Chapter 75 - Chronic Skin Conditions

A nurse is providing information about a new prescription for corticosteroid cream to a client who has mild psoriasis. Which of the following should the nurse include in the information? (Select all that apply.) A. Apply an occlusive dressing after application. B. Apply three to four times per day. C. Wear gloves after application to lesions on the hands. D. Avoid applying in skin folds. E. Use medication continuously over a period of several months.

A. CORRECT: An occlusive dressing can enhance the efficacy of the topical corticosteroid on the exposed lesions. B. INCORRECT: Corticosteroid cream is applied twice daily to prevent development of local and systemic adverse effects. C. CORRECT: Gloves worn after the medication can enhance the efficacy of the topical corticosteroid on the exposed lesions of the hands. D. CORRECT: Corticosteroid cream applied to lesions in skin folds increases the risk of yeast infections. E. INCORRECT: Corticosteroid cream used continuously can increase the risk for development of local and systemic adverse effects.

A nurse is assessing a client who has seborrheic keratosis on the forehead and nose. Which of the following manifestations should the nurse expect to find? (Select all that apply.) A. Waxy appearance of the lesions B. Black, rough lesions C. Pruritus of the lesions D. Purplish skin stain around the lesion E. Wartlike surface of the lesions

A. CORRECT: Seborrheic keratosis lesions appear waxy in texture. B. CORRECT: Seborrheic keratoses are tan, brown, or black lesions that are rough and become irritated due to friction. C. INCORRECT: Seborrheic keratoses may become irritated from friction but are not pruritic lesions. D. INCORRECT: Seborrheic keratosis does not cause a purplish skin stain around the lesion. E. CORRECT: A wartlike surface of the lesions is common for seborrheic keratosis, and the lesions are removed for cosmetic reasons.

A nurse is educating a female client on the use of calcipotriene (Dovonex) topical medication for the treatment of psoriasis. Which of the following information should the nurse include? (Select all that apply.) A. Recommended for facial lesions. B. Expect a stinging sensation upon application. C. Apply to the scalp. D. Obtain a pregnancy test. E. Limit application to skin folds.

A. INCORRECT: Applying calcipotriene to the face is not recommended because it may cause facial dermatitis. B. CORRECT: Calcipotriene causes stinging and burning sensations when applied to the lesions. C. CORRECT: Calcipotriene solution is applied to scalp lesions. D. CORRECT: Calcipotriene can cause birth defects. Female clients should obtain a pregnancy test before using the medication. E. CORRECT: Applying calcipotriene to skin folds can cause a possible local reaction of itching, irritation, and erythema.

A nurse is teaching a client who has a history of psoriasis about photochemotherapy and ultraviolet light (PUVA) treatments. Which of the following should the nurse include in the teaching? A. Apply coal tar before each treatment. B. Administer a psoralen medication before the treatment. C. Use this treatment every evening. D. Remove the scales gently following each treatment.

A. INCORRECT: PUVA treatment does not involve the use of coal tar. B. CORRECT: PUVA treatment involves the administration of a medication, such as a psoralen, to enhance photosensitivity. C. INCORRECT: PUVA treatments are completed two to three times each week and not on consecutive days. D. INCORRECT: Removal of scales may cause bleeding and is not recommended when treating psoriasis.

A nurse is providing teaching to a client who has a prescription for methotrexate (Trexall) for severe psoriasis. Which of the following information should the nurse include? A. Drink a glass of wine daily. B. Monitor for evidence of infection. C. Monitor kidney function tests regularly. D. Expect increased bruising.

A. INCORRECT: The client should not drink alcohol when taking methotrexate because the medication can cause liver damage. B. CORRECT: The client should monitor for fever and sore throat, which are signs of infection. Methotrexate can cause blood dyscrasias such as leukopenia. C. INCORRECT: The client should have liver function levels monitored frequently because the medication can cause liver damage. D. INCORRECT: The client should report increased bruising because methotrexate can cause blood dyscrasias such as thrombocytopenia.