Nursing Care Required by a Patient with a Psoriasis

Affiliation

Skincare is an important aspect of patient care with a skin condition. Psoriasis is a skin condition that is a non-contagious disease, which affects people’s skin. It is found in a class of diseases that are described as immune-mediated. It occurs when a person’s body starts sensing the skin cells that are foreign cells of disease-causing microorganisms hence reacting against them. In this case, I will look at patient education and patient assessment as an important skin nursing care.

MiniCalc with vip services

Patient Education

Psoriasis refers to a chronic skin disease, which causes inflammation and scaling. Psoriasis can develop due to an abnormality of immune system in the body. The immune system fights allergic reactions and infection. Psoriasis has a genetic constituent. A good number of patients’ family members are affected with psoriasis. Some medications can trigger psoriasis. Other certain medication worsens psoriasis in people who already have the disorder Walji, Kingston, & Natural Medicines Society, 1994).

Symptoms

Psoriasis grounds skin inflammation and scaling. It may be or may not be itching. There exist several kinds of psoriasis that include:

  1. Plaque Psoriasis

In this type of psoriasis, there exist oval or rounded patches (plaques) of impacted skin. These are normally red that are enclosed with a chunky silvery scale. The plaques usually occur on the knees, elbows, and scalp and in the buttocks. They can as well appear on the arms, legs and trunks.

  1. Inverse Psoriasis

In inverse type of psoriasis tends to impact the skin creases. Creases are in the groin, underarms, buttocks, under the breast or genital areas which are specifically affected. The red scraps might be damp instead of scaling.

  1. Pustular Psoriasis

Pustular psoriasis is the skin patches that are studded with pustules or pimples.

  1. Guttate Psoriasis

They are found in guttate psoriasis, several small, scaly and red patches develop simultaneously and suddenly. Guttate psoriasis usually occurs in young persons who have of late had respiratory infection or strep throat.

More people with psoriasis skin symptoms also have atypical fingernails. This nails are usually thick and with small indentations, known as pitting.

A certain type of arthritis known as psoriatic arthritis influence a group of persons. Psoriatic arthritis can occur previous to skin changes starts.

Diagnosis

Your physician will determine the characteristic of nail and skin changes of this disease. He can often diagnose psoriasis focused on the physical examination. Once skin symptoms are not characteristically of the disease, your doctor can recommend skin biopsy. In the process of biopsy, a small amount of sample skin is taken and inspected in a clinical laboratory. The biopsy may substantiate the diagnosis and determine other probable skin diseases (Braverman, 1998).

Expected Time

Psoriasis makes a long-term disease. All the same, symptoms may fluctuate.

Prevention

There exist no means of preventing psoriasis.

Treatment

Psoriasis treatment varies based on the:

  1. Kind of psoriasis.
  2. Location and amount of the skin affected.
  3. Benefits and risks of each kind of management.

Psoriasis treatments include but not limited to:

Topical Treatments

It refers to treatments applied to the skin directly

Skincare daily with emollients concerned with lubrication. These is inclusive of unscented moisturizers or petroleum jelly

Lotions, Corticosteroid Creams and Ointments

They may be approved in high-strength and medium forms for mulish plaques on the feet, hands, arms, trunk, and legs. They may be approved in low-strength types for fields of fragile skin like in the face:

  1. Dovonex (Calcipotriol) slows the production of scales in the skin.
  2. Tazorac (Tazarotene) refers to an imitation vitamin A by-product.
  3. Salicylic acid removes scales.
  4. Coal tar.
  5. Phototherapy.

Widespread or extensive psoriasis can be treated using light. Phototherapy utilizes ultraviolet A or ultraviolet B only or in the combination of coal tar.

Treatment known as PUVA that merge ultraviolet A light cure with a spoken medication, which improves the efficiency of treatment using light

Laser Treatment

It allow treatments to be focused in that higher amount of UV light may be utilized

Vitamin A Plagiaristic

These are utilized to treat modest to harsh psoriasis linking large fields of the whole body. These managements are quite influential. Several have potential to ground harsh side impacts. It is important to comprehend the risks that should be closely monitored (Roenigk, & Maibach, 1998).

