Integumentary (includes Burns) Flashcards
Immunofluorescence- identifies site of an __________ reaction.
immune/auto antibody
Patch Testing- identifies substances pt may be ______ to.
allergic
Skin Scrapings- scrapings from suspected_____ lesion.
fungal
Tzanck Smear-examine cells d/t ______ (blisters, ie herpes simplex / zoster.)
vesicles
Wood’s Light Examination-ultraviolet (UV) light to differentiate epidermal from dermal lesions.(Bacterial infections, _______ infections, Porphyria) Skin color changes, such as vitiligo).
Fungal
Impetigo
Bacterial infection of skin caused by a pathogen = ______________ and/or ___________.
Is it contagious?
Staphylococcus aureus
group A beta-hemolytic streptococci
It’s Very Contagious!!
Impetigo
Most common TOPICAL antibiotics: B________ and m________.
Bactroban and mupirocin.
In Impetigo, we use these drugs if what is present?
Clindamycin, vancomycin, trimethoprim-sulfamethoxazole
MRSA
Top 2 nursing precautions for Impetigo:
1) Good hand hygiene is critical!!!
2) Wear gloves when coming into contact with lesions!!!
Top Impetigo Pt. Education:
Use separate towels, combs, etc; change linens _____ (how often)
Keep ______ short & trimmed
DO NOT “____” lesions
Lesion care; wash with ___ ____
Apply antibiotic cream (IF oral, antibiotic completion)
____ (how often) baths w/________ soap
daily
fingernails
pick
mild soap
Daily, antibacterial
Folliculitis, Furuncles & Carbuncles:
Folliculitis: inflammation of cells within wall & ____ of hair follicle.
Furuncles: acute inflammation arising deep in hair follicle which can spread to surrounding dermis. (staphylococcus).
—-Begins as small, red, raised painful pimple; involves skin and subcutaneous tissue🡪center becomes yellow or black (within days).
Carbuncle: _____ (pocket of pus) of skin and subcutaneous tissue; extension of furuncle
ostia
abscess
Folliculitis, Furuncles & Carbuncles:
Medical:
Systemic _____ therapy: oral dicloxacillin & cephalosporins (1st line); if MRSA suspected = ________(which medicine?), etc. (pg. 1818)
Get ______ before we start any antibiotic!!!
Bed rest if needed
Never ______ -> avoids spread of infection
antibiotic
clindamycin
C & S (Culture and Sensitivity)
squeeze
1 thing to remember is to: _________. Why?
Cellulitis
Nursing Care:
If applying a compresses, assess for _____ ______!!
Educate pt. on keeping skin healthy. How??
Elevation of extremity (3-6”). Reduces inflammation, improves venous return = reduces risk for DVT.
sensory deficits
We use _____ _______ antibiotics for gram (+) & gram (-) cocci; and anaerobic bacteria.
Broad spectrum antibiotics
Herpes Zoster: (shingles):
Reactivation of _______ (chicken pox) virus along sensory nerve (dermatomes).
Virus can lie dormant in dorsal root ganglia of sensory cranial and spinal nerves.
varicella
How severe is Herpes Zoster Ophthalmicus (HZO)? It’s considered an __________ _________.
In this condition, which cranial nerve is affected?
ophthalmic emergency
The ophthalmic division (V1) of the trigeminal nerve
Herpes Zoster:
Medical Management:
Goal: relieve pain & ↓ or avoid complications (infection, scarring & neuralgia), but definitely to _______ ___________ of infection.
prevent transmission
Herpes Zoster:
Treatment:
Antiviral agents i.e. ______ (Zovirax, Valtrex or Famvir) to ↓ pain and delay progression of disease.
Should be given within __ hours of initial eruption!!
acyclovir
24
Acyclovir
Side effects:
Agitation, HA, N/V; diarrhea; _________; gingival hyperplasia, _________, phlebitis w/ IV adm.
dizziness
nephrotoxicity
Acyclovir
Nursing Interventions:
Teach: Does this cure or just relieve pain?
Adm IV over _ hour to prevent _____
Monitor for phlebitis / nephrotoxicity issues
Pain, hematuria
Big Teaching: ______ during infusion & _ hours post infusion. Why?
Wear _____ for topical adm.
Just relieves pain
1 hour, nephrotoxicity
Hydrate, 2. Dehydration can cause nephrotoxicity!!!
gloves
Acyclovir
Nursing Management:
Isolate the client until ____ ______ _____ ________ ____.
_______ precautions too!! (CDC)
Maintain strict wound care precautions by ______ ______ & ____ _______.
the vesicles have crusted over
Airborne
Wearing gloves & hand hygiene
Medical Management: Fungal infection
Monitor _____, kidney & bone marrow suppression
Which test do we do for this?
Liver
A hepatic pannel
What’s a particularly important Patient Teaching for Fungal Infections?
Also teach patients that Hair loss associated with tinea capitus _________(how long does it last)
Keep skin folds and feet dry
temporary
Scabies:
Most obvious manifestation is _____.
Wear gloves when coming into contact with ______!!!
itching
burrows
Psoriasis
Chronic, __________ over-production of_____ cells; plaques
How long does it last?
autoimmune, keratin
life-long
Psoriasis Complications:
Arthritis of the joints that’s:
Symmetrical or Asymmetrical?
RF-positive or RF-negative?
Asymmetrical RF-negative arthritis of joints
Psoriasis Manifestations:
What does the skin look like?
Unilateral or Bilateral symmetry?
Painful or painless?
Silvery, scaly skin plaques
Bilateral symmetry
Painful
Psoriasis Medical Management:
Goal is to _________________
slow the rapid epidermal turnover.
Psoriasis Medical Management:
For Tar Preparations, monitor for _______.
Why?
skin lesions (that looks like cancer)
Can cause skin cancer!
Psoriasis Medical Management:
Tazarotene (Tazorac); a retinoid derivative of Vitamin _
Causes birth defects (Category X): use birth control during usage.
Clients should use _________ and/or a____ s__ e______.
May ____ psoriasis
A
Clients should use sunscreen and/or avoid sun exposure.
May worsen psoriasis
Psoriasis Medical Management:
Cytotoxic meds: Methotrexate (Mexate), azathioprine (Imuran), cyclosporine (Neoral)
Reduces turnover of epidermal cells
Big One: Contraindicated in _____ _______. why?
pregnant women (cus it kills “cells” = birth defects)
Psoriasis Medical Management:
Nursing Actions:
Monitor for _____ ______ (kidneys & liver) and bone marrow suppression.
Client Education:
Instruct client to avoid _____ why??
Advise client to monitor for fever and sore throat. Why??
Advise client to monitor for increased bleeding or bruising, and fatigue. Why??
organ toxicity
alcohol. Leads to organ toxicity in LIVER.
Infection! (The WBCs are suppressed)
Bone marrow suppression! (The platelets are suppressed) (For fatigue, the RBCs are suppressed)
Which is the most serious type of skin cancer??
Which is considered one of the least serious forms of skin cancer?
How often should clients perform self-checks of their skin?
Melanoma is the most lethal!! (pg. 1836)
Basal Cell Carcinoma (BCC) is the most prevalent in the U.S. and is rarely a cause of death. (pg. 1834)
Monthly according leading dermatologist and the Skin Cancer Foundation.
