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Pathophysiology > Ch-41 Disorders of the Integument > Flashcards

Ch-41 Disorders of the Integument Flashcards

1
Q

What is decubitus ulcers?

A

when pressure interrupts NORMAL BLOOD FLOW to skin and underlying tissues

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2
Q

Pressure ulcers from ____ (1) pressure, shearing forces, friction and ____ (2).

A

(1) unrelieved; (2) moisture

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3
Q

What are the risks for pressure ulcers? (5pts)

A

immobilization, prolonged moisture exposure, neurological disorders (spinal cord injuries), malnutrition, dehydration.

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4
Q

What are the 4 stages of Pressure Ulcers?

A

Stage 1: skin unbroken but inflamed

Stage 2: skin breaks open; site tender and painful; epidermis and dermis involved

Stage 3: below dermis fat tissue involved

Stage 4: MUSCLE, BONE, ligaments or tendons visible.

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5
Q

Pathophysiology of PU:

Prolonged pressure = tissue ____/ (1) will return to normal with repositioning or stimulation

Pressure continues = blocked blood flow = ____ (2) = shearing or friction = detachment of tissues = if continued ___ (3) will occur.

A

(1) reddens; (2) hypoxia; (3) necrosis

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6
Q

Tx for pressure ulcers? (4 pts)

A
  • early detection and prevention
  • fq. assessment of skin, repositioning, adequate skin care, promoting independent movement
  • special beds prevent friction and eliminate excess moisture
  • adequate nutrition, hydration
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7
Q

What is the tx required for First degree brun? What are some symptoms?

A

no tx required; may have nausea and vomiting

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8
Q

Who are the vulnerable groups for first degree burn? How long is the healing time for first degree burns?

A
  • young and old experiencing dehydration
  • Heals within 3-5 days – no scarring
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9
Q

What are the two types of 2nd degree burn?

A

Superficial partial thickness & Deep partial thickness

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10
Q

What is superficial partial thickness?

A
  • fluid filled blisters – develop within minutes of injury
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11
Q

How long does superficial partial thickness heals? Is there scarring formation?

A

heals within 3-4 weeks; scarring is unusual

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12
Q

T or F: In superficial partial thickness, pain sensors are lost.

A

FALSE; Pain sensors remain intact.

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13
Q

What is the tx for deep partial thickness? Is there scarring formation?

A

tx: Graph of own skin required

Hypertrophic scarring occurs – thick raised scar

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14
Q

What is deep partial thickness?

A
  • waxy white look that takes weeks to heal.
  • necrotic tissue may be present —- need to be surgically removed
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15
Q

What are some characteristics of 3rd degree burn?

A
  • full thickness/ dry leathery appearance
  • loss of dermal elasticity
  • all nerve endings have been destroyed
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16
Q

What is the tx for 3rd degree burn

A
  • requires escharotomy
17
Q

What is escharotomy?

A

cutting through burned skin to release pressure and prevent compartment syndrome

18
Q

What is eschar?

A

dead tissue that forms over healthy skin

19
Q

What are the 2 types of degree burns that are considered medical emergencies?

A

3rd and 4th degree burns

20
Q

What does 4th degree burn requires?

A

skin grafting & reconstructive surgery

21
Q

Surgery requires “____ __ __s” for estimation of total body surface.

A

Rule of 9

22
Q

What are the Burns Rule of 9s?

A
  • used to estimate percentage of body burned.
23
Q

What is the % of the groin area in Burns of Rule of 9s?

A

1%

24
Q

What are the 3 burn phases?

A
  1. Burn shock phase
  2. Ebb phase
  3. Flow phase
25
Q

During burn shock phase, combination of ___ (1) hypovolemia & ____ (2) hypovolemia = massive fluid losses/ increased capillary permeability, thus fluid shift to interstitial spaces

Result: ____(3) blood volume/ ____ (4) cardiac output

Integumentary and pulmonary damage will result in loss of ability to regulate water evaporation = loss of several liters of fluid due to _____ (5) each day.

A
  1. CV
  2. Cellular
  3. Decreased
  4. Decreased
  5. Evaporation
26
Q

During ebb phase, the blood shunted away from ___(1), ____(2) & ____ (3) in first ____ (4) hours.

After 24 hours, restoration begins of capillary integrity, edema begins to resolve, ____ ____ (5) phase ends.

A
  1. liver
  2. kidneys
  3. Gut
  4. 24
  5. burn shock
27
Q

During flow phase, the state of HYPERmetabolic response = increased _____ (1), _____ (2) & _____(3).

Hyperglycemia also occurs with increased _____ (4) resistance and muscle loss.

This phase can last up to ___(5) years.

A
  1. catecholamines
  2. cortisol
  3. glucagon
  4. insulin
  5. two
28
Q

What is the goal of burns tx?

A

fluid restoration and nutrition

29
Q

The first ___ hours is critical for burns

A

24

30
Q

What is required to restore fluids for burns? And what is used to monitor to prevent fluid overload?

A

IV required to restore fluids

Parkland formula – prevent fluid overload

31
Q

Parkland formular requires __mL(1) of ____’s ____ (2) per kg of body weight per %TBSA burned. 1/2 to be given during the first __ (3) hours after injury and the rest in next ___ (4) hours = vol required in a 24-hour period.

A
  1. 4mL
  2. Ringer’s Lactate
  3. 8 hours
  4. 16 hours
32
Q

What is a ringer’s lactate?

A

IV fluid for dehydration, having surgery or receiving IV meds

33
Q

What are the 4 types of cold injury?

A
  1. Frostnip
  2. Chilblains
  3. Frostbite
  4. Flash freeze
34
Q

What is frostnip?

A

superficial frostbite, pain increases during tissue rewarming

35
Q

What is chilblains?

A

partial thickness frostbite; purple tone; can develop chronic vasculitis (inflammation of blood vessel.

36
Q

What is frostbite?

A

tissue freeze; ice crystals form; whiteness of tissue; numbness with no sensation of pain; potentially irreversible.

37
Q

What is flash freeze?

A

rapid formation of ice crystals; associated with contact with cold metals or volatile liquids

Pathophysiology (20 decks)

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