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N106 Integumentary > Integumentary > Flashcards

Integumentary Flashcards

1
Q

What are the five functions of the skin?

A
  1. Protection from pathogenic organisms and foreign substances; natural barrier against infection.
  2. Regulates temperature
  3. Prevents excessive water loss (dehydration)
  4. Insulates body & protects from trauma through subcutaneous layer.
  5. Has nerve endings that provide sensory perception to the brain related to pain, heat, cold, touch, pressure and vibration.
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2
Q

Pallor in the dark-skinned individual should be assessed in what locations?

A

The lips and mucous membranes

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3
Q

Assessment of a rash in the darker-skinned patient should be assessed using what technique?

A

Palpation

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4
Q

When performing an assessment of an integumentary complaint, what should be included? (PQRST)

A

P: Provocative and Palliative factors (factors that cause the condition)
Q: Quality and Quantity (characteristics and size) of the skin problem
R: Region of he body
S: Severity of the signs and symptoms
T: Time (Length of time the patient has had the disorder.

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5
Q

When assessing a mole, what characteristics should be included? (ABCDE)

A 
A: Is it Asymetrical?
B: Are the Borders irregular?
C: Is the Color uneven or irregular?
D: Has the Diameter of hte growth changed recently?
E: Has the surface area become Elevated?
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6
Q

Name the type of primary skin lesion that:

  • Is elevated, circumscribed & superficial
  • Not into dermis
  • Is filled w/ serous fluid
  • <1 cm in diameter
    ie. varicella, herpes zoster
A

Vesicle

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7
Q

Name the type of primary skin lesion that:

  • Is elevated
  • Irregularly shaped area of cutaneous edema
  • Solid, transient and variable in diameter
    ie. urticaria, insect bites
A

Wheal

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8
Q

Name the type of primary skin lesion that:

  • Is flat, nonpalpable
  • Irregularly shaped macule
  • > 1 cm in diameter
    ie. vitiligo, port-wine stains
A

Patch

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9
Q

Name the type of primary skin lesion that:

  • Is elevated & firm
  • Circumscribed area
  • < 1 cm in diameter
    ie. wart, elevated moles
A

Papule

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10
Q 
Name the type of primary lesion that:
-Is elevated and solid
-May or may not be clearly demarcated
-Deeper in the dermis
> 2 cm in diameter
ie. neoplasms, hemangioma
A

Tumor

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11
Q 
Name the type of primary lesion that:
-Is elevated & firm
-Circumscribed lesion
-Deeper in the dermis
1-2 cm in diameter
ie. lipomas, erythema nodosum
A

Nodule

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12
Q 
Name the type of primary lesion that:
-Is elevated and firm
-Rough lesion w/ flat top surface
> 1 cm in diameter
ie. psoriasis, actinic keratoses
A

Plaque

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13
Q

Name the type of primary lesion that:
-Is a vesicle (elevated, circumscribed, filled w/ serous fluid)
> 1 cm in diameter
ie. blister, pemphigus vulgaris

A

Bulla

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14
Q

Name the type of primary lesion that:

  • Is elevated
  • Superficial lesion
  • Similar to vesicle but filled w/ purulent fluid
    ie. impetigo, acne
A

Pustule

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15
Q 
Name the type of primary lesion that:
-Is flat
-Circumscribed area that is a change in the skin color
< 1 cm in diameter
ie. freckles, measles, petechiae
A

Macule

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16
Q

Name the type of primary lesion:

  • A loss of epidermis and dermis
  • Concave
  • Varies in size
    ie. pressure sores
A

Ulcer

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17
Q

Name the type of primary lesion:

  • A loss of the epidermis
  • Linear hollowed-out crusted area
    ie. abrasion, scabies
A

Excoriation

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18
Q

Name the type of primary lesion:

  • Thinning of the skin surface
  • Loss of skin markings
  • Skin translucent and paperlike
    ie. striae, aged skin
A

Atrophy

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19
Q

Name the type of primary lesion:

  • Dried serum, blood, or purulent exudate
  • Slightly elevated
  • Size varies
  • Brown, red, black or tan
    ie. eczema, scab
A

Crust

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20
Q

Name the type of primary lesion:

  • Linear crack or break from the epidermis to the dermis
  • May be moist or dry
    ie. athlete’s foot, cracks at the corner of the mouth
A

Fissure

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21
Q

Name the type of primary lesion:

  • Loss of part of the epidermis
  • Depressed, moist, glistening
  • Follows rupture of a vesicle or bulla
    ie. ruptured variola (chicken pox)
A

Erosion

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22
Q

People with darker complexions are predisposed to what skin conditions?

