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Med Surg & OB > EXAM I > Flashcards

EXAM I Flashcards

1
Q

autograft

A

a graft derived from one part of a patient’s body and used on another part of that same patient’s body

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2
Q

A of ABCDEs

A

airway

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3
Q

B of ABCDEs

A

gas exchange or breathing

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4
Q

C of ABCDEs

A

circulatory and cardiac status

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5
Q

D & E of ABCDEs

A

disability (D) including neurologic deficit, and expose and examine (E) while maintaining a warm environment

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6
Q

If the victim has severe respiratory distress and/or airway edema, the rescuers must insert an

A

endotracheal tube and initiate mechanical ventilation

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7
Q

If the burn exceeds 20% to 25% TBSA ______ is inserted?

A

a nasogastric tube is inserted and connected to low intermittent suction.

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8
Q

To help guide the treatment plan, the following are essential:

A

documentation of body temperature, body weight, and preburn weight; history of allergies, tetanus immunization, past medical and surgical history, and current illnesses; and a list of current medications.

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9
Q

The acute/intermediate phase of burn care follows the __________ phase

A

emergent/resuscitative phase

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10
Q

The acute/intermediate phase begins ____________ hours after the burn injury.

A

48 to 72 hours after the burn injury.

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11
Q

Airway obstruction caused by upper airway edema can take as long as ________ to develop

A

48 hours

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12
Q

Causative agents of burn infections may include _____,_________,_________

A

bacteria, fungi, or viruses.

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13
Q

Circumferential dressings should always be applied _________________ in order to promote return of excess fluid to the central circulation

A

distally to proximally

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14
Q

Natural debridement is accomplished when

A

nonliving tissue sloughs away from uninjured tissue.

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15
Q

What uses surgical tools to separate and remove the eschar?

A

Mechanical debridement

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16
Q

Enzymatic debridement

A

encompasses the use of topical enzymes to the burn wound.

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17
Q

What uses forceps and scissors during dressing changes?

A

Surgical debridemen

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18
Q

Three of the most common GI alterations in burn-injured patients are:

A

paralytic ileus (absence of intestinal peristalsis)**
Curling’s ulcer, and translocation of bacteria.
Decreased peristalsis and bowel sounds are manifestations of paralytic ileus.

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19
Q

total destruction of dermis

A

full-thickness burn

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20
Q

epidermis is destroyed & small portion of the underlying dermis is injured.

A

superficial partial-thickness burn

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21
Q

sun burn

A

superficial partial-thickness burn

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22
Q

extends into the reticular layer of the dermis

A

deep partial-thickness burn

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23
Q

It is red or white, mottled, and can be moist or fairly dry.

A

deep partial-thickness burn

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24
Q

scalds and flash flames

A

deep partial-thickness burn

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25
Q

obtained from recently deceased or living humans other than the patient

A

Homografts

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26
Q

obtained from animals, principally pigs or cows

A

xenograft or heterograft

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27
Q

Burns of the _______ ________ _______ have the potential to impair ventilation.

A

face, neck, or chest

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28
Q

BUN levels of 28 mg/dL can indicate

A

possible renal failure

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29
Q

Lactated Ringer’s solution replaces

A

lost sodium and corrects metabolic acidosis

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30
Q

burns involving the ________ may affect dexterity and mobility

A

hands

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31
Q

After managing respiratory what is your next priority

A

prevent irreversible shock by replacing lost fluids &electrolytes.

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32
Q

report loss of pulse/sensation or presence of pain to the physician immediately and to prepare to assist with _________

A

an escharotomy.

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33
Q

reassess &revise the estimate of burn depth because

A

early appearance of burn injury may change

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34
Q

Indicators of possible pulmonary damage include:

A

singed nasal hair, hoarseness, voice change, stridor, burns of the face or neck, sooty or bloody sputum, and tachypnea.

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35
Q

nutritional support with burn injury is to

A

decrease catabolism.

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36
Q

what helps skin healing & prevents hypertrophied tissue from forming

A

continuous-compression wraps

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37
Q

During the initial assessment of burn victim, look for evidence of inhalation injury.
Once oxygen saturation and respirations are determined, -___________ is evaluated.

A

pain intensity

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38
Q

Immediately after burn injury___________results from massive cell destruction.

A

hyperkalemia (excessive K+)

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39
Q

_________may occur later with fluid shifts and inadequate potassium replacement

A

HYPOkalemia

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40
Q

main concern of superficial partial-thickness burn

A

pain management

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41
Q

Is sodium level of 140 mEq/L expected during the fluid remobilization phase of a major burn

A

NO

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42
Q

A urine output of less than 30 ml/hour in a client with burns indicates

A

a deficient fluid volume.

