A patient who has severe refractory psoriasis on the face, neck, ...

[mrsjacobs44]

A patient who has severe refractory psoriasis on the face, neck, and extremities is socially withdrawn because of the appearance of the lesions. Which action should the nurse take first?
 
  a. Discuss the possibility of enrolling in a worker-retraining program.
  b. Encourage the patient to volunteer to work on community projects.
  c. Suggest that the patient use cosmetics to cover the psoriatic lesions.
  d. Ask the patient to describe the impact of psoriasis on quality of life.

Question 2

An older adult patient with a squamous cell carcinoma (SCC) on the lower arm has a Mohs procedure in the dermatology clinic. Which nursing action will be included in the postoperative plan of care?
 
  a. Describe the use of topical fluorouracil on the incision.
  b. Teach how to use sterile technique to clean the suture line.
  c. Schedule daily appointments for wet-to-dry dressing changes.
  d. Teach about the use of cold packs to reduce bruising and swelling.

[EAN94]

Answer to Question 1

ANS: D
The nurse's initial actions should be to assess the impact of the disease on the patient's life and to allow the patient to verbalize feelings about the psoriasis. Depending on the assessment findings, other actions may be appropriate.

Answer to Question 2

ANS: D
Application of cold packs to the incision after the surgery will help decrease bruising and swelling at the site. Since the Mohs procedure results in complete excision of the lesion, topical fluorouracil is not needed after surgery. After the Mohs procedure the edges of the wound can be left open to heal or the edges can be approximated and sutured together. The suture line can be cleaned with tap water. No debridement with wet-to-dry dressings is indicated.