A primary care NP is considering using a topical immunosuppressive agent for a patient who has atopic dermatitis that is refractory to treatment with topical corticosteroids. The NP should:
a. begin therapy with pimecrolimus (Elidel).
b. tell the patient that these agents may be used long-term.
c. counsel the patient that these agents are more likely to cause skin atrophy.
d. tell the patient that laboratory monitoring for hypothalamic-pituitary-adrenal (HPA) suppression will be necessary.
A
Topical calcineurin agents are considered second-line agents for treating atopic dermatitis and should be limited to use in patients who have failed treatment with other therapies. Pimecrolimus permeates skin at a lower rate than tacrolimus and so should be tried first. These agents are for short-term use only because of the risk of skin cancer. These agents are less likely than steroids to cause skin atrophy, and HPA suppression is not a risk.
You might also like to view...
A patient for whom the nurse is caring has positron emission tomography (PET) scheduled. In preparation, what should the nurse explain to the patient?
A) The test will temporarily limit blood flow through the brain. B) An allergy to iodine precludes getting the radio-opaque dye. C) The patient will need to endure loud noises during the test. D) The test may result in dizziness or lightheadedness.
The nurse has just begun administering intravenous streptokinase (Streptase). The nurse assesses vital signs and notes a temperature of 37° C, a heart rate of 70 beats per minute, and a blood pressure of 88/58 mm Hg
The nurse will contact the provider to a. request an adjustment of the streptokinase dose. b. request an order for aminocaproic acid (Amicar). c. request epinephrine to prevent anaphylaxis. d. report potential hemorrhage in this patient.
A client who had a total hip replacement asks the nurse about the continuous regional analgesia being used. What information should the nurse include when explaining the benefits of the treatment over conventional methods to control pain?
a) adjusting the dose is easily done b) neuropathic pain can be relieved c) systemic side effects are minimal d) the need for parenteral medication is avoided
Which of the following is true of intrinsic factor?
A. The lack of intrinsic factor leads to a microcytic hypochromic type of anemia.
B. Intrinsic factor is a glycoprotein that is necessary for the intestinal absorption of vitamin B12.
C. Intrinsic factor is an enzyme that is necessary for the metabolism of vitamin B12.
D. None of these are correct.