A

pseudofolliculitis, keloids & mongolian spots

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23
Q

Name four viral disorders of the skin.

A

Herpes zoster (shingles)
Herpes simplex 1 (cold sore)
Herpes simplex 2 (genital herpes)
Pityriasis Rosea (starts w/ herald patch)

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24
Q

Name the bacterial disorder:

  • Caused by S. aureus, streptococci or a mixed bacterial invasion
  • Most commonly in children
  • Lesions start as small macules then develop into pustulant vesicles.
  • The vesicles rupture and form dried exudate that then forms a honey colored crust.
  • Smooth red skin under crust
  • Generally affects face, hands, arms and legs.
A

Impetigo Contagiosa

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25
Q

Name the bacterial disorder:

  • A cluster of furuncles. An infection of several hair follicles that spreads to surrounding tissue.
  • Obesity, poor nutrition, untreated diabetes and poor hygiene contribute to the formation of this disorder.
A

Carbuncle

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26
Q

Name the bacterial disorder:
An infection of the soft tissue under and around an area such as the fingernail. The involved finger becomes erythematous, edematous and tender to touch.

A

Felon

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27
Q

Name the bacterial disorder:

  • Most common cause for adults is streptococci and staphylococcus aureus.
  • Most common cause for children is Haemophilus influenzae type B.
  • It is an infection of the skin and underlying subcutaneous tissues.
  • The affected areas become erythematous, edematous, tender and warm to the touch.
  • S/S fever, & erythema, pain and tenderness over an area of skin
  • Infected skin may look slightly pitted, like an orange peel.
A

Cellulitis

28
Q

Name the bacterial disorder:

  • Often occurs after shaving.
  • One example is a stye.
  • Generally caused by S. aureus
  • Infection of one or several hair follicles.
A

Folliculitis

29
Q

Name the bacterial disorder

  • AKA boil
  • Inflammation that begins deep int he hair follicles and spreads to the surrounding skin.
  • Can require a surgical incision and drainage.
A

Furuncle

30
Q

What does the term suppuration mean?

A

The production of purulent material.

31
Q

Name the four common types of fungal infections and what areas they each affect.

A

Tinea capitis - ringworm of the scalp
Tinea corporus - ringworm of the body (areas w/ little or no hair)
Tinea cruris - jock itch (groin)
Tinea Pedis - athlete’s foot

32
Q

What oral supplement is a type of amino acid that is commonly used to shorten Herpes outbreaks and reduce the severity of symptoms?

A

L-Lysine

33
Q

What visual differences are there between a Pityriasis Rosea patch and Ringworm?

A

Pityriasis Rosea - scaly, w/ raised border and pink center.

Ringworm - lesions are flat w/ clear centers and erythematous borders.

34
Q

What visual differences are there between Herpes Simplex 1 and Impetigo Contagiosa?

A

Herpes Simplex 1- vesicle (cold sore) is elevated and filled w/ serous fluid. Erythematous and edematous. Once ruptured, it ulcerates and encrusts.
Impetigo Contagiosa - No vesicles, has a honey colored crusty exudate. Smooth red skin under teh crust.

35
Q

Name the inflammatory disorder with these characteristics:

  • Vesicles and papules, typically on the scalp, forhead, cheeks, neck and surfaces of the extremities.
  • Commonly associated with an allergic reaction to chocolate, eggs, wheat and orange juice.
  • When the vesicles rupture, they discharge a yellow, tenacious exudate that dries and encrusts
  • Distintuishing characteristic is scales accompanied by dryness in the involved areas
A

Eczema (Atopic Dermatitis)

36
Q

What is another name for blackhead and why does it appear dark?

