Question

A client with exfoliative psoriasis is being treated with ultraviolet radiation therapy three times a week. Which finding indicates overexposure? A. Lightening of the skin B. Crusting of lesions C. Appearance of blisters D. Desquamation

Short answer

Answer: C. Appearance of blisters

Step-by-step solution

Analyze each option

Let's look at each option and discuss whether it could be an indication of overexposure to ultraviolet radiation therapy. A. Lightening of the skin: This could be a normal response to ultraviolet radiation therapy as it can sometimes cause the skin to lighten. However, it does not necessarily indicate overexposure. B. Crusting of lesions: Crusting of lesions could be a sign of the healing process, as the skin forms a crust to protect the delicate new skin forming underneath. This doesn't necessarily indicate overexposure. C. Appearance of blisters: Blisters can be a sign of overexposure to ultraviolet radiation therapy, as the skin may become damaged from too much radiation. This option is a possible indication of overexposure. D. Desquamation: Desquamation refers to the shedding of the outer layers of the skin. It is a natural process that occurs as new skin cells replace old ones. It is not an indication of overexposure to ultraviolet radiation therapy.

Choose the correct option

Based on the analysis performed in Step 1, Option C (Appearance of blisters) is the most likely indication of overexposure to ultraviolet radiation therapy. This is because blisters are a sign of skin damage and can be caused by too much radiation exposure. Thus, the correct answer is C. Appearance of blisters.

Key concepts

Exfoliative Psoriasis

Exfoliative psoriasis is a rare and severe form of psoriasis that involves widespread inflammation and exfoliation of the skin's surface. This can be alarming to patients as the skin can become red, itchy, and covered in scales. Due to its systemic nature, it affects extensive parts of the body and can sometimes lead to severe complications, such as infections or dehydration.

• Key signs include redness over large areas of the skin, scaling, shedding (which can be extensive) and possible irritation or pain.
• It's often triggered by factors such as infections, stress, or withdrawal from certain psoriasis medications.
• Managing exfoliative psoriasis requires medical attention, and treatments may include systemic therapies to control severe symptoms.

Proper care and monitoring are crucial in managing this condition to prevent complications and ensure optimal patient well-being.

Ultraviolet Radiation Therapy

Ultraviolet radiation therapy, commonly known as phototherapy, is a treatment option for various skin conditions, including psoriasis. It involves exposing the skin to ultraviolet light under controlled conditions. There are two main types of UV therapy: UVB and PUVA, which vary in strength and effect.

• UVB Therapy: This uses broadband or narrowband ultraviolet B light waves and is typically the first line of treatment for psoriasis. It minimizes adverse effects, making it safer for regular use.
• PUVA Therapy: It combines psoralen (a medication that makes the skin more sensitive to UV light) with UVA exposure. This can be effective but requires more caution due to side effects like skin aging or increased risk of skin cancer.
• Regular sessions are necessary to see improvement. However, overexposure can lead to side effects such as redness, burning sensations, or blisters appearing on the skin.

Safety measures, like wearing protective eyewear and using lotions or creams, are vital during treatment to shield unaffected areas of the skin from radiation.

Nursing Assessment Skills

Nursing assessment skills are crucial in identifying patient needs and determining appropriate care plans. These skills involve observing, gathering, and analyzing information to assess a patient's health status. For patients undergoing treatments like phototherapy, thorough assessments help prevent complications like overexposure.

• Nurses need to be adept at observation. This includes monitoring changes in skin condition, such as looking for blisters or unusual redness.
• Communication with patients is key to understanding their experiences and concerns during therapy.
• Accurate documentation provides a record of skin changes and therapy progress, ensuring continuity of care.

Being proactive with these skills is essential for optimizing patient outcomes and adjusting care plans as necessary.

Patient Care Management

Effective patient care management involves developing strategies that ensure the well-being of patients undergoing challenging treatments like those for exfoliative psoriasis. Care management focuses on personalized care approaches tailored to individual patient needs.

• Creating a comprehensive care plan involves assessing not only physical symptoms but also psychological and social factors that may affect treatment compliance.
• Collaboration among healthcare providers, including dermatologists and nurses, ensures a multidisciplinary approach to patient care.
• Ongoing education for patients helps them understand their condition and treatment options, enhancing their ability to manage symptoms effectively.

By prioritizing continuous assessment and communication, care managers can make necessary adjustments to each patient's plan, promoting the best possible health outcomes.