Chapter 45 Flashcards

1
Q

Origins of skin lesions

A
  • injuries
  • hereditary factors
  • skin reactions
  • systemic disease (psoriasis)
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2
Q

describe children’s skin

A
  • thinner and blood vessels closer to surface
  • contains more water
  • less pigmented, makes them more at risk for UV
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3
Q

Risk factors for :

  1. Bacterial
  2. Viral
  3. fungal
A
  1. Contanct, immunodeficiencies and immuno supression
  2. contact
  3. contact
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4
Q

Diagnostic test for integumentary diseases

A
  1. CBC and electrolytes
  2. wound or drainage culture
  3. Nutritional indices (Zinc and protein)
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5
Q

age related skin manifestation

  1. infants
  2. earlychildhood
  3. school age
  4. adolescents
A
  1. birthmarks
  2. dermatitis
  3. ringworm
  4. acne
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6
Q

Criteria for lesion identification

A
  1. linear
  2. shape
  3. Morbilliform
  4. target lesions
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7
Q

process of wound healing

A

1st phase - inflammation, edema, phagocytosis
2nd phase - granulation lasting 5 to 30 days
3rd phase - contraction bringing wound edges together
4th phase - maturation where scar forms

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8
Q

what factors influence healing

A
  1. moist enhances wound healing
  2. nutrition
  3. stressful hinders healing
  4. infection
  5. disease
  6. circulation
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9
Q

therapeutic management for wound care

A
  1. dressings ( e.g wet to dry is wet first then dry dressing, use of tegaderms)
  2. topical therapy and agents
  3. agents
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10
Q

signs of wound infections

A

, erythema beyond wound margins, edema, purulent, pain increased temperature

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11
Q

what to assess wound for?

A

deviations, colour, shape, distribution of lesions, depth, healing and signs of infection

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12
Q

bacterial infections of skin

A
  1. bollus and nonbollus impetigo
  2. folliculitis
  3. cellulitis
  4. staph scalded skin syndrome
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13
Q

what are your nursing considerations

A

prevent infection and prevent complication

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14
Q
  1. most communicable disease in childhood have what?

2. what are examples of viral infecitons

A
  1. characteristic rash

2. verruca, herpes simplex 1 and 2, varicella zoster, shingles, and molluscum

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15
Q

fungal infections

  1. aka
  2. examples and what they affect
A
  1. dermatophytoses
  2. T. capitis - scalp, eye brows and eye lashes
    T corporis - arms legs,
    T Pedis - feet
    Candidiasis
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16
Q

Scabies

  1. caused by?
  2. manifestation
  3. treatment
  4. nursing consideration
A
  1. scabies mites
  2. inflamed, itching, excoriation, and intense pruritus, rash usually affected areas are between fingers
  3. scabicied (8 to 14 hours), treat all contact
    4 wash clothes, apply calamine lotion for comfort
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17
Q

Pediculosis capitis

  1. aka, very common in?
  2. treatment and prevention
A

1 lice, school age children

2. nit removal and pediculicides. no sharing hats and combs and brushes.

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18
Q

how can mycotic infections (fungal) appear

A

may appear with granulmatous ulcers, plaques

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19
Q

rickets

A

spread through Paracites (flees, ticks, mites)

20
Q

most common tick borne disorder in US
2 how is it diagnosed
3. treatment
4. what is the focus

A
  1. Lyme disease
  2. ELISA?
  3. antibiotic treatment
  4. focus on prevention
21
Q

Cat scratch disease

manifestation

A
  1. commonly occurs form cat scratch

2. usually benign lasting 2 to 4 days. other treatment is antibiotic, swelling and pain management)

22
Q

poison Ivy, Oak, and sumac treatment

A
  1. antiitch cream, prevention is focus through avoidance
23
Q
  1. when it comes to sunburn, what to remember

2. when it comes to drug reactions, what are treatments

A
  1. remind to use sunscreen and avoid extended exposure to sun
  2. discontinue, give antihistamines and/or corticosteroids if severe
24
Q

Toxic epidermal Necrolysis

  1. aka
  2. caused by
  3. concenrs
A
  1. lyelle disease
  2. can be caused by antiseizure meds, sulfa, penicillin
  3. if not recognized and treated it can be deadly
25
Q

neurofibromatosis

  1. what is it
  2. identified through?
  3. nursing considerations
A
  1. genetic condition that affects, heart and kidneys
  2. can be identified by : cafe-au-lait spots, pigmented nevi, axillary and inguinal freckling
  3. it can cause tumors of brain and spinal cord, heart and kidneys. early identification is key
26
Q

staph scalded skin syndrome

  1. cause
  2. manifestation
  3. management
A
  1. staph aureus
  2. macular erythema, bullae formation, looks like burns
  3. antibiotic, burrow’s solution, silver nitrate
27
Q

cellulitis

  1. caused by
  2. manifestation
  3. treatment
  4. when does it become an emergency
A
  1. strep, staph, haemophilus influenza
  2. firm, swollen, red area of skin, fever, malaise
  3. oral antibiotics
  4. when it affects face and/ or eyes
28
Q

folliculitis

  1. caused by?
  2. patho?
  3. management
A
  1. staph aureus, MRSA
  2. hair follicle infection
  3. warm compress, clean skin, topical antibiotics
29
Q

impetigo

  1. caused by
  2. manifestation
  3. management
A
  1. staphylococcus
  2. honey coloured crust
  3. bacterial agent OTA
30
Q