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43
Q

Debridement is the

A

removal of necrotic tissue.

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44
Q

An escharotomy is an incision into the eschar to

A

relieve pressure on the affected area

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45
Q

Acticoat antimicrobial barrier dressings can be left in place for

A

up to 5 days

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46
Q

Silver nitrate solution is

A

hypotonic and acts as a wick for sodium and potassium

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47
Q

A disadvantage of surgical debridement is

A

bleeding

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48
Q

Cardiac dysrhythmias are common for victims of

A

electrical burns

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49
Q

The nurse is applying an occlusive dressing to a burned foot. What position should the foot be placed in after application of the dressing?

A

adduction

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50
Q

With use of silver sulfadiazine (Silvadene), the nurse should watch for

A

leukopenia 2 to 3 days after initiation of therapy. (Leukopenia usually resolves within 2 to 3 days.)

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51
Q

the client with a burn is prone to develop

A

gastric (Curling’s) ulcers.

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52
Q

Anemia develops because of

A

the heat destroying the erythrocytes.

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53
Q

The greatest volume of fluid loss occurs in the first ___to____hours after the burn, peaking by ___to___ hours.

A

24 to 36

6 to 8

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54
Q

Skin grafting is essential for

A

deep partial-thickness burns

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55
Q

Sodium deficit, potassium excess, and decreased urinary output occur in ______ phase

A

EMERGENT

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56
Q

Rehabilitation begins immediately after

A

the burn has occurred and often extends for years after injury

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57
Q

Which phase has a duration From onset of injury to completion of fluid resuscitation

A

Emergent/resuscitative

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58
Q

Which phase has a duration From beginning of diuresis to near completion of wound closure

A

Acute/intermediate

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59
Q

Which phase has a duration From major wound closure to return to individual’s optimal level of physical and psychosocial adjustment

A

Rehabilition

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60
Q

Decreased peristalsis and bowel sounds are manifestations of

A

Paralytic ileus

Paralytic ileus and dilated bowel can lead to increased abdominal pressure, which can further increase ischemia

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61
Q

A number of factors have been instrumental in reducing mortality from fire, including

A

smoke alarms, carbon monoxide detectors, safer appliances for heating and cooking, flame-resistant materials, child-resistant lighters, and sprinkler systems

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62
Q

First-degree burns are superficial injuries that involve

A

only the outermost layer of skin

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63
Q

Second-degree burns involve the

A

entire epidermis and varying portions of the dermis

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64
Q

blister formation

A

Second-degree burns

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65
Q

Third-degree (full-thickness) burns involve

A

total destruction of the epidermis and dermis and, in some cases, destruction of underlying tissue.

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66
Q

Fourth-degree burns (deep burn necrosis) are those injuries that extend into

A

deep tissue, muscle, or bone

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67
Q

cellular death occurs in which zone

A

inner

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68
Q

(see full question) Which of the following is the key sign of onset of ARDS?
Stridor
Hypoxemia

A

Hypoxemia

69
Q

scalds and flash flames are a _____________ burn

A

deep partial-thickness burn

70
Q

electrical current or prolonged exposure to hot liquids cause a ________ burn

A

Full-thickness burns

71
Q

Following a burn injury, which of the following areas is the priority for nursing assessment?

a) Cardiovascular system
b) Pain
c) Pulmonary system
d) Nutrition
A

Pulmonary system

Explanation:
Airway patency and breathing must be assessed during the initial minutes of emergency care. Immediate therapy is directed toward establishing an airway and administering humidified 100% oxygen. Pulmonary problems may be caused by the inhalation of heat and/or smoke or edema of the airway. Assessing a patent airway is always a priority after a burn injury followed by breathing. Remember the ABCs

72
Q

Cushing syndrome can be caused by which condition that we learned about in chapter 60?

A

hirsutism: the condition of having excessive hair growth

73
Q

Which skin layer is the outermost layer of stratified epithelial cells

A

epidermis

74
Q

Which layer is composed predominantly of keratinocytes

A

epidermis

75
Q

The epidermis layer is almost completely replaced every

A

3-4 weeks

76
Q

Production of melanin is controlled by ________ secreted from the _______?

A

a hormone secreted from the hypothalamus

77
Q

What is the true skin?

A

DERMIS

78
Q

What makes up the largest portion of the skin?

A

DERMIS

79
Q

provides strength and structure to the skin

A

DERMIS

80
Q

the innermost layer of the skin

A

subcutaneous

81
Q

The subcutaneous tissues and the amount of fat deposited are important factors in body

A

temperature regulation.

82
Q

what is the growth phase

A

anagen

83
Q

how long does the anagen phase last on the scalp

A

6 years, whereas the

telogen or resting phase lasts approximately 4 months

84
Q

Hair quantity and distribution can be affected by

A

endocrine conditions.

