Chapter 18: The Integumentary System Flashcards
Bony prominences
Areas of the body where the bone lies close to the skin
Bruise
A purple, black, or blue discoloration on the skin caused by the leakage of blood from broken blood vessels into the surrounding tissues; also called a contusion
Dermatitis
Inflammation of the skin
Dermis
The inner layer of the two main layers of tissue that make up the skin
Epidermis
The outer layer of the two main layers of tissue that make up the skin
Gangrene
Death of tissue caused by infection or lack of blood flow
Integument
Natural protective covering
Lesion
An area of abnormal tissue or an injury or wound
Melanin
The pigment that gives skin its color
Melanocyte
Cell in the skin that produces and contains the pigment called melanin
Necrosis
The death of living cells or tissues caused by disease or injury
Open Wound
A type of wound in which the skin’s surface i snot intact
Pressure points
Areas of the body that bear much of its weight
Pressure ulcer
A serious wound resulting from skin breakdown; also known as pressure sore, decubitus ulcer, or bed sore
Psoriasis
A chronic skin condition caused by skin cells growing too quickly which results in red, white, or silver patches, itching, and discomfort
Scabies
A contagious skin infection caused by mites burrowing into the skin that results in pimple-like irritations, rashes, intense itching, and sores
Shingles
A viral infection caused by the same virus that causes chickenpox; results in pain, itching, and rashes
Sitz Bath
A warm soak of the perineal area to clean perineal wounds and reduce inflammation and pain
Skin cancer
The growth of abnormal skin cells
Tinea
A fungal infection that causes red, scaly patches to appear in a ring shape, generally on the upper body, or the hands and feet
Wart
Contagious hard bump caused by a virus
What makes up the integumentary system?
1) Skin
2) Hair
3) Nails
4) Sebaceous (oil) Glands
5) Sweat glands
6) Subcutaneous tissue
7) Nerve endings
What is the largest organ in the human body?
The skin
Important points about the integumentary system
1) Natural, protective covering
2) Largest organ and system
3) Covers and protects the body
4) Skin is a sense organ
What are the functions of the integumentary system?
1) Protects internal organs from injury
2) Protects body against bacteria
3) Prevents loss of too much water
4) Regulates body temperature
5) Responds to heat, cold, pain, pressure, and touch
6) Excretes waste products in sweat
7) Helps with production of vitamin D
What are normal changes of aging in the integumentary system?
1) Amount of fat and collagen decreases
2) Elastic fibers lose elasticity
3) Hair and nail growth slows
4) Skin becomes drier
5) Skin becomes thinner and more fragile
6) Protective fatty layer thins
7) Hair thins and turns gray
8) Brown spots may appear on the skin
What causes burns and scalds?
1) Fire
2) Hot liquids
3) Warm water applications
4) Electrical equipment
5) Hot objects
6) Certain chemicals
What part of the skin does a first-degree burn affect?
They are also called superficial burns. They affect the epidermis and cause redness and pain
What is a second-degree burn?
It is also called a partial-thickness burn. They affect the dermis and cause some skin damage, redness, pain, swelling, and blistering
What is a third-degree burn?
Also called a full-thickness burn. It burns the epidermis, dermis, underlying tissue, and causes serious scarring. A third-degree burn may affect muscle and bone, white or charred skin, pain, swelling, and peeling skin
Important points about burns and scalds
1) May require surgery
2) Can cause resident’s condition to deteriorate rapidly
3) Offer pain medication before beginning care
4) Be gentle with moving and positioning
5) Report pus or other fluids around burn area or complaints of pain
What causes scabies?
Mites that burrow into the skin to lay eggs
What are the symptoms of scabies?
1) rash
2) Intense itching
3) Sores that may become infected
How is scabies usually transmitted?
Through person-to-person contact
Who are at a higher risk for scabies?
The Elderly and those with weak immune systems
What do you use to treat scabies?
Special lotions
What causes shingles?
Viral infections such as varicella-zoster (The virus that causes chickenpox)
What are the symptoms of shingles?
