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NCLEX > Integumentary & Burns > Flashcards

Integumentary & Burns Flashcards

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1
Q

epidermis

A

inhibits proliferation of microorganisms, prevents dehydration and electrolyte loss, sweat glands allow for temp regulation, synthesizes vitamin D, stimulation through neuroreceptors

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2
Q

Cells of the epidermis include

A

keratinocytes
melanocytes

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3
Q

components of dermis

A

connective tissue, hair follicles, sweat and oil glands, blood vessels, nerves, lymphatic vessels

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4
Q

hypodermis

A

absorbs shock to protect from injury, temp regulation (fats cells insulate and retain body heat)

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5
Q

types of lesions

A

primary and secondary

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6
Q

primary lesion

A

direct result of a disease process

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7
Q

secondary lesion

A

develop as a consequence of the clients activities

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8
Q

pruritus

A

itching

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9
Q

urticaria

A

hives

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10
Q

lichenified

A

thickened

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11
Q

annular

A

ring like with raised borders around flat centers of normal skin

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12
Q

circinate

A

circular

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13
Q

circumscribed

A

well defined, sharp borders

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14
Q

diffuse

A

wide spread

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15
Q

macular

A

flat

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16
Q

papular

A

raised

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17
Q

macule

A

discolouration of the skin that is salt and level with the skin

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18
Q

fissure

A

cleft or groove in the skin

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19
Q

module

A

small, node like structure that is solid and elevated

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20
Q

papule

A

small, solid and raised caused by thickening of epidermis

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21
Q

vesicle

A

small blister that contains clear fluid

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22
Q

polyp

A

growth that forms on a mucus membrane or other surface inside the body

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23
Q

cyst

A

closed pouch under the skin that contains a fluid or a semisolid substance

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24
Q

pustule

A

a small elevation on the skin that contains pus

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25
Q

wheal

A

area of all that is slightly raised and appears either redder or paler than the surrounding skin

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26
Q

secondary lesions include

A

scales, crust, ulcer, scar

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27
Q

risk factors for pressure ulcers

A

lack of mobility, exposure to excessive moisture, undernourishment, aging skin

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28
Q

blanchable

A

returns back to pink/red from white when area pushed on

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29
Q

non-blanchable

A

does not turn white when area is pushed on; means no perfusion

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30
Q

stage 1 pressure ulcer

A

non blanchable
tissue has started to become damaged
decreased perfusion
skin intact

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31
Q

stage 2 pressure ulcer

A

skin is no longer intact
wound bed visible
exposed dermis

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32
Q

stage 3 pressure ulcer

A

exposed dermis and hypodermis
slough, eschar, tunneling, adipose tissue, granulation tissue
damaged or necrotic subcu tissue

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33
Q

stage 4 pressure ulcer

A

all the way through hypodermis
can through integ system into MSK system

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34
Q

unstageable pressure ulcer

A

cannot see base of wound; covered with slough or eschar

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35
Q

eschar

A

dry, thick, leathery, brown/tan/black

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36
Q

slough

A

yellow/tan/green/brown, moist, loose, stringy

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37
Q

deep tissue injury

A

localized deep red/maroon area that is non-blanchable, no circulation, skin is intact, cannot see how far down it goes

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38
Q

to prevent shearing of skin do not elevate head of bed above

A

30 degrees

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39
Q

donut shaped pillow can damage

A

capillary beds and increase tissue necrosis

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40
Q

for clients that cannot reposition themselves they should be turned and repositioned every _____ hours

A

2

41
Q

dermatitis

A

inflammation of dermis

42
Q

contact dermatitis

A

hypersensitivity when exposed to certain allergen

43
Q

atopic dermatitis is also known as

A

eczema

44
Q

eczema S&S

A

intense itching, red, dry, scaly, skin
occur in flare ups
immune system is attacking dermis

45
Q

Psoriasis

A

chronic autoimmune T-cell mediated inflammatory skin disease; exacerbations and remissions; scaly, erythematous, pruritic plaques

46
Q

Psoriasis Tx

A

no cure because it’s autoimmune; for symptoms can do light therapy, methotrexate, folic acid, systemic retinoids, infliximab

47
Q

stevens-johnson syndrome

A

cytotoxic T cell drug reaction; T cells are killing keratinocytes in epidermis causing extensive blistering; is a response to a drug reaction

48
Q

stevens johnson syndrome treatment

A

stop all possible medications
fluids
nutrition
wound care
pain
prevent infection
corticosteroids

49
Q

cellulitis

A

bacterial infection of skin in dermis and hypodermis

50
Q

cellulitis S&S and causes

A

red, warm, swollen, painful skin

staph, MRSA, group B strep

51
Q

cellulitis tx

A

systemic abx

52
Q

impetigo

A

bullous or ulcerative; caused by staph or strep

53
Q

impetigo is more common in

A

children

54
Q

MRSA

A

staph infection resistant to abx; contact precautions

55
Q

HSV type 1 and 2

A

type 1 mouth and face
type 2 genitals

56
Q

HSV presentation

A

groups of vesicle on erythematous base and can turn into pustules, rupture, and form crusts

