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Nursing 102 > Integumentary Exam #2 > Flashcards

Integumentary Exam #2 Flashcards

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1
Q

What is dermatitis?

A

Superficial inflammatory response of the epidermis caused by infections, allergies, irritating substances.

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2
Q

What is the primary nursing goal with dermatitis?

A

Relieve pruritis

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3
Q

What is Seborrheic Dermatitis?

A

Dandruff

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4
Q

What causes dandruff?

A

overproduction of sebum by sebaceous glands of scalp and irritation from a yeast

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5
Q

What are Sx of seborrheic dermatitis?

A

oiliness, erythema, yellow greasy scales, ITCHY

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6
Q

What is Tx for seborrheic dermatitis?

A

dandruff shampoo, topical steroids, olive oil

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7
Q

What is contact dermatitis?

A

condition in which skin becomes red, sore and inflamed after direct contact with a substance. Can be irritant or allergic

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8
Q

Inflammation intensity for contact dermatitis is R/T to:

A
  • concentration of irritant
  • exposure time
  • repeated use
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9
Q

What is the diff between an irritant & allergic reaction?

A

irritant needs no prior exposure

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10
Q

How many days after exposure to allergen does reaction occur?

A

2-7 days after contact

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11
Q

How can you Dx allergic contact dermatitis?

A

visual assessment

patch testing

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12
Q

What is rhus-dermatitis?

A

allergic reaction to plants (ie poison ivy)

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13
Q

When do Sx occur after contact with rhus-dermatitis?

A

24-48 hours

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14
Q

What is Tx for rhus-dermatitis?

A

ASAP: wash skin, antihistamines, steroids

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15
Q

What does an acute allergic contact dermatitis reaction look like?

A

papules, vesicles or bulla

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16
Q

What does a chronic allergic contact dermatitis reaction look like?

A

Thick & scaly, like atopic dermatitis

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17
Q

What are some common allergens causing allergic contact dermatitis?

A

topical ABX, jewelry, latex, poison ivy, oak & sumak

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18
Q

What is atopic dermatitis?

A

Eczema, exaggerated response to environmental allergens characterized by remissions & exacerbations

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19
Q

What causes atopic dermatitis?

A

chronic & inherited immunological abnormality- elevated IgE

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20
Q

What is Xerosis?

A

dry skin

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21
Q

When is eczema worse?

A

in childhood

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22
Q

What does acute atopic dermatitis look like?

A

Bright red, oozing vesicles, very itchy!

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23
Q

What does subacute atopic dermatitis look like?

A

Scaly plaques

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24
Q

What does chronic atopic dermatitis look like?

A

Thickened skin, lichenification

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25
Q

When is lichenification?

A

thickened skin which appears “bark-like”

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26
Q

What are causes of exacerbations of eczema?

A

excess washing, temp/humidity, irritating substances, emotional stress

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27
Q

What is Tx for eczema?

A

no Tx! only control of Sx

topical steroids, relieve pruritis, phototherapy (severe cases)

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28
Q

What are s/e of long-term use of topical steroids?

A

skin atrophy, increased risk for ulcers

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29
Q

What is Exfoliative dermatitis?

A

scaling, erythematous dermatitis that progresses to desquamation of skin & mucous membranes

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30
Q

What are examples of exfoliative dermatitis?

A

Steven-Johnson Syndrome & TENS

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31
Q

What are common causes of exfoliative dermatitis?

A

severe allergic reaction to meds (often ABX) & pre-existing skin conditions (psoriasis or eczema)

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32
Q

What are complications of exfoliative dermatitis due to skin loss?

A

Dehydration, protein loss, hypothermia & infection

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33
Q

What % of skin is lost with SJS & TENS?

A 
SJS = less than 10%
TENS = 30-100%
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34
Q

What are S/Sx of SJS & TENS?

A

begin w flu-like Sx, then diffuse painful & burning rash, bulla (blisters), erosion & crusting, Mucous membranes affected in over 90% of cases

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35
Q

How long after drug ingestion does exfoliative dermatitis occur?

A

1-3 weeks

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36
Q

What are urticaria?

A

hives, immediate post-allergen exposure

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37
Q

How do you Tx urticaria?

A

antihistamines

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38
Q

What is angioedema?

