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Instructions:

 

* Read the articles. The test for this CE activity can only be taken online at http://www.nursingcenter.com/ce/ANC. Tests can no longer be mailed or faxed. You will need to create (its free!) and login to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Williams & Wilkins online CE activities for you.

 

* There is only one correct answer for each question. A passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.

 

* For questions, contact Lippincott Williams & Wilkins: 1-800-787-8985.

 

Registration Deadline: October 31, 2018

 

Disclosure Statement: The authors and planners have disclosed that they have no financial relationships related to this article.

 

Provider Accreditation:

Lippincott Williams & Wilkins, publisher of Advances in Neonatal Care, will award 3.0 contact hours for this continuing nursing education activity.

 

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

 

This activity is also provider approved by the California Board of Registered Nursing, Provider

 

Number ANC0516 for 3.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida, CE Broker #50-1223. Your certificate is valid in all states.

 

This article has been approved by the National Association for Neonatal Nurses Certification Board for Category B credit toward recertification as an NNP.

 

Payment:

This continuing education activity is offered free of charge to NANN members and nonmembers thanks to an educational grant from Kimberly-Clark.

 

CE TEST QUESTIONS

GENERAL PURPOSE: To provide an overview of key issues regarding neonatal skin care and treatment advances.

  
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LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:

  

1. Identify interventions to prevent diaper dermatitis, describe the clinical presentation of diaper dermatitis, and present an evidence based treatment plan to manage diaper dermatitis.

 

2. Identify features of the skin and techniques to improve skin care and minimize harm to extremely preterm infants.

 

 

Questions 1-9 are associated with the article "Diaper Dermatitis: What Do We Do Next?"

 

1. What feature of diapered skin promotes the development of diaper dermatitis?

 

a. overhydration

 

b. low pH

 

c. dehydration

 

2. The most common type of diaper dermatitis is

 

a. irritant.

 

b. allergic.

 

c. candida.

 

3. The usual presentation of candida diaper dermatitis includes

 

a. poorly demarcated erythema.

 

b. involvement of the folds of the groin.

 

c. distinct areas without satellite lesions.

 

4. What product ingredient provides antiseptic, antibacterial, and astringent properties while repelling fluids and, unless specifically labeled, is not absorbed into the skin?

 

a. petrolatum

 

b. zinc oxide

 

c. bacitracin

 

5. Pasek et al. demonstrated a decrease in the incidence of diaper dermatitis among a wide-scale pediatric population with

 

a. consistent barrier cream application.

 

b. once a day "butt" baths with mild cleanser.

 

c. the creation of an algorithm.

 

6. According to the Infant Diaper Dermatitis Care algorithm, prevention of diaper dermatitis includes daily cleaning of the diaper area with consistent application of

 

a. petrolatum.

 

b. petrolatum + zinc oxide.

 

c. petrolatum + zinc oxide + lanolin.

 

7. Following the algorithm, what did care providers on the implementation unit use during every diaper change to clear stool and urine from the area?

 

a. a chlorhexidine prep

 

b. sterile saline

 

c. a barrier wipe

 

8. With the appearance of redness, the application of a protective barrier cream is recommended for a minimum of

 

a. 2 days.

 

b. 3 days.

 

c. 5 days.

 

9. Which statement accurately describes the algorithm for care when severe skin breakdown occurs?

 

a. The barrier cream should be completely removed and reapplied with each diaper change.

 

b. Stool should be blotted off the barrier cream and more cream applied on top.

 

c. A mild cleanser should be used at each diaper change and petrolatum used on the skin exclusively.

 

Questions 10-18 are associated with the article "Extremely Preterm Infant Skin Care: A Transformation of Practice Aimed to Prevent Harm"

 

10. Medical adhesive related skin injuries can be reduced among extremely preterm infants through the use of

 

a. silicone tape.

 

b. diaper wipes.

 

c. petrolatum based emollients.

 

11. Which statement regarding the skin structure of an extremely preterm infant is accurate?

 

a. Accelerated skin maturation is usually completed within the first to second week of life.

 

b. Levels of transepidermal water loss decrease with a decrease in skin barrier function.

 

c. The infant's ruddy appearance is a reflection of the decreased presence of stratum corneum.

 

12. The most common type of medical adhesive-related skin injury in the neonatal intensive care unit is

 

a. skin tearing.

 

b. moisture maceration.

 

c. epidermal stripping.

 

13. Lesions associated with anetoderma of prematurity

 

a. are acute injuries which resolve with simple, focused interventions.

 

b. are located on the posterior scalp and other pressure areas.

 

c. may appear as late as 10 months of age.

 

14. It has been speculated that, in cases of atopic dermatitis, allergen penetration of the epidermal barrier in infancy may lead to the development of

 

a. scleroderma.

 

b. asthma.

 

c. inflammatory bowel disease.

 

15. Chang & Nakrani (2013) released a report on children initially diagnosed with eczema, impetigo, or psoriasis who were actually found to have

 

a. developing hemangioma.

 

b. cellulitis following skin breakdown.

 

c. allergic reactions to methylisothiazolinone.

 

16. The 2013 study by Aitken & Williams showed that preterm neonates' exposure to topical iodine placed them at increased risk for dysfunction of the

 

a. thyroid.

 

b. thymus.

 

c. kidney.

 

17. The authors argue that, during the first 2 weeks of life, extremely premature infants should be cleaned with only

 

a. sterile water.

 

b. soap free cleansers.

 

c. pH balanced wipes.

 

18. What do the authors recommend for use on visibly dry/cracked areas of skin for infants 22 to 28 weeks gestational age?

 

a. lanolin ointment

 

b. 6% dimethicone cream

 

c. zinc oxide