Psoriasis Overview and Treatment Options
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Questions and Answers

What is the appearance of psoriasis?

Silvery, erythema, scaly/thick

What are some topical therapies used to treat psoriasis?

  • Corticosteroids (correct)
  • Vitamin D analogs (correct)
  • Coal tar (correct)
  • Salicylic acid (correct)
  • All of the above (correct)

    • Which of the following are concerns for a client with psoriasis?

  • Pain and discomfort from lesions (correct)
  • Risk of secondary infections (correct)
  • Quality of life issues (correct)
  • Associated conditions like psoriatic arthritis (correct)
  • Psychological impact due to the visible nature (correct)
  • All of the above (correct)

    • What are some preventative measures to take to reduce the risk of pressure injuries?

    <p>Frequent repositioning</p> Signup and view all the answers

    How do you treat a stage II pressure injury?

    <p>Keep the area clean and moist with dressings</p> Signup and view all the answers

    What type of exudate is thick, yellow, green, or brown and indicates infection?

    <p>Purulent</p> Signup and view all the answers

    Increased purulent drainage and a foul odor are local signs of infection in wound exudate.

    <p>True</p> Signup and view all the answers

    What type of exudate would you expect in a wound that is actively bleeding?

    <p>Sanguineous</p> Signup and view all the answers

    What is the definition of status asthmaticus?

    <p>A severe asthma attack that does not respond to standard treatments like inhaled bronchodilators and corticosteroids.</p> Signup and view all the answers

    A tension pneumothorax is a less severe form of pneumothorax.

    <p>False</p> Signup and view all the answers

    Which of the following is NOT a pathophysiological mechanism involved in asthma exacerbations?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What are some clinical manifestations of a severe asthma attack?

    <p>Tachypnea</p> Signup and view all the answers

    Which of the following medications is NOT used in the emergency treatment of asthma?

    <p>Digoxin</p> Signup and view all the answers

    A silent chest is a good sign indicating adequate airflow in a severe asthma attack.

    <p>False</p> Signup and view all the answers

    What is the usual range for PaCO₂ in a healthy individual?

    <p>35-45 mmHg</p> Signup and view all the answers

    What is the most likely cause of respiratory acidosis?

    <p>Hypoventilation</p> Signup and view all the answers

    What type of acid-base imbalance is most likely to occur in a patient experiencing hyperventilation?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    Intubation is an option for managing severe asthma exacerbations if respiratory failure develops.

    <p>True</p> Signup and view all the answers

    Which of the following is a sign of worsening acidosis in a patient with severe asthma?

    <p>Decreasing blood pH</p> Signup and view all the answers

    Which of the following is NOT a symptom of peritonitis?

    <p>Headache</p> Signup and view all the answers

    Which type of medications are typically used for pain control during an acute pancreatitis episode?

    <p>IV opioids</p> Signup and view all the answers

    Patients with acute pancreatitis should be NPO initially to allow the pancreas to rest.

    <p>True</p> Signup and view all the answers

    What type of feeding is considered if prolonged fasting is necessary for a patient with acute pancreatitis?

    <p>Enteral feeding</p> Signup and view all the answers

    Patients with acute pancreatitis may experience hyperglycemia due to decreased insulin production during inflammation.

    <p>True</p> Signup and view all the answers

    What is the name of the bluish discoloration around the umbilicus that can occur in severe pancreatitis?

    <p>Cullen's sign</p> Signup and view all the answers

    What are some of the key features of chronic pancreatitis?

    <p>Recurrent pain, malabsorption, steatorrhea (fatty stools), weight loss, diabetes</p> Signup and view all the answers

    Chronic pancreatitis can lead to diabetes due to the progressive loss of endocrine function.

    <p>True</p> Signup and view all the answers

    What is the goal of pain management for a patient with acute pancreatitis?

    <p>Reduce pain and discomfort</p> Signup and view all the answers

    Patients with acute pancreatitis should be encouraged to lie flat on their backs for pain relief.

    <p>False</p> Signup and view all the answers

    What is the recommended diet for a patient with acute pancreatitis who is recovering?

    <p>Low-fat, high-protein</p> Signup and view all the answers

    Patients with chronic pancreatitis should avoid alcohol completely.

    <p>True</p> Signup and view all the answers

    What type of medication is recommended for patients with chronic pancreatitis to help with digestion?

    <p>Pancreatic enzyme supplements</p> Signup and view all the answers

    Patients with chronic pancreatitis should always crush or chew their pancreatic enzyme supplements for better absorption.

