The client has a red, raised skin rash. During the client's bath, which of the following should be the nurse's priority action?
a. Assess for further inflammatory reactions.
b. Discuss the body-image problems created by the presence of the rash.
c. Wash the skin thoroughly with hot water and soap.
d. Moisturize the skin to prevent drying.
A
The first action the nurse should take is to assess for further inflammatory reactions to determine if they are localized or systemic. The nurse assesses the condition before adapting hygiene prac-tices.
Discussing body-image problems would not be the priority nursing action.
Skin should be washed with warm water, not hot, as hot water may dry the skin. All soap should be rinsed off well, so as not to leave residue that may cause further irritation.
The rash may be caused by moisture; thus moisturizing the skin would not be appropriate. A lo-tion to help prevent itching may be applied.
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