integumentary (class 4) Flashcards
epidermis
five layers. melanin. keratin.
dermis
capillaries & pain/touch receptors. blood vessels, sweat/sebaceous glands, collagen fibers.
skin assessment history
onset/duration of problem.
characteristics.course. severity. precipitating/relieving factors. timing and circumstances. history of associated illness. presence of risk factors.
physical assessment
private room. patient comfort. systematic head to toe. compare symmetry. general inspection. lesion-specific inspections: measure with metric system, appropriate terminolgy, remove cosmetics, oils, location, distribution, color, pattern, edges, size, elevation, exudate.
primary lesions
caused directly by disease. present at onset of disease.
Ex. vesicles RT chicken pox. nodules RT RA.
secondary lesions:
result from changes over time caused by disease progression, manipulation, or treatment.
ex: crusted, excoriated or infected lesion caused by scatching the vesicle, pressure ulcers, vascular ulcers RT PVD, scars, keloids.
macule
flat, nonpalpable change in color
papule
small elevated, solid mass, < 0.5 cm
plaque
raised, flat lesion-groups of papules
nodule
larger than a papule (more than 1 cm) raised solid lesion extending deeper into the dermis.
vesicle
elevated, fluid-filled, thing wall
pustule
elevated, pus-filled
cyst
elevated, encapsulated in the SQ, fluid or semi-solid
ulcer
deep, irregularly-shaped area of skin loss, dermis or SQ.
pruritus
variable size of area. itch-scratch-itch cycle.
causes: may or may not be associatd with rash. environmental factors & allergies. emotional distress. secondary to systemic disease.
management: identify eliminate cause, meds to manage itch, secondary effects.
Xerosis
common in older adults due to decrease lubrications and reduced moisture retention.
manifestations: pruritis, flaking of skin surfaces, secondary lesions & liechenification.
nevi
macules and papules with defined borders. arise from melanocytes early in life and migrate up. dysplastic nevi- can become malignant.
management: monitor for changs in size, thickness, color, bleeding, or itching.
keratoses
generally benign overgrowth and thickening. adults>50. tan, waxy, can appear greasy, commonly on face or trunk. seborrheic ketatoses: waxy or warty, uneven pigment, can be malignant.
psoriasis
chronic, immune characterized by raised red round circumscribed plaques covered by silvery white scales.
psoriasis: medication
steroids, topical: tar preps, calcipotriene.
furuncle
inflammation of hair follices. deep firm rea painful nodule 1-5 cm.
contributing factors: trauma, poor hygeine, systemic disease.
carbuncle
group of infected hair follices. multiple openings to skin surface, firm mass in SQ/dermis. common on neck, upper back, thighs. s/s: swelling & pain, systemic: chills, fever, malaise.
* usually staph aureus.
cellulitis
localized infection of dermis & SQ tissue. area is red, swollen, and painful, diffuse borders. s/s fever, chills, HA, swollen lymph nodes. MRSA: HA-MRSA, CA-MRSA, 1/3 population+ is colonized.
cellulitis treatment
culture to identify correct antibiotic. assess local and systemic symptomrs. cover draining lesions. handwashing & isolation. moist heat. immobilize & elevate, hospital for severe case. can progress to gangrene or sepsis.
non-melanoma cancers:
fair skin, freckles, blond or red hair, blue or green eyes.
family hx. unprotected excessive exposure to uv radiation.
actinic keratosis
sun damage, 20% convert to squamous cell carcinoma. erythematous rough macules shiny or scaly.