    <p>False</p> Signup and view all the answers

    What are some signs of complications that a patient with pancreatitis should watch for?

    <p>Severe pain, jaundice, fever, signs of infection</p> Signup and view all the answers

    Study Notes

    Psoriasis

    • Appearance: Silvery, erythematous, and scaly/thick plaques. Common locations include scalp, elbows, knees, and lower back.

    • Treatment:

      • Topical therapies: Corticosteroids, vitamin D analogs (e.g., calcipotriol), coal tar, salicylic acid.
      • Phototherapy: UV light exposure.
      • Systemic medications (moderate to severe): Oral medications (e.g., methotrexate, cyclosporine), biologics (e.g., adalimumab, etanercept, infliximab).
      • Lifestyle adjustments: Stress management, moisturizers, avoid triggers (medications, stress, infections).

    • Concerns for clients with psoriasis:

      • Physical symptoms: Pain, discomfort, risk of secondary infections.
      • Quality of life: Social impact, disrupted sleep/activities due to itching/pain.
      • Associated conditions: Psoriatic arthritis, cardiovascular disease, obesity, diabetes, depression.
      • Psychological impact: Increased anxiety and depression.
      • Medication side effects: Immunosuppression, liver damage.

    Pressure Injuries (Decubitus Ulcers)

    • Prevention: Frequent repositioning, support surfaces (mattresses, cushions), proper skin care (clean, dry, barrier creams), nutritional support (protein, vitamins, hydration). Risk assessment tools (Braden Scale).

    • Treatment:

      • Staging: Determine stage (I-IV) to guide treatment.
      • Stages I-II: Protective measures, clean, moist dressings.
      • Stages III-IV: Debridement, infection control, advanced wound care.
      • Unstageable: Debride necrotic tissue to assess.
      • Wound care: Saline or wound cleansers, appropriate dressings (hydrocolloid, foam, alginate).
      • Infection control: Antibiotics if needed, antimicrobial dressings.
      • Advanced therapies: Wound vac, skin grafts.

    Wound Exudate

    • Types:

      • Serous: Clear, watery, normal healing.
      • Sanguineous: Red, bloody, active bleeding/vascular injury.
      • Serosanguineous: Pink, pale red, healing wounds.
      • Purulent: Thick, yellow/green/brown, infection.
      • Fibrinous: Sticky, yellow-white, chronic/severe inflammation.

    • Signs of infection: Local (redness, warmth, swelling, pain, foul odor, delayed healing); Systemic (fever, chills, increased heart rate, elevated WBCs, CRP, ESR).

    Asthma

    • Status Asthmaticus: Severe asthma attack unresponsive to standard treatments, severe airway obstruction/inflammation, life-threatening, requiring immediate intervention.

    • Pathophysiology: Bronchoconstriction, inflammation, mucus hypersecretion.

    • Clinical manifestations/emergency treatment: Severe dyspnea, wheezing (may diminish), accessory muscle use, tachypnea, tachycardia, cyanosis, silent chest (no airflow), altered mental status.

      • Airway management: Ensure airway patency; intubation (if necessary).
      • Oxygen therapy: High-flow oxygen.
      • Bronchodilators: Nebulized short-acting beta-agonists (e.g., albuterol), possibly with ipratropium.
      • Corticosteroids: IV methylprednisolone, or oral prednisone.
      • Magnesium sulfate: IV for severe cases.
      • Epinephrine: IM epinephrine for anaphylaxis/severe bronchospasm.
      • Pneumothorax treatment: Immediate needle decompression (tension pneumothorax), chest tube.
      • Monitoring: Oxygen saturation, ABGs, vital signs.
      • Key interventions: Rapid escalation (respiratory therapists, intensivists), continuous patient reassessment, readiness to intubate.

    Acid-Base Imbalances

    • Normal ranges: pH (7.35-7.45), PaCO₂ (35-45 mmHg), HCO₃⁻ (22-26 mEq/L).

    Other Conditions (Abdomen, GI, etc.)

