Exam 1 Flashcards
Punch Biopsy
Used for Squamous cells
Shave Biopsy
Basal Cell Carcinoma
Skin Excision
Melanoma
Wood’s light examination
fungal or viral
Pruritus
sunburn
Urticaria
hives
Furuncles
boils. caused by staphylococcus,Treatment- do not squeeze, do not keep covered, make sure to clean area before putting antibiotic ointment.
Methicillin- Resistant Staphylococcus Aureus (MRSA)
spread by contact, treated with vancomyicin
Herpes Simplex Virus
never goes away, Stress, dry lips, sunburn on lips, fatigue, trauma, girls on their periods, fever, seen on brides and nursing students
Fungal infections
keep body dry, clean, and give antifungal cream
Scabies
Treatment is scabicides, wash everything in hot water and detergent
Bed bugs
topical antihistamine for itching, get rid of bugs, heat can kill insects and eggs
Psoriasis
A chronic auto-immune disorder, noninfectious disease of the skin in which epidermal cells are produced at an abnormally rapid rate. Treatment; topical steroids UV light therapy
Rosacea
Condition that causes red patches and visible blood vessels on face. No cure
Stasis Ulcers
Causes- poor circulation, constant high pressure on veins. Risk factors- age, obesity, varicose veins, cigarette smoking. Lose weight, use compression socks, dont smoke
Peripheral vascular disease
Bad blood circulation. Pain will go away with rest, check neuro, capillary refills, at risk for pressure ulcers
Skin cancer
Risk factors- pale skin, overexposure of sun. Noses and ears are most common
patient teaching for skin cancer
Teach patients- if they are out in sun they need to wear sunblock, reapply sunblock every 2 hours, apply 30 mins before going into water and reapply after getting out of water, stay out of the sun between 10am-2pm. Use light clothing to cover your skin, wear hats, use sunglasses (you can get cancer in your eyes from the sun), do not use tanning beds.
reapply sunblock
every 2 hours, and 30 mins before going into water and reapply after getting out.
Stay out of the sun during
10am-2pm
Wounds
take pics, chart the location, length, width, depth, color, exudate, type of tissue involved, surrounding tissue, presence of foreign body
Stage 1 pressure ulcer
Do not scratch or moisturize. Do not rub on skin
can send home on stage 1.
nonblanchable and skin is intact
Stage 2 pressure ulcer
Skin not intact, partial thickness, crack in the skin, may look like a small blister
Stage 3 Pressure ulcers
full skin loss, Subcutaneous tissue may be damaged or necrotic, Damage extends to underlying fascia. Does not expose muscle or bone
Stage 4 pressure ulcers
Full thickness skin loss, Can see tendons, bones, muscles, Sloughing (dead tissue), scabbing (eschar), purulent drainage
Unstageable pressure ulcers
Have an eschar (scab over it)
Suspected deep tissue injury
No tears, no rips in skin, but have bruising (dark bruising) will be seen in traumas
Non surgical wound treatment for pressure ulcers
Dressings, electrical stimulation, wound irrigation, drugs, hyperbaric chambers
wound vacs cannot be used on patients
patients on blood thinners or if they have an anticoagulant problem)
Skin grafts
Braden Scale
tells us the risk for pressure ulcers, higher the number the lower the risk, patient with 2-3 is high risk, 20 is no risk
Factors affecting wound healing
Nutrition- high protein good carbs good fat
Tissue perfusion (do they have good circulation
Infection (are there any other infections)
Age (younger people heal faster, older takes longer)
Psychosocial (impact of the wound, diabetic patients not following doctors orders)
Phases of wound healing
Hemostasis (fibrin) sends fibrogen to that area to clot
Inflammatory phase when white blood cells go to the area
Proliferation phase- fills up with tissues
Remodeling- collagen goes to area to repair skin,etc
Primary intention
can be sutured up. An incision the physician makes during surgery
Secondary intention
burn, laceration, will scar
Tertiary intention
delayed wound closure, may need wound vacs
Cellulitis
Strep or staph involved deeper connective tissue, non compliant diabetics, Infection elsewhere in body that has moved to another portion.
Isotonic exercises
exercises that have muscle shortening with active movement (ex. Bicep curls, squats, climbing up the steps, etc)
Isometric exercises
muscle contractions without shortening ( there is no movement or only a minimum shortening of the muscle fibers) (ex. planks)
Isokinetic
Muscle contractions with resistance provided by an external device (working on a machine)
Mobility
ability to move about freely
Immobility
inability to move about freely
Bed Rest
an intervention that restricts patients for therapeutic reasons
Metabolic changes
decrease in amount of nutrition intake, this decrease causes a decrease in the necessary amount for our body, calcium decreases and our body doesn’t get enough
Respiratory Changes
Immobility causes an increase of a chance of pneumonia (we can use an incentives spirometer to decrease the chance of pneumonia) ( can teach them to deep breath, cough, and turn in bed. This helps relieve the particles in or lung)
Cardiovascular
blood vessels constrict, patient may develop orthostatic hypotension, we may dangle patients at the bedside for 15 mins, increased cardiac workou
Musculoskeletal
Muscle atrophy develops with decreased use of the musculoskeletal system. To determine if they have even muscle mass on both sides we will do exercises bilaterally. Skeletal changes- disuse osteoporosis, joint contracture. Passive range of motion- someone else moving the body part, active motion- patient moving the body part themselves. Always tent up the blankets on the feet to prevent foot drop.
Urinary elimination changes
urinary stasis ( gravity pulls your urine down when standing up, when laying down your bladder stays in one spot can cause utis, kidney infections, stones, etc.) offer bedpan every 2 hours, insert an indwelling catheter (48 hours is the max a catheter can stay in. If it stays in longer it can cause infections which can lead to sepsis, and death). Leading sign of elderly uti is confusion. You can bladder scan patients and straight cath.
Integumentary changes
too much pressure in one spot will cause a pressure ulcer. Turn the patient every 2 hours, increase fluid intake, good protein and carb diet, if incontinent check beds, keep clean, use purewick. Pad bony prominences (the coccyx, elbows, knees, knuckles, etc.)
Psychosocial
What has happened to the patient’s mental health. Many patients become depressed, do not get enough sleep. Patients may become hostile, giddy, fearful, anxious, etc. It is important to know how someone copes.
GI system
Constipation- increase fluids, increase movement as much as possible, increase fiber.
