integumentary function Flashcards
what color undertone does a healthy, dark-skinned person have?
reddish
what color undertone does an unhealthy, dark-skinned person have?
brown skin: yellow brown
black skin: ashen gray
what does a cyanotic, dark-skinned person skin look like?
dark but dull, observe conjunctiva, oral mucosa
papule
A papule has distinct borders, <1 cm in diameter, and it can appear in a variety of shapes. Warts, psoriasis
Wheal
Wheal - Transient, circumscribed, elevated papules or plaques, often with erythematous borders and pale centers. Urticaria (hives) insect bites
Bulla
fluid-filled sacs or lesions. Large Burns, poison ivy
Nodule (Tumor)
A nodule is a growth that forms under your skin. A nodule may be filled with inflamed tissue or a mixture of tissue and fluid.
Pustule
Pustule: a small, circumscribed, elevated lesion containing prurulent material. Macule: a flat rash
cyst
sac-like structures that may be filled with gas, liquid, or solid materials
fissure
a cutaneous condition in which there is a linear-like cleavage of skin, sometimes defined as extending into the dermis.
scales
sign of dry skinand other skinconditions, such as eczema and psoriasis.
atrophy
Thinning or depression of skin due to reduction of underlying tissue. Atrophyof the epidermis manifests as a thin and wrinkled surface.
crust
result of drying of plasma or exudate on the skin
Lichenification
a common consequence of atopic dermatitis (eczema) and other pruritic (itchy) disorders.
Petechiae
purpura or ecchymosis describes red blood cells that are outside the vessel walls & areas are nonblanchable
Spider Angioma
a central and elevated red dot, about the size of a pinhead, from which small blood vessels radiate.
associated with high estrogen levels as occur in pregnancy or when the liver is diseased and unable to detoxify estrogens
Venous Star (Telangiectasia)
A small red nodule formed by a dilated vein in the skin. It is caused by increased venous pressure.
Cherry Angiomas
small, vascular bright-red, papular lesions shown on the image are called cherry hemangiomas
Contact dermatitis
a condition in which the skin becomes red, sore, or inflamed after direct contact with a substance.
Seborrhoeic dermatitis
a common, harmless, scaling rash affecting the face, scalp and other areas
Scabies
an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis).
Herpes zoster
also known as shingles or zoster, is a reactivated VZV infection of the sensory nerve ganglion and the peripheral nerve and its branches
Which can cause hyperpigmentation of the skin?A.Eczema
B.Fungal infection
C.Sun injury
D.Vitiligo
C.Sun injury
Hyperpigmentation can be a result of sun injury.
What would be considered a normal finding in the skin assessment of an older adult?A.Elastic skin
B.Uneven pigmentation
C.Cherry angiomas
D.Petechiae
B.Uneven pigmentation
Older adults have thin, nonelastic skin that is fragile and easily injured.
What causes hypopigmentation
may be caused by a fungal infection, eczema, or vitiligo.
What are the objectives of therapy for patients with skin conditions?
Prevent additional damage
Prevent secondary infection
Reverse inflammatory processes, and relieve symptoms.
What are passive wound dressings?
have only a protective function/maintain moist environment for healing. Tagaderm
What are interactive wound dressings?
capable of absorbing wound exudate and maintaining a moist environment. hydrocolloid, alginates, hydrogel
What are active wound dressings?
improve the healing process and decrease healing time. skin grafts and biologic skin substitutes
Systemic disorders associated with pruritis
Chronic kidney disease, Obstructive biliary disease (cirrhosis, drug induced, Endocrine disorders (diabetes, hypothyroidism), Psychiatric disorders (phobias, stress, anxiety), Malignancies ( leukemia, lung, breast, GI tract), Neurological disorders (MS, brain abscess, brain tumor), Hematologic disorders (iron deficiency anemia), Pregnancy, Folliculitis (bacterial, candidiasis, dermatophyte), Skin conditions (seborrheic dermatitis, atopic dermatitis)
Nursing implications for pruritis
Bathe in tepid water, no vigorous rubbing/toweling
Avoid situations that cause vasodilation (warm environment, alcohol, hot foods)
Use humidifier
Cotton clothing
Hidradentitis Suppurativa
Chronic folliculitis found in the perianal area, axillary, and genital area, underneath the breasts. African Americans are at greater risk
Fungal infections (skin)
tinea pedis (athletes foot), tinea coporis, tinea capitis (scalp), tinea cruris (jock itch), tinea unguium (toe nail function)
viral infections (skin)
herpes zoster
Herpes simplex: orolabial, genital
Bacterial infections (pyodermas)
Impetigo
Folliculitis, furuncles, and carbuncles
Herpes zoster: viral infection care
instruction regarding prescribed antiviral medications, lesion care, dressings, and hand hygiene
Herpes simplex: viral infection care
instruction regarding prescribed antiviral medications and prophylactic medication use, instruction regarding spread of herpes, and measures to reduce contagion of partner or of neonates born to mothers with genital herpes
Impetigo: bacterial infection care
A contagious and may spread to other parts of patient’s body or to other persons.
