Pharmacology Antifungal #4

Question

An obese client reports severe redness and itching in the folds of the skin following an extended time of antibiotic therapy. Which assessment would the nurse perform next?

Answers

  1. Inspection of the tongue
    • Rationale:

      This answer is correct because Candidiasis occurs in various areas of the body. Therefore, if antibiotics have produced candidiasis in one area (folds of the skin), then oral candidiasis would be important to check next. Candidiasis symptoms include pain, redness, and itching especially in folds of the skin (abdominal, groin, under breasts, underarms) and vaginally. Oral candidiasis can also have a white, curd-like appearance in the mouth. Generally there is no itching in oral candidiasis, but redness and pain is common.

  2. Visualization of the toenails
    • Rationale:

      This answer is not correct because the client has candidiasis of the skin so other areas with skin (such as the common area of the mouth and tongue) should be assessed next. Toe fungus is not associated with candidiasis of the skin.

  3. Auscultation of the lungs
    • Rationale:

      This answer is not correct because auscultation of the lungs does not need to be next. It should be done as a basic assessment, but since that is not the client concern, it is not priority. Since antibiotics have produced candidiasis in one area (folds of the skin), then oral candidiasis would be important to check next.

  4. Deep palpation of the skin folds
    • Rationale:

      This answer is not correct because deep palpation is not appropriate for skin folds. Deep palpation is designed to assess organs deep in the abdomen, such as the liver. Since antibiotics have produced candidiasis in one area (folds of the skin), then oral candidiasis would be important to check next.

Overview

Candidiasis is a fungal yeast infection found anywhere there is skin. Therefore, if use of antibiotics has caused candidiasis in skin folds, there is a high risk of oral candidiasis.

Explanation

Learning Outcomes

Candidiasis occurs in various areas of the body. Therefore, if antibiotics have produced candidiasis in one area (folds of the skin), then oral candidiasis would be important to check next. Candidiasis symptoms include pain, redness, and itching especially in folds of the skin (abdominal, groin, under breasts, underarms) and vaginally. Oral candidiasis can also have a white, curd-like appearance in the mouth. Generally there is no itching in oral candidiasis, but redness and pain is common. Sometimes, the cognitively impaired client presents with nutritional problems, weight loss, or anorexia and it is found that oral candidiasis makes it too uncomfortable to eat.

Test Taking Tip

Generally, warm and moist environments are not a good thing for the body since it will generally become a place that harbors infection. An exception is when a body part that is supposed to be inside the body, becomes exposed to outside of the body, such as the bowel, in evisceration.

Video Rationale