Furuncle

  1. aka
  2. caused by
  3. manifestation
  4. managemnt
A
  1. boil, occurs in one single hair follicle
  2. staph aureus, mrsa
  3. large, red, swollen lesions, involving hair follicle
  4. incision and drainage with antibiotics
31
Q

Carbuncle

A

same concept with furuncle with multiple hair follicles

management through incision and drainage, bleach solution soaks if MRSA

32
Q

Pyoderma

  1. caused
  2. manifestation
  3. Management
A
  1. staph or strep
  2. fever, and lymphangitis
  3. antibacterial, launder clothes separately, apply mupirocin
33
Q

Risk factors for MRSA

A
  1. turf burns, towel sharing, participation in team sports, day care and outdoor camps
34
Q

nursing management for arthropod bites and stings

A
  1. symptomatic measures and and prevention secondary to infection.
  2. if bee sting, remove sting ASAP (be aware of anaphylaxis)
  3. spider bites from scorpions, recluse spiders, black qidow can be dealy, medical emergency
  4. when it comes to ticks, grasp tick as close as possible to point of incision. prevention is key
35
Q

mammal bites

  1. high risk in?
  2. management
A
  1. younger than 5

2. wound care, prophylcatic antibiotics, and rabies concern

36
Q

snake bites

1. goal

A
  1. early detection, apply loose tourniquet, suction may be appropriate
37
Q

human mouth concerns

A
  1. risk for infection: wound care, treatment through antibiotics
38
Q

when it comes to acne, what is our concern

  1. risk?
  2. goal
  3. how to use tretenol
A
  1. determine risk :genetic, grease,
  2. psychosocial effect specially in adolescents. Avoid scrubbing
  3. when using tretenol, apply then wash off then apply sunscreen. usually used at night
39
Q

dermatitis

  1. aptho
  2. symptoms
A
  1. inflammation and hypersensitivity from an offensive substance
  2. red papules, pruritus, itching
40
Q

contact dermatitis

  1. caused by
  2. expected findings
  3. care
A
  1. inflammatory hypersensitive reaction to irritants
  2. oozing or drainage of crusts, pruritus, delineation between inflamed and normal skin
  3. remove irritant, mild soap, expose to air, gentle scrub and gentle brush (not every day), use medications on a schedule and it can cause sedation (diphenhydramine, hydroxyzine). prevent irritants and exposures.
41
Q

atopic dermatitis

A

can be treated but not cured
avoid irritants, keep skin hydrated (luke warm water), pat skin dry, use lotions, use cotton, avoid excessive heat and sweating, avoid bubble baths and perfumes
the skin may have itching, hypopigmentation, bluish discoloration, antihistamine use (sedative effects)

42
Q

psoriasis

  1. describe
  2. issue is what
A
  1. inflammatory skin disease with periods of remission and exacerbation, scaly and flaky usually in elbows and knees. incidence depend on genetics and climate
  2. body image
43
Q

erythema multiforme

  1. aka
  2. symptoms
  3. management
A
  1. steven sjohnson syndrome
  2. fever malaise, aching, rash, itching, burning
  3. supportive treatment, goes away on its own (hydrate, itching management)
44
Q

where can urticaria come from?

A
  1. foods, drugs, animal stings, stress, infections, environmental stimuli.
45
Q

burns

  1. 4 classifications classify
  2. nursing care
A
  1. superficial - affects epidermis and heals without scaring in 4 to 5 days
  2. partial thickness - affects epi and dermis with minimal scarring in 2 weeks
  3. deep partial thickness - takes longer to heal and change nails, hair, sebacious gland
  4. full thickness - significant tissue damage with extensive scarring
  5. oxygenation, ventilation, restore fluid volume and wound care.
46
Q

wound care techniques

A
  1. wash wound with mild soap and rinse
  2. cover open wounds
  3. small wound uses adhesive bandage and occlusive dressing is used for large wound. if leakage, remove dressing.
47
Q

relief of symptoms

A

1 cooling baths or cool compresses

2. prevent scratching through mittens, short nails, antipruritic medications