Patient education regarding antibiotics, hygiene, and skin and lesion care.
Don’t share towels, combs, and so on.
Bathe daily with antibacterial soap.
Furuncles, boils, or pimples should never be squeezed.
Fungal infection care
Instruction regarding medications, use of oral and topical agents, and shampoos
Instructions regarding hygiene: use clean towels and washcloths every day
Do not share towels, combs, and so on.
Keep skin folds and feet dry.
Wear clean, dry, cotton clothing, including underwear and socks; avoid synthetic underwear, tight-fitting garments, wet bathing suits, and plastic shoes.
Avoid excessive heat and humidity.
Hair loss associated with tinea capitis is temporary.
Parasitic skin infestations
Pediculosis (lice): pediculosis capitis, pediculosis corporis, Phthirus pubis
Scabies (mites): Sarcoptesscabei
Pediculosis Capitis care
Head lice may infest anyone and are not a sign of uncleanliness.
Instruction in use of shampoo (lindane [Kwell] or pyrethrin [RID]) and combing of hair with fine-tooth comb dipped in vinegar to remove all nits
Note lindane may have toxic effects and must be used only as directed.
All articles of clothing and bedding must be disinfected, washed in hot water, or dry cleaned. Furniture and floors should be frequently vacuumed.
Do not share combs, hats, and so on.
All family members and close contacts must be treated.
Pediculosis Corporis and Pubis care
Pediculosis corporis is a disease related to poor hygiene and of those who live in close quarters.
Spread chiefly by sexual contact.
Bathe in soap & water, apply prescription scabicide or OTC permethrin (NIX). If eyelashes are involved, Vaseline may be applied twice a day for 8 days. Mechanically remove any nits.
All family members & sexual contacts must be treated & instructed regarding personal hygiene.
All clothing & bedding must be washed in hot water or dry cleaned.
Patient & partner should also be scheduled for checkup to assess for coexisting sexually transmitted disease.
When should scabicide be applied?
immediately after bathing and before the skin dries and cools increases percutaneous absorption. The potential for central nervous system abnormalities.
psoriasis
A chronic, noninfectious inflammatory disease of the skin in which epidermal cells are becomes infiltrated by activated T cells and cytokines, produced at an abnormally rapid rate
Treatment for psoriasis
baths to remove scales and medications; Corticosteroids, tar preparations, other topical therapies, ultraviolet light therapy
Pemphigus Vulgaris
Autoimmune disease
Bullae (Blisters) on normal skin and mucous membranes
Level of serum antibody is a predictor of severity
Jewish or Mediterranean decent
Starts with oral lesions. Becoming widespread
Bullous Pemphigoid
Chronic disease with flare ups and remission
Most common in older adults, can be fatal
Bullae that tend to appear on flexor muscle of arms
Pruritus before blisters
Dermatitis Herpetiformis
Manifests with small, tense blisters over extensor surfaces of elbows, knees, buttocks and back
Most common between 20-40 years of age
European heritage
Defect in gluten metabolism
Nursing assessment for patients with blistering disease
Appearance of the skin
Monitor VS frequently and assess for signs and symptoms of infection
Pain, pruritus, and discomfort
Coping of the patient with condition
Note impact of the disease on patient activities and interactions
Nursing diagnosis and potential problems for patients with blistering disease
Acute pain: skin and oral cavity Impaired skin integrity Anxiety Ineffective coping Deficient knowledge
Infection and sepsis
Fluid volume deficit and electrolyte imbalance
Assessment and Care of the Patient With Toxic Epidermal Necrolysis and Stevens–Johnson Syndrome
Skin inspection Oral cavity inspection Vital signs Respiratory secretions Fatigue Pain level Coping mechanism
Collaborative Problems and Potential Complications Patient With Toxic Epidermal Necrolysis and Stevens–Johnson Syndrome
Sepsis
Conjunctival retraction, scars, and corneal lesions
Kaposi’s Sarcoma
A malignancy of endothelial cells that line the blood vessels: dark reddish-purple lesions of the skin, oral cavity, GI tract, and lungs
Frequently seen in AIDS patients. can migrate to lymphatic system
What is the most common type of skin cancer?
basal cell carcinoma, generally don’t matastisize
What are the ABCDE’s of assessing moles?
A for Asymmetry B for Irregular Border C for Variegated Color D for Diameter E for Evolving
Laser Treatment of Lesions
Carbon dioxide laser
Pulse-dye laser
Pulsed Er: YAG laser