Immunosuppressants

These types of treatment work through repressing immune systems. They are utilized to treat reasonable to harsh psoriasis concerning large body areas

Antineoplastic Agents

These drugs that are used to cure cancer cells may be stipulated for harsh psoriasis

Biologic Therapies

These are current agents that are used for psoriasis, which does not react to other type of treatments. Psoriasis is partly caused by substances manufactured by immune systems that grounds inflammation. Biologics acts against such substances. Biologics treatments are quite expensive and they should be instilled instead of taken as pills

When to invite a Professional?

If one is unsure whether or not infected with psoriasis, just ensure you contact your physician. You should also contact your doctor to determine whether you have psoriasis.

Prognosis

In majority of patients, psoriasis remains a long-term situation. There exists no cure for this disorder. But there exist various effective treatments. For various patients, doctors can switch treatment every twelve to twenty-four months. These put off the treatments from trailing their efficiency and reduce the risk of negative impacts.

Self-Care at abode

  1. Direct exposure to sunlight assist many persons infected with psoriasis
  2. Maintaining the skin moist and soft is important. You should apply profound moisturizers after taking shower you should not utilize irritating soaps or cosmetics
  3. Avoid itching or scratching which can cause excessive irritation or bleeding
  4. Drenching in bath water with added oil and utilizing moisturizers might assist. Bath infuse with other agents or coal tar that remove reduce the plaque or scales can also assist
  5. Cortisone creams may lower the dying of mild psoriasis that are available with no prescription.
  6. Certain people utilize an ultraviolet B at home with the help of doctor's regulation. A dermatologist can set down the element and advise the patient on abode use, particularly if it is hard for patients to get to doctors for phototherapy treatments.

Prevention

  1. Avoiding ecological factors, which trigger psoriasis, like smoking, stress and sun exposure can help minimize or prevent psoriasis flare-ups. Sun exposure can assist in several psoriasis cases while aggravating in others.
  2. In many cases, alcohol is taken as a psoriasis jeopardy factor in young and middle-aged males. Minimize or avoid alcohol use once you realize you have psoriasis.
  3. Restrictions to supplements or specific dietary instead of adequate and a well-balanced diet are not important in the cure of psoriasis plaque.

Follow-ups

Psoriasis disorder is a chronic disorder that keeps fluctuating. Follow-up care focuses on the harshness of the disease at a given period

Patient Assessment

Health practitioners should assess patients with all psoriasis types for:

  • wellbeing;
  • disease severity;
  • psoriatic arthritis;
  • effect of the disease on psychological, social and physical aspect;
  • presence of comorbidities.

Assess psoriasis impact and severity:

  • at initial the report;
  • before the referral for expert advice as well as at any referral stage in the treatment trail to evaluate the effectiveness of interventions.

During the assessment of psoriasis severity, record the following:

  1. Static Physician’s Global Assessment Results (These are classified as nearly clear, clear, moderate, mild severe and very severe.)
  2. Body surface area affected
  3. Any engrossment of nails noted
  4. High-affected or hard-to-treat locations (for example, scalp, palms, the face, flexures, genitals, and soles).
  5. Noticed systemic upset (such as in individuals with generalized pustular or erythroderma psoriasis).

A specialist setting uses a ratified tool in assessing severity, for instance the Severity Index and Psoriasis Activity in adults in adults. For the young children, the PGA is used in assessment. The specialist has to be aware that:

  • BSA and PASI are not certified for use in kids;
  • erythema is likely to be underestimated in persons with darker skin, for example skin types five and six on the Fitzpatrick scale.

It is important to assess the effect of all psoriasis types on psychological social and physical wellbeing of the patient by asking:

  1. Which daily living aspects does the psoriasis impact in the patient?
  2. How is the patient coping with psoriasis skin condition?
  3. What treatment is the patient currently using?
  4. Does the patient require further support or advice?
  5. Has the patient’s psoriasis had a big effect on their emotions and moods?
  6. It is important to ask children and teenagers how the disease has impacted on their families. Age-appropriate interrogations should be applied.

In a specialist setting as well as non-specialist setting if applicable, it is important to use a certified tool in assessing the effect of psoriasis on the social, psychological, and physical wellbeing of the patient. For instance:

  1. Assessing the Adults’ Dermatology Life Quality Index for adults.
  2. Kid’s Dermatology Life Quality Index for kids and teenagers.

The assessment also includes assessing whether the patients with psoriasis have depression. Depression is assessed when assessing psoriasis severity, impacts as well as when intensifying therapy. It is important to offer appropriate support and advice in accordance with depression in patients with a chronic health condition.

