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NUR372 > Integ > Flashcards

Integ Flashcards

1
Q

epidermis

A

outer layer

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2
Q

dermis

A

middle layer that has a lot of collagen and elasticity

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3
Q

subcutaneous tissue

A

fat tissue

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4
Q

Age Related Change

A

color and texture changes, thinning of layers, loss of elasticity, impaired wound healing, pressure changes

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5
Q

What does this mean in terms of nursing interventions and patient teaching?

A

limit tears, paper tape, adhesive removal help

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6
Q

ABCDE assessment

A 
A-asymmetry
B-Border irregularity
C- Color variation
D- diameter
E- Evolving/changing features
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7
Q

Hirsutism

A

Excessive growth of body hair due to hormonal imbalance or side effect of drug therapy

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8
Q

punch biopsy

A

small circle of tissue is removed (only a few mm)

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9
Q

shave biopsy

A

remove only part that rises above the surrounding tissue

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10
Q

Excisional biopsy

A

for large deep specimens and closed up with sutures (less common)

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11
Q

Skin trauma

A

goal is to restore skin tissue integrity

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12
Q

First intention

A

Edges brought together with skin lined up in approximated position

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13
Q

Second intention

A

Granulation and contraction; deeper tissue injury or wound

don’t approximate the edges ourself

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14
Q

Third intention

A

Delayed closure; high risk for infection with resulting scar

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15
Q

Partial-Thickness Wounds

A

Damage to epidermis, upper layers of dermis

Heal by re-epithelialization within 5 to 7 days

injury followed by local inflammation

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16
Q

Full-Thickness Wounds

A

Damage extends into lower layers of dermis, underlying subcutaneous tissue

heals from bottom up

contraction develops in healing process

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17
Q

Pressure Ulcers or Pressure Injuries

A

Compression of skin and underlying soft tissue between bony prominence and external surface for extended period

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18
Q

3 mechanical forces for pressure ulcers

A

pressure
friction
shear

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19
Q

capillary closing pressure

A

with a certain amount of pressure these collapse

reduce blood flow to that area

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20
Q

patients with pressure ulcers need what kind of diet to help

A

high protein diet

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21
Q

Pressure Ulcer Prevention

A

Identify high-risk patients earl

Implement aggressive intervention of prevention with pressure relief devices

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22
Q

braden scale

A

likelihood to get pressure ulcers

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23
Q

Pressure-Relieving Techniques

A

rotate
floating heels
sliding board
positioning- move frequently

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24
Q

Dynamic systems

A

alternate inflation and deflation

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25
Q

Static devices

A

constant state of inflation

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26
Q

Stage 1 pressure ulcer

A

skin intact
reddening, does not blanch(turn white)
discoloration
feel for texture change

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27
Q

Stage 2 pressure ulcer

A

Skin not intact

partial thickness skin loss

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28
Q

Stage 3 pressure ulcer

A

no bone, tendon, or muscle should be exposed

may have undermining and tunneling
full thickness skin loss

29
Q

Stage 4 pressure ulcer

A

Bone, tendon, muscle exposed

slough and eschar often present

crater like appearance

30
Q

contamination

A

Presence of organisms without infection

always contaminated, not always infected

31
Q

infection

A

Pathogenic organisms grow and spread, cannot be controlled by body’s immune defenses

32
Q

If a patient has a wound what should be increased?

A

calories
fluid
protein

33
Q

nonsurgical management

A

dressings, nutrition therapies, VAC

34
Q

Pruritis

A

itching

break the itch-scratch-itch cycle
caused by allergic reactions, systemic disorders

35
Q

Treatment for pruritis

A

Cool sleeping environment

Fingernails should be trimmed short

Antihistamines

Topical steroids

Prevent dry skin—apply lotion or emollients after bath/shower

Patient teaching: DON’T SCRATCH

36
Q

Urticaria(hives)

