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Gero > Gero- skin care-chapter 13 > Flashcards

Gero- skin care-chapter 13 Flashcards

1
Q

What are the functions of skin?

A
  • Protect underlying structure (heart, lungs, bones, keep out bacteria)
  • Regulate body temp.
  • Sensory input (vehicle for sensation)
  • Store fat
  • Metabolism of salt/ water
  • Gas exchange (2 way gas exchange O2-CO2)
  • Production of vitamin in the presence of sunlight
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2
Q

What is xerosis?

A
  • Extremely dry, cracked, and itchy skin (due to dryness)
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3
Q

What is the most common skin problem associated with aging?

A

Xerosis

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4
Q

What causes xerosis?

A

decrease in epidermal filaggrin, which is a protein required for binding of keratin into macrofibrils (leads to separation of the dermal/epidermal surfaces compromising nutrients transfer between skin)

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5
Q

Where xerosis found?

A

Mostly on the legs, may affect trunk and face

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6
Q

What is pruritis?

A

Itchy skin (symptom of dry skin)

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7
Q

What does pruritis cause?

A

Skin injury secondary to scratching b/c of paper-like skin

Leads to increase risk for eczema, excoriations, cracks, and infection

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8
Q

What aggravates (do not use) pruritis?

A

perfumed detergents, fabric softeners, heat, sweating, restrictive clothing, fatigue, exercise, and medications

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9
Q

What systemic diseases cause pruritis?

A

Chronic renal failure
Biliary Disease
Hepatic disease

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10
Q

What interventions are done to treat pruritis?

A
  • 60% humidity
  • fluid intake (water rehydrates the skin)
  • Creams, lubricants, emollients (towel-patted dry/ damp skin after bath), water-laden emulsions w/o alcohol or perfume
  • Mineral oils and Vaseline
  • Tepid water for bathing or sponge bathing (short durations)
  • Use super-fatted soaps (dove, cetaphil, caress, Neutrogena, Oil of Olay bath washes)
  • Petroleum Jelly (applied to affected areas before bed)
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11
Q

What is Scabies?

A
  • Pink dots on skin that in circles things like the wrist, knee, ankles, most often around the waste no need to scrape skin (visible).
  • Contagious, easily transmitted through close physical contact, intimate or casual, clothing , linen, furniture.
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12
Q

What causes scabies?

A

Sarcoptes Scabiei

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13
Q

How do you treat scabies?

A
  • Treated ONCE with prescribed lotions and creams
  • Clothing/Linens must be washed in hot soapy water and dried with high heat.
  • Rooms must be cleaned, vacuumed, and wiped down
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14
Q

What is purpura?

A
  • blood vessel have gotten fragile their thinning we do not have as much blood flow to skin so they are easier to rupture
  • little purple dots seen on dorsal forearms and hands (sometimes on face and over eyelids)
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15
Q

Who are susceptible for Purpura?

A

Person on BLOOD THINNERS (anticoagulants)

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16
Q

What causes skin tears?

A
  • Skin is thin and fragile
  • pain, acute, accidental in nature (falls/moving pt.)
  • skin shear/tears (if patient on anticoagulants they will bleed uncontrollably)
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17
Q

How are skin tears categorized?

A

Payne-Martin Classification system

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18
Q

How do you manage skin tears?

A
  • Proper assessment
  • Control of bleeding
  • Cleanse with nontoxic solution
  • Appropriate dressing
  • Manage exudate
  • prevention of infection/wounds
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19
Q

What are common preventions of skin tears?

A
  • Non adherent dressings
  • Lubricants (hypoallergenic)
  • Wearing long sleeves/pants on extremities
  • Use non-rinse bathing products
  • Hydration/nutrition
  • Use lift sheet to turn patient.

(what you put on know how to take it off tegaderm, paper tape…etc think of skin being paper thin)

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20
Q

What is keratosis?

A

Benign growth (non cancerous)

Mainly seen on trunk, face, and neck

White, Waxy, stuck on appearance

Flesh colored, pigmented, various sizes

21
Q

What is Actinic keratoses?

A
  • Precancerous
  • age-related light colored complexion
  • rough scaly and paper-like
  • pink-to- reddish brown w/ erythematous base
22
Q

What is herpes zoster (shingles)?

A
  • reactivation of varicella-zoster (chicken pox) virus
  • itching, tingling, rash w/ dermatome prior to outbreak of vesicular lesions
  • lesions rupture (infectious), crust over (non-infectious), heal (only on one side either left or right unilateral following dermatome only from front-back & back to front)
23
Q

What cause herpes zoster (shingles) to reactivate?

A
  • stress (emotional or physical) by other illnesses
24
Q

What treatments are used for Herpes Zoster (Shingles)?

A
  • analgesics, calamine lotion, antiviral agents( causes liver toxicity impact liver function), Zoster vaccine in patients > 60 yrs.
25
Q

If left untreated (Herpes Zoster) what complications arise?

A
  • postherpetic neuralgia, eye involvement

- get patient to optomologist immediately (notify provider)

26
Q

What causes Candidiasis (Yeast)?