85
Q

fingernails grow _____ daily

A

0.1 mm

86
Q

finger nail renewal is

A

170 days

87
Q

toenail renewal is

A

12-18 months

88
Q

Sweat glands are found in the skin over most of the body surface, but they are most heavily concentrated in

A

the palms of the hands and soles of the feet.

89
Q

Only the _____ ______ _____ ______ are devoid of sweat glands.

A

glans penis, the margins of the lips, the external ear, and the nail bed

90
Q

The eccrine sweat glands are found

A

in all areas of the skin.

91
Q

_______ is released from eccrine glands

A

sweat

92
Q

The rate of sweat secretion is under the control of

A

the sympathetic nervous system.

93
Q

Which is larger: apocrine or eccrine?

A

apocrine

94
Q

The apocrine sweat glands are located in

A

in the axillae, anal region, scrotum, and labia majora.

95
Q

Apocrine glands produce

A 
milky sweat 
(that is sometimes broken down by bacteria to produce the characteristic underarm odor.)
96
Q

which glad becomes active at puberty

A

apocrine

In women, they enlarge and recede with each menstrual cycle.

97
Q

what is the outer layer of the epidermis

A

The stratum corneum

98
Q

During immersion in water, the skin can accumulate water up to

A

three or four times its normal weight

99
Q

What is the transfer of heat to another object of lower temperature situated at a distance.

A

radiation

100
Q

What s the transfer of heat from the body to a cooler object in contact with it.

A

conduction

101
Q

What consists of movement of warm air molecules away from the body

A

convection

102
Q

The total blood circulated through the skin is approximately _______/min

A

450 mL

103
Q

Blood flow through skin vessels is controlled primarily by

A

the sympathetic nervous system

104
Q

Sweating does not occur until the core body temperature exceeds

A

37°C (98.6°F)

105
Q

Vitamin D is essential for preventing

A

osteoporosis and rickets,

(people need 5 to 30 minutes of sun exposure twice a week)

106
Q

what meds increase the damage that results from sun exposure

A

antihistamine, antibiotic, and diuretic agents

107
Q

bright red “moles” are AKA

A

cherry angiomias

108
Q

Lentigines are

A

freckles

109
Q

Spider angiomas is a_________ lesion

A

vascular

110
Q

Xerosis is

A

dryness

111
Q

yellowish waxy deposits on upper and lower eyelids is

A

Xanthelasma

112
Q

what techniques commonly used in examining the skin

A

Inspection and palpation

113
Q

Secondary lesions result from

A

changes in primary lesions

resulting from external causes, such as scratching, trauma, infections, or changes caused by wound healing

114
Q

MACULE:
characteristic?
size?
ex?

A

flat,

115
Q

PAPULE:
characteristic?
size?
ex?

A

elevated, less than 0.5 cm, wart, psoriasis

116
Q

PLAQUE
size?
ex?

A

> 0.5 cm,

EX:Psoriasis, actinic keratosis

117
Q

NODULE:
characteristic?
size?
ex?

A

0.5–2 cm; circumscribed, Lipoma, squamous cell carcinoma, poorly absorbed injection, dermatofibroma

118
Q

TUMOR:
size:
characteristic

A

1–2 cm;

tumors do not always have sharp borders, Larger lipoma, carcinoma

119
Q

VESICLE
size
ex

A

less tham 0.5mm bulla, Circumscribed, elevated, palpable mass containing serous fluid

120
Q

BULLA

A

> 0.5 cm,

Pemphigus, contact dermatitis, large burn blisters, poison ivy, bullous impet

121
Q

PUSTULE
characterisitc
ex

A

Pus-filled vesicle or bulla

Acne, impetigo, furuncles, carbuncles

122
Q

Chapped lips is an ex of

A

fissure

123
Q

Dandruff, psoriasis, dry skin, pityriasis rose

are examples of

A

scales

124
Q

impetigo, herpes, eczema are examples of

A

crust

125
Q

Hypertrophied scar tissue secondary to excessive collagen formation during healing; elevated, irregular, red Greater incidence among African Americans

A

keloid

126
Q

Thin, dry, transparent appearance of epidermis; loss of surface markings; secondary to loss of collagen and elastin; underlying vessels may be visible

A

atrophy

127
Q

Thickening and roughening of the skin or accentuated skin markings that may be secondary to repeated rubbing, irritation, scratching Contact dermatitis

A

LICHENIFICATION

128
Q

Skin moisture, temperature, and texture are assessed primarily by

A

palpation

129
Q

Edema is indicated when the skin appears

A

tense and shiny,

when a finger gently pressed into the skin leaves an indentation or “pit.”