A

Comedo

It is dark because of the effect of oxygen on sebum, not because of the presence of dirt.

37
Q

Name the inflammatory skin disorder with these characteristics:

  • autoimmune disorder
  • chronic, multisystem inflammatory disorder that occurs when the body produces antibodies against its own cells
  • s/s include alopecia, photoseneitivity, butterfly rash
A

Systemic Lupus Erythematosus

38
Q

What should the care plan for a patient with Systemic Lupus Erythematosus include?

A
  • Skin care, including teaching avoidance of direct sunlight and use of protective clothing and sunscreen
  • Balance between rest and activity
  • Recognition of signs of exacerbation (ie. fever, rash, cough or increasing muscle and joint pain)
  • Early recognition of signs and symptoms of infection
  • Stress reduction and management
  • Balanced nutrition and reduction of sodium intake
39
Q

What is the difference between urticaria and angioedema?

A

Urticaria is a skin and mucous membrane lesion characterized by wheals or hives.
Angioedema occurs in the subcutaneous tissue. Characterized by local edema of an entire area such as an eyelid, hands, feet, tongue, larynx, GI tract, genitalia or lips.

40
Q

Name the inflammatory skin disorder with these characteristics:

  • noninfectious
  • chronic and hereditary
  • skin cells divide much more rapidly than normal resulting in severe scaling
  • Silvery scaling plaques located on the scalp, elbows, chin and trunk
A

Psoriasis

41
Q

What are the common clinical manifestations of a scabies infection?

A
  • wavy, brown, threadlike lines on body, especially the hands, arms, body folds, and genitalia
  • Severe pruritus
  • Excoriation caused by scratching
42
Q

What is the most deadly skin cancer?

A

Malignant melanoma

43
Q

What are the four types of malignant melanomas?

A
  1. Superficial spreading melanomas
  2. Malignant lentigo melanomas
  3. Nodular melanomas
  4. Acral lentiginous melanomas
44
Q 
This type of malignant melanoma occurs in areas not exposed to sunlight and where no hair follicles are present (ie. hands, soles &amp; mucous membranes of dark-skinned people.
A.  Nodular melanomas
B.  Malignant lentigo melanomas
C. Acral lentiginous melanomas
D. Superficial spreading melanomas
A

C. Acral lentiginous melanomas

45
Q 
This type of malignant melanoma is usually found on the heads and necks of older adults.  Characterized as tan, flat lesions that change shape and size.
A.  Nodular melanomas
B.  Malignant lentigo melanomas
C. Acral lentiginous melanomas
D. Superficial spreading melanomas
A

B. Malignant lentigo melanomas

46
Q 
This is the most common malignant melanoma and can occur anywhere on the body.  These are slightly elevated, irregularly shaped and may be tan, brown, black, blue , gray or pink.
A.  Nodular melanomas
B.  Malignant lentigo melanomas
C. Acral lentiginous melanomas
D. Superficial spreading melanomas
A

D. Superficial spreading melanomas

47
Q 
This malignant melanoma appears as a blueberry-type growth, varying from blue-black to pink.  Often mistaken for a blood blister that fails to resolve.  These grow faster than the other types.
A.  Nodular melanomas
B.  Malignant lentigo melanomas
C. Acral lentiginous melanomas
D. Superficial spreading melanomas
A

A. Nodular melanomas

48
Q

What type of skin tumor has these characteristics:

  • benign, viral lesion with a rough, papillomatous growth occurring in many forms.
  • Commonly on hands, arms, fingers and feet but can occur anywhere on the body.
  • May occur singly or in groups and are thought to be contagious
A

Verruca (wart)

49
Q

What type of skin tumor has these characteristics:

  • a type of skin cancer
  • metastasis is rare but underlying tissue destruction can progress to include vital structures.
  • usually scaly in appearance.
  • may be a pearly papule with a central crater and waxy or pearly border
A

Basal Cell Carcinoma

50
Q

What type of skin tumor has these characteristics:

  • a pigmented, congenital skin blemish
  • usually benign but may become cancerous
A

Nevi (Moles)

51
Q

What type of skin tumor has these characteristics:

