Chapter 49-Integumentary Disorders Flashcards
What are the five major functions of the skin?
protection, temperature regulation, vit D metabolism, sensation and excretion
What is the integumentary system comprised of?
Hair, skin & nails
What is the major source of vitamin D for the body?
Epidermis, vit D enters by UV light that enters through circulation & GI system to facilitate calcium absorption
where is sensation controlled?
Dermis - many nerve receptors that communicate with the CNS
Where are eccrine sweat glands?
most of the body’s surface
Where are apocrine sweat glands?
hair follicles of the armpits and genitalia
What are Langerhans cells?
outermost cells of the immune system located in the epidermis. They ingest foreign substances and present the antigen to the body’s T cells which destroy the pathogen if needed.
What does the 3rd layer of skin, the subcutaneous tissue, contain?
adipose tissue, connective tissue, nerves and blood supply.
When complete death of a hair follicle is induced by heredity, stress or illness, what is this called?
Alopecia (baldness)
Coloration of this body part provides information about the perfusion status of the distal regions of the body.
nailbeds
All of the skin’s primary functions are affected by what?
age
What is included in the history assessment?
Demographics (age/race), personal history-comorbid conditions/medications, family history (many skin conditions are genetically linked), diet and environmental factors
What is included in a physical assessment of the skin?
color & temperature, moisture, integrity, cleanliness, tissue changes, vascular markings and lesions
Give an example (s) of a macule.
freckles, flat moles, petechiae (non-blanching, red to purple flat lesions)
An example of a patch.
port-wine stain, mongolian spots, vitiligo (irregularly shaped)
An example of a papule
lichen planus, elevated moles, warts
Example of a plaque
Atopic dermatitis, psoriasis, mycosis fungoides, eczema
Example of a wheal
Insect bites, allergic reaction
Example of a nodule
lipoma (fatty, benign tumor)
examples of a tumor
lipoma, cancer, benign growth.
What is a cyst?
elevated growth in the dermis or subQ tissue filled with a liquid or solid substance
ex: epidermoid or sebaceous cyst
A vesicle?
elevated, filled with serous fluid and located in the epidermis. less than 1 cm
ex: small blister, varicella (chickenpox), herpes zoster, herpes simplex
What is a bulla?
filled w/ serous fluid, greater than 1 cm
ex: large blister, partial-thickness burns, pemphigus vulgaris (autoimmune disorder, large breakout of blisters)
a pustule?
filled with purulent fluid, size varies
ex: acne, folliculitis (inflammation of follicle)
a scale?
flakes of stratum corneum, may be dry or oily
ex: skin flaking after a drug rash, scaly dermatitis
a lichenification?
caused by excessive manipulation of skin (scratching, causing epidermis to become rough and thick
ex: chronic dermatitis
an excoriation?
linear, hollowed out appearance, wound bed is dry
ex: abrasions from scratching
fissure?
linear, cracked tissue that may extend into the dermis, wound bed dry or moist
ex: athlete’s foot
what is an erosion?
limited to epidermis, red/moist & concave wound bed, heals without scar formation
ex: open vesicles or bullae
what is a crust?
dried exudate from a wound bed (serum, blood or pus)
ex: eczema, scab, impetigo (bacterial infection in children, school sores)
what is an atrophy?
thinning epidermis or dermis or both, skin appears thin and tears easily
ex: skin in older adults, striae (stretch marks)
For pt’s in acute or long-term care, this risk assessment tool predicts the risk for skin changes caused by immobility, moisture and inadequate nutrition.
Braden Scale
What is onycholysis?
The nail plate detaching from the nailbed
What are the nursing implications for a skin biopsy?
Monitoring and supporting the patient’s response to the procedure, then biopsy care instructions
What lab studies are done to identify a pathogen?
culture, site biopsy, CBC, chemistry screening, blood cultures and ultrasound
What are the infectious sources to the skin?
fungal, bacterial, or viral
