Page 1235 - Saunders Comprehensive Review For NCLEX-RN

self from absorption of the medication. Caregivers should also be taught
to wash hands thoroughly before and after administration.
III. Topical Glucocorticoids

A. Description
1. Antiinflammatory, antipruritic, and vasoconstrictive
actions
2. Preparations vary in potency and depend on the
concentration and type of preparation and method of
application (occlusive dressings enhance absorption,
increasing the effects).
3. Systemic effects are more likely to occur with
prolonged therapy and when extensive skin surfaces
are treated.

Topical glucocorticoids can be absorbed into the systemic

circulation; absorption is greater in permeable skin areas (scalp, axilla,
face and neck, eyelids, perineum) and less in areas where permeability
is poor (palms, soles, back).
B. Contraindications
1. Clients demonstrating previous sensitivity to
corticosteroids
2. Clients with current systemic fungal, viral, or bacterial
infections
3. Clients with current complications related to
glucocorticoid therapy
C. Local side and adverse effects
1. Burning, dryness, irritation, itching
2. Thinning of the skin, striae, purpura, telangiectasia
(causes thread-like red lines on the skin)
3. Skin atrophy
4. Acneiform eruptions
5. Hypopigmentation
6. Overgrowth of bacteria, fungi, and viruses
D. Systemic adverse effects
1. Growth retardation in children
2. Adrenal suppression
3. Cushing’s syndrome
4. Ocular effects (glaucoma and cataracts)
E. Interventions
1. Wear gloves; wash the area just before application to
ensure cleanliness and to increase medication
penetration.
2. Apply sparingly in a thin film, rubbing gently.
3. Avoid the use of a dry occlusive dressing unless
specifically prescribed by the primary health care
provider (PHCP).

1235