Integumentary

Question 1

Cellulitis patho

Answer 1

Bacterial infx
Insect/animal bite, cute, abrasion, wound -> bacteria -> infx and inflammation of subcutaneous tissue

Question 2

Risk factors of cellulitis

Answer 2

DM
Insect bites
Immunosuppression
PVD
IV recreational drug use

Question 3

S+S of cellulitis

Answer 3

Unilateral
Common in lower extremities
Redness, warmth, edema
Pain
Fever
Chills
Sweating
Tender/enlarged lymph nodes

Question 4

Complications of cellulitis

Answer 4

Abscess
Osteomyelitis
Endocarditis
Sepsis

Question 5

Nursing interventions of cellulitis

Answer 5

Abx and blood cultures
Gown and gloves when handling
Mark/date area of inflammation
Elevate and rest affected extremities
Warm compresses to affected area
Avoid prolonged exposure to moist linens
Wear nonrestrictive clothing

Question 6

Scabies patho

Answer 6

Highly contagious skin infestation
Skin-to-skin contact
Common in crowded spaces
Pregnant mite burrows into skin later -> lays eggs -> superficial burrow track

Question 7

S+S of scabies

Answer 7

Result of body’s inflammatory response to mite eggs and feces
Intense itching, especially at night
Erythematous, excoriated papules
Presence of burrows

Question 8

Tx of scabies

Answer 8

Topical permethrin
1-2 applications
Massage into skin surfaces
Avoid contact w/ eyes and mouth
Leave for 8-12 hrs before bathing
Applied overnight
Second application 1-2 wks later
Treat all family members and pets

Question 9

Pt teaching of scabies

Answer 9

Hand hygiene
Itching may continue for several wks
Wash clothes and bedding in hot water
Place non-washable belongings and toys in sealed, plastic bags for 3-4 days

Question 10

Rules of 9s (head, arms, thoracic, legs, groin)

Answer 10

Head: 9%
Arms: 4.5% each
Thoracic: 18%
Legs: 9% each
Groin: 1%

Question 11

Tx for severe burn injuries

Answer 11

Administer IV analgesics
Administer tetanus immunization
Insert urinary cath
Cleanse and debride wounds
Collect blood specimen for CO level

Question 12

1st degree burn

Answer 12

Doesn’t extend past epidermis
Blanchable redness
Painful

Question 13

2nd degree burn (partial thickness)

Answer 13

Extends into dermis
Painful blisters
Edema

Question 14

3rd degree burn (full-thickness)

Answer 14

Extends past dermis into subcutaneous tissue

Question 15

4th degree burn (deep tissue)

Answer 15

Full thickness + muscle and bone
Severe edema
Eschar
Pain may be absent due to nerve damage

Question 16

Inhalation injury S+S

Answer 16

Burns on face/neck
Singed nasal hair
Soot-tinged sputum
Coughing, wheezing, stridor
Oropharyngeal edema or blisters

Question 17

Inhalation injury tx

Answer 17

100% oxygen
Prepare for endotracheal intubation

Question 18

Tx of burns

Answer 18

High Fowler position for inhalation injury -> if not intubated
Remove clothing and jewelry and burn area
Flush w/ cool water
IV fluids
Indwelling urinary cath (genital burns)
Monitor EKG for cardiac changes caused by hyperkalemia
Pain management
Minimize heat loss
Tetanus immunization
High protein, high carb diet
Prepare pt for debridement, surgical excision, or escharotomy if compartment syndrome develops

Question 19

Frostbite tx

Answer 19

Remove clothing and jewelry
Don’t massage
Immerse affected area in warm water
Avoid heavy blankets or clothing
Provide analgesia
Elevate injured area after rewarming
Keep wounds open immediately after water bath and allow drying before applying loose, nonadherent, sterile dressings