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NUR 334: exam 3 > integumentary > Flashcards

integumentary Flashcards

1
Q

6 primary skin lesions

A
  1. macule
  2. papule
  3. plaque
  4. pustule
  5. vesicle
  6. wheal
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2
Q

macule

A

circumscribed, flat discoloration
blue, red, brown, hypo pigmented
<0.5cm (if >0.5 it is a patch)

examples: freckles, petechiae, measles, flat mole (nevus), vitiligo (complete depigmentation)

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3
Q

papule

A

elevated, solid lesion
<0.5cm (if >0.5 it is a nodule)

examples: wart, elevated moles, lipoma, basal cell carcinoma

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4
Q

plaque

A

circumscribed, elevated, superficial, solid lesion
>0.5cm

examples: psoriasis, seborrheic and actinic keratoses

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5
Q

pustule

A

elevated, superficial lesion filling with purulent fluid

examples: acne, impetigo

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6
Q

vesicle

A

circumscribed, superficial collection of serous fluid
<0.5cm (if >0.5, it is a bulla)

examples: varicella (chickenpox), herpes zoster (shingles), 2nd-degree burn

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7
Q

wheal

A

firm, edematous, irregularly shaped area
size varies + may only last a few hours

examples: insect bite, urticaria, angioedema

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8
Q

6 secondary lesions

A
  1. atrophy
  2. excoriation
  3. fissure
  4. scale
  5. scar
  6. ulcer
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9
Q

atrophy

A

depression in skin r/t thinning of epidermis or dermis

examples: aged skin, striae (stretch marks)

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10
Q

excoriation

A

epidermis is missing - dermis is exposed

examples: abrasion, scratch

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11
Q

fissure

A

linear crack or break from epidermic to dermis
dry or moist

examples: athlete’s foot, chapping, eczema

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12
Q

scale

A

excess, dead epidermal cells made by abnormal keratinization and shedding

examples: flaking of skin after a drug reaction, sunburn

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13
Q

scar

A

abnormal formation of connective tissue that replaces normal skin

examples: surgical incision, healed wound

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14
Q

ulcer

A

loss of epidermis and dermis
crater-like, irregular shape
heals with a scar

ex: pressure ulcer, chancre

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15
Q

cyanosis

A

blue
late sign of hypoxia

cause: heart or lung disease, cold environment

where: nail beds, lips, base of tongue, skin

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16
Q

pallor

A

decrease in color
reduced amt of hgb; decreased blood flow
caused by: anemia or shock
where: skin, nail beds, conjunctiva (line of demarcation), lips, face, palms

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17
Q

vitiligo

A

loss of pigmentation
caused by: congenital autoimmune condition
where: patchy areas on skin over face, hands, arms

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18
Q

jaundice

A

yellow-orange
increased deposits of bilirubin in tissues

caused by: liver disease, destruction of RBC
where: sclera, mucous membranes, skin

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19
Q

erythema

A

red
increased visibility of hgb d/t dilation or increased blood flow

caused by: fever, direct trauma, blushing, alc intake
where: face, area of trauma, areas at risk for pressure (sacrum, shoulders, elbows, heels)

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20
Q

tan-brown

A

increased amount of melanin
caused by: suntan, pregnancy
where: areas exposed to sun (face, arms), areolae, nipples

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21
Q

skin cancer

A

most diagnosed cancer
classified as non melanoma or melanoma
early detection more common bc of visible lesions

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22
Q

risk factors for skin cancer

A

-fair skin (blonde/red hair, blue eyes)
-hx of outdoor activities
-living near equator or high altitudes
-fam hx of skin cancer
-work outdoors
-tanning beds

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23
Q

non melanoma skin cancers

A

basal cell carcinoma

squamous cell carcinoma

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24
Q

basal cell carcinoma

A

locally invasive cancer from basal cells (erythematous, pearly, sharply defined, barely elevated plaques, depression in middle)

25
Q

squamous cell carcinoma

A

comes from keratinizing epidermal cells, can be aggressive (thin, scaly erythematous plaque)

26
Q

malignant melanoma

A

*tumors come from melanocytes
*genetic and environmental factors contribute to development –> 5-10% have 1st-degree relative
*treatment depends on depth of lesion (correlation between survival and depth of lesion)
*poor prognosis unless diagnosed and treated early
*may metastasize to any organ, if untreated

27
Q

lesion > 1.5 mm

A

would require treatment after surgical removal

28
Q

how do we evaluate lesions with malignant melanoma?