    • Peritonitis: Inflammation of peritoneum due to infection, perforation, or trauma. Symptoms: Severe abdominal pain, rigidity, rebound tenderness, fever, nausea/vomiting, tachycardia. Care: NPO, isotonic IV fluids, IV antibiotics, possible surgery.
    • Appendicitis: Inflammation of appendix due to obstruction. Symptoms: RLQ pain (McBurney's point), rebound tenderness, nausea, fever, elevated WBCs. Care: Appendectomy, pain management, IV fluids, antibiotics.
    • Gastroenteritis: Inflammation of stomach and intestines. Symptoms: Diarrhea, vomiting, abdominal cramps, dehydration. Care: Oral/IV rehydration, electrolyte replacement, antiemetics, dietary adjustments.
    • Ulcerative Colitis: Chronic inflammation of colon with continuous lesions. Symptoms: Bloody diarrhea, urgency, abdominal pain, weight loss, fatigue. Care: Medications (aminosalicylates, corticosteroids, immunosuppressants), monitor for complications.
    • Diverticulitis: Inflammation/infection of diverticula in the colon. Symptoms: LLQ pain, fever, constipation, bloating, elevated WBCs. Care: Bowel rest, antibiotics, pain control, possible surgery.
    • Sepsis: Systemic inflammatory response to infection. Symptoms: Fever/hypothermia, tachycardia/tachypnea, altered mental status, hypotension (late), elevated lactate, WBCs, oliguria. Care: Isotonic fluids, broad-spectrum antibiotics.
    • Crohn's Disease: Chronic inflammation affecting any part of GI tract (mouth to anus). Challenges: Strictures, fistulas, abscesses; malnutrition. Symptoms: Persistent diarrhea (may be bloody), abdominal cramping (often RLQ). Care: Medications, low-residue diet when flaring, and high-calorie/high-protein when improving, avoid trigger foods, stress reduction, regular follow-ups and lab monitoring.
    • Cirrhosis: Liver scarring and damage. Symptoms/Appearance: Jaundice, ascites, peripheral edema, caput medusae, muscle wasting, fatigue, abdominal pain, confusion/lethargy (hepatic encephalopathy). Labs: High AST, ALT, bilirubin, low albumin, prolonged PT/INR, high ammonia, electrolyte imbalances, anemia, thrombocytopenia, leukopenia, monitor kidney function. Management: Ascites management (paracentesis, low sodium, diuretics), hepatic encephalopathy management (lactulose, monitor mental status), prevent bleeding (avoid NSAIDs, monitor PT/INR, vitamin K), nutrition, vitamin supplements, monitor for complications (infection, bleeding). Teaching: Avoid alcohol, low-sodium, recognize encephalopathy/infection signs, medication adherence, and follow-ups.
    • Hepatitis: Inflammation of the liver. Transmission varies by type (A, B, C, D, E). Care varies by type, acute vs. chronic. Prevention emphasizes hand hygiene, vaccination (for A, B) and safer practices.
    • Peptic Ulcer Disease (PUD): Ulcers in the stomach or duodenum. Causes: H. pylori infection, NSAID use, alcohol. Treatment: Lifestyle modifications (no alcohol, smoking, NSAIDs, stress reduction, smaller meals), medications (PPIs, H2-blockers, antacids, sucralfate), H. pylori treatment (triple/quadruple therapy). Management of Hemorrhage:IV fluids, blood transfusions if needed, endoscopic intervention (cauterization, injection therapy), medications (IV PPIs). Education: Medication adherence, avoid triggers, monitor for complications.
    • Irritable Bowel Syndrome (IBS): Functional disorder affecting the large intestine. Symptoms: Abdominal pain, bloating, changes in bowel habits (diarrhea, constipation). Triggers: Stress, certain foods (low FODMAP diet). Management: Dietary modifications (low-FODMAP, high fiber), stress management therapy.
    • Cholecystitis: Inflammation of gallbladder; often due to gallstones. Symptoms: RUQ pain, nausea, vomiting, fever, jaundice (severe). Care: NPO, IV fluids, pain management, antibiotics, surgical intervention (cholecystectomy).
    • Pancreatitis: Inflammation of the pancreas. Symptoms: Severe epigastric pain radiating to back, nausea, vomiting, fever, abdominal tenderness, jaundice (obstruction); severe signs: Cullen's sign (bluish discoloration), Grey Turner's sign (flank bruising). Care: Pain management (IV opioids), fluids (aggressive IV hydration), nutrition (NPO initially, then low-fat, high-protein, high-carbohydrate), pulmonary care (prevent atelectasis), Blood Glucose Management, enzyme replacements, follow-up.

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    Description

    Explore the key features and treatment strategies for psoriasis, including its appearance, topical and systemic therapies, and lifestyle adjustments. Understand the physical and psychological concerns that individuals with psoriasis may face. This quiz will enhance your knowledge of managing this chronic skin condition effectively.

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