In a specialist setting, the Nail Psoriasis Severity Index is used to assess the nail disease as follows:

  • in case there is a key cosmetic or functional impact;
  • before and after the treatment is started particularly for the nail disease.

In case an assessment is done in a non-specialist setting, it is important to provide a referral for the dermatology specialist attention especially if:

  • the psoriasis is very severe
  • there is analytical uncertainty
  • there is extensive uncertainty, for instance, more than 10% of the Body Service Area involvement
  • psoriasis is uncontrollable with topical therapy
  • acute guttate psoriasis needs phototherapy
  • the nail disease has the main cosmetic or functional impact
  • psoriasis condition is having the main impact on a patient’s physical, social or psychological wellbeing

Client's Review

"The quality of the writings is really good. Guys who work there are friendly and help a lot. I ordered papers and got them on time as we arranged. As for me, this service does the job properly without any problems."

reviewed Exclusive-Paper.com on May 20, 2020, via TrustpilotClick to see the original review on an external website.

Patients having unstable psoriasis such as erythroderma or generalized pustular psoriasis require to be referred immediately for specialist treatment and assessment. When assessing psoriasis patients, it is important to take into consideration their age and any disabilities they may be having such as cognitive or visual impairment, physical disability, and language and communication difficulties. This helps the health practitioner to provide appropriate support and help required. It is also essential to ensure the selected assessment tools are continuously accurate. Additionally, kids with psoriasis condition at presentation should be referred to a specialist immediately.

Assessment for Psoriatic Arthritis

It is an assessment to assess for psoriatic arthritis to all patients with any psoriasis type. This is important for psoriatic arthritis to be conducted within the first ten years of psoriasis onset. A validated tool should be used for assessing adults for this type of arthritis in specialist and primary care settings, for instance, the Psoriasis Epidemiological Screening Tool. However, caution should be taken since Psoriasis Epidemiological Screening Tool does not identify inflammatory back pain or axial arthritis. Immediately after psoriatic arthritis is detected or suspected, the patient should be referred to a rheumatologist. The rheumatologist assesses the severity of the condition and offers advice concerning patient care (Fabian, et. al., 2011).

Comorbidities Identification

For every adult who has severe psoriasis condition at presentation, the cardiovascular risk assessment should be conducted using a certified risk assessment tool. Further assessment should be done every five years. Assessment can also be done more frequently if there is a need to do so.

It is important to discuss risk factors for the comorbidities with persons who are infected with psoriasis of all harshness. Explain that, they are at higher risks of diabetes, hypertension, hyperlipidemia, and obesity than persons with no psoriasis. Provide preventative advice and healthy existence data in line with NICE guidance that includes:

  • obesity;
  • lipid modification;
  • averting the type two diabetes: community-level and population interventions in great-risk groups as well as the general population;
  • averting cardiovascular diseases at the population level;
  • alcohol-use diseases: averting the developmental harmful and hazardous drinking;
  • smoking termination service in basic care, local authorities, workplaces, and pharmacies specifically for manual operational groups, marginalized communities, and pregnant women.

In persons with several comorbidities and a single type of psoriasis requiring second- or a third-line therapy guarantee multidisciplinary operating and communication among professionals and, if necessitated, interdisciplinary working team, for instance when both joints and skin are importantly affected (Smith, Barker & Menter, 2002).

The patient should know that psoriasis is a venous thromboembolism risk factor, particularly for persons with harsh psoriasis and:

  • must explain this risk factor to persons with psoriasis;
  • must provide advice on how to minimize the risk factor for instance, during hospital admission, periods of immobility or surgery;
  • must manage the risk factor in line with blood thromboembolism: lowering the risk factor.

Conclusion

In conclusion, the nursing process of any psoriasis patient does not just require observation of the two aspects discussed above. Rather it requires all the nurses and medical practitioners to maintain people's medical services to the patients, educate them, and plan for the discharging process well. This will help to improve the health of this skin infection victim and reduce society's misconception about the disease.

Our Benefits
  • 300 words/page
  • Papers written from scratch
  • Relevant and up-to-date sources
  • Fully referenced materials
  • Attractive discount system
  • Strict confidentiality
  • 24/7 customer support
We Offer for Free
  • Free Title page
  • Free Bibliography list
  • Free Revision (within two days)
  • Free Prompt delivery
  • Free Plagiarism report (on request)
Order now
scroll to top call us
live-chat-button
Chat with Support