What risk is increased with children who have been diagnosed with infantile eczema?

Choice A rationale

Peripheral arterial disease causes reduced blood flow to the extremities, making them highly susceptible to thermal injury. A heating pad can cause a severe burn because the compromised circulation prevents adequate heat dissipation, and the impaired sensation often associated with PAD means the client may not feel the excessive heat.

Choice B rationale

Crossing legs compresses the popliteal artery and other vessels, further impeding already compromised arterial blood flow to the lower extremities. This action increases resistance and reduces tissue perfusion, exacerbating the ischemic symptoms and potentially worsening the disease progression.

Choice C rationale

Wearing warm, heavy socks is a safe and effective way to promote warmth and vasodilation in the feet without the risk of burns. By maintaining warmth, it helps to prevent vasospasm and promotes better collateral blood flow to the affected extremities, improving comfort and circulation.

Choice D rationale

Smoking causes intense vasoconstriction through nicotine's effects on the sympathetic nervous system and damages the endothelial lining of blood vessels, accelerating the atherosclerotic process. Quitting smoking is the single most effective intervention to slow the progression of PAD and reduce cardiovascular risk.

Choice A rationale

Tazarotene, a retinoid, increases photosensitivity by thinning the stratum corneum, the skin's outermost layer. This reduces the protective barrier against ultraviolet (UV) radiation, making the skin more susceptible to sunburn and UV-induced DNA damage. Patients must be educated to use sun protection, but it is not the most critical question.

Choice B rationale

While a history of skin cancer can influence dermatological treatment plans, it is not the primary contraindication for tazarotene. Tazarotene is an analog of vitamin A, and its mechanism involves regulating cell proliferation and differentiation, which is not directly related to a personal or family history of skin cancer.

Choice C rationale

Tazarotene is a potent teratogen, meaning it can cause severe congenital malformations if taken during pregnancy. This teratogenic risk necessitates that all female patients of child-bearing potential use reliable contraception to prevent pregnancy. A pregnancy test is also required before initiation of therapy.

Choice D rationale

While some medications interact with alcohol, tazarotene is a topical retinoid primarily metabolized in the liver to its active form, tazarotenic acid. There is no significant systemic absorption or direct interaction with alcohol consumption that would cause a major adverse effect, making it a less critical question than contraception.