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Chapter 40

Case Study

1.
b. Red, scaling skin on the scalp and elbows and joint pain are findings consistent with psoriasis.
2.
b. Coal tar is very damaging to unaffected skin and therefore should not be applied outside of the lesion borders. Zinc oxide or petrolatum should be used to protect the wound margins.

Review Questions

1.
c. Adalimumab decreases the mitotic rate of skin cells to decrease scaling plaques in psoriasis.
2.
a. Risks for embryo/fetal loss or abnormalities prevent the use of tretinoin during pregnancy.
3.
c. Tetracycline drugs, when taken by children under the age of 8 years, may cause damage to bones and teeth; therefore, they are contraindicated in this population.
4.
b. Psoriasis treatment requires exfoliation to remove plaque formation and drugs to decrease rapid skin cell growth to prevent plaques.
5.
a. Covering topical steroids may cause both local irritation and systemic absorption of the drug.
6.
d. Impetigo is a localized infection that requires treatment with antibiotics to eliminate the causative bacteria.
7.
a. Acitretin is contraindicated in clients with decreased renal function.
8.
a. Applying a nonocclusive dressing to protect the area is appropriate, but applying an occlusive dressing is contraindicated because it will increase the systemic effects of the medication.
9.
c. With proper treatment, most forms of acne can be controlled with resolution or improvement in skin lesions.
10.
c. Drinking alcoholic beverages when taking metronidazole results in a disulfiram-like reaction, which is evidenced by diaphoresis, hypotension, and nausea/vomiting.
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