integ

Question 1

for integ, what is done during evaluation and treatment

Answer 1

observation of skin
noting of abnormalities
documentation of this

Question 2

things that are examined in skin

Answer 2

integrity - intact vs not
color
scar formation
hair/nail growth

Question 3

what is hair/nail growth indicative of

Answer 3

healthy dermis with adequate circulation

Question 4

what could cause skin to not be intact

Answer 4

decubitus - pressure ulcers
opening skin injuries
surgical incisions
burns/frostbite

Question 5

what should be documented with surgical incisions

Answer 5

location, length
# of staples/sutures
wet/dryness
oozing or not
bandage condition

Question 6

how to document wound location

Answer 6

precise anatomical terminology
wound relations to anatomical landmarks
side and body surface of lesion

Question 7

what characteristics of wounds will be measured

Answer 7

location / size

Question 8

how are burn sizes calculated typically

Answer 8

rule of 9s
% of total body surface

Question 9

what is the difference between turgor in young vs old adults

Answer 9

young - no delay before rebound
old - delay before rebound

Question 10

what are age related skin changes

Answer 10

thinning
translucent
pale

Question 11

what are characteristics of integumentary integrity

Answer 11

structure and quality
color
epithelial appendages

Question 12

what is associated with structure/quality of integ

Answer 12

age-related skin changes
periwound hydration
turgor
quality of skin - dry/scaly vs moisturized
scar formation

Question 13

what could be affected around a wound

Answer 13

skin color
- erythema / hemosiderin staining

Question 14

what is hemosiderin staining indicative of

Answer 14

longstanding vascular disease as RBC leak out of circulation

Question 15

what is bluish periwound color indicative of

Answer 15

long standing ischemia

Question 16

if there is a periwound blueish tint, will there be epithelial appendages

Answer 16

no, they cannot support hair/nail growth

Question 17

what is a sign of arterial insufficiency

Answer 17

shiny hairless, pigmented skin

Question 18

during vascular exam, what should you inspect

Answer 18

symmetry of limbs
skin color, size, shape
edema
ulcerations
varicosities

Question 19

what causes edema

Answer 19

acute injury response
retention of salt and water
venous stasis
right heart failure
hypoalbumienemia
lymphedema
increased capillary permeability
orthostatic edema

Question 20

salt and water retention can cause

Answer 20

dependent edema due to increased interstitial fluid

Question 21

what is venous stasis

Answer 21

obstruction of veins that can lead to edema

Question 22

what are characteristics of right heart failure

Answer 22

decreased heart pumping
increased hydrostatic pressure
dependent edema
jugular vein distention
enlarged liver

Question 23

what is kwashiorkor disease? what is it an example of?

Answer 23

severe protein malnutrition that causes abnormal swelling in the extremities and abdomen

hypoalbumienemia

Question 24

what is associated with Hypoalbumienemia

Answer 24

decreased osmotic pressure
feet, leg, eyelid edema initially
common w/ poor nutrition (decreased protein)
more typical in poor countries, especially infants

Question 25

what are characteristics of lymphedema

Answer 25

damaged, obstructed, inflamed or fibrosed lymph vessels causing pitting/non-pitting edema in an extremity

Question 26

what causes increased capillary permeability

Answer 26

burns, allergies, inflammation

Question 27

what will increased capillary permeability lead to

Answer 27

local / dependent edema

Question 28

what are characteristics of orthostatic edema

Answer 28

sitting/standing for a long time little muscle contraction dependent edema

Question 29

what is pitting vs non pitting edema

Answer 29

pitting - accumulation of interstitial fluid that causes a pit when pressure is applied "not easily moved away from pressure"

Question 30

how to test edema

Answer 30

press for 5-10 sec measure time it takes to respond

Question 31

how to document edema

Answer 31

location: ____ cm below landmark, 1+ to 4+ scale and type of edema

Question 32

what # mm are related to pitting edema scale

Answer 32

1+ = <2 mm 2+ = 2-4 mm 3+ = 5-7 mm 4+ = >7 mm

Question 33

what is the verbal descriptor of edema

Answer 33

1+ = barely perceptible depression 2+ = easily identifiable, rebounds in <15 sec 3+ = rebounds in 15-30 sec 4+ = depression lasts >30 sec

Question 34

what are measurements of edema

Answer 34

circumferential or volumetric method

Question 35

what is important to remember for edema test and measures

Answer 35

to measure non-injured extremity for comparison

Question 36

what are linear measurements of edema

Answer 36

tape measure recordings of girth at predetermined landmarks

Question 37

what is the reference point for the forefoot

Answer 37

MTP joints

Question 38

what is the reference point for the midhand

Answer 38

proximal palmar crease

Question 39

what is the reference point for the forearm

Answer 39

ulnar styloid process

Question 40

what is the reference point for the mid-calf / distal thigh

Answer 40

lateral malleolus tibial tuberosity

Question 41

what are the marked locations for the figure 8 pattern of ankle edema measurements

Answer 41

navicular tuberosity base of 5th metatarsal distal tip of lateral malleolus distal tip of medial malleolus tibialis anterior tendon

Question 42

process of figure 8 ankle edema measurements

Answer 42

1. start tape measure mid-way between tib ant tendon and lateral malleolus at anterior aspect of ankle 2. wrap medially to pass the navicular tuberosity through the arch and proximal to base of 5th metarsal 3. loop back around to tib ant tendon distal to distal tip of medial malleolus 4. encircle achilles tendon and placed distal to distal end of lateral malleolus 5. measurement ends at start of tape

Question 43

increased periwound temperature indicates

Answer 43

inflammation, infection or impaired circulation

Question 44

what is temperature recorded as? in comparison to what

Answer 44

increased, decreased, or normal as compared to contralateral/intact side

Question 45

contralateral difference of greater than ______° indicates

Answer 45

4 clinically significant

Question 46

when considering temperature of skin, what are some considerations

Answer 46

allowing skin to normalize to room temperature

Question 47

how can skin be normalized to room temperature

Answer 47

uncovered for 5 min prior to evaluation if using hand uncovered for 15 min prior to using thermographer

Question 48

how assess skin temperature by hand

Answer 48

back of the hand assess proximal skin and contralateral side

Question 49

what is xeroderma? what are its characteristics / what worsens it?

Answer 49

excessive dryness of the skin rough and scaly worsens with dry climates, soaps, drying skin cleaners

Question 50

who is at risk of xeroderma

Answer 50

older adults due to dehydration, thinning skin

Question 51

what is eczema/dermatitis

Answer 51

superficial inflammation that is more common in older adults

Question 52

what causes eczema and dermatitis

Answer 52

hypoproteinemia venous insufficiency allergens, irritants underlying malignancy drug interaction

Question 53

what are examples of bacterial skin infections

Answer 53

impetigo pyoderma folliculitis

Question 54

what are examples of viral skin infections

Answer 54

warts shingles herpes simplex

Question 55

what are examples of fungal skin infections

Answer 55

ringworm athletes foot jock itch

Question 56

what are some "other" skin infections

Answer 56

scabies lice

Question 57

how to judge skin cancer

Answer 57

A - asymmetry B - border C - color D - diameter E - evolving

Question 58

what are colors associated with skin cancer

Answer 58

black, brown, red, white, pink, blue

Question 59

what diameter is noted as possible skin cancer

Answer 59

wider than a pencil eraser

Question 60

what types of psoriasis are there

Answer 60

chronic inherited recurrent non-infectious