130
Q

Beau’s lines in the nails may reflect

A

retarded growth of the nail matrix because of severe illness or, more commonly, local trauma.

131
Q

Pitted surface of the nails is a definite indication of

A

psoriasis

132
Q

Spoon-shape nails can indicate

A

a severe iron deficiency anemia.

133
Q

Clubbing
can occur from?
manifested by?

A

can occur from hypoxia,

is manifested by a straightening of the normal angle

134
Q

PETECHIA
description
size
secondary to

A

PETECHIA (PL. PETECHIAE)
Round red or purple macule
Small (1–2 mm)
Secondary to blood extravasation

135
Q

Oily hair is usually caused by increased secretion from the

A

sebaceous glands close to the scalp

136
Q

The most common cause of hair loss is

A

male pattern baldness
(i.e., androgenic alopecia)
Androgen is necessary for male pattern baldness to develop.

137
Q

_________ signs may be the first manifestation of human immunodeficiency virus (HIV)

A

cutaneous signs

appearing in more than 90% of HIV-infected (Low CD4 count

138
Q

Biopsies are performed on ____ _____ ____ _____ to rule out ________ and to establish _______

A

skin nodules, plaques, blisters, and other lesions

to rule out malignancy and to establish an exact diagnosis.

139
Q

The Tzanck smear is a test used to examine cells from blistering skin conditions, such as

A

herpes zoster, varicella, herpes simplex, and all forms of pemphigus

140
Q

The nurse is caring for a patient with dark skin who is having gastrointestinal bleeding. How can the nurse determine from skin color change that shock may be present?

A

The skin is ashen gray and dull.

141
Q

What is the application of extreme cold to destroy tissue

A

Cryosurgery

142
Q

Patch test reactions include

A

*Blisters
• Pain
• Ulceration

143
Q

Pallor is the absence of or a decrease in normal skin color and vascularity and is best observed in ______

A

the conjunctivae or around the mouth.

144
Q

Skin scrapings are used to diagnose

A

spores and hyphae

145
Q

Cherry red nail beds, lips, and oral mucosa in a dark-skinned person are signs of

A

carbon monoxide poisoning.

146
Q

The production of melanin is controlled by a hormone secreted from the

A

hypothalamus

147
Q

What is the primary function of sebum?

A

Prevents drying and cracking of the skin and hair

148
Q

______ are small red or purple macules, usually 1 to 2 mm in size, associated with bleeding tendencies

A

Petechiae

149
Q

Possible carbon monoxide poisoning in a dark skinned individual..

A

Cherry red color to the nail beds, lips, and oral mucosa

150
Q

Production of melanin is controlled by a hormone secreted by which of the following?

A

Hypothalamus

151
Q

Shock due to decreased perfusion and vasoconstriction is indicated in black skin as

A

ashen gray, dull appearance.

152
Q

a skin lesion that is elevated, round, and filled with serum is a

A

vesicle

153
Q

Photochemotherapy involves a combination of psoralen methoxsalen and type A ultraviolet light. The psoralen methoxsalen is taken 1 to 2 hours before exposure to ultraviolet A. What problem is this used to treat?

A

psoriasis

154
Q

what kind of lesion is a spider angioma?

A

vascular

155
Q

A patient diagnosed with Addison’s disease would be expected to have which of the following skin pigmentations?

a) Gray 
b) Bronze 
c) Yellow 
d) Orange-green
A

bronza

156
Q

To detect cyanosis in persons with dark skin, the nurse should assess which of the following areas?

A

oral mucosa

157
Q

Pitted surface of the nails is a definite indication of

A

psoriasis

158
Q

Solar lentigo refers to

A

liver spots

159
Q

Which type of heat loss is caused by a cool breeze that blows across the body surface?

A

convection

160
Q

which hair growth is the most rapid

A

beard.

followed by hair on the scalp, axillae, thighs, and then eyebrows.

161
Q

Which layer of the skin is made of primarily adipose tissue?

A

subcutaneous

162
Q

The dermis is made up of

A

blood, lymph vessels, nerves, sweat and sebaceous glands, and hair roots

163
Q

The epidermis contains ___ ___ ___ cells

A

Merkel cells, Langerhan cells, and melanocytes

164
Q

Blood vessels and sweat glands are found in the

A

dermis

165
Q

Petechiae are associated with which of the following disorders?

A

thrombocytopenia

166
Q

evaporation, called insensible perspiration, amounts to approximately _____ daily in an average-sized adult

A

600 mL

167
Q

Petechiae are associated with

A

bleeding tendencies or emboli to the skin

168
Q

Spider angioma is associated with

A

liver disease, pregnancy, and vitamin B deficiency.

169
Q

Telangiectasia is associated with

A

venous pressure states.

Med Surg & OB (3 decks)

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