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Medical Surgical Nursing 1 😭 > Integumentary Function chap. 60, 61 > Flashcards

Integumentary Function chap. 60, 61 Flashcards

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1
Q

Steroids and anticoagulants make skin ______ if we don’t care for it properly.

A

Thin

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2
Q

How long should person stay on the sun?

A

5-30 min twice a week

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3
Q

Skin biopsy: Scapel or punch is used to _______?

A

Remove tissue; pathology to rule in/out malignancy

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4
Q

Patch testing Apply _____ Worn for _____days? Assessed_____hr?

A

Apply to intact skin with occlusive patches worn for 2 days and assessed in 72 hours; condition of skin determines reaction

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5
Q

Skin scraping

A

Scape suspected fungal infection and examined under microscope

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6
Q

Tzanck smear is what kind of lesions?

A

Blistering lesions such as herpes ; secretions are examined on the slides

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7
Q

Wood’s light examination

A

Special lamp; used in darkened room; examines lesions and unusual pigmentation patterns Usually this person loves sun !!!!!

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8
Q

Photographs in the hospital are used for? What should we include?

A

Document nature and extent of skin conditions and document progress resulting from treatment. Also track moles. Photographs in the chart Medical # - keep it confidential Include body area

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9
Q

Essentials to consider when bathing

what soap?

A

Mild soap/ soap substitute - DOVE/CETAPHIL Rinse completely and blot dry - soft cloth (under folds as well) Avoid deodorant soaps (they are very drying)

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10
Q

What precautions we use to prevent secondary infection?

A

Standard precautions/ PPE

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11
Q

Reversing the inflammatory process: Acute? Chronic?

A

Acute- soothing lotions

Chronic- water-soluble, emulsions, creams, ointments, pastes

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12
Q

Chronic wound is covered for how long?

A

48-72

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13
Q

Acute wound is covered for how long?

A

24 hours

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14
Q

The natural wound should NOT be _______

A

Disrupted unless infected or draining

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15
Q

Passive wound dressing

A

Protective function and to maintain a moist environment

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16
Q

Interactive wound dressing

A

Absorb exudate (drainage); gives moisture to wound and protects surrounding skin

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17
Q

Active wound dressing

A

Improve healing and decreases healing time; examples include: Skin grafts Biologic skin substitutes, Pigskin, Amniotic tissue

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18
Q

Rules of wound care

1.

2.

3.

4.

5.

A
  1. Categorization
  2. Selection
  3. Change
  4. Evolution
  5. Practice
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19
Q

Debridement: more like passive dressing

Autolytic?

Chemical?

Mechanical?

A

Autolytic- body’s own digestive breaks down necrotic tissue; dead tissue softens and separates from wound

Chemical- commercially prepared (santyl); foul odor is from the breakdown of necrotic tissue, not infection

Mechanical- surgical debridement

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20
Q

Occlusive dressing

A

Sterile and non sterile gauze or bio-occlusive dressings; plastic wrap may be used as well, but no more than 12 hours each day

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21
Q

Moisture retentive dressing can remain in place___hrs?

Some?

What is it good for?

Hydrogels dressing?

Hydrocolloids dressing?

Foam dressing? 2 parts to it

Calcium alginates?

A

Can remain in place for 12-24 hours Some up to a week Good to remove exudate CHECK MANUFACTURER’S RECOMMENDATION FOR TIME

Hydrogels- good for autolytic debridement

Hydrocolloids- most can remain in place for 7 days; promotes debridement and granulation. Can be foul-smelling (this is expected)

Foam dressing:

  • hydrophilic (absorbs exudate from the wound)
  • hydrophobic (blocks exudate leakage from secondary covering)

Calcium alginates- from seaweed; good for deep wounds (packing); needs secondary dressing; foul-smelling is expected.

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22
Q

Intralesional therapy

A

Sticking needle into lesions with steroids

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23
Q

Systemic medications

A

Steroids

Anti-fungals

Antibiotics

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24
Q

Balneotherapy

A

Therapeutic bath with high salt concentration

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25
Q

Pruritus When is it worse? What might help?

A

Worse at night Diphenhydramine helps

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26
Q

Perineal/ Perianal pruritus can be because of?

