An infant has a severe contact diaper dermatitis. The provider orders triamcinolone acetonide (Kenalog) 0.1% cream to be applied 3 times daily. When teaching the infant's parents about this medication, the nurse will instruct them to apply:
a. a thick layer and massage the cream into the skin.
b. a thin layer and leave the diaper open as much as possible.
c. the cream and place an occlusive dressing over the area.
d. the cream and put the infant's diaper on tightly.
ANS: B
Topical glucocorticoids can be absorbed systemically and cause adverse effects. To minimize systemic and local adverse effects, the medication should be applied sparingly. Parents should be taught to avoid tight-fitting diapers. The cream should be rubbed gently into the skin. Occlusive dressings increase the risk of adverse effects. Putting the diaper on tightly creates an occlusive dressing.
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