Question

MG, a 15-year-old patient, complains about blackheads and large, raised acne with surrounding erythema on her face. She seeks help from a health care provider.

1. To assist in identifying her skin problem, what should the health history and assessment include?

2. Which nonpharmacologic measures might the nurse discuss with MG in caring for her skin condition?

    MG’s skin disorder does not improve. Her health care provider says she has acne vulgaris and has prescribed benzoyl peroxide and oral tetracycline.

3. MG asks the nurse how to use benzoyl peroxide. What should the explanation of the method and frequency for use of benzoyl peroxide include?

4. What patient teaching will you do related to the use of oral tetracycline?

5. What other agents for acne might be prescribed for MG use? Explain their uses and side effects.

6. MG asks if she will have to remain on benzoyl peroxide and oral tetracycline for the rest of her life. What is the nurse’s best response or course of action? Explain your answer.

1. Write a complete nursing diagnosis for each case study. (Nursing Diagnosis R/T ________ secondary to __________ AEB _____________.
2. List 2 interventions with rationales for the nursing diagnoses you wrote for each case study.

Answer 1

1. To assist in identifying her skin problem, what should the health history and assessment include?

Health history includes:

• Duration of having acne.
• Family history of acne.
• Hormonal changes experienced during menstural cycle and pregnancy.
• Certain conditions such as polycystic ovary,Cushing syndrome and congenital adrenal hyperplasia.
• stress
• smoking
• Use of certain medications like corticosteroids,bromide,lithium and iodide containing drugs.

Assessment includes:

Skin assessment should focus on color ,type and area of acne.

Pain assessment due to acne

2. Which nonpharmacologic measures might the nurse discuss with MG in caring for her skin condition?

Washing the skin with a gentle cleanser twice daily is recommended.

Patients should also be advised to avoid picking at acne lesions as this may cause permanent damage and scarring.

3. MG asks the nurse how to use benzoyl peroxide. What should the explanation of the method and frequency for use of benzoyl peroxide include?

Check for allergies with medicine first by applying little cream in one spot .if no allergies then will proceed with next application to all areas.

Wash the area of involvement gently and pat dry before application of the medicine.

Apply benzoyl peroxide to the areas of skin affected with acne.

Avoid medicine entering into eyes,nose , ears or any areas of broken skin as it cause irritation.

Benzoyl peroxide cause bleach of hair and fabrics,so use carefully .

Apply once or twice as per the physician recommendations

Wash hands after the use.

4. What patient teaching will you do related to the use of oral tetracycline?

Tetracycline should be taken on an empty stomach, at least 1 hour before or 2 hours after meals or snacks.

Do not take tetracycline with foods, especially dairy products such as milk, yogurt, cheese, and ice cream as it decreases the absorption.

Take each dose with full glass of water for better absorption.

Report any allergic reaction occurs.

5. What other agents for acne might be prescribed for MG use? Explain their uses and side effects

Topical antibiotics egs.Clindamycin

side effects include

• skin burning or itching,
• dry skin,
• skin redness,
• oily skin,
• skin peeling

Oral isotretinoin

side effects include

• Skin Rash
• Abnormal skin peeling
• Backache
• skin dryness
• Dry mouth and eyes
• joint pain
• Inflammation of lips
• Abnormal liver enzymes
• Muscle pain

6. MG asks if she will have to remain on benzoyl peroxide and oral tetracycline for the rest of her life. What is the nurse’s best response or course of action? Explain your answer.

Nurse will explain as the initial treatment will be for 8 to 10 weeks and if it makes a good result with acne ,then will consider of reducing or stopping the treatment.

Tetracycline antibiotic use will focus for 6 to 8 weeks and if good recovery happens will followup and decide the treatment course.

patient will be told if it is recurring after the stoppage of drug,then we need to consider the long term use of both medicine.