A

Hemorrhoids

Fungal/yeast infection

Incontinent (usually used anti fungal powder more than creams)

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27
Q

Secretory disorders (sweat glands):

Hidradenitis suppurativa

Seborrheic dermatoses

Acne vulgaris

A

Hidradenitis suppurativa- chronic folliculitis (perianal, axilla, genital)

Seborrheic dermatoses- chronic inflammation of sebaceous glands (small oil-producing gland usually attached to a hair follicle)

Acne vulgaris- diet, stress, genetics

28
Q

the underlying cause of pruritis

A
  • chronic kidney diseases
  • endocrine diseases
  • folliculitis
  • hematologic disorders
  • infestations (scabies, lice, other insects)
  • malignancies
  • neurologic disorders
  • obstructive biliary disease
  • pruritus of pregnancy
  • psychiatric disorders
  • skin conditions
29
Q

Bacterial Infections

impetigo

folliculitis

which one is contagious?

what should you not do with furuncles (boils) or pimples?

boils on the face can invade sinuses resulting in_____

A

impetigo- superficial (staph and strep infections);bullae (fluid-filled blister)

folliculitis- inflamed hair follicle, furuncles (boil), and carbuncles (abscess of subcutaneous tissue and skin) THEY SHOULD NEVER BE SQUEEZED! if they have furuncles and carbuncles it means something more is going on. blood cultures are taken.

never squeeze them!

a brain abscess

impetigo is contagious!

30
Q

viral infections

herpes zoster (shingles)

what can it cause? if it’s around the eyes?

pain?

A

varicella zoster virus. Follows nerve pathway, if around the eyes can cause blindness.

pain goes away but can be permanent.

31
Q

herpes simplex

orolabial ___?

genital ____?

A

1

2

32
Q

herpes zoster medications:

acyclovir

valacyclovir

famciclovir

A

acyclovir

valacyclovir

famciclovir

lesion care, dressing, and hand hygiene

if given within 24 hours of eruption will stop progression and minimize the severity

33
Q

herpes simplex care?

A

teach about medications and prophylactic

teach about the spread of the herpes

measures to reduce contagion of partners or of neonates born to mothers with genital herpes

34
Q

tinea capitis(head)

antifungal shampoo____?

what does it cause?

A

ketoconazole

causes hair loss but NOT permanent

it will grow back

35
Q

tinea corporis(body)

antifungal creams?

PO?

A

clotrimazole

flucanazole (PO)

36
Q

Tinea Cruris (groin area)

antifungal

creams /powders

check under folds

separate towels

make sure dry are well

what meds can also help?

A

nystatins

37
Q

Tinea Pedis

check webs

socks____ underwear to dec. cross contamination

flip flops in the shower

A

before

38
Q

Tinea unguium

PO with or without topical

long term treatment (about 12 weeks)

be careful where you get your pedi

A
39
Q

parasitic skin infections

pediculosis (lice)

  • pediculosis capitis (head)
  • pediculosis corporis (body)
  • Phthirus pubis (perianal)

what area should be checked for lice?

A

live on outside of the body and feed on human blood; their digestive enzymes cause itching

check the back of the head and ears

40
Q

scabies

A

living in substandard hygienic conditions

break out skin

41
Q

lice shampoo?

comb hair with fine-tooth comb dipped in vinegar to remove all nits

A
  • Lindane (kwell) may have toxic effect and must be used only as directed. affect NS, liver, kidneys and may be a carcinogen.
  • pyrethrin compounds (RID)
  • permethrin (NIX)
42
Q

lice

natural prevention

natural treatment

A

rosemary, coconut

mayo, olive oil

43
Q

pediculosis corporis is a disease related to

pediculosis pubis spread

what do we do with lashes?

A

poor hygiene and of those who live in close quarters

by sexual contact

vaseline

44
Q

scabies

what precautions?

tell patient to take ___ and ___ bath; allow skin to cool and apply ____ to body NO ___ and ___

how long should they leave the cream on?

repeat the treatment in 1 week to prevent reinfestation

A

contact/ full PPE

warm/soapy

5% permethrin (NIX)

face and scalp

12-24 hrs

45
Q

psoriasis

how does it look like?

affect___ of the population especially____population

what aggravates it?

treatment?

what meds? Topical

  • corticosteroids
  • nonsteroidal
  • intralesional therapy
  • coal tar products
  • medication shampoo

phototherapy

systemic therapy

  • cytotoxic
  • biologics - infliximab, ustekinumab, adalimumab

​we are watching WBC, protect from infection because they are already immunocompromised!

A

a chronic, noninfectious inflammatory disease of the skin in which epidermal cells are produced at an abnormally rapid rate

RED, RAISED SILVERY SCALES, DARK RED BASE

2%

European ancestry

stress, trauma, seasonal and hormonal changes

baths to remove scales and medications

  • corticosteroids- cover with an occlusive dressing. not on the face can cause pigmentation.
  • nonsteroidal-calcipotrine, tazarotene no preg women?
  • intralesional therapy-injection into patches
  • coal tar products-thick black liquid
  • medication shampoo-wear shower cap
46
Q

collaborative problems and potential complications of psoriasis

infection

psoriatic arthritis (a doctor that they going to visit?)

