27. A nurse knows that the choice of a topical antimicrobial for a client with burns is most influenced by:
27. A nurse knows that the choice of a topical antimicrobial for a client with burns is most influenced by:
. The bactericidal and fungicidal effectiveness of the agent.
. The form of the agent, whether it is a liquid or cream.
. The presence and extent of eschar formation.
. The ability of the agent to deliver uniform absorption.
Test-Taking Tip
Look for an option that would inhibit the absorption ability of the topical agent (e.g., eschar), and therefore render the antimicrobial less effective.
Content Area: Adult Health, Integumentary; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is incorrect because all of the topical therapies must be effective against gram-negative organisms. The agent does not sterilize the burn but reduces the number of bacteria so that the body's defense mechanisms are able to overcome the infection. Answer 2 is incorrect because the form of the topical agent is not important. Treatment may alternate between a liquid and a cream. Answer 3 is correct because, since eschar is devitalized tissue, the topical agent must be able to penetrate eschar and not be systemically toxic. Answer 4 is incorrect because burn injuries are not uniform. Variations in burn depth and the presence of eschar affect the absorption of a topical agent.