Nursing homework help>Response 2 Patho Luisa
\nIntegumentary Function<\/p>\n
Psoriasis Triggers and Types<\/p>\n
Psoriasis is a common, chronic inflammatory condition that affects the life cycle of the skin<\/p>\n
cells (Dlugasch, 2021). Some of the triggers to psoriasis are bacterial or viral infections, dry air<\/p>\n
or dry skin, skin injuries such as cuts, burns, and insect bites, some medications such as<\/p>\n
antimalaria agents, beta blockers, and lithium. Stress, exposure to sunlight or no sunlight at all,<\/p>\n
and excessive alcohol (Dlugasch, 2021).<\/p>\n
Plaque (chronic): is described as thick, red plaques covered by flaky, silver white scales<\/p>\n
(most common). Lifting the scale causes bleeding. The bleeding occurs because of the abnormal<\/p>\n
blood vessels proximity to the scales. Usual location is the scalp, extensor surface of elbow,<\/p>\n
knees, and gluteal cleft (Dlugasch, 2021).<\/p>\n
Erythrodermic (acute or chronic): extreme erythema and scaling that covers a large area<\/p>\n
usually from head to toe. The lesions are usually pruritic and painful. There is high risk for<\/p>\n
infections and fluid and electrolyte abnormalities due to the large skin area affected (Dlugasch,<\/p>\n
2021).<\/p>\n
Gluttate: small, pink-red papules and plaques that usually appear abruptly and acutely with<\/p>\n
no necessary prior history of psoriasis. Guttate means drop-like and refers to the small size of the<\/p>\n
lesion. Usual location is the trunk and proximal extremities. This type may remit, recur, or<\/p>\n
progress to plaque psoriasis (Dlugasch, 2021).<\/p>\n
Inverse: erythema and irritation usually with no scaling that occur in the intertriginous areas<\/p>\n
such as armpits, groin, and skin folds; referred to as inverse as the location of the lesions are<\/p>\n
opposite of the usual extensor surface areas that are affected (Dlugasch, 2021).<\/p>\n
Pustular: papules or plaques with pustules surrounded by erythema. This type can be acute<\/p>\n
in onset, and severe forms can be associated with infections signs such as malaise and fever.<\/p>\n
Systemic complications can include sepsis and respiratory, renal, or hepatic abnormalities<\/p>\n
(Dlugasch, 2021).<\/p>\n
Psoriasis Treatments<\/p>\n
Some of the treatments that can help Ms. K.B with her plaque type psoriasis are topical<\/p>\n
treatments, phototherapy, and systemic medications (Dlugasch, 2021).<\/p>\n
Topical treatments<\/p>\n
Corticosteroids help slow cell turnover and decrease inflammation. Vitamin D analogues<\/p>\n
slow down skin cell growth and immune modulations. Anthralin normalizes DNA activity in<\/p>\n
skin cells, remove scales, and smooths the skin. Retinoids normalize DNA activity in skin cells<\/p>\n
and possibly decrease inflammation. Calcineurin inhibitors disrupt the activation of T<\/p>\n
lymphocytes. Salicylic acid promotes shedding of dead skin cells and reduces scaling. Coal tar<\/p>\n
reduces scales, itching, and inflammation. Moisturizers reduce dryness, itching, and scaling.<\/p>\n
Dandruff shampoo reduces cellular turnover (Dlugasch, 2021).<\/p>\n
Phototherapy<\/p>\n
Sunlight uv light natural\/artificial active T lymphocytes in the skin to die, slowing cell<\/p>\n
turnover, reducing scaling, and decreasing inflammation. Broadband ultraviolet B (UVB) slows<\/p>\n
cellular growth. Narrowed UVB newer treatment and more effective, like broadband ultraviolet<\/p>\n
B. Photochemotherapy, or psoralen plus ultraviolet A is a light sensitizing medication, psoralen<\/p>\n
administration before exposure to UVA light to increase the response to the light. Excimer laser<\/p>\n
is a controlled beam of UVB light of a specific wavelength that is directed to only the involved<\/p>\n
skin (Dlugasch, 2021).<\/p>\n
Systemic medications<\/p>\n
Retinoids reduce production of skin cells. Methotrexate decreases skin cells and suppress<\/p>\n
inflammation. Cyclosporine suppresses the immune system. Hydroxyurea suppresses the<\/p>\n
immune system. Phosphodiesterase 4 inhibitor reduces cytokine. Immunomodulator drugs block<\/p>\n
interactions between certain immune system cells, Janus kinase a inhibitors interrupt cellular<\/p>\n
signaling (Dlugasch, 2021).<\/p>\n
