(^414) Medical-Surgical Nursing Demystified
intradermal test, where the allergen is injected just under the skin, or a patch test,
where an allergen patch is placed on the skin, may also be used.
Before the test—Instruct the patient to withhold antihistamines, steroids, and leuko-
triene modulator medications which would interfere with the results of the test.
Explain to the patient what to expect.
Skin Biopsy
A skin biopsy is usually done to diagnose an abnormal area of the skin, such as a
growth or mole for cancer It is also used to diagnose a bacterial or fungal skin
infection or other abnormal skin condition. A sample of tissue is taken for analy-
sis by a pathologist to determine if cellular changes have occurred. There are sev-
eral types of biopsy as follows:- Punch biopsy where a small cylindrical fragment of tissue is removed from
the affected area, by a sharp cookie-cutter-like tool (punch). - Shave biopsy where a superficial piece of skin is removed from the affected
area with a sharp, sterile blade - Excisional biopsy where a larger area of skin is removed, allowing for analy-
sis of deeper skin structures or removal of the entire lesion. A local anesthetic
is typically used.
After the test—Monitor the area for healing.
Gram Stain
Gram stain or Gram’s method is a way of differentiating bacterial species into two
large groups, Gram-positive and Gram-negative based on properties of their cell
walls. A stain is added to a culture on a slide which will show blue for Gram-
positive cells or red for Gram-negative cells. This is the first step in determining
the identity of a particular bacterial sample and can be used to allow empiric anti-
biotics to be started, before the final culture is ready.Herpes Simplex Virus (HSV)
Culture
The test is performed by taking a fluid sample from the lesions within 3 days of
appearance. The virus, if present, can be detected in this fluid sample in a few days.