Integumentary Flashcards
what are wounds
break or opening in the skin
factor sthat delay wound healing
think “ DID NOT HEAL”
drugs infection ischemia diabetes nutrition oxygen toxins hyperthermia/hypothermia ETOH - ethanol acidosis local anesthetics
and then meds and age
- immunosuppressants and corticosteroids
primary intetnion
method of wound healing
used when wound edges can be closed by stitches, staples skin glue or steri strips
secondary intention
method of wound healing
cannot be brought together by wound edges
- example: pressure ulcers
wound healing occurs through slow, gradula filling in lost tissue
tertiary intetnion
when a delay in closing the wound is NEEDED to allow for drainage and swelling to subside
surgical debridement, skin grafts and flaps are additional interventions used for certain wounds
wound management
successful wound management includes:
- removing or eliminating causative factors, preventing infection, using the appropriate type of dressing and ensuring systemic support
maintain adequate hydration and nutrition
what is atopic dermatitis
chronic, inhertied skin disorder
eczema
exacerbated by stress and certain foods
atopic dermatitis manifestation
acute:
- dry skin
- itching
- erythema
- macules
- papules
- pustules and/or vesicles
subacute and chronic stages:
- scaly, dry skin
- skin color changes
- lichentification: thickened or leather like areas
atopic dermatitis diagnostic studies
med history
physical exam
skin biopsy
allergy skin testing
atopic dermatitis nursing management
lubriacation of dry skin
administration of corticosteroids, topical immunomodulators
stress reduction
phototherapy when inflammation is severe
antibiotics for secondary infections
soaking the hands in lukewarm water will debrider the crust and scales and soft the skin
what is seborrheic dermatitis
recurrent inflammatory reaction of the skin that causes flaky, white to yellowish scales to form on oily areas like:
- scalp
- external ear canal
aka: dandruff or “cradle cap” in infants
seborrheic dermatitis manifestation
observe non-pruritic, oily scales on scalap, forehead and eyebrows or behind ears
seborrheic dermatitis nursing management
cradle cap in infants:
- massage baby’s scalp gently with your gfingers or soft brush
- shampoo daily with mld baby shampoo
- use hydrating creams or mineral oils
dandruff:
- recommended OTC or medicated shampoos
- prescription or lotions are available to severe cases
what is incontinence associated dermatitis
aka diaper rash
incotinence associated dermatitis nursing management
maintain perineal skin integrity
minimize episodes of incontinence
treat any underlying cause of loose stools
apply barrier cream.ointment
treat any underlying skin infections
prompt changing of wet, soiled clothing or incontinence products
using a fecal management system if appropriate
ensuring adequate hydration and nutrition
supporting diligent perineal hygiene with pH-based cleansers
what is contact dermatitis
inflammatory reaction of the skin to a chemical substance, whether natural or synthetic
ex: posison ivy
foods, solutions, allergens, plants are factors
contact dermatitis manifestations
irritant:
- dry, inflamed
- pruritic lesions wherever the irritant touched
allergic:
- “weeping blisters” as well as pruritic lesions
contact dermatitis management
topical application like anti-inflammatory and anti-pruritics
- topical corticosteroids are preferred for mild, localized cases of allergic dermatitis
try not to too frequently hand wash because itll become dry
systemic corticosteroids and antihistamines might be required if dermatitis is severe and widespread
exposure to heat or cold may cause or exacerbate symptoms
what is candidiasis
bacteria that causes candidiasis normally live in the body without any problems
its if they grow out of control that can lead to candida albicans
develops in the mouth or throat and is called thrush
in vagina = yeast infection
tends to appear in warm, moist areas and inhales steroids
- commonly seen in cancer and HIV/AIDs people
candidiasis manifestations
white plagues on the tongue, gums or buccal mucosa
- inner lining of the cheeks and back of lips where they touch teeth
ulcerations in oral mucosa
may also complain of itching
candidiasis management
oral anti-fungals will be prescribed
- either use swish and swallow after feeding or through topical application
those who use inhaled steroids should rinse their mouth after to avoid candidiasis
be sure to monitor whether infection has spread to groin or buttocks
can be prescribe prophylactic probiotic
- Florastor
eating products with live cultures of lactobacillus acedophillus like some yogurts can be beneficial
what is acne vulgaris
skin condition in which pores becomes clogged and inflamed
acne breakouts may be exacerbated by emotional stress
sebaceous glands secrete more sebum and pores become more plugged and dilated
acne vulgaris manifestation
whiteheards (close comedones) blackheads (open comedone) papules pustules nodules
red and excoriated skin
acne vulgaris management
good cleansing of the skin
nutrition
avoiding squeezing or picking at lesions
teach about resulting body image users
pharmacological intervention:
- Vit A
- benzoyl peroxide
- antibiotics
- isotretinoin: generic only- available as Accutane
- photodynamic therapy
- dermabrasion or chemical skin peels
what is impetigo
highly contagious, bacterial infections of the skin
infective agents:
- Staph A
- group A beta hemolytic streptococcus
MRSA is becoming a common cause
will invade broken skin are and is highly contagious for 7-10 days
most common in young children
impetigo manifestations
primary phase:
pustules or vesicles
secondary phase: honey-colored crusts for strep clear for staph superficial erosion pustules that easily bleed and itche
skin does tend to heal without scarring unless there is a secondary infection
impetigo diagnostic studies
based on the appearance of skin lesion
maybe skin culture
impetigo nursing management
priority interventions should focus on preventing transmissions:
- careful removal of lesions crusts or debris with warm soapy solution
- cutting childrens fingernails
pharmacological interventions:
- apply topical antibiotics for early small lesions
- systemic antibiotics are treatment of choice
teach caregiver that infection is HIGHLY CONTAGIOUS
good handwashing is essential
- sharing towels and eating utensils should be AVOIDED
what is cellulitis
infection of the dermis and or subcutaneous tissue
causative agents:
- streptococcal bacteria
- Group A strep
- streptococcus pyogenes
- staph aureus
- Haemophilus influenza
cellulitis manifestation
affected area:
- red, edematous
- tender
- occasional discoloration
enlarged lymph nodes
fever
malaise
headache
streaking is frequently seen
