The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving a psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment?
Thick skin plaques topped by silvery white scales
Tenderness upon palpation and generalized erythema
Brown, rough, greasy, wart-like papules on the face.
Requires sunglasses because sunlight hurts eyes.
The Correct Answer is D
A. Thick skin plaques topped by silvery white scales:
This is a characteristic presentation of psoriasis vulgaris, not an indicator of overexposure to PUVA.
B. Tenderness upon palpation and generalized erythema:
This may be associated with various skin conditions but is not specific to overexposure to PUVA.
C. Brown, rough, greasy, wart-like papules on the face:
This description is not consistent with the expected outcomes or side effects of PUVA treatment.
D. Requires sunglasses because sunlight hurts the eyes.
PUVA treatment involves the use of psoralen, a light-sensitizing medication, followed by exposure to ultraviolet A (UVA) light. Overexposure to PUVA can lead to phototoxic reactions, including eye sensitivity to sunlight (photophobia). If the client requires sunglasses because sunlight hurts the eyes, it suggests that the eyes have been affected by the treatment, and the nurse should intervene to prevent further damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Increasing anxiety:
While emotional and psychological aspects are important in holistic care, immediate intervention is usually required for physiological concerns. Increasing anxiety may need attention, but it is not as urgent as addressing potential respiratory issues.
B. Inappropriate laughter:
Changes in emotional expression, such as inappropriate laughter, can occur in ALS due to involvement of upper motor neurons. While notable, it may not be as urgent as addressing respiratory concerns.
C. Weakened cough effort.
In ALS, respiratory muscles can become affected as the disease progresses, leading to respiratory complications. Weakened cough effort is concerning because it can indicate potential respiratory muscle weakness, which may lead to difficulty clearing secretions and an increased risk of respiratory compromise or infection.
D. Asymmetrical weakness:
Asymmetrical weakness is a common feature of ALS, but it may not necessarily warrant immediate intervention unless there are sudden changes or signs of acute distress. Respiratory symptoms, such as weakened cough effort, often require more immediate attention.
Correct Answer is D
Explanation
A. Type 2 diabetes mellitus
Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis. In fact, peritoneal dialysis can be a suitable option for individuals with diabetes who require renal replacement therapy. However, the presence of diabetes may require additional considerations and close monitoring.
B. Nephrotic syndrome history
Having a history of nephrotic syndrome is not a contraindication for peritoneal dialysis. Peritoneal dialysis can be used in individuals with various causes of chronic kidney disease, including those with nephrotic syndrome.
C. Latent hepatitis C
Latent hepatitis C alone may not be an absolute contraindication for peritoneal dialysis. However, the decision to initiate peritoneal dialysis would depend on the overall health status of the client, the degree of liver involvement, and the risk of infection. Close monitoring and appropriate precautions may be necessary.
D. Crohn's disease with colectomy
Crohn's disease with colectomy is considered a contraindication for peritoneal dialysis. Surgical alterations in the abdomen, such as colectomy, can lead to adhesions or other complications that may interfere with the effectiveness of peritoneal dialysis. In such cases, alternative forms of dialysis, such as hemodialysis, may be considered.
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