Psoriasis

  1. General information
    1. Chronic type of dermatitis that involves accelerated turnover rate of the epidermal cells
    2. Predisposing factors include stress, trauma, infection; changes in climate may produce exacerbations; familial predisposition to the disease
  2. Medical management
    1. Topical corticosteroids
    2. Coal tar preparations
    3. Ultraviolet light
    4. Antimetabolites (methotrexate)
  3. Assessment findings
    1. Mild pruritus
    2. Sharply circumscribed scaling placques that are mostly present on the scalp, elbows, and knees; yellow discoloration of nails
  4. Nursing interventions
    1. Apply occlusive wraps over prescribed topical steroids.
    2. Protect areas treated with coal tar preparations from direct sunlight for 24 hours.
    3. Administer methotrexate as ordered, assess for side effects.
    4. Provide client teaching and discharge planning concerning
      1. Feelings about changes in appearance of skin (encourage client to cover arms and legs with clothing if sensitive about appearance)
      2. Importance of adhering to prescribed treatment and avoidance of commercially advertised products

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