A

ABCDE
asymmetry
border irregularity
color
diameter (>6mm)
evolving or elevated

29
Q

interprofessional care for integumentary problems

A

skin integrity care
anxiety/coping issues with diagnosis
teach related care of biopsy
annual dermatology checkups

30
Q

what is most likely to occur for lesions?

A

biopsy

31
Q

bacterial skin infections

A

impetigo + cellulitis
*staph aureus or B-hemolytic streptococci usually responsible
*if exudate present, drainage also infectious

32
Q

risk factors for bacterial skin infections

A

excess moisture
obesity
atopic dermatitis (eczema)
systemic corticosteroid or antibiotic use
chronic diseases (T2DM)

33
Q

cellulitis

A

inflammation of SQ tissue

34
Q

manifestations of cellulitis

A

hot
tender
erythematous area w/ diffused borders
fever and chills
malaise

35
Q

treatment of cellulitis

A

localized: moist heat (warm compress to reduce swelling), immobilization, elevation

systemic: antibiotics –> hospitalize if severe; progression to gangrene, if not treated

36
Q

viral infections

A

more difficult to treat
lesions can result from inflammatory response to systemic viral infections

37
Q

systemic viral infections

A

herpes simplex
herpes zoster (shingles)
HPV (human papillomavirus)
warts

38
Q

herpes zoster

A

activation of varicella-zoster virus (chickenpox)
incidence increased with age
potentially contagious if haven’t had chickenpox yet

39
Q

herpes zoster manifestations

A

burning pain and neuralgia along dermatome

40
Q

prevention of herpes zoster

A

vaccine (Zostavas) to prevent shingles
*one time dose for adults > 60

41
Q

HPV

A

human papillomavirus

warts in genital area or anywhere on body
usually preventable with vaccine

42
Q

fungal infections examples

A

candidiasis
-mouth
-vagina
-skin
tinea corporis (ringworm)
tinea cruris (jock itch)
tinea pedis (athletes foot)

43
Q

fungal infections

A

most are harmless - can be embarassing
skin, hair, nails more susceptible to fungal infections
usually treat with topical anti-fungal creams or solutions

44
Q

allergic skin problems

A

irritant or allergic dermatitis –> benign (contact dermatitis) vs life-threatening (Stephen johnson syndrome and toxic epidermal necrolysis)

45
Q

Stephen Johnson Syndrome and Toxic epidermal necrolysis

A

rare, LIFE-THREATENING skin conditions
- immune responses are generally due to a severe adverse reaction to medication or infection
- causes acute destruction of epithelium of skin and mucous membranes

46
Q

Stephen Johnson Syndrome and Toxic epidermal necrolysis: S/S?

A

fever
cough
HA
anorexia
myalgia
nausea
precede skin and mucous membrane findings by 1-3 days

47
Q

examples of infestations and insect bites

A

ex: pediculosis (lice), bed bugs, ticks, scabies

48
Q

what plays a key role in insect bites?

A

allergy to venom
sometimes, clinical manifestations are related to eggs, feces, or body parts of invading organism

49
Q

how to prevent insect bites?

A

avoid + repellants

50
Q

what is important to do with insect bites

A

meticulous hygiene –> hair, skin, clothing, bedding, pets, sexual partners
routine skin inspections –> especially if traveling to high-risk areas (ESP TICK BITES)

51
Q

psoriasis

A

benign skin problem

*chronic autoimmune disease
*usually develops in those 15-35
*familial
*up to 40% develop psoriatic arthritis
*can be painful and emotional disabling r/t body image disturbance

52
Q

most common form of psoriasis

A

plaque psoriasis
lesions are distinct, red, intact
*located: knees, elbows, hands, lower back

53
Q

types of psoriasis

A

plaque (MOST COMMON)
-guttate
-pustular
-inverse
-nail
-psoriatic arthritis

54
Q

care for psoriasis

A

phototherapy (UV light) : psoriasis

55
Q

care for basal/squamoous cell carcinoma

A

radiation

56
Q

drug therapy for skin conditions

A

antibiotics
steroids (NOT long-term)
antihistamines
immunomodulators (suppress overreactive immune system)

57
Q

therapy for malignant melanoma

A

diagnostic/surgical therapy (punch biopsy, scraping)

58
Q

nursing management of skin problems

A

-wet compresses (room temp tap water w/ possible additive) –> ASSESS for maceration
-baths: tepid (lukewarm) *too hot makes itchy
-hygienic practices: lotions while skin still damp; seals in moisture
-topical meds
-control of itching

NUR 334: exam 3 (11 decks)

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