A patient is being treated with long-term methotrexate (Trexall) ...

[audragclark]

A patient is being treated with long-term methotrexate (Trexall) for severe psoriasis. Which laboratory result or results are most important for the nurse to monitor? (Select all that apply.)
 
  a. Potassium level
  b. Complete blood counts (CBC)
  c. Liver function studies
  d. Renal function studies
  e. Serum sodium level

Question 2

A patient comes to the clinic for a follow-up appointment after using a glucocorticoid ointment for eczema for 3 weeks.
 
  Because the patient is pleased with the results, she states that she would like to continue treatment with an oral glucocorticoid. What response from the nurse is most appropriate?
  a. Oral glucocorticoids are only indicated if topical glucocorticoids have been ineffective.
  b. Oral glucocorticoids will have fewer side effects, so your suggestion is good.
  c. You make an excellent point Topical glucocorticoids can cause skin atrophy, whereas oral agents don't have the same effect.
  d. Oral glucocorticoids are more convenient to use, so I agree with your suggestion.

[janeli]

Answer to Question 1

ANS: B, C
The nurse should monitor the patient's CBC and liver function studies, because methotrexate is absorbed systemically and may cause anemia, leukopenia, thrombocytopenia, and hepatic dysfunction.
Nothing indicates that potassium, sodium, or renal function is affected by the use of methotrexate.

Answer to Question 2

ANS: A
The nurse should tell the patient that there is no basis for administration of oral glucocorticoids, because the topical agent has been effective.
Oral glucocorticoids have more serious side effects (e.g., adrenal suppression), and there is no basis for their use.
Whether applied topically or taken orally, glucocorticoids can still lead to skin atrophy.
Convenience is not an adequate reason for switching to oral agents when the topical agents have been effective.

[audragclark]

Thanks

[janeli]

Welcome