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NCLEX Saunders > Integumentary > Flashcards

Integumentary Flashcards

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1
Q

eczema

A

dermatitis
atopic-sensitivity to allergens (eg. asthma)
contact-direct contact to allergens (eg. jewelries)
statis dermatitis-areas w/ low blood flow

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2
Q

eczema mgt

A

-tepid baths from 5 to 1mins
-moisturizers right after
-antihistamines & corticosteroids
-antibiotics for 2nd infxn
-cool wet compresses
-avoid skin irritants
-wash clothes w/ mild detergent
-eliminate scratching/itching

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3
Q

impetigo

A

-beta hemolytic strep or staph
-during hot humid months
-contact prec, highly contagious
-honey colored crusts

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4
Q

impetigo mgt

A

-cover lesions w/ gauze
-handwashing
-warm bath w/ antibacterial soap
-wash clothes linens w/ warm water & separate from others
-use separate towels, linens, utensils, dishes
-oral & topical antibiotics
-warm compresses

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5
Q

pediculosis capitis mgt

A

head lice
-use of pediculide
-one brush per individual; no sharing
-all members might need treatment
-use of extra fine tooth nit comb daily after pediculide (wear gloves)
-discard or soak comb in boiling water for 10min
-wash clothes linens in warm water& dried hot for 20min
-furniture & carpets vacuumed
-clothes toys that cannot be washed or dry cleaned sealed for 2 weeks (life is 7 to 10days)
-beddings changed daily

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6
Q

scabies mgt

A

itch mite (+ skin burrows)
greyish red lines
common in school children & institutionalized populations

-topical scabicide
*neck down, not head & face esp. lindane shampoo and 💀 below 2yo
*30mins after bath in a dry skin: permethrin cream, no to eyes
-beddings changed daily for 1 week
-laundry separate & wash w/ warm water, dried warm & ironed!
-nonwashables sealed in 4 days

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7
Q

inaccurate estimate of burns in children

A

rule of nines

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8
Q

extent of burns in children

A

percentage of total body surface area
A 1/2 head
B 1/2 one thigh
C 1/2 one leg

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9
Q

adequacy of fluid volume checked thru

A

vs (esp heart rate)
urinary output
capillary refill time
sensorium

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10
Q

pedia considerations of burn victims

A

-scarring is more severe
-delay in growth may occur -immature immune system presents an increased risk of infection
-higher proportion of body fluid to body mass in a child increases the risk of cardiovascular problems
-Burns involving more than 10% of total body surface area require some form of fluid resuscitation
-at increased risk for protein and calorie deficiencies because they have smaller muscle mass and less body fat

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11
Q

phases of wound healing

A
  1. inflammatory
  2. fibroblastic -forming of scar & granulation tissue
  3. maturation-scar tissue thinner firm inelastic
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12
Q

healing by intention

A

1st intention - wound edges easily closed & approximated

2nd intention - tissue loss that require gradual filling w/ connective tissue

3rd intention - with exudates & debris that require irrigation or removal

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13
Q

serous

A

clear /N° part of healing process

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14
Q

serosanguineous

A

pink colored (serous + small bloodcells)
N° part of healing process

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15
Q

sanguinous

A

red drainage from trauma to a blood vessel
may occure during wound cleansing
abN°

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16
Q

hemorrhaging

A

frank blood from a leaking blood vessel
emergent care
abN°

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17
Q

purulent

A

yellow, gray or green
due to infxn
abN°

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18
Q

skin biopsy

A

punch, excisional or shave
keep dressing for 8hrs
antibiotic ointment

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19
Q

skin/wound culture

A

-taken before antibiotic therapy
-done usually together with a nasal swab
-viral culture placed immediately on ice

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20
Q

wood’s light examination

A

skin viewed under UV light in a special glass (wood’s light)
-darken the room
-light is not harmful to skin & eyes

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21
Q

diascopy

A

glass slide pressed over the lesion causing blanching and revealing lesion more clearly
if erythema is:
inflammatory or hemorrhagic (petechiae)

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22
Q

candida albicans

A

fungal/yeast infxn in skin folds & mouth
oral candidiasis/thrush (red white patches)

-antifungal
-give non irritating foods&fluids
-oral care w/ non irritating products
-keep skin folds clean & dry as well as bed linens

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23
Q

herpes zoster

A

shingles
+hx of chickenpox, reactivation of varicella zoster
unilateral clustered skin vesicles

contact prec as long as vesicles present
lightweight loose cotton clothes
astringent compresses