1) begins with pain or itching where rash will appear
2) Fever
3) Chills
Important points about shingles
1) Can occur in anyone who has had chickenpox
2) Pain may last for may years
3) Virus is spread when in blister form
4) Keep rash covered at all times
What are some types of open wounds?
1) Abrasion
2) Avulsion
3) Incision
4) Laceration
5) Puncture wound
`What is one common type of closed wound?
a contusion or bruise
What are symptom of wounds?
1) Pain
2) Tissue damage
3) Discoloration
4) Bleeding
5) Fever
6) Chills
7) Trouble breathing
What is the treatment for wounds?
1) stop bleeding
2) Cleaning wound
3) Applying dressing
What are the types of skin lesions?
1) Macules
2) Papules
3) Pustules
4) Vesicles
5) Wheals
6) Hematoma
7) Purpura
What are macules?
The simplest skin lesion. They are flat spots that can be seen but not felt. They are visible because they change the color of the skin. Freckles are an example.
What are papules?
Skin lesions that are raise, little round bumps on the skin. They do not contain pus. Contact dermatitis is an example.
What are pustules?
Raised spots filled with pus, such as acne or infected boils
What are vesicles?
Small blisters that contain fluid. They can occur on the skin or inside the mouth. Chickenpox is an example
What are wheals?
Large raised, irregular areas, that are usually itchy. Hives from an allergic reaction are an example
What is a hematoma?
A collection of blood in one area. The spot can be visible as a bruise, but may also occur on internal organs. Hematomas can become larger over time. They may also change color.
What are purpuras?
Small, purplish spots caused by bleeding under the skin. In elderly people, these spots are called senile purpura. Senile purpura occurs because blood vessels become more fragile with age
What causes Gangrene?
1) Lack of blood flow
2) Burns
3) Diabetes
4) Injuries
5) Circulatory disorders
6) Weakened immune system
7) Complications from surgery
What are the symptoms of Gangrene?
1) Discoloration of skin
2) Sores that do not heal
3) Pain
4) Loss of feeling
5) Foulsmellling discharge
6) Chills
7) Change in vital signs
What treatment is needed for Gangrene?
1) Antibiotics
2) Surgery
3) Amputation
4) Hospitilization
What is one type of dermatitis?
Eczema
What causes Dermatitis?
1) Stress
2) Allergies
3) Family history
4) Irritating agents in enviornment
What treatment for dermatits?
1) Topical steriod creams
2) Soothing or drying lotions
What causes Cellulitis?
Bacteria moving deep into the tissues due to a break in the skin
What puts a person at a higher risk for cellulitis?
1) Diabetes
2) Edema
3) Obesity
4) Weakened immune system
What are the symptoms of psoriasis?
1) White or silver patches on skin
2) Itching and discomfort
3) Arthritis
4) Pain
What causes psoriasis?
1) Heredity
2) Dry climate
3) Cold weather
4) Stress
5) Weakened immune system
What treatment is needed for psoriasis?
1) Topical creams
2) Shampoos
3) Lotions
4) Medication
5) Phototherapy
6) Dietary changes
7) Sun therapy
What are the causes of fungal infections?
Overgrowth of fungus due to overuse of antibiotics and reduced immune system function
What are the symptoms of fungal infections?
1) Red scaly patches
2) Itching
3) rawness
4) Pain
What are some examples of fungal infections?
1) Jock itch
2) Vaginal yeast infection
3) Athlete’s food
4) Tinea
Treatment form fungal infections
1) Topical antifungal creams
2) Medications
Where do fungal infection most commonly occur on the body?
moist areas of the body
What causes a wart?
Contagious virus enters skin through cut or tear
What treatment is used for warts?
1) Medication
2) Removal with laser or special instrument
What is the most serious form of skin cancer?
Malignant melanoma
What causes skin cancer?
Sun exposure
What are the symptoms of skin cancer?
1) Changes in a mole
2) Wart
3) Spot on the skin
4) Sores that do not heal
5) Itching
6) Pain
7) Skin that is oozing or bleeding
What is the treatment for skin cancer?
1) Removing cancerous area and tissue
2) interferon
Obesity increases the risk for what?
