The skin lesion presented in this case study is melanoma, which is a skin cancer. However, it is not severe although it can develop to become malignant and cause metastasizes in other body parts (Jarvis, 2011). The descriptors that should be used are, Asymmetry (location and distribution on both sides of the shoulders), Borders (regularity of the margins), Color (consider color of its surface), and Diameter (size of the lesion and thickness) (Jarvis, 2011). Others include Elevation above the skin, Firmness and Growing (how the disorder progresses with time). All these descriptors are used in malignant cases of nodular melanoma (Jarvis, 2011). The findings in this case study are clear guidelines for treatment because they will help the physician in assessing the progress of the lesion and help him to determine what kind of management plan should be employed at different stages (Macfarlane, 2009).
The health education plan should involve informing the patient about his condition. Most importantly, the patient should be notified how the disorder comes about and the necessary preventive measures. The melanoma presented in this case study is a disorder caused by genes mutation and one can acquire the lesion when the predisposing factors are triggered, which includes factors such as age, skin color, and exposure to sunlight (Jarvis, 2011). This condition is common among the elderly people. Skin color is another factor and people with light skin color are more vulnerable compared to people with dark skin color (Gloster and Neal, 2006). Lastly, overexposure to sunlight is also another causal factor that may lead to this condition. It important to educate the patient about all these mentioned factors.
The patient should minimize exposure to sunlight because the sunrays have a component called ultra violet rays that destroys the melanocytes, which produces melanin (Macfarlane, 2009). One of the protective and prevention measures is wearing protective clothing such as long sleeved shirts, avoid wearing shorts, and use broad brimmed hats (Gloster and Neal, 2006). Alternatively, individuals should avoid basking under the sun between 9 A.M and 3 P.M because during this time of the day the sun has high concentration of Ultra Violet radiations. The opinion is that, people should only bask in the sun during the early morning hours and during the evening hours because during these hours, the human skin synthesizes vitamin D properly. Additionally, people should use sunscreens because they protect and block the destructive rays (Gloster and Neal, 2006). Generally, it’s basic to educate the patient to become very observant especially regarding the color of his skin. For instance, when he observes any change of skin color and formation of ulcerations, then the condition is worsening (Macfarlane, 2009).
For proper treatment of the lesion, the patient should wash it on a daily basis with an antiseptic and apply the proper medications (Jarvis, 2011). This is an important nursing care because it prevents developing hospital acquired infections that would complicate the healing process of the lesion. It is important to advice the patient to put on clothing that would allow proper aeration of the skin because it is very important in the healing process. Additionally, advice the patient to apply excision biopsy on the lesion and a confirmatory test should be done regularly (Jarvis, 2011). All these steps are necessary because they help in the management plan. This is helpful in curbing the spread and prognosis of the melanoma, which becomes easy when detected early enough.
It is necessary to discuss available medical options of dealing with this condition. For this case, surgical procedure known as Moh’s surgery should be done because its cheap and easy to perform (Macfarlane, 2009). This method has produced positive results compared to other options like chemotherapy, immunotherapy, and radiotherapy, which can predispose the patient to other carcinomas in the body (Macfarlane, 2009). Adjuvant treatment is recommendable in cases where the condition becomes severe.
Gloster, H., & Neal, K. (2006). Skin Cancer in Skin Color. Continuing Medical Education 55 (5), pp. 744-756.
Jarvis, C. (2011). Physical Examination and Health Assessment. (6th ed.). Philadelphia: Saunders.
Macfarlane, D. (2009). Skin Cancer Management: A Practical Approach. Berlin: Springer.