While caring for a 4-year-old girl with vulvovaginitis, the nurse ...

[ss2343]

While caring for a 4-year-old girl with vulvovaginitis, the nurse teaches the girl's mother how to prevent subsequent episodes. Which of the following responses by the mother indicates a need for further teaching?
 
  A) I'll tell her to wipe from front to back.
  B) I will make sure she changes her underwear every day.
  C) She should probably avoid taking bubble baths.
  D) I'll help supervise her wiping after bowel movements.

Question 2

The nurse is caring for an infant with bladder exstrophy. As part of the nursing plan, the nurse monitors for abdominal skin excoriation. Which intervention would best promote healing and prevent further skin breakdown?
 
  A) Cleaning the area well with a scented diaper wipe
  B) Applying a barrier/healing cream or paste on the skin
  C) Keeping the bladder moist and covering it with a sterile bag
  D) Covering the area with sterile gauze pads after bathing

[Kimmy]

Answer to Question 1

A
Response:
At the age of 4, the mother should not assume that the girl will wipe properly, from front to back. Therefore, the mother will need to supervise her wiping to train her properly. Daily underwear changes and avoidance of bubble baths are appropriate responses.

Answer to Question 2

B
Response:
The nurse should use barrier/healing cream or paste on the surrounding skin to promote healing and prevent further skin breakdown. Diaper wipes that contain fragrance or alcohol can sting if used on non-intact skin and can worsen skin breakdown. It is important to protect the bladder, but this will not address the skin excoriation. Meticulous attention to cleanliness is important, but the nurse should sponge bathe the infant rather than immerse the infant in water to prevent pathogens in the water from entering the bladder.