57
Q

HSV lasts

A

2-6 weeks

58
Q

HSV tx

A

topical/oral antiviral drugs

59
Q

Herpes zoster

A

grouped lesions with weeping and crusting; unilaterally along segment of skin that follows a cranial nerve

60
Q

herpes zoster S&S

A

appearance of HSV, follows cranial nerve, pain, parenthesia

61
Q

herpes zoster tx and prevention

A

antiviral drugs
vaccination

62
Q

tinea

A

fungal infection classified by location

63
Q

tinea pedis is also called

A

athletes foot

64
Q

tinea appearance

A

annular patches with elevated borders and scaling

65
Q

tinea tx

A

topical antifungal therapy

66
Q

candidiasis

A

yeast like fungal infection

67
Q

candidiasis S&S

A

erythematous macular eruption with isolated pustules at the border, burning and itching, common in skin folds (where warm and moist ideal for fungal growth)

68
Q

oral thrush lesions are

A

creamy white, white coated

69
Q

thrush is treated with

A

nyastatin

70
Q

squamous cell carcinoma and tx

A

top layer of epidermis grows out of control, from on areas of body exposed to sun (face, ears, neck), start at top and grow into deeper layers

tx: remove it

71
Q

basal cell carcinoma

A

most common type of skin cancer, form on areas of body exposed to sun, start in bottom layer of epidermis , slow growing and really spread

72
Q

melanoma

A

melanocytes that grow out of control, more dangerous and can spread easily

73
Q

melanoma appearance

A

dark brown or black, most commonly located on trunk or legs

74
Q

melanoma tx

A

surgery, immunotherapy, targeted therapy drugs, chemo, radiation

75
Q

1st degree burn

A

superficial, skin remains intact, redness, no blisters, can be painful to touch

76
Q

2nd degree

A

partial thickness burn, blisters form, affects epidermis and dermis, skin is moist and red, very painful

77
Q

3rd degree burns

A

full thickness burn, penetrate all the way into subcu tissue, destroy nerve endings so not as painful, red/tan/black, dry and leathery, area of eschar

78
Q

4th degree burns

A

full thickness and involvement of MSK, dry and dull, necrotic tissue

79
Q

tx of 3rd and 4th degree burns requires

A

skin graphing because cells that grow new skin cells are destroyed so it cannot heal on their own

80
Q

3 stages of burn management

A

emergent, acute, rehabilitative

81
Q

emergent burn management

A

first 24-48 hrs, large shift in membrane permeability/ fluids shift from intravascular space to interstitial space, high risk for hypovolemic shock, electrolyte imbalances, renal failure - fluids are priority (parkland burn formula)

82
Q

acute burn management

A

48-72 hrs after injury until would heals, membrane permeability is stabilized, focus on healing, preventing infection, pain relief, nutrition, wound care

83
Q

rehabilitative burn management

A

burn is now healed, focus on regaining function

84
Q

rule of 9s

A

Head 9%
Chest 18%
Abdomen 18%
each arm 4.5%
each leg 9%
genital 1%

85
Q

rule of 9s

A

head 9%
chest 18%
abdomen 18%
each arm 4.5%
each leg 4.5%
genitals 1%

86
Q

complications of burn injuries

A

hypovolemic shock, renal failure, hyperkalemia, hyponatremia

87
Q

third spacing is _______ and occurs in _______

A

plasma moving from intravascular space to interstitial space; hypovolemic shock

88
Q

decreased intravascular volume = decreased bp = __________

A

hypovolemia

89
Q

CVS recognizes hypovolemia and compensates by

A

increasing HR -> decrease CO -> decrease bp

90
Q

hypovolemic shock leads to decreased perfusion of

A

kidneys and renal damage

91
Q

insufficient urine output is

A

<30ml/hr

92
Q

in renal failure ________ will be increased

A

BUN and creatinine

93
Q

why does hyperkalemia occur in burn pts and S&S

A

injury to cells release the potassium into bloodstream; muscle weakness, cramps, nausea, chest pain, arrhythmias, tall peaked t waves

94
Q

why does hyponatremia occur in burn pts and S&S

A

due to increased capillary membrane permeability water leaves the intravascular space and sodium follows entering into the interstitial space; headache, confusion, restlessness, irritability, seizures, coma

95
Q

two electrolyte abnormalities in burn pts

A

hyperkalemia and hyponatremia

96
Q

fluid replacement is most crucial in the first ______ in burn pts

A

24 hrs as this is when slowly is losing largest volume and is at risk for hypovolemic shock

97
Q

fluid of choice for burns

A

Lactated ringers

98
Q

parkland formula for burns

A

total to be infused = 4ml x TBSA % x weight (kg) -> divide in half -> first half over 8hrs -> second half over 16 hrs

NCLEX (23 decks)

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