The nurse is caring for a young woman who comes to the ...

[Sufayan.ah]

The nurse is caring for a young woman who comes to the dermatologist's office.
 
  The patient states that she has been taking Estrostep for 6 months and has not seen any improvement in her acne, and she wants to try something more effective. What medication would the nurse expect to be added to the regimen?
  a. Benzoyl peroxide
  b. Spironolactone (Aldactone)
  c. Ortho Tri-Cyclen as a substitute for Estrostep
  d. Isotretinoin (Accutane)

Question 2

The public health nurse is teaching a class on summer and sun precautions. Which statement by a member of the class about the use of sunscreens best demonstrates understanding?
 
  a. Sunscreens containing PABA should be avoided in those with allergy to hydrochlorothiazide .
  b. Sunscreens cannot protect against photoaging of the skin.
  c. Sunscreens cannot protect against photosensitivity reactions during use of sulfonamides.
  d. An SPF of 40 is twice as potent as an SPF of 15.

[wilsonbho]

Answer to Question 1

ANS: B
As a rule, spironolactone is added to the regimen after an oral contraceptive, such as Estrostep, has proved inadequate. Spironolactone blocks androgen receptors, which benefits females with acne. Because spironolactone is teratogenic, it must be added after, not before, the contraceptives.
Benzoyl peroxide and isotretinoin are not indicated as additions to this regimen.
Ortho Tri-Cyclen is not indicated, because it would have the same effect as Estrostep.

Answer to Question 2

ANS: A
Sunscreens that contain para-aminobenzoic acid (PABA) should not be used by people with allergies to benzocaine, sulfonamides, and thiazides, all of which can cross-react with PABA. Hydrochlorothiazide is a thiazide diuretic. This statement demonstrates understanding.
Sunscreens do protect against photoaging of the skin; further teaching is needed.
Sunscreens protect against photosensitivity reactions associated with sulfonamides; further teaching is needed.
An SPF of 40 (97.5 block) is not twice as potent as an SPF of 15 (93 block); further teaching is needed.

[Sufayan.ah]

TYSM

[tanna.moeller]

Excellent