OSSSC Nursing Officer-2023
Medical & Surgical Nursing
Easy
Which of the action could aggravate the cause of flare ups in a patient with pruritus?
Appeared in: OSSSC Nursing Officer-2023
Explanation
- Daily baths with fragrant soap can worsen pruritus by stripping the skin of its natural oils, leading to excessive dryness (xerosis).
- The fragrances and chemicals in many soaps act as irritants or allergens, which can trigger an inflammatory response and intensify itching.
- Frequent washing, especially with hot water, increases transepidermal water loss, further dehydrating the skin and exacerbating the itch-scratch cycle.
Why Other Options Were Wrong
- Option A: A cool and humidified environment is a recommended intervention to soothe the skin and reduce itching. Cool temperatures decrease inflammation and nerve sensitivity, while humidity prevents the skin from drying out.
- Option C: Clothing made from 100% cotton is advised for patients with pruritus. Cotton is a soft, breathable fabric that minimizes mechanical irritation and allows for air circulation, reducing sweat and heat buildup which can trigger itching.
- Option D: Increasing fluid intake is a beneficial action. Adequate hydration helps maintain skin turgor and moisture from the inside out, which can help alleviate dryness-related itching.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Identification of aggravating factors in pruritus management to guide bedside assessment, documentation, and the next nursing action.
- A key nursing role is patient education on skin care. Nurses must teach patients with pruritus to identify and avoid triggers like harsh soaps and to adopt a routine of gentle cleansing and consistent moisturizing.
- Nurses should assess the patient's current bathing habits, soap choices, and environmental factors to create a personalized care plan for managing pruritus.
- What if the patient is an older adult? Pruritus is common in gerontologic populations due to age-related skin dryness (xerosis). Nursing interventions should be even more focused on preserving skin moisture, such as recommending bath oils and immediate application of emollients, as their skin is more fragile and susceptible to breakdown from scratching.
How to Approach the Question
- First, identify the core of the question: what action makes pruritus (itching) worse? The keyword is 'aggravate'.
- Next, evaluate each option based on fundamental principles of dermatology and skin care.
- Option A (cool/humid environment): This is soothing. Eliminate.
- Option B (fragrant soap): Fragrances are common irritants, and soap is drying. This is a likely candidate.
- Option C (cotton clothes): Cotton is recommended as it's non-irritating. Eliminate.
- Option D (increasing fluids): Hydration is good for the skin. Eliminate.
Concept Tested & Keywords
- Concept Tested: Identification of aggravating factors in pruritus management.
- Stem keywords: aggravate, flare ups, pruritus
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
Qd5s7tBVoUtoIqv0-9oDzf
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 69-71
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1124-1126
Practise the full OSSSC Nursing Officer-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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