A

allergic response, severe swelling, esp of face & resp tract, abrupt onset

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39
Q

What are common causes of angioedema?

A

ACE inhibitors, shellfish & peanuts

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40
Q

What are primary concerns with angioedema?

A

airway & anaphylactic shock

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41
Q

Tx for angioedema?

A

antihistamines, epi, steroids

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42
Q

What is acne vulgaris?

A

Acne, disease of pilosebaceous unit

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43
Q

When does acne vulgaris begin?

A

during puberty

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44
Q

What is non-inflammatory acne?

A

plug of keratin, sebum & bacteria = white heads & black heads

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45
Q

What is inflammatory acne?

A

papules & pustules

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46
Q

What is Tx for non-inflammatory acne?

A

Vit A retinoic acid

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47
Q

What is Tx for inflammatory acne w papules, pustules & cysts?

A

benzoyl peroxide

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48
Q

What is Tx for severe nodulocystic acne?

A

accutane

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49
Q

What is psoriasis?

A

chronic, non-contagious skin disorder caused by excessive growth of epidermal keratinocytes & rapid turnover of epidermal cells

50
Q

Mild psoriasis vs severe psoriasis?

A 
mild= at least 3% of body
severe= over 10% of body
51
Q

Which season is psoriasis better? worse?

A

worse winter, better summer

52
Q

What does psoriasis look like?

A

red patches covered with silver scales (heaped up dead skin cells)

53
Q

What is the Keobner Isomorphic Phenomenom?

A

psoriasis spreads along skin injury

54
Q

S/Sx of psoriasis?

A

silver scales & pitting nails

can also cause joint pain

55
Q

What is Tx for psoriasis?

A

UV light therapy, PUVA (ingestion of photosensitizing agents prior to exposure to UVA light)

56
Q

What are risks of PUVA?

A

premature aging & increased risk of skin CA

57
Q

What is a port wine stain?

A

type of angioma, present at birth, usually on face, flat irregular, red/purple patches initially smooth then darken with age and become papular (cobblestone surface)

58
Q

What is best Tx for port wine stain?

A

argon laser (high energy beam selectively absorbs red pigment of Hgb)

59
Q

What are telangiectasia?

A

vascular lesions caused by dilated superficial dermal vessels due to increased vessel pressure (ie spider veins)

60
Q

What are cherry angiomas?

A

round, bright red papule less than 6mm that blanches with presure

61
Q

What are cherry angiomas possible signs of?

A

HTN, hepatic disease, infection

62
Q

What are lentigo?

A

sun spots/ liver spots

63
Q

what causes lentigo?

A

sun damage

64
Q

How do you Tx lentigo?

A

cryotherapy

65
Q

What are seborrheic Keratoses?

A

benign growths, not R/T sun exposure, caused by increase in # of pigmented cells (increase with age)

66
Q

What are nevi?

A

moles

67
Q

What are developmental stages of moles?

A

junctional
compound
dermal

68
Q

What is the junctional stage of nevi?

A

occurs in childhood, nevus cells in dermo-epidermal junction

69
Q

What is compound stage of nevi?

A

some nevus cells migrate into dermis

70
Q

What is dermal stage of nevi?

A

All nevus cells migrate into dermis. Not cancerous!

71
Q

What is congenital nevi?

A

birthmark

72
Q

What is a halo nevi?

A

mole with white ring around it

73
Q

What does UV damage target?

A

DNA (cell replication)

74
Q

What is UVA responsible for? UVB?

A

uvA=Aging

uvB=Burning

75
Q

Which UV is the major contributor of melanoma?

A

UVB

76
Q

What is the leading cause of skin CA?

A

sunlight

77
Q

What is dysplastic nevus syndrome?

A

marker for young onset melanoma, appear in childhood as moles and change at puberty. larger than common moles, mixture of colors within lesion, irregular borders

78
Q

What is actinic keratosis?

A

rough, scaly papules, premalignant lesions, pre-cursor to SCC

79
Q

What is Tx for actinic keratosis?

A

surgical removal, cryosurgery, chemical peel

80
Q

What is 5FU topical chemo?

A

topical chemo that selectively targets sun-damaged skin, works in stages

81
Q

What are the stages of 5FU topical chemo?

