential aggression. d. using withdrawal.
The nurse is caring for a client with nephrotic syndrome. Which of the following manifesta-tions are typical? (Select all that apply.)
A. Proteinuria less than 3 g/24 hr B. Hypoalbuminemia C. Fluid volume deficit D. Lipiduria E. Dysuria F. FrequencyG. CVA tenderness H. Hypotension
The client asks the nurse how Lipitor will help lower cholesterol. Which response by the nurse is most appropriate?
1. Its action is not understood. 2. It makes the body excrete cholesterol quicker. 3. It binds to cholesterol and inhibits its production. 4. It interferes with how cholesterol is made.
The nurse observes two PACs in 1 minute on a patient's cardiac monitor. The patient is asymptomatic. What action is required by the nurse?
a. Administer digoxin. b. Notify the physician. c. Continue monitoring the patient. d. Take vital signs every 15 minutes.