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Walkthrough: Basic Care and Comfort Q1

by Rhonda Lawes

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    00:00 Let's start with the stem of the question. The nurse provides discharge instructions for the parents of a toddler client who's been diagnosed with eczema. Which statement by the nurse describes the non-medicated eczema treatment? Okay, there are the words we all kind of look for too. Right? Huh, select all that apply.

    00:23 I really want you to reframe your thinking, I want to encourage you that you can get these questions right. Just follow the same systematic thinking each time you answer these questions and you're going to raise your scores. Okay, let's break this question down. Take the first sentence. The nurse provides discharge instructions for the patients of a toddler client who's been diagnosed of eczema.

    00:47 Okay. So I'm the nurse, I'm doing discharge instructions or teaching to the parents because the client is a toddler and they have a diagnosis of eczema. So now I see what's particular about this client being discharged from the hospital, they're a toddler, they have eczema, and my job is to teach them. The last sentence that focuses it which happens to be the second sentence in this question, which statement by the nurse describes non-medicated eczema treatment? Now, why do we emphasize that word? Hey, that's a keyword I want you to look for. It's a descriptor word. We're talking about eczema treatment, but it specifically says non-medicated. So make sure when you're reading the stems of any question that you look at those descriptor words, slow down, keep an eye out for them.

    01:41 Now you know what your job is, take all of these dissection, put the stem of the question in your own words. Go ahead. Pause the video, put the stem of this question into your own words and then restart the video. Welcome back. Hopefully you took the opportunity to do that. Now, I tell you when you put it in your own words it doesn't have to be exactly like mine, but this is kind of how I would work through the question. I'd be thinking "What is the appropriate discharge education to the parents of a toddler with eczema, but remember Rhonda non-medicated eczema treatment." Okay. So with each question option I'm going to look at the answer choices and eliminate those one at a time. So, let's bring in the answer choices so you can see them. Okay, good. First, pay attention how many answer choices do you see? 5. So I want you to write down on your piece of scratch paper 1, 2, 3, 4, and 5. Just the numbers, not the answer choices but write down number 1, number 2, number 3, number 4, and number 5. Now, pause the video after I help you with this instruction. The way you worded the question, put it into your own words, I want you to ask yourself that question 5 separate times, one time for each one of those answer options. So, what's the appropriate non-medicated eczema treatment? So if I'm going to look at number 1, I would say "Is applying loose scented powder on the child's lesion appropriate non-medicated eczema treatment?" So I'm going to answer that question yes or no. If the answer is yes, then I check the box because what I'm looking for is everything that is appropriate for non-medicated eczema treatment. If I think no, cross through the number, either way make your decision, go on to the next option. So now is the time to actually push the pause button, work through this question with that strategy, each of the 5 answers, then restart the video and we'll go over the rationales. Hey, welcome back. Hopefully that didn't feel like too much heavy lifting. Always remember as we're going over the right answers, it's an opportunity for you to learn. No, I really mean that. It's an opportunity for you to know things like "Oh I didn't know that." Whether you got the answer right or wrong, what's the goal? Take those things that are new to you or that you needed to be reminded of and write them down in your notebook. I want you to actually write those out so that you can review them on a regular basis. Now on top of that, remember we've done the work for you, we have questions that come up after each video, and we also have spaced repetition cards. So when you're using the Lecturio system, you can also use our spaced repetition questions to help you stay on top of things. Okay, so let's take a look at this one. We're looking for number 1.

    05:04 Is apply loose scented powder on the child's lesion, is that appropriate non-medicated eczema treatment? What did you say? Well, it's actually not. If you have a lesion, you don't want to put powder on it. Scented powder is going to have some things in it that could also be harmful to the skin and particularly painful on an open lesion. So, do not include number 1, cross that off. Let's look at number 2. Is it appropriate non-medicated eczema treatment if you provide daily warm baths for 10-15 minutes? Now the first part is daily, that's how often it happens. A warm bath, seems okay. 10-15 minutes, yeah. This one is okay.

    05:53 It's non-medicated and it should help the child's eczema. Kind of help relieve some of that itching and help make that skin feel a little better. Now number 3. Is it appropriate non-medicated eczema treatment to apply over-the-counter topical steroids as much as possible? Okay, I got a few problems with this answer. Right? Over-the-counter topical steroids in a kid, that starts to make me nervous. Right? And then it says as much as possible. Whoah, no. I'm really hesitant to give children steroids. You'd have to have specific instructions, directions, and a prescription from the physician. Now this is a toddler. Their body surface area is tiny. Right? So if I'm slithering them up with as much as possible topical steroids, that is not a safe or appropriate option. So, I've eliminated number 3. Also I've eliminated number 1. So far, only number 2 has been selected as being safe, non-medicated eczema treatment. Number 4. Is this a safe non-medicated eczema treatment? Apply occlusive wet dressings on the lesions at night. Okay, now this one might have caught you up. Right? Because think about those types of dressings, we don't use those on other wounds. Would this be helpful? Actually, in this specific case of eczema, sometimes this is appropriate to use an occlusive wet dressing on lesions. So, this answer should be included. If you miss this one, don't worry. This is an example of where you should write yourself a note that in some cases occlusive wet dressings with exacerbations of eczema, outbreaks of eczema is appropriate. Now, number 5. Is it appropriate non-medicated eczema treatment to avoid the use of fabric conditioner and perfumed soaps? Oh, yeah. This little baby, his skin is so sensitive, it's irritated from the eczema, you don't want anything else that's going to irritate the skin or cause like kind of an inflammatory or allergic response. So, no fabric conditioner, no perfumed soaps. That's really going to help that child's skin start to heal. Okay, so, 5 options. See how long it took us to walk through those. Now, it's because I'm speaking it so it's even longer than if you're doing it in your head but I promise you that is the most effective strategy with select-all-that-apply questions. Why? Because I've often seen students go through the first part of the question and answer things that are correct and then they flip and start answering things that are incorrect. So, they knew the information but because they weren't meticulous about making sure they knew the topic of the question and then asking it 5 different times, they end up missing the question. Don't do that. So now we know the correct answers are number 2, number 4, and number 5. Number 1 and 3, those guys are out. So, pause here, think back through each one of the answer choices, review the rationales, see what needs to be added to your notebook and go ahead and do it right now before you go on to the next question.


    About the Lecture

    The lecture Walkthrough: Basic Care and Comfort Q1 by Rhonda Lawes is from the course NCLEX-RN® Question Walkthrough: Basic Care and Comfort.


    Included Quiz Questions

    1. Loose powder
    2. Warm baths
    3. Wet dressings on lesions
    4. Any interventions ordered by the provider for eczema treatment
    1. Daily warms baths
    2. Application of occlusive dressings over lesions
    3. Scented powder
    4. Scented antibacterial soap
    5. Over-the-counter topical steroids
    1. "Is the special soap scented?"
    2. "What brand of dressings are you using?"
    3. "Is the water at the house filtered?"
    4. "Is the water at the house hard water?"
    1. Re-word the stem of the question in your own words.
    2. Identify descriptor words.
    3. Identify the first word in the sentence.
    4. Identify the diagnosis.
    5. Identify the last word in the final sentence.

    Author of lecture Walkthrough: Basic Care and Comfort Q1

     Rhonda Lawes

    Rhonda Lawes


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