💀postherpetic neuralgia: pain even if no more lesions

complication: bells palsy 7th cranial nerve assessment

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24
Q

tzanck test/smear

A

chickenpox & herpes skin test

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25
Q

MRSA

A

methillin resistant staphylococcus aureus

*community acquired - contact thru sports, share equipment
*hospital acquired

folliculitis (inflammed follicles) & furuncle (carbuncle is clusters of furuncle)

*nasal swab

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26
Q

erysipelas vs cellullitis

A

e: superficial than c but red marks is well demarcated
dermis & lymphatics

c: depeer than e and red marks are scattered
dermis up to hypodermis only
rest in affected area and warm compress

27
Q

poison ivy, oak & sumac plants

A

contains irritant urushiol also found in MANGOES
result to dermatitis

cold wey compress
topical or oral corticosteroids
topical ointments for itching

28
Q

spider bites

A

-brown recluse (necrotic area/loxoscelism)
-black widow spider (neurotoxicity
*both ice applied immediately
-tarantula
*elevate & immobilize, use of sticky tape to remove hair & nss irrigation if reached the eye

*tetanus prophylaxis for all

29
Q

bark scorpion stings

A

venom neurotoxic, emergency

30
Q

bees & wasps

A

-stings usually cause a wheal and flare reaction
-Emergency care involves quick removal of the stinger and application of an ice pack
-The stinger is removed by gently scraping or brushing it off with the edge of a needle or similar object; tweezers are not used because there is a risk of pinching the venom sac
-If the victim is allergic to the venom of a bee or wasp, a severe allergic response can occur (hives, pruritus, swelling of the lips and tongue) that can progress to life-threatening anaphylaxis; immediate emergency
-Individuals who are allergic should carry an epinephrine autoinjector for self-administration of intramuscular epinephrine if a bee or wasp sting occurs. After use of the epinephrine autoinjector, the individual should seek emergency medical attention. Persons should have 2 injectors available and obtain a replacement as soon as possible.

31
Q

snake bites

A

should rest to decrease venom circulation
-extremity is immobilized and kept below the level of the heart
-Constricting clothing and jewelry are removed before swelling
-kept warm and is not allowed to consume caffeinated or alcoholic beverages, which may speed absorption of the venom
-if unable to seek emergency medical attention promptly, a constricting band may be applied proximal to the wound to slow the venom circulation; monitor the circulation frequently and loosen the band if edema occurs
-wound is not incised or sucked to remove the venom; ice is not applied to the wound
-Emergency care in a hospital is required as soon as possible; an antivenom may be administered along with supportive care
-the snake should not be transported with the victim for identification purposes unless it can be safely placed in a sealed container during transportation.

32
Q

frostbite

A

-Rewarm the affected part rapidly and continuously with a warm water bath or towels to thaw the frozen part
-Handle the affected area gently and immobilize.
-Avoid using dry heat, and never rub or massage the part
-rewarming process may be painful; analgesics may be necessary
-Avoid compression of the injured tissues and apply only loose and nonadherent sterile dressing
-Monitor for signs of compartment syndrome
-tetanus prophylaxis is necessary, and topical and systemic antibiotics may be prescribed
-Debridement of necrotic tissue may be needed; amputation may be necessary if gangrene develops.

33
Q

seborrheic vs actinic keratosis

A

me vs hr foldenauer
seborrheic is benign

for actinic
-caused by chronic exposure to the sun and appear as rough, scaly, red, or brown lesions that are usually found on the face, scalp, arms, and backs of the hands
-Lesions are considered premalignant, and there is risk for slow progression to squamous cell carcinoma
-medications, excision, cryotherapy, curettage, and laser therapy

34
Q

skin cancer major types

A

squamous cell
basal cell
melanoma

35
Q

squamous cell cancer

A

-rough scaly patch or wartlike growth
-oozing bleeding crusting lesion
-2nd most common
-in the epidermal keratinocytes and can infiltrate surrounding structures and metastasize to lymph nodes.

