Question

A client uses triamcinolone (kenalog), a corticosteroid ointment, to manage pruritis caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. What action should the nurse implement?

Answer 1

The nurse should instruct the client to stop using triamcinolone and seek medical consultation due to symptoms that suggest a bacterial infection, potentially exacerbated by the immunosuppressive effects of the corticosteroid.

Step-by-step explanation:

The nurse should advise the client to discontinue the use of triamcinolone and consult the doctor as the signs indicate a possible bacterial infection. Inflammation and purulent exudate are not typical reactions to corticosteroid treatment and suggest a complication such as infection.

Corticosteroids like triamcinolone can suppress immune responses, paving the way for infections to flourish, especially in chronic use or if an individual is immunocompromised. Therefore, the emergence of increased erythema and purulent exudate could indicate a superimposed bacterial infection that may need treatment with an antibiotic.

A quick assessment by the healthcare provider is essential to prevent further complications, such as the spread of infection or escalating inflammation.

Corticosteroids are effective in managing symptoms like pruritis and inflammation but may not address underlying causes of skin conditions. They work by reducing histamine secretion, which diminishes the body's inflammatory response, but with prolonged use, can heighten the risk of infection due to immune suppression.