1) Pressure ulcers
2) Skin infections such as cellulitis
3) Excess facial and body hair
4) Slow wound healing
What are the pressure ulcer danger zones for the lateral position?
1) Side of the head
2) Ear
3) Shoulder
4) Hip
5) Greater Trochanter
6) Knees
7) Ankles
What are the pressure ulcer danger zones for the prone position?
1) Cheek
2) Collarbone
3) Breats (Women)
4) Buttocks
6) Genitals (Men)
7) Knees
8) Toes
What are the pressure ulcer danger zones for the Supine position?
1) Back of the head
2) Shoulder blades
3) Elbows
4) Abdomen
5) Sacrum
6) Between the legs
7) Heels
How many stages of pressure ulcers are there?
4
Describe a stage 1 pressure ulcer
1) Skin is intact, but reddens or appears blue or gray
2) May appear purple or darker than the skin surrounding the area in dark complexions
3) Redness or discoloration is not relieved after removing pressure
4) Can be reversed if discovered promptly and treated
5) If not treated promptly, the pressure ulcer will worsen and progress into other stages
Describe a stage 2 pressure ulcer
1) Partial-thickness skin loss involving the epidermis and the dermis
2) Ulcer is superficial and looks like a blister or shallow crater
3) Accompanied by pain and tenderness
4) Skin around the pressure ulcer may be discolored
5) No dead (Necrotic) tissue in the site at this stage
Describe a stage 3 pressure ulcer
1) Full-thickness skin loss (both the epidermis and dermis will be gone)
2) Ulcer looks like a shallow or deep crater
3) Bottom of the wound may have yellow, dead tissue
4) Damage may extend to the tissue that covers muscle
5) Require weeks or months to fully heal
Describe a stage 4 pressure ulcer
1) Full-thickness skin loss extending through all layers of the skin, tissue, and possible, muscle, bone, and other structure, such as joints or tendons
2) Ulcer will look like a deep crater and will have some necrotic tissue
3) Healing process extends over months
4) Serious infections can result
5) May require a skin graft
List the risk factors for pressure ulcers
1) Immobility
2) Wrinkled linens that do not lie flat
3) Crumbs or other irritating objects in bed
4) Malnutrition or dehydration
5) Urinary and fecal incontinence
List the guidelines for prevention of pressure ulcers
1) Report changes in skin
2) Perform regular skin care and closely observe skin
3) Keep skin clean and dry
4) Assist immobile residents to change position often, at least every two hours
5) Ask residents in wheelchairs to change position at least every 15 minutes
6) Avoid rubbing skin against surfaces during transfers or repositioning
7) Keep linens dry, clean, and wrinkle-free
8) Perform ROM exercises as ordered
9) Use special positioning devices
10) Use pillows to separate skin surfaces
11) Follow diet and fluid orders
How does a heat application help a resident?
1) relieves pain and muscular tension
2) Decreases swelling
3) Elevates temperature in the tissues
4) Increases waste removal
5) Brings more oxygen and nutrients to tissues for healing
How does cold application help a resident?
1) Helps stop bleeding
2) Prevents swelling
3) Reduces pain
4) Brings down high temperatures
What helps strengthen the effect of heat and cold?
Moisture
Sitz baths cause an increase in what?
Circulation to the pelvic area
What decreases because of a sitz bath?
Blood flow and other parts of the body decrease
How may a resident feel after a sitz bath?
1) Weak
2) Faint
3) Dizzy
When should a nursing assistant stop the sitz bath?
IF the resident complains of feeling dizzy or faint. Sitz baths may cause the urge to void
What are Non-sterile dressings?
Dressings that are applied to wounds that have less chance of infection
What are Sterile dressings?
Dressings that are required when a wound is new, open or draining, or when there is a higher risk of infection
Important points about sterile dressing care
1) Sterile field is created
2) Use supplies considered sterile
3) If any part of the sterile field becomes contaminated, the entire process must be restarted
What supplies are considered sterile?
1) Sterile dressings
2) Sterile drapes or pads
3) Tubing and catheters
