A home health nurse is making a home visit to a client with multiple sclerosis. The nurse reviews the home medications taken by the client. Which question should the nurse ask to determine the effectiveness of the client's medication, baclofen (Lioresal)?

A. Intense pruritus (itching) noted during the assessment of the moles: While intense itching can be associated with skin changes and should be monitored, it is not a definitive sign of malignancy. However, it can be an early indicator that warrants further investigation, especially if accompanied by other changes in the mole.

B. Purulent drainage coming out of the moles: Purulent drainage typically indicates an infection rather than malignancy. While infections are serious and require treatment, they are not usually linked to skin cancer. This finding should prompt further assessment and appropriate wound care.

C. A healed sore noted upon assessment: A healed sore generally indicates that the area has resolved and is not immediately concerning. However, a non-healing or recurrent sore could be a sign of skin cancer and would need further evaluation by a healthcare provider.

D. The mole is larger than 6mm: A mole larger than 6mm is a significant indicator for potential malignancy, as size is one of the criteria in the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolving) used for identifying melanoma. Larger moles warrant further examination to rule out skin cancer.

A) Use a razor to shave the hair in the treated area:
Shaving the treated area with a razor is not recommended during radiation therapy. The skin in the treated area becomes sensitive and fragile, so shaving could cause irritation, cuts, or abrasions. Instead, clients are usually advised to use electric razors or avoid shaving the area altogether. This instruction should not be followed to minimize the risk of injury.

B) Wash treated area gently with lukewarm water and mild soap:
This is a key self-care instruction for clients receiving radiation. Gentle cleansing with lukewarm water and mild soap helps to avoid further irritation to the skin, which can become dry and sensitive during radiation therapy. The treated area should not be scrubbed or rubbed, as this can cause damage to the skin, exacerbate dryness, or cause skin breakdown. This guideline is appropriate and should be followed.

C) Purchase aloe-approved skin-care products:
Using aloe vera or skin-care products approved for use during radiation therapy can help soothe and moisturize the skin, which often becomes dry, irritated, or sunburned from radiation. It is important to use products that are specifically designed for use during radiation to avoid any potential irritants or allergens. Aloe-based products or products recommended by the healthcare provider can provide relief and reduce side effects.

D) Wear loose-fitting, soft clothing over the treated skin:
Wearing loose-fitting, soft clothing is a crucial self-care recommendation for clients undergoing radiation. Tight or rough fabrics can irritate the sensitive skin, potentially leading to discomfort or skin breakdown. Soft fabrics like cotton are ideal, as they allow the skin to breathe and help avoid further friction or pressure on the treated area. This is an important aspect of skin protection during radiation therapy.

E) Sun tan the affected area for no more than 30 minutes a day:
Sun tanning or exposing the treated skin to direct sunlight is strictly forbidden during and after radiation therapy. The skin in the treated area is much more sensitive to UV radiation and can burn easily, even with minimal sun exposure. It can increase the risk of skin damage and delayed healing. The client should be advised to avoid direct sun exposure entirely and to wear protective clothing and sunscreen if they must be outdoors.