A

Early inflammation- erythema in Tx’ed areas
Severe inflammatory- erythema, edema, burning, stinging, oozing (can last up to 6 wks)
Lesion disintegration- erosion/ulceration, pain, eschar

82
Q

What are the 2 types of nonmelanoma skin cancers?

A

Squamous Cell Carcinoma (SCC) (more aggressive)

Basal Cell Carcinoma (more common)

83
Q

Which cells are associated with Squamous Cell Carcinoma?

A

keratinizing cells of the epidermis

84
Q

What does SCC look like?

A

firm nodules with indistinct borders, red, inflamed base with thin, scaly plaque

85
Q

What is Tx for SCC?

A

Electrodessication & curretage

86
Q

What kind of tumor is Basal Cell Carcinoma?

A

enlarging tumor of the epidermis, rarely metastasizes beyond skin

87
Q

What does BCC look like?

A

begins as pearly white dome, extends peripherally, center depresses with rolled pearly border, center ulcerates, bleeds, crusts & scales (cycle of ulceration & healing)

88
Q

What is Tx for BCC?

A

excision

89
Q

What is Moh’s procedure?

A

microscopically controlled surgery, thin layers & margins of skin removed until tumor is removed

90
Q

What kind of cell is associated with melanoma?

A

melanocytes

91
Q

What does melanoma look like?

A

usually dark brown or jet black with red around it

92
Q

What are early signs of melanoma?

A

change in shape and/or color of mole

93
Q

What are late signs of melanoma?

A

ulceration & bleeding of mole

94
Q

How is melanoma Dx?

A

excisional biopsy (bc of thickness)

95
Q

How is melanoma staged?

A

Stage 0= tumor in situ (no spread)
Stage I-II= ulceration possible with extension into dermis (local spread)
Stage III= one or more lymph nodes involved (regional spread)
Stage IV= distant metastasis to lung, liver & brain (in that order)

96
Q

What is primary Tx for melanoma?

A

wide excision surgery, chemo, radiation

97
Q

What kind of biopsy is used for melanoma?

A

Excisional biopsy

98
Q

What is blepharoplasty?

A

removal of loose skin & protruding peri-orbital fat in the upper & lower eye lids

99
Q

What is the major concern with rhinoplasty?

A

airway

100
Q

What is a rhytidectomy?

A

face lift

101
Q

What is the purpose of the constrictive dressings after rhytidectomy?

A

prevent hematoma formation

102
Q

What is hypomastia?

A

small boobs!

103
Q

Why is dermabrasion performed?

A

to smooth scars & surface irregularities, remove foreign body tattoos

104
Q

What is dermabrasion?

A

removal of epidermis & portion of dermis (aggressive exfoliation)

105
Q

Which is a light peel?

A

AHA

106
Q

Which is medium depth peel?

A

TCA

107
Q

Which is strongest, deep peel?

A

Phenol

108
Q

Most important thing to teach pt after chemical peel?

A

avoid sun exposure!

109
Q

What is botox?

A

neurotoxin that interferes w neuromuscular transmission (paralyzes small muscle groups)

110
Q

What is botox used for?

A

to Tx migraines & hyperhidrosis & decrease wrinkles

111
Q

How often does botox need to be repeated?

A

q 3-6 months

112
Q

What is a free graft?

A

transfer of tissue

can be full thickness or split thickness

113
Q

What is a flap?

A

tissue that is detached from 1 area of body and transferred to recipient area w o terminating the vascular attachment

114
Q

What is a pedicle?

A

point where flap remains attached to vascular supply

115
Q

What is a homograft?

A

temporary skin cover, from cadaver

116
Q

What is a heterograft/xenograft?

A

temporary skin cover, from another species (usually pig)

117
Q

What is an autograft?

A

permanent skin cover, living tissue transfer from same person

118
Q

What kind of bandage must be used over grafted skin?

A

non-adhesive!!

119
Q

What is full-thickness skin grafting?

A

over 1 mm thick, includes all skin layers + blood vessels used for exposed surfaces & friction prone areas (looks good + functions)

120
Q

What is split-thickness skin grafting?

A

0.2-1 mm, epidermis & part of dermis, for nonexposed areas, more likely to survive

121
Q

What is a dermatome?

A

tool used to remove skin to be grafted

Nursing 102 (9 decks)

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