A female client with atopic dermatitis is prescribed medication for photochemotherapy. The nurse teaches the client about the importance of protecting the skin from ultraviolet light before drug administration and for 8 hours afterward and stresses the need to protect the eyes. After administering medication for photochemotherapy, the client must protect the eyes for:
A. 4 hours
B. 8 hours
C. 24 hours
D. 48 hours
Correct Answer: D. 48 hours
To prevent eye discomfort, the client must protect the eyes for 48 hours after taking medication for photochemotherapy. Protecting the eyes for a shorter period increases the risk of eye injury. PUVA or photochemotherapy is a type of ultraviolet radiation treatment (phototherapy) used for severe skin diseases. PUVA is a combination treatment which consists of Psoralens (P) and then exposing the skin to UVA (long wave ultraviolet radiation). It has been available in its present form since 1976.
Option A: Avoid photosensitizers such as certain oral medications, perfumes, cosmetics, and applications of coal tar. If the eyes are not protected from UV radiation, keratitis may occur. This results in red sore gritty eyes and can be very unpleasant.
Option B: The client must protect the skin and eyes from natural sunlight for twelve hours after taking methoxsalen tablets. During treatment, the client must wear special goggles provided. Wear wrap-around ultraviolet-protective sunglasses both indoors and outdoors, from the moment the client takes the methoxsalen tablets until nightfall on the treatment day. After dark, the glasses must still be worn under fluorescent lighting, but are not necessary outside or with incandescent lamps.
Option C: An overdose of PUVA results in a sunburn-like reaction called phototoxic erythema. It is more likely in fair-skinned patients who sunburn easily. A burn is most likely 48–72 hours after the first two or three treatments. Sensitive areas such as breasts and buttocks may need to be covered for all or part of the treatment.
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