36
Q

basal cell cancer

A

-most common
-small shiny bump or red scaly patch, pearly borders, res central crater
-rarely spreads, locally invasive

37
Q

melanoma

A

-irregular, circular, bordered w/ hues of tan black or blue
-usually a new or changing mole or pigmented area
-occur any place on the body, especially where birthmarks or new moles are apparent
-highly metastatic to the brain, lungs, bone, and liver, with survival depending on early diagnosis and treatment

38
Q

skin CA mgt

A

-Instruct to avoid sun exposure between 10 a.m. and 4 p.m.
-Advise to have moles or lesions that are subject to chronic irritation removed
-Advise to avoid contact with chemical irritants
-Instruct to wear layered clothing and use and reapply sunscreen lotions with an appropriate sun protection factor when outdoors.
-Assist with surgical management, which may include cryosurgery, curettage and electrodessication, or surgical excision of the lesion

39
Q

psoriasis

A

noninfectious skin inflammation
*some also develop arthritis

no scratching
light clothing
no OTC drugs

40
Q

koebner phenomenon

A

development of psoriatic lesions after a skin injury (scratch, new tattoo etc)

clean the injury as often as possible to prevent or lessen

41
Q

acne vulgaris

A

-no scrubbing the skin
-no squeeze prick pick the lesions
-noncomedogenic, water based makeups and less oil based

42
Q

stevens johnson syndrome SJS

A

medication induced skin reaction
*nsaids
*sulfonamides
*antiseizure
*allopurinol
common in immunocompromised

initial: flu like symptoms + erythema
serious: +lesions in larynx esophagus & bronchi

43
Q

toxic epidermal necrolysis TEN

A

medication induced skin reaction
severe form of SJS

more than 30% of the body have burn like lesions

44
Q

eschar

A

dead skin tissue around pressure ulcer injuries

45
Q

pressure ulcer stage 1

A

transparent dressing
hydrocolloid

46
Q

pressure ulcer stage 2

A

composite film
hydrocolloid
hydrogel

47
Q

pressure ulcer stage 3

A

hydrocolloid
hydrogel w/ Foam Dressing
gauze
growth factors

48
Q

pressure ulcer stage 4

A

hydrogel w/ Foam Dressing
calcium alginate
gauze

49
Q

pressure ulcer unstageable

A

Adherent film
Gauze with a prescribed solution Enzymes

50
Q

frostbite s/s

A

before thawing
white or blue color; the skin will be hard, cold, and insensitive to touch

after thawing,
flushing of the skin, the development of blisters or blebs, or tissue edema appears

51
Q

bentoquatam

A

poison ivy, oak and sumac
PREVENTIVE LOTION (murag off lotion)

52
Q

poison ivy oak sumac

A

calamine
hydrocortisone
zinc acetate
oatmeal baths

53
Q

topical immunosuppressants

A

tacrolimus & pimecrolimus

*treated areas should be shaded from the sun
-increase risk of contracting varicella zoster
-increased risk to skin cancer

54
Q

systemic immunosuppressants

A

Azathioprine ▪ Cyclosporine ▪ Methotrexate ▪ Oral glucocorticoids

55
Q

topical glucocorticoids

A

-wash area
-wear gloves
-thin film, rub gently
-avoid occlusive dressing (may increase absorption)
-check plasma cortisol levels

56
Q

actinic keratosis meds

A

*Diclofenac sodium 3% gel - may take up to 3 mos to be effective
*Fluorouracil - results are seen after 2 weeks
*Imiquimod 5% cream - also used for venereal warts
*Ingenol mebutate - can cause development of herpes zoster

57
Q

sunscreen

A

-should be at least spf 15
-applied 30min before sun exposure
and reapplication every 2-3hrs
-UV light greatest at 10am to 4pm
-wear sunglass, protective clothing & hat

58
Q

psoriasis meds

A

Topical Medications
Calcipotriene (vit d analog)
Coal tar
Glucocorticoids
Keratolytics (topical salicylic acid; sulfur)
Tazarotene (vit a derivative)

Systemic Medications
Acitretin (teratogenic)
Cyclosporine (last resort)
Methotrexate (teratogenic)

Systemic Biological Medications Adalimumab,Brodalumab,Etanercept Guselkumab,Infliximab,Ixekizumab
Ustekinuma,Secukinumab

Phototherapy
Coal tar and ultraviolet B irradiation Photochemotherapy (psoralen and ultraviolet A therapy)

59
Q

burns meds

A

silver sulfadiazine (check for WBC)
mafenide acetate (can lead to acidosis)

apply 1/16inch
cover always

60
Q

salicylic acid toxicity

A

tinnitus
dizziness
psychological disturbance

61
Q

can increase triglyceride levels

A

isotretinoin

62
Q

highly permeable areas

A

scalp, axilla, face, eyelids, neck, perineum, genitalia

63
Q

low permeable areas

A

soles, palms, back

NCLEX Saunders (16 decks)

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