  • an overgrowth of collagenous scar tissue at the site of a wound of the skin
  • More common in blacks than whites
A

Keloids

52
Q

What type of skin tumor has these characteristics:

  • a type of skin cancer
  • arises in the epidermis
  • a firm, nodular lesion topped with a crust or a central area of ulceration and indurated margins
A

Squamous cell carcinoma

53
Q

What type of skin tumor has these characteristics:

  • develops when a group of blood vessels dilate and form a tumorlike mass
  • examples include: port-wine birthmark or telangiectasis
A

Angiomas

54
Q

What disorder of the skin appendages has these characteristics:

  • can be hereditary or acquired as a result of hormone dysfunction and medications
  • excessive growth of hair in a masculine distribution
A

Hypertrichosis (Hirsutism)

55
Q

What disorder of the skin appendages has these characteristics:

  • can be caused by skin disease, endocrine problems or malnutrition.
  • absence of hair or a decrease in hair growth
A

Hypotrichosis

56
Q

What disorder of the skin appendages has these characteristics:

  • nail disorder
  • Nails get soft or brittle and the shape can change as they grow into the soft tissue
  • nicknamed “runaround” because an infection of hte nail develops and spreads around the nail
A

Paronychia

57
Q

What disorder of the skin appendages has these characteristics:

  • loss of hair
  • may be due to aging, anxiety, disease processes or drugs such as antineoplastics.
  • usually not permanent
A

Alopecia

58
Q 
The nurse is caring for a patient who has complaints of excessive hair growth.  Which of the following terms is used to describe this condition?
A.  Alopecia
B.  Hirsutism
C.  Hypotrichosis
D.  Paronychia
A

B. Hirsutism

59
Q 
The physician has diagnosed a patient with paronychia.  When planning care, the nurse recognizes that it will likely be managed with?  (select all that apply)
A.  chemical depilation
B.  wet dressings
C.  surgical debridement
D.  antibiotic therapy
E.  antiviral therapy
A

B. wet dressings

D. antibiotic therapy

60
Q 
The LPN/LVN is assisting the registered nurse to prepare the plan of care for the patient with alopecia.  Which of the following nursing diagnoses will be most appropriate to include?
A.  Alteration in comfort
B.  Pain
C.  Potential for infection
D.  Impaired body image
A

D. impaired body image.

61
Q 
A patient arrives to be seen at the physician's office with complaints of hypotrichosis.  The nurse recognizes that potential causes for the disorder include:
A.  excessive dietary fat intake
B.  iron deficiency anemia
C.  malnutrition
D.  diabetes mellitus
A

C. malnutrition

62
Q 
A patient is admitted with complaints of pain and tenderness in his lower right leg.  The nurse's assessment reveals that the extremity is warm, swollen and has a slightly pitted appearance.  Based on the nurse's knowledge, what medical diagnosis can be anticipated?
A.  Cellulitis
B.  Impetigo
C.  Herpes zoster
D.  Folliculitis
A

A. Cellulitis

63
Q

When assisting a mother to plan meals for a child recently diagnosed with eczema, the nurse should advise her that common allergies for a patient with this diagnosis may include:
A. chocolate, strawberries, and cured sandwich meats
B. eggs, rye-containing products, and preservatives
C. orange juice, wheat and eggs
D. rye, wheat and bananas

A

C. orange juice, wheat and eggs

64
Q

A 16-year-old questions why the physician has prescribed Accutane for her acne. The nurse advises her that the medication will:
A. reduce the scarring associated with acne.
B. reduce the formation of blackheads
C. counteract the overactive hormones of adolescence associated with acne
D. reduce the production of sebum

A

D. reduce the production of sebum

65
Q

Which of the following factors is associated with aging of the integumentary system? (Select all that apply)
A. Localized clusters of melanocytes surrounded by areas of decreased pigmentation
B. Loss of pigmentation
C. Reduced thickness of the skin
D. Reduced incidence of seborrheic dermatitis of the scalp

A

A. localized clusters of melanocytes surrounded by areas of decreased pigmentation
B. loss of pigmentation
C. Reduced thickness of the skin

N106 Integumentary (3 decks)

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