Sample Answer for NUR-635 Topic 15 DQ 2 Included After Question
Josh is a 17-year-old male who presents to your clinic with self-esteem issues. He is currently on a SSRI for depression. Upon talking to the patient, you find his acne has caused issues with his social life which contributes to his depression. Based on your visualization, his acne is prominent with many comedones, presence of nodules, and some scarring. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Based on Josh’s presentation, how would diagnose his acne (mild or moderate to severe)? Explain your rationale.
How do you manage treatment expectations to ensure maximum patient adherence?
What are some non-pharmacological approaches to the treatment of acne?
Based on the AAFP guidelines, what treatment strategy is considered first-line?
Be sure to include the drug, dose, frequency, and treatment length, and explain your rationale for choosing this medication. Include spectrum of coverage, if applicable, and mechanism of action.
Determine monitoring, side effects, and drug-drug interactions associated with each medication.
After 12 weeks of adherence to the medication regimen, Josh’s confidence has improved and now he wants to stop his SSRI today. How would you advise the patient?
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2
A Sample Answer For the Assignment: NUR-635 Topic 15 DQ 2
Title: NUR-635 Topic 15 DQ 2
Based on Josh’s presentation, how would diagnose his acne (mild or moderate to severe)? Explain your rationale.
Mild acne is the lowest classification for acne. Your acne is categorized as mild when you routinely only have a few breakouts. While you may consistently have blackheads and bumpiness, you will only occasionally have an inflamed pimple. While annoying, these breakouts are considered minor. Mild acne can progress into a moderate or severe form of acne, so it is best to treat your mild acne (Regula, 2020).
Moderate acne is characterized by noticeable breakouts. These breakouts often include not only blackheads and bumpy skin, but also papules and pustules. Papules are red and irritated looking bumps that can be painful to the touch. They are caused by hair follicles that become clogged by excess skin cells and oil. Papules often turn into pustules by becoming infected and filled with white, yellow, or cream-colored pus (Regula, 2020).
How do you manage treatment expectations to ensure maximum patient adherence?
Hurdles to primary nonadherence where the medication is not even started, include lack of knowledge, confusion about usage, weak physician patient relationship, fear of adverse reactions, and cost. Secondary nonadherence hurdles where the medication is started but is not taken as directed include lack of results, complex regimens, side effects, busy lifestyle, forgetfulness, inconvenience, and psychiatric comorbidity. Solutions to these hurdles include treatment simplification, technology, and dynamic education (Tychayi, 2016).
What are some non-pharmacological approaches to the treatment of acne?
The most commonly used non-pharmacological therapies for acne vulgaris are laser and light-based therapies, chemical peels, microneedling, (micro)dermabrasion and (mechanical) lesion removal, and they are generally used for patients with chronic acne who require long term therapy (Torjesen, 2018).
Based on the AAFP guidelines, what treatment strategy is considered first-line?
First line treatment for acne includes benzoyl peroxide or topical retinoid. For moderate acne, an oral antibiotic can be added (AAD, n.d.).
Antibiotic:
Doxycycline is an antibiotic appropriate for treatment, meaning it is a medication used to kill bacteria. Appropriate dose would be Doxycycline 50 mg to 100 mg orally twice a day. This medication is often limited to 3 months treatment to prevent resistance (Mikhail, 2023).
Side effects/Monitoring:
The most common side effects are sun sensitivity and nausea. Since bacteria can become resistant, don’t take doxycycline for longer than 3 to 4 months, and use it with another medication, like benzoyl peroxide. If your acne doesn’t get better, talk with a provider about other acne treatment options (Mikhail, 2023).
After 12 weeks of adherence to the medication regimen, Josh’s confidence has improved and now he wants to stop his SSRI today. How would you advise the patient?
I would advise josh, that when it comes to medicine, the healthcare providers are his biggest allies. I would tell him to have an open and honest conversation with the healthcare provider who prescribed the antidepressants about any skin side effects. They may be able to offer an alternative antidepressant or counteractive acne medication, such as prescription-strength retinoids (Gronich, 2023).
References:
Acne clinical guideline. American Academy of Dermatology. (n.d.). https://www.aad.org/member/clinical-quality/guidelines/acne
Mikhail, M. (2023, July 7). Doxycycline for acne: How long do side effects last?. GoodRx. https://www.goodrx.com/conditions/acne/doxycycline-for-acne-how-it-works
Moradi Tuchayi S, Alexander TM, Nadkarni A, Feldman SR. Interventions to increase adherence to acne treatment. Patient Prefer Adherence. 2016 Oct 11;10:2091-2096. doi: 10.2147/PPA.S117437. PMID: 27784999; PMCID: PMC5067002.
Regula, C. (2021, March 17). Mild vs moderate acne: How to tell the difference: Vujevich dermatology. Vujevich Dermatology Associates. https://www.vucare.com/2020/11/06/mild-vs-moderate-acne/
Torjesen, I. (2020, November 13). The best and worst of acne treatment options. Dermatology Times. https://www.dermatologytimes.com/view/best-and-worst-acne-treatment-options
