Integument

Question 1

What are the lesions?

Answer 1

Anything on slide 3

Question 2

Secondary lesions can only occur from primary ones

True/False

Answer 2

True

Question 3

Pressure Ulcers (Slide 6)

Answer 3

Ulcers occur from prolonged unrelieved pressure, especially in bony areas. Especially happens in people who are on prolonged bedrest where there is pressure on blood vessels quite the blood flow making the area necrosed. May experience discomfort

Question 4

Friction vs Shearing forces

Answer 4

Two things rubbing against each

Shearing: one surface is moving the other isn’t; the patient being moved up and down in bed causing wear on the skin

Question 5

Moisture

Answer 5

harbors bacteria, can lead to skin breakdown

Question 6

Stages of pressure ulcers

Answer 6

Stage 1: erythema the skin is red, press on it and it stays red means this(no break in the skin)

Stage 2: top layer of skin is gone; a fluid filled blister that ruptures, superficial; area where the skin is gone

Stage 3: fatty tissue present in the wound

Stage 4: muscle is seen, bone is seen, ligament(silvery, light)

Question 7

Suspected deep tissue injury

Answer 7

the area that is discolored if it is pressed, the tissue feels mushy, skin will eventually break open; characterized by a discolored (purple or maroon)intact skin or blood-filled blister

Question 8

‘Unstageable’ Stage of pressure ulcer

Answer 8

full-thickness tissue loss with base of ulcer covered by slough or eschar, or both

Slough:

Eschar: black coating that is really hard and leathery and cant be removed (usually seen on the heel)
-these can be present on top of any of the stages of the pressure ulcer

Question 9

Preventative techniques of pressure ulcers

Answer 9

• Conducting Frequent skin assessments
• Repositioning: Min of 2 hours a patient should be repositioned
• Pressure Reduction, removal, and distribution
• Elimination of Moisture: especially for patients that are incontinent

Question 10

Risk factors for pressure ulcers

Answer 10

Don’t memorize but just look at pg 1055

Question 11

Ischemia
Malnutrition

     Causes of pressure ulcers

Answer 11

• impaired perfusion, lack of adequate blood flow

- adequate amt of proteins, vitamins, and other things vital for the body is key for skin integrity

Question 12

Pg 1059, Table 41-4

Answer 12

Comedone:

Burrow: caused by a parasite

Petechiae: ruptured capillaries(b.v), causing red dots to form
Purpura: really large bruise, purple in color, >.5cm in diameter
Telangiectasia: dilated superficial blood vessels

Question 13

Pruritis

Answer 13

Itching, this is just a symptom of of something

*chronic itching can result in infections and scarring due to persistent scratching

Question 14

What’s the most common cause of itching(pruritus)?

Answer 14

*Histamine; released by mast cells *

Question 15

What is the most common symptom of primary skin disorders?

Answer 15

Pruritus

Question 16

Dermatitis

Answer 16

Causing inflammation of the skin

Question 17

Eczema

Answer 17

the most common inflammatory disorder of the skin

Characterized by: tiny little bumps that are extremely itchy, lesions with indistinct borders, epidermal changes
**When chronic, the skin becomes thickened, leathery, and hyperpigmented from recurrent irritation and scratching

Question 18

Allergic Contact Dermatitis

Answer 18

-delayed hypersensitivity type IV reaction, caused by T-cell mediated or delayed hypersensitivity
Ex. Poison Ivy
Characterized by fluid filled bumps

Question 19

What are the manifestations of Allergic contact dermatitis?

Answer 19

Erythema, Swelling, Pruritus, Vesicular lesions

Question 20

Irritant Contact Dermatitis

Answer 20

-when the skin becomes ‘irritated’ when it comes into contact with something that they may not be allergic to but is causing a response to the skin
Could be detergent, jewelry, fabric softner, etc

Question 21

Atopic Dermatitis

Answer 21

Type 1 hypersensitivity reaction; it is an allergic dermatitis but is not caused by what the skin comes in contact with(physical) but instead mast cells releasing histamine and high levels of eosinophils(IgE antibodies(; allergies)

Question 22

Stasis dermatitis

Answer 22

always occurs in the legs as a result of venous stasis (blood in the veins that just accumulates and doesn’t move)
Characterized by a rusty, brown color. Eventually the area can break open resulting in a sore

Question 23

Treatment for Stasis Dermatitis

Answer 23

• Elevate legs as much as possible
• Avoid tight clothes around legs
• Don’t stand for long periods of time
• Antibiotics (acute lesions)

Question 24

What is Seborrheic dermatitis?

Answer 24

dandruff further classified by age group, can be on the head or any part of the body really

• Chronic inflammation of the skin
• Inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals
• Scaly, white, or yellowish plaques
• Starts in infancy and lasts to old age
• Remission/exacerbations
• Treatment:
  
  • Topical steroid

Question 25

What is psoriasis(Papulosquamous Disorders)? very common

Answer 25

• A skin disorder that is somewhat of an autoimmune problem (the body is doing it to itself)?
• with autoimmune problems, you’ll always have remissions and exacerbations
• the top of the lesion is **white, silvery and scaly ** plaques
• the epidermal skin cells turnover is too fast

Question 26

Vasiculobullous diseases

Answer 26

blister that ruptures
-Pemphigus: painful blister
-Erythema multiforme: blistering skin(the blisters pop; putting patient at risk high risk for infection) disorder
Ex stevens Johnson’s syndrome

Question 27

what are the 3 different Types of Infections

Answer 27

• Bacterial: cellulitis, necrotizing fasciitis, erysipelas, impetigo
• Fungal: tinea(ring worm infection that is contagious, characterized by “round” reddish lesions); diff types 41-10, candidiasis(yeast infection when its in the mouth its called thrush
• Viral: Herpes simplex, Herpes Zoster(can only get if you have previously had chickenpox) and varicella(chickenpox), warts

Question 28

Insect Bites

Answer 28

Scabies: mite that burrows under the skin
Pediculosis: