Alterations in Skin Integrity

Question 1

Contact dermatitis ( patho, causes, tx )

Answer 1

Patho: inflammation + redness of the skin r/t allergen or irritant
- goes away with removal of irritant
- last 3-4 wks

Causes: poison ivy/ oak, Neosporin, rubber, Nickle, latex

Tx: topical or oral steroids

Question 2

Diaper dermatitis ( cause, tx, nursing )

Answer 2

Cause: long exposure to urine feces, moisture, friction

Tx: barrier creams ( A & D ointment ), allow to dry

Nursing: use wipes w/o fragrance and educate
- Can develop secondary infection ( Candida )
- TX: nystatin

Question 3

Seborrheic Dermatitis (patho, s/sx, tx )

Answer 3

Patho: overactive sebaceous glands on scalp

S/Sx: pruritis ( itching ), waxy scaling

TX: daily shampoo w/ baby shampoo, emollient cream, steroid cream (rare)

Question 4

Atopic Dermatitis Eczema (patho, s/sx, tx, nursing )

Answer 4

Patho: chronic inflammation w/ intense pruitis (itching ) it is a inappropriate immune response

S/SX: xerosis (dry skin ), red area, vesicles, exudate, crust, lichenification ( thick leathery skin)

TX: remove allergens + hydrate the skin, steroid , antibiotics for secondary infection, antihistamines, aveeno baths, eucerin

Nursing: infection risk

Question 5

Impetigo (cause, s/sx, tx, nursing )

Answer 5

Cause: bacterial - staph or strep ( highly contagious )

S/SX: BLISTERING HONEY COLORED CRUST AT SITE, bullae ( before blisters burst ), fever, malaise, red, painful skin

TX: Antibiotics topical ( early ) or PO (later)
- SOAK + GENTLY REMOVE CRUST BEFORE APPLICATION

Nursing: contagious until 24 hrs on antibiotic therapy, wash hands , dont share wash cloths/towels

Question 6

Thrush (patho, causes, s/sx, tx, nursing )

Answer 6

Patho: fungal infection in the mouth

Causes: antibiotics, inhaler, perinatal, immunocompromised, bottles not sterilized

S/SX: white patches on tongue that bleed, very painful = feeding issues

TX: oral NYSTATIN

Nursing: Education (rinse mouth after taking meds, boil bottles )

Question 7

Dermatophytosis ( Patho, s/sx, tx, nursing )

Answer 7

Patho: Fungal infection to hair, skin, nails (ringworm)
1. tinea capitus (head)
2. corporis (body)
3. cruris (inguinal)
4. pedis (feet)

S/SX: hair loss, redness, pruritis (itchy) , peeling skin, PINK CIRCULAR LESIONS, vesicles

TX: topical or PO antifungals (2-12 wks for tx)

Nursing: spread person to person or animal

Question 8

Pediculosis Capitis (lice ) (patho, s/sx,/ tx )

Answer 8

Patho: lice crawl they dont jump or fly , spread via direct contact with infected object/person

S/Sx: pruritis (intense itching ), nits

TX: Shampoo, PO med (if needed ), WASH ITEM IN HOT WATER, DRY W/ HEAT, SEAL ITEMS IN PLATIC BAG FOR 2 WKS

Question 9

Causes of burns

Answer 9

1. thermal
2. chemical
3. electrical
4. radiation
   Ex: abuse, hot water scalds

Question 10

Types of burns + DX

Answer 10

1. Superficial - epidermis
   
   • ex: sunburn
2. Partial Thickness - epidermis +part of the dermis
   
   • tissue can regenerate
3. Full Thickness - epidermis + dermis + subcutaneous tissue
   
   • no regeneration of the skin, pt doesnt feel pain b/c nerve ending are burned
   • will need skin graft

DX; Total body surface area (TBSA)

Question 11

Burns: complications + nursing

Answer 11

Complications
- airway compromise, inhalation injuries, aspiration, pulmonary edema , PE (clotting)
- Shock (fluid loss), infection (b/c skin is compromised ), tetanus (vaccine )

Nursing: manage the airway