A client with breast cancer who received chemotherapy two weeks ago returns to the clinic for follow-up. Which priority follow-up assessment should the practical nurse (PN) anticipate for this client?

Choice A reason: Initiating contact isolation precautions is not necessary for psoriasis. Psoriasis is a non-infectious and non-contagious chronic skin condition, so isolating the client would not be appropriate. The main focus should be on managing the symptoms and providing the client with strategies to alleviate their discomfort and improve their quality of life.
Choice B reason: Explaining the need to keep the affected areas dry is not suitable for managing psoriasis. In fact, keeping the skin hydrated is crucial in managing psoriasis symptoms. Dry skin can exacerbate the condition, leading to increased flaking, itching, and discomfort. The practical nurse should educate the client on proper skin care, including using moisturizers to keep the skin hydrated and avoiding harsh soaps and hot water.
Choice C reason: Preparing the client for allergen testing is not relevant in the context of psoriasis. Psoriasis is an autoimmune condition, not an allergic reaction, so allergen testing would not provide useful information for managing the condition. The focus should be on identifying and managing triggers that can exacerbate psoriasis, such as stress, infections, and certain medications.
Choice D reason: Reviewing stress reduction strategies with the client is the most appropriate action. Stress is a known trigger for psoriasis flare-ups, and helping the client develop effective stress management techniques can significantly improve their symptoms. Techniques such as mindfulness, relaxation exercises, and counseling can be beneficial in reducing stress and minimizing psoriasis symptoms. Educating the client on the importance of stress management and providing them with practical strategies can empower them to better manage their condition.

Choice A reason: Administering a prescribed analgesic is important for managing the client's pain and improving their comfort. However, before addressing the client's pain, it is crucial to ensure that appropriate infection control measures are in place. Herpes zoster (shingles) is a contagious condition, especially when there are draining lesions. The first priority is to prevent the spread of the infection to other clients and healthcare workers.
Choice B reason: Measuring the client's temperature is important for monitoring for signs of systemic infection, such as fever. While this is a necessary assessment, it is not the most immediate priority. Ensuring that appropriate isolation precautions are in place takes precedence to prevent the transmission of the infection.
Choice C reason: Initiating contact isolation precautions is the most critical action to take first. Herpes zoster can be spread through direct contact with the fluid from the lesions. Implementing contact isolation precautions, such as wearing gloves and gowns, and placing the client in a private room, helps to contain the infection and protect others. This is the first step in managing the client's condition and ensuring a safe environment for all.
Choice D reason: Applying cool, wet compresses to the lesions can help soothe the affected area and provide some relief from the pain and discomfort associated with herpes zoster. However, this is not the immediate priority. The first action should be to implement isolation precautions to prevent the spread of the infection. Once isolation measures are in place, the nurse can then focus on providing symptomatic relief.