Forensic Nursing Chronicles

Caring for our skin over the course of a lifetime takes preventative measures, though it is sometimes not always easy to detect a potential problem. When skin issues are reported to a health care provider, a nurse needs to investigate a variety of possibilities that may have caused a negative outcome to specific areas of the body. Stress often aggravates and intensifies certain conditions, with skin being the most visible. When the nervous system is affected negatively with on-going stress, particularly within an abusive relationship, the epidermis can be irritated by itching. Acne, psoriasis, dermatitis and hair loss are related diagnoses from stress-related instances. According to Lehne (2007), “Topical glucocorticoids are employed to relieve inflammation and itching associated with a variety of dermatologic disorders (eg, insect bites, minor burns, seborrheic dermatitis, psoriasis, eczema, pemphigus)” (Pg. 1201). Under the “Actions and Uses” section of this textbook, no other alternatives are discussed for relieving such symptoms, except for the use of medication. Why? With our society becoming more and more accustomed to using drugs as a way to “fix” physical symptoms and concerns, should not the emotional, social and spiritual characteristics of human beings be considered when attempting to properly diagnose patients of all ages. As an example, if a patient were to be removed from his or her daily environment or living conditions changed for a period of time, might negative symptoms diminish or possibly disappear without medication of any kind? With that said, incorporating a more comprehensive approach when evaluating patients may result in a more favorable outcome when treating specific physical ailments. Hormonal effects may also play a role in skin irritations, and coupled with other stressors may cause symptoms such as those listed above. Lehne (2007) noted, “About 85% of teenagers develop acne, which often persists into adulthood. Acne is a chronic skin disorder that usually begins during puberty” (Pg. 1203). While the increase in hormones during this timeframe is significant, so to is the heightened inability to cope with new stressors such as peer pressure and dating. Any type of abusive situations at home could also significantly contribute to a teenagers physical well-being. Lehne (2007) stated in the nondrug therapy for acne, “Dietary measures don’t help” (Pg. 1204). I do not totally agree with this observation, since total health and well-being include nutrition, sleep patterns, family and social interactions and one’s spirituality, any of which may require evaluation to properly diagnose skin conditions. Medication should be carefully administered, with minimal doses considered, in an effort avoid adverse reactions to a patient. Atopic dermatitis (eczema) is often a common skin reaction when stress is heightened. Lehne (2007) defined, “Atopic dermatitis as a chronic inflammatory skin disease characterized by dry, scaly skin and intense pruritus that often leads to scratching and rubbing, which in turn can lead to erythema, abrasions, rash erosions with an exudates, an increased susceptibility to skin infection. Treating this condition glucocorticoids can cause skin atrophy, hypopigmentation, telangiectasis (permanent focal red lesions)” (Pg. 1212). With the prospects of such reactions, why does the textbook not also suggest other options to reduce such irritating symptoms? To effectively treat patients with any type of skin ailment, nursing professionals should investigate a patient’s background and share such with their doctor before he/she prescribes drug therapy. As a nursing student with a specialized interest and knowledge in domestic violence, I questioned whether current medical/nursing curricula adequately correlates, recognizes and prescribes treatment, both physiological and psychological, for skin conditions and one’s resultant well-being. References Lehne, R.A. (2007). Pharmacology for Nursing Care (Sixth Edition). Pgs. 1201-1212.

Forensic Nursing Online Introduction Course

Forensic Nursing Online Certificate Program

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