Question

The physician has prescribed methotrexate (Folex) weekly for a client with psoriasis. Prior to beginning therapy with methotrexate, the client should have: A. An EEG B. A liver panel C. An ECG D. A serum iron

Short answer

Answer: A liver panel.

Step-by-step solution

Analyze the given options

First, let's take a closer look at the options given and rule out any irrelevant tests. A. An EEG (Electroencephalogram) - This test measures the electrical activity in the brain. It is not related to methotrexate therapy or psoriasis. B. A liver panel - This test measures the liver enzymes and is often used to monitor liver function. Methotrexate can be toxic to the liver, so it is important to check liver function before starting therapy. C. An ECG (Electrocardiogram) - This test records the electrical signals of the heart and is usually performed to detect heart problems. It is not directly related to methotrexate therapy or psoriasis. D. A serum iron - This test measures the level of iron in the blood. It is not directly related to methotrexate therapy or psoriasis.

Select the most relevant test

Based on our analysis of the given options, a liver panel (Option B) is the most relevant test for a client before starting methotrexate therapy for psoriasis. This is because methotrexate can be toxic to the liver, making it essential to monitor liver function before initiating therapy.

Key concepts

Liver Panel Before Methotrexate

Understanding the importance of a liver panel before initiating methotrexate therapy is crucial for students and healthcare professionals alike. Methotrexate, a chemotherapeutic agent and immune system suppressant, is used in the treatment of various conditions, including psoriasis. Due to its potential hepatotoxic effects, it is imperative to conduct a liver panel to assess the patient's liver function. This test includes measurements of liver enzymes such as alanine transaminase (ALT) and aspartate transaminase (AST), which are indicators of liver health.

A normal liver panel result suggests that the liver can likely handle the methotrexate without causing significant damage. However, elevated levels of liver enzymes might indicate existing liver damage or increased risk of hepatotoxicity, necessitating a different treatment approach or more frequent monitoring. Therefore, for a student practicing for their NCLEX-PN or any professional managing psoriasis treatment with methotrexate, knowledge of pre-treatment evaluation is essential for patient safety.

Psoriasis Treatment

Psoriasis is a chronic autoimmune condition characterized by red, scaly skin patches. Treatment of psoriasis may involve a variety of approaches, including topical treatments, light therapy, and systemic medications like methotrexate. Methotrexate works by suppressing the overactive immune response that leads to the rapid skin cell turnover seen in psoriasis.

Methotrexate is often considered for patients with moderate to severe psoriasis when other treatments have not been effective. It can significantly slow down cell turnover, thereby reducing the severity of symptoms. However, given its impact on the body, especially on the liver, appropriate patient education and monitoring are paramount. Always remember to discuss the risks, benefits, and alternatives with patients, reinforcing the importance of following up with laboratory tests like liver panels to ensure the safety and effectiveness of the treatment.

NCLEX-PN Preparation

Preparing for the National Council Licensure Examination for Practical Nurses (NCLEX-PN) is a pivotal step for nursing students. This standardized test assesses the knowledge and skills necessary to practice safely and effectively as a newly licensed, entry-level nurse. One key area that is often tested is pharmacology, including understanding the use of medications like methotrexate and the pre-treatment assessments required.

When preparing for the NCLEX-PN, it's essential to become familiar with the classes of medications, their mechanisms of action, side effects, and the nursing interventions required before, during, and after administration. For instance, recognizing the need for a liver panel before starting a patient on methotrexate is part of safe medication administration practices. Comprehensive study plans, including review courses, practice tests, and staying current with treatment guidelines, can build a strong foundation for passing the exam and providing high-quality patient care.