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NURS 322 > Integumentary Disorders > Flashcards

Integumentary Disorders Flashcards

1
Q

What are some functions of the skin?

A
  • protection
  • homeostasis
  • temperature regulation
  • sensory organ
  • vitamin synthesis
  • psychosocial
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2
Q

What are some important assessments to make for the skin?

A
  • color
  • lesions
    • primary: initial reaction to a problem that alters the structure of the skin
    • secondary: lesion that forms over time
  • edema
  • moisture
  • vascular changes
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3
Q

How do you assess a pt for skin cancer?

A

– ABCD:

  • asymmetry of shape
  • border irregularity
  • color variation within one lesion
  • diameter > 6mm
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4
Q

What is petechiae? What is ecchymoses?

A

– petechiae: tiny, brown/purple spots that appear on the skin due to bleeding under the skin

– ecchymoses: bruising

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5
Q

What is the purpose of palpation?

A
  • determines size of lesions
  • determines whether macular or papular
    • macular: flat
    • papular: raised
  • determines temperature – use back of hand
  • determines turgor – tent/pinch skin
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6
Q

What are the main hair assessments?

A

– inspect and palpate for:

  • cleanliness
  • distribution
  • quantity
  • quality
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7
Q

Define dandruff and hirsutism.

A

– dandruff: accumulation of patchy or diffuse white or grey scales on the scalp

  • severe dandruff can result in subsequent alopecia

– hirsutism: excessive growth of body hair

  • manifestation of hormonal imbalance
  • common with Cushing’s
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8
Q

What are the main nail assessments?

A
  • dystrophic nails – abnormal nails
  • color
    • depends on
      • thickness
      • transparency
      • blood flow
      • pigmentation
  • perfusion
  • shape changes
  • lesions
    • thickness
    • consistency
  • paronychia – inflammation of skin around the nail
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9
Q

What is the difference between acute and chronic paronychia?

A

– acute paronychia: inflammation around the nail due to acute infection

– chronic paronychia: infection that persists for months; common in constant water exposure

  • common on feet of surfers
  • can see in immunocompromised pts
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10
Q

How do assessments change for pts with darker skin?

A

– look at lips, tongue, nail beds, and eyes for:

  • pallor
  • cyanosis
  • inflammation
  • jaundice
  • bleeding
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11
Q

What are the 4 types of skin biopsies?

A
  1. punch biopsy: used for sampling possible cancers, tumors, and inflammatory skin conditions
  2. shave biopsy: horizontal shave of the skin lesion with only superficial portion of the dermis
  3. excisional biopsy: complete lesion removed with margin of normal skin down to adipose tissue
  4. incisional biopsy: cross-section wedge of tissue through center of lesion
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12
Q

How is a Wood’s lamp used for skin inspection?

A

UV light that is used to examine the skin; some infections produce a different color under Wood’s lamp

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13
Q

What is xerosis? What population commonly experiences xerosis? What are some complications that may result from xerosis?

A

– xerosis: dry skin; fine flaking of stratum corneum

– common in older pts

– results in generalized pruritus

  • scratching may result in
    • lesions
    • excoriations
    • lichenification – thickening and leathering of skin (callosing)
    • infection
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14
Q

What are some interventions for xerosis?

A
  • rehydration to relieve itching
    • moisturizing soaps, oils, lotions
    • water to soften skin layers
    • creams and lotions to seal in moisture
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15
Q

What is a sunburn? How is it treated?

A

– first degree, superficial burn that results from excessive exposure to UV light

– treatments:

  • cool baths
  • soothing lotions
  • antibiotic ointments for blistering/infected skin
  • topical corticosteroids for pain
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16
Q

What is urticaria? How is it treated?

A

– urticaria: hives; white or red edematous papules or plaques of varying sizes

– treatment:

  • removal of triggers
  • antihistamines
  • avoid things that can worsen symptoms
    • overexertion
    • alcohol consumption
    • warm environments
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17
Q

What are the 3 phases of wound healing?

A
  1. inflammatory phase – 3 - 5 day window after trauma
  2. fibroblastic/connected tissue repair – formation of clot and tissue repair
  3. maturation/remodeling – collagen is reorganized to provide greater strength
18
Q

What are the 3 types of intention in wound healing?

A
  1. first intention – results in a thin scar
  2. second intention – granulation and contraction; results in a deeper tissue injury or wound
  3. third intention – delayed closure; much larger scar
    • high risk for infection
19
Q

What is a full thickness wound? How are full thickness wounds healed?

A

– full thickness wound: damage which extends into the lower layers of the dermis and subcutaneous tissue

– healed by removing damaged tissue so granulation tissue can fill the space and heal

  • results in wound contraction
20
Q

What is a pressure ulcer? What are 3 mechanical forces that can cause pressure ulcers?

A

– pressure ulcer: tissue damage caused when the skin and soft tissue and compressed between a bony prominence and another surface for an extended period

– 3 mechanical forces:

  1. pressure
  2. friction
  3. shear
21
Q

What is the difference between contamination and infection?

A

– contamination: presence of organisms without any manifestations of infection

– infection: contamination with pathogenic organisms to the degree that growth and spread cannot be controlled by the body’s immune defenses

– an exposed wound is always contaminated but not always infected

22
Q

What are some nonsurgical therapies for wound care?

A
  • mechanical debridement
  • natural chemical debridement
  • hydrophobic material
  • hydrophilic material
  • physical therapy – whirlpool/hydro therapy to clean the wound
  • drug therapy – antibacterial agents
  • nutrition therapy – high protein diet
  • technologies
    • electrical stimulation
    • wound vacs
    • hyperbaric oxygen (HBO) – 100% oxygen at sea level to stimulate healing; increases oxygen concentration
    • topical growth factors – biologically active substances that stimulate cell growth and movement
    • skin substitutes – skin grafts; provide temporary or permanent wound closure
23
Q

What are the 3 types of bacterial infections?