A

presence of white or red edematous papules or plaques of varying sizes

37
Q

Treatment for urticaria

A

Removal of triggering substance

Antihistamines helpful

Avoid overexertion, alcohol consumption, and warm environments, which can worsen symptoms

38
Q

Folliculitis

A

superficial infection involving only upper portion of follicle

39
Q

furuncle(boil)

A

much deeper infection in the follicle

40
Q

Cellulitis

A

generalized infection with staph or strep involving deeper connective tissue

can lead to sepsis

41
Q

MRSA

A

contact precautions

wash hands before and after contact

don’t share items

wash clothes in hot water

vancomycin, clindamycin, zyvox

42
Q

Cutaneous Anthrax

A

Caused by spores of bacterium Bacillus anthracis

treat with oral antibiotics: 60 days

most likely seen with people who work with animals

43
Q

How is a anthrax diagnosed?

A

positive culture

presence of anthrax antibodies

44
Q

Herpes simplex virus (HSV)

A

cold sores, raised vesicles

most common on lips and mucous membranes, can occur on hands

45
Q

Herpes Zoster(shingles)

A

varicella zoster lives in your nerves and comes out later

most often its older adults

contagious to people who have not had the vaccine or has not had chicken pox

46
Q

Dermatophyte infections

A

“tinea”

47
Q

tinea capitis

A

infection of the scalp

48
Q

Interventions for Common Skin Infections

A

skin care with proper cleansing

contact precautions(MRSA, shingles)

drug therapy

49
Q

candida

A

yeast

50
Q

Parasitic disorders

A

Pediculosis (lice)
Scabies
Bedbugs

51
Q

Pediculosis

A 
Infestation of LICE
Head lice (capitis)
Body lice (corporis)

wash all clothes and linens

permethrin 5% is effective to get rid of lice
contagious

52
Q

scabies

A

linear burrow

ointment

53
Q

Contact dermatitis

A

Acute or chronic rash caused by direct contact with irritant or allergen causing immune reaction

“don’t buy cheap jewelry”

54
Q

Atopic dermatitis

A

Chronic rash occurring with allergies made worse by dry skin, chemicals, or stress

severe reaction, happens more quickly

55
Q

Psoriasis

A

Chronic autoimmune disorder affecting skin; exacerbations and remissions for life

raised plaque formation

56
Q

Exfoliative psoriasis

A

eruptive inflammatory form that is much more rare

57
Q

psoriasis is the overstimulation of the immune system that causes

A

increased cell division and plaque formation

58
Q

treatment for psoriasis

A 
Corticosteroids
Tar preparations
Ultraviolet light therapy
Systemic therapy 
Emotional support
59
Q

Skin Cancer

A

HEALTH PROMOTION AND PREVENTION

limit exposure to sunlight
occupational exposure

60
Q

What is needed to confirm malignancy in a tumor?

A

Biopsy

61
Q

What do we teach patients about skin cancer?

A

self examine using ABCDE guide

62
Q

Skin cancer treatment nonsurgical

A 
chemo
radiation(doesn't respond well)
63
Q

Skin cancer treatment surgical

A

Cryosurgery(freeze off)

Curettage and electrodessication (electricity)

Excision(cut the whole thing out)

Wide excision(take the whole area and more skin around it)

64
Q

sunburn

A

Superficial burn to the skin caused by UV exposure

65
Q

sunburn interventions

A

Cool baths
Lotions, aloe
Antibiotic ointments to protect from infection if blistering is present
WEAR SUNSCREEN

66
Q

Toxic Epidermal Necrolysis (TEN)

A

RARE, acute drug reaction

Peeling of skin and mucous membranes

67
Q

what do we do to treat Toxic Epidermal Necrolysis (TEN) and stevens-johnson syndrome?

A

STOP THE DRUG

treat it like a burn
prevent infection

68
Q

Stevens-Johnson syndrome

A

RARE, acute drug reaction

Macular rash that spreads and blisters, sheds, then heals

69
Q

drugs thats cause TEN

A

chemo therapy
sulfas
barbituates

NUR372 (13 decks)

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