Ward Class

An Online Resource Site For Student Nurses

Welcome

Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

Site Announcement

The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.




Integumentary Disorders: Psoriasis


  • Psoriasis is a chronic type of dermatitis that affects the life cycle of skin cells
  • in this common skin disease, the life cycle of epidermal cells is shortened from a month to a few days resulting in thick, scaly, dry, and red patches on the skin
  • the most significant risk factor for psoriasis is family history of the disease; other factors include stress, trauma, infection (eg. HIV), obesity, and smoking.
  • triggers of psoriasis also include heavy alcohol consumption, cold weather, and medications (beta-blockers, lithium, iodides, and antimalarial drugs)
Assessment Findings
  • red patches of skin covered with silvery scales
  • small scaling spots (commonly seen in children)
  • dry, cracked skin that may bleed
  • itching, burning or soreness
  • thickened, pitted or ridged nails
  • swollen and stiff joints
Medical Management
  1. topical corticosteroids-->for mild to moderate psoriasis
  2. coal tar preparations-->oldest treatment for psoriasis; reduces scaling, itchiness, and inflammation
  3. ultraviolet light
  4. antimetabolites (methotrexate) -->suppresses inflammation and halts progression of arthritis; may cause liver damage and decrease in production of blood cells (usually taken with folic acid to reduce side effects)
Nursing Management
  1. apply wraps over prescribed topical corticosteroids
  2. areas treated with coal tar preparations should be protected from direct sunlight for 24 hours
  3. when administering methotrexate, check for side effects
  4. encourage patient to use cover-ups when feeling self-conscious
  5. stress the importance of adhering to prescribed treatments and avoidance of products not prescribed by physician
Prognosis

Although psoriasis is not fatal, it can increase the risk for drug and alcohol abuse, thereby increasing mortality rates in psoriasis patients. Patients, therefore, must be taught coping skills so they will feel more in control despite the emotional and social consequences of having the disease.

Prevention

There is no known prevention of psoriasis. Avoidance of triggers, however, will improve symptoms and reduce the number of flare-ups.

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