A
  1. folliculitis: superficial infection involving only the upper potion of the follicle
    • usually Staph infection
  2. furuncle: boil; much deeper infection in the follicle
    • usually Staph infection
  3. cellulitis: generalized infection involving deeper connective tissue
    • either Staph or Strept
24
Q

What are the 4 manifestations of herpes simplex virus (HSV)?

A
  1. type 1 (HSV-1): classic recurring cold sore
  2. type 2 (HSV-2): genital herpes
  3. herpes zoster/shingles: reactivation of dormant varicella-zoster virus in pts who have previously had chickenpox
  4. herpetic whitlow: form of herpes infection occurring on the fingertips of medical personnel who have come into contact with viral secretions
25
Q

How does shingles present? What is one potential complication of shingles?

A

– presents as multiple lesions in a segmental distribution on the skin area innervated by the infected nerve

– complication is postherpetic neuralgia: chronic pain even after lesions resolve due to damage to the nerves from the virus

26
Q

What are dermatophytes? What are some types of fungal infections?

A

– dermatophytes: fungal infections of the skin (require keratin for growth)

– types of fungal infections:

  • Tinea infections – ringworm
  • Candida albicans
27
Q

Why is eczema unique? What other condition often accompanies eczema?

A

– eczema presents differently from pt to pt

– asthma often goes hand-in-hand with eczema

28
Q

What are 3 diagnostic tests that can be used for skin conditions?

A
  1. Tzanck smear: exam for viral infections
  2. swab culture: exam for bacterial infections
  3. KOH test: exam for fungal infections
29
Q

What are some interventions for skin conditions?

A
  • skin care – proper cleansing
  • warm compresses – helps folliculitis and furuncles
  • heat
  • isolation precautions
  • drugs
    • antibacterial drugs
    • antifungal drugs
    • anti-inflammatory drugs
    • Burrow’s solution – for viral infections
30
Q

In what population do parasitic disorders of the skin occur most often? What are some examples of parasitic disorders? What is the recommended treatment?

A

– occurs most often in pts with poor hygiene

– examples:

  • pediculosis – human lice
  • scabies – mites
  • bedbugs

– treatment = eradication

31
Q

What is the most common symptom for pediculosis? What are the treatments?

A

– symptom = pruritus

– treatments:

  • drugs
  • laundering of clothing and bed linens
32
Q

What is scabies? How is it transmitted? How is it identified and confirmed? How is scabies treated?

A

– scabies: contagious skin disease caused by mites

– transmitted by close and prolonged contact or infested bedding

– identified by examination of the skin between fingers and on the palms (these areas are very common sites for infestation) and is confirmed by examination of a scraping of a lesion under a microscope

– treatment:

  • topicals
  • laundering
33
Q

What is the difference between contact dermatitis and atopic dermatitis?

A

– contact dermatitis: acute or chronic rash caused by direct irritants

– atopic dermatitis: rash that often occurs when accompanied by respiratory allergens

34
Q

What are some interventions for dermatitis?

A
  • steroids
  • avoidance of oil-based products
  • antihistamines
  • compresses
  • baths
35
Q

What is psoriasis? What is the most common type of psoriasis? What is exfoliative psoriasis?

A

– psoriasis: lifelong disorder with exacerbations and remissions; scaling disorder with underlying dermal inflammation; potentially autoimmune

– most common = psoriasis vulgaris

– exfoliative psoriasis: explosively eruptive and inflammatory form of psoriasis

36
Q

How is psoriasis treated?

A
  • corticosteroids
  • tar – reduces inflammation
  • topical therapies
  • UV light therapy
  • biologic agents – can make the pt more immunocompromised
  • cytotoxic agents – Methotrexate
  • immunosuppressants
  • emotional support
37
Q

What are the 4 types of benign tumors?

A
  1. cysts: flesh colored, can move around
  2. seborrheic keratoses: wart-like appearance but benign
  3. keloids: overgrowth of scar tissue
    • common in POCs
    • can remove but risk of it coming back worse
    • can get steroid injections to thin it out, but could become irritated and enlarge
  4. nevi: moles; well-defined borders, uniform in color
38
Q

What are the 4 types of skin cancers?

A
  1. actinic keratoses: pre-malignant lesions
    • can progress into squamous cell carcinomas
    • results from sun exposure
    • use a punch biopsy to test malignancy
  2. squamous cell carcinoma: cancerous lesions in squamous cells
    • likely to metastasize if not treated
  3. basal cell carcinoma: cancerous lesions in basal cells (deeper layer than squamous)
    • linked to UV exposure
  4. melanomas: highly metastatic cancer
    • diagnose by ABCDs
    • arise from melanin-producing cells
    • survival depends on early diagnosis and treatment
39
Q

What are the 5 surgical ways to treat skin cancer?

A
  1. cryosurgery: freezing of the lesion
  2. curettage and electrodesiccation: scrape off lesion until there are no remnants, place electrical probe to kill anything microscopic that remains
  3. excision: biopsy of lesions
  4. Mohs’ surgery: excision by layers to treat carcinomas
  5. Wide excision: treatment of melanomas; deeper and wider area of removal than other surgeries
40
Q

What are some nonsurgical treatments for skin cancers?

A
  • drugs
    • systemic
    • topical
  • radiation
    • limited effectiveness and use – pts with larger carcinomas or with more malignant carcinomas are not candidates
41
Q

What is the most common form of skin biopsy?

A

punch biopsy

NURS 322 (19 decks)

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