A

Rheumatologist

47
Q

toxic epidermal necrolysis and steven johnson sydrome

reaction to medications

scaled skin syndrome similar to total body burn. characterized by widespread _____ macules with blisters then skin sought off.

who is at risk?

treatment?

complications?

A

erythema

immunocompromised patients are at the greatest risk

  • methylprednisolone,
  • IVIG (make sure to pre-medicate before)
  • cyclosporine or cyclophosphamide
  • biologic dressing/plastic semipermeable dressing used to decrease pain and infection and evaporation

​SEPSIS/MODS(multiple organ dysfunction system) =life threatening

conjunctival reaction, scars, and corneal lesions

48
Q

prevention of all types of skin cancers

  1. avoid the sun between 10 am to 4 pm
  2. wear protective clothing
  3. seak shady areas
  4. use caution around snow and water
  5. use sunscreen 15 SPF or higher. apply 20 min before going out. reapply every 2 hours or immediately after swimming
  6. use lip balm with SPF of 15 or higher
  7. no tanning
  8. check your skin monthly
  9. schedule to be examined by primary provider after 50
A
49
Q

basal cell carcinoma

how does it look?

A

most common type and most successfully treated because tumors remain localized and do not metastasize.

pearly, waxy-looking

50
Q

squamous cell carcinoma

treatment involves eradication of the tumor __________, electrosurgery, cryosurgery

A

prognosis depends upon the presence of metastasis

moh’s microscopic surgery

crusty lesions

51
Q

malignant melanoma

2 % of all skin cancers but most lethal

average age of diagnosis is 57 years

60% of all patients with melanoma have BRAF genetic mutation

types:

  • superficial spreading melanoma
  • lentigo maligna melanoma
  • nodular melanoma
  • acral lentiginous melanoma
  • mucosal lentiginous melanoma

spread in two growth phases what are they?

A

radial and vertical

52
Q

assessing the ABCDE’s moles

A

B

C

D

E

A

ASYMMETRICAL

BORDERS

COLORS

DIAMETER

EVOLVING

53
Q

collaborative problems and potential complications for malignant skin tumors

metastasis

infection of surgical site

A
54
Q

treatment of malignant melanoma

A

surgical excision

lymph node if necessary

chemo/adjuvant immunotherapeutic agents/ monoclonal antibodies

55
Q

Kaposi sarcoma

categories:

  • classic KS-chronic , rarely fatal
  • endemic (African) KS- eastern Africa; characterized by enlarged lymph nodes
  • Iatrogenic/organ transplant-associated KS-transplant or immunosuppressants
  • AIDS-related (epidemic) KS

what do they use to stage KS?

A

a malignancy of endothelial cells that line the blood vessels: dark reddish-purple lesions of the skin, oral cavity, GI tract, and lungs

TNM used to stage KS

56
Q

skin grafts

autografts

allografts or homografts

xenografts

split-thickness or full-thickness

cite selection:

donor/host site

recipient site bed or recipient graft bed

  • graft application
  1. adequate blood supply
  2. close contact with bed
  3. immobilized (we don’t want them to be moving)
  4. free from infection (dressing)

important! BOTH THE DONOR SITE AND THE GRAFTED AREA MUST BE PROTECTED FROM EXPOSURE TO EXTREMES IN TEMP, EXTERNAL TRAUMA, AND SUNGLIGHT BECAUSE THESE AREAS ARE SENSITIVE, ESPECIALLY TO THERMAL INJURIES.

A

self to self

same species

another species

thickness of graft

minimize scarring

57
Q

flaps

A

mass of tissue attached at one end (other end move to recipient area)

survival depends on venous/arterial blood supply and lymphatic drainage

more likely to take than graft because it has its own ORIGINAL blood supply

58
Q

eschar

this is good!

A

shedding of epidermis

59
Q

epithelization

this is good!

A

regrowth of skin over a wound

60
Q

granulation

this is good!

A

new vascular tissue on the healing surface of a wound

61
Q

denudation

this is good!

A

wearing away of the skin layers

62
Q

Hydrogels dressing

A

Hydrogels- good for autolytic debridement

63
Q

Hydrocolloids dressing

A

Hydrocolloids- most can remain in place for 7 days; promotes debridement and granulation. Can be foul-smelling (this is expected)

64
Q

Foam dressing? 2 parts to it

A

Foam dressing:

hydrophilic (absorbs exudate from the wound)

hydrophobic (blocks exudate leakage from secondary covering)

65
Q

Calcium alginates

A

Calcium alginates- from seaweed; good for deep wounds (packing); needs secondary dressing; foul-smelling is expected.

66
Q

eczema is linked with ____? and why ?

A

Medical Surgical Nursing 1 😭 (1 decks)

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