A
  • fungus Candidas albicans found on the skin
27
Q

What are the risk factors for Candidiasis? (may be a select all that apply)

A
  • Obesity
  • malnourishment
  • Antibiotics (knock out the good bacteria instead of bad)
  • Steroid use (will feed the bacteria)
  • Immunocompromised
  • Chemotherapy
  • Diabetes (diabetics)
28
Q

Where is candidiasis found?

A
  • warm, moist areas of skin, like skin fold, axilla, groin

- breast of females/larger males

29
Q

Prevention/Treatment of Candidiasis?

A
  • Provide adequate drying (hair dryers in low setting for hard-reach areas)
  • Dry folded washcloth or cotton sanitary pad (under breast/skin folds)
  • Loose fitting underwear/clothing (Damp? change!)
  • Avoid incontinent products that are tight/touches skin
  • Optimize nutrition/glycemic control
  • Treatment: Anti-fungal creams especially OTC use 7-14 days or until symptoms subside
  • AVOID POWDERS, CREAMS, LOTIONS
30
Q

What is the most common cancer?

A
  • Cancer of the skin
  • Caucasian population at higher risk (all skin types can get it)
  • Minimize sun exposure
  • 2.5 times more likely to develop before age 35
31
Q

What is basal cell?

A
  • mainly in older people
  • slow growing metastasis rare
  • triggered by extensive sun exposure/burns
  • early detection/treatment minimizes damage
  • 1.5 times more likely to develop before age 35
32
Q

What is squamous cell?

A
  • aggressive/high incidence metastasis
  • Risk factor: sun exposure, skin (fair),
  • immunosuppression
  • maybe overlooked
  • treatment: depends on size, histology, presentation
33
Q

What is Melanoma?

A
  • Neoplasm of Melanocytes

- Highest in caucasians

34
Q

How’s does Melanoma presents?

A
  • Multicolored, raised, asymmetrical, irregular borders (may not have completely round shape)
  • let provider know
  • most common In men
  • most common cancer in people less than 30 years
35
Q

What are risk factors for Melanoma?

A
  • more than 50 moles
  • sun sensitivity
  • history of excessive sun exposure
  • severe sunburns
  • tanning beds (increase risk by 75% when started before age 35)
36
Q

What are the danger signs of melanoma?

A

A- Asymmetry of mail (one that is not regularly round/oval)
B- Border irregular
C- Color variation (area of black, brown, tan, blue, red, white, or combination)
D- Diameter greater than size of pencil eraser
E- Elevation and enlargement

37
Q

What are pressure ulcers?

A

“localized injury” over bony prominence (sacrum, lateral ankles, lateral knees, heels(25-35%), greater trochanter, pinna of ear, occiput, scapulae, elbows where weight comes down on the bony areas (bed/chair), as a result from pressure, or pressure combines with shear.

  • pressure injury take up body’s energy and ability to heal
  • major cause of morbidity/ mortality worldwide
  • person w/ PVD at greater risk of PU
  • If PU is found on heels (get heels off of bed, tint blanket)
38
Q

What is Stage I PU?

A

Red, purple, discoloration of INTACT SKIN

39
Q

What is Stage II PU?

A

Red discoloration of skin with OPEN AREAS (first layer of skin broken-epidermis)

40
Q

What is Stage III PU?

A

EXCORIATED, red, SANGUINEOUS TISSUE

41
Q

What is Stage IV PU?

A

ULCER showing MUSCLE

42
Q

What is Unstageable?

A

BLACK NECROSIS IN CENTER

43
Q

How are pressure injuries classified?

A

-Highest stage achieved although it is getting better it is still considered the stage it was prior.

-

44
Q

What are the risk factors for PU?

A
  • Changes in skin
  • Comorbid illnesses
  • Nutrition Status
  • Frailty
  • Surgical procedure (orthopedic/cardiac)
  • Cognitive deficits
  • Incontinence
  • Reduced mobility
  • Consider intensity and duration of pressure and tissue tolerance (How long can that person sit in position before skin become negatively effected)
  • Redness or blanching may NOT be the first sign of PU in darker pigmented persons, but may look purplish incisor or look like a bruise
45
Q

What is the treatment for PU?

A
  • Prevention:

+ position patient q2hrs use a draw sheet (prevent shear and friction) / soft pillow between knees and other bony prominences.
+ Assess the skin during activities, moving patient, bathing, change briefs …etc

  • Intervention: addressing limited mobility, compromised skin integrity, and nutritional support
  • Team approach (Multiple people)
46
Q

What scale do you use to assess the skin?

A 
Braden Scale 
Nutritional Evaluation 
Positioning 
Incontinence Care 
Wound Specialist (call at stage I for early prevention)
Labs
47
Q

Why is skin the nursing sensitive quality indicator?

A
  • maintenance of skin is an indicator of if pt’s are receiving quality care or not.
  • impair recovery and rehabilitation (think about pt. w/ knee sepsis it impaired his recovery and prolonged rehabilitation)
  • increase of mortality (death)
  • medicare/medicaid do not reimburse treatment for PU acquired during admission
48
Q 
Which is the most common malignant skin cancer?
Melanoma 
Squamous 
Basal
Actinic keratosis
A
  • Basal Cell carcinoma (How?)
49
Q 
What is the #1 treatment for PU?
Prevention 
Early Identification
Thorough patient history 
Risk assessment
A
  • Prevention (How?)

Gero (7 decks)

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