Nonpharmacological treatments that can help K.B are reducing stress, avoiding triggers, and<\/p>\n
join support groups (Dlugasch, 2021).<\/p>\n
Medication Reconciliation<\/p>\n
In K.B case it is very important to know which medications she is taking because as we<\/p>\n
discussed earlier some of the triggers to psoriasis can be related to medications such as<\/p>\n
antimalaria agents, beta blockers, and lithium (Dlugasch, 2021).<\/p>\n
Psoriasis Manifestations<\/p>\n
Other manifestations relating to psoriasis are joint pain or aching. Nail changes such as<\/p>\n
thickening, yellow-brown spots, dents on the nail surface and separation of the nail from the<\/p>\n
base, nail changes can occur prior to skin manifestation (Dlugasch, 2021). Research studies show<\/p>\n
that psoriasis has been shown to be associated with several comorbidities, such as psoriatic<\/p>\n
arthritis, Crohn\u2019s disease, psychological\/psychiatric disorders, and ocular diseases. Several<\/p>\n
ocular manifestations have been reported including uveitis, dry eye, retinal abnormalities,<\/p>\n
blepharitis, conjunctivitis, keratitis, iridocyclitis, UV-induced cataracts, and birdshot<\/p>\n
chorioretinitis (Ruggiero, 2021)<\/p>\n
References<\/p>\n
Dlugasch, L., & Story, L. (2021). Applied Pathophysiology for the Advance Practice Nurse. Jones &<\/p>\n
Bartlett Learning.<\/p>\n
Ruggiero, A., Fabbrocini, G., Cacciapuoti, S., Cinelli, E., Gallo, L., & Megna, M. (2021). Ocular<\/p>\n
Manifestations in Psoriasis Screening (OcMaPS) Questionnaire: A Useful Tool to Reveal<\/p>\n
Misdiagnosed Ocular Involvement in Psoriasis. Journal of clinical medicine, 10(5), 1031.<\/p>\n
https:\/\/doi.org\/10.3390\/jcm10051031<\/p>\n
Sensory Function<\/p>\n
Diagnosis<\/p>\n
Based on the clinical manifestations that C.J is presenting with we can conclude that he has<\/p>\n
bacterial conjunctivitis with otitis media. Bacterial conjunctivitis is usually due to<\/p>\n
Staphylococcus in adults. Usually shows up with symptoms such as the one C.J is experiencing<\/p>\n
yellow-green exudate in one eye or both, and can be accompanied by otitis media (Dlugasch,<\/p>\n
2021). Otitis media is an infection or inflammation of the middle ear. Physical manifestations are<\/p>\n
inflammation as the tympanic membrane is red and bulging. Due to the middle ear effusion, the<\/p>\n
tympanic membrane may be opaque and air-fluid levels may be visible behind the membrane<\/p>\n
(Dlugasch, 2021).<\/p>\n
Etiology<\/p>\n
The probable etiology of the affected eye symptoms C.J is experiencing is due to the<\/p>\n
bacterial conjunctivitis; this type of conjunctivitis is usually unilateral, and the manifestations are<\/p>\n
yellow-green exudate in one eye or both, and can be accompanied by otitis media Dlugasch,<\/p>\n
2021). Viral conjunctivitis normally produce watery or mucus like discharge that is scant and<\/p>\n
stringy or rop-like. Allergic is due to allergens. Gonococcal is sexually transmitted form of<\/p>\n
conjunctivitis that causes blindness. Trachoma conjunctivitis is also bacterial, but its has been the<\/p>\n
leading cause of infectious blindness worldwide and is endemic in remote areas with lack of<\/p>\n
resources such as clean water and sanitation (Dlugasch, 2021).<\/p>\n
Therapeutic Approach<\/p>\n
The best therapeutic approach to treat symptomatic relief is to include warm, moist<\/p>\n
compress to soothe discomfort. Cool compress can improve edema if present. Artificial tears can<\/p>\n
be used for relief. Bacterial conjunctivitis is treated with antibiotics (Dlugasch, 2021). Studies<\/p>\n
agree that to treat some type of bacterial conjunctivitis includes the use of oral azithromycin or<\/p>\n
oral doxycycline in adults, and erythromycin in neonate (Yeu, 2020)<\/p>\n
Refences<\/p>\n
Dlugasch, L., & Story, L. (2021). Applied Pathophysiology for the Advance Practice Nurse. Jones &<\/p>\n
Bartlett Learning.<\/p>\n
Yeu, E., & Hauswirth, S. (2020). A Review of the Differential Diagnosis of Acute Infectious<\/p>\n
Conjunctivitis: Implications for Treatment and Management. Clinical Ophthalmology, 14, 805\u2013<\/p>\n
813. https:\/\/doi.org\/10.2147\/OPTH.S236571<\/p>\n","protected":false},"excerpt":{"rendered":"
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