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Med Surg 1 > Integumentary (includes Burns) > Flashcards

Integumentary (includes Burns) Flashcards

1
Q

Immunofluorescence- identifies site of an __________ reaction.

A

immune/auto antibody

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2
Q

Patch Testing- identifies substances pt may be ______ to.

A

allergic

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3
Q

Skin Scrapings- scrapings from suspected_____ lesion.

A

fungal

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4
Q

Tzanck Smear-examine cells d/t ______ (blisters, ie herpes simplex / zoster.)

A

vesicles

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5
Q

Wood’s Light Examination-ultraviolet (UV) light to differentiate epidermal from dermal lesions.(Bacterial infections, _______ infections, Porphyria) Skin color changes, such as vitiligo).

A

Fungal

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6
Q

Impetigo

Bacterial infection of skin caused by a pathogen = ______________ and/or ___________.

Is it contagious?

A

Staphylococcus aureus
group A beta-hemolytic streptococci

It’s Very Contagious!!

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7
Q

Impetigo

Most common TOPICAL antibiotics: B________ and m________.

A

Bactroban and mupirocin.

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8
Q

In Impetigo, we use these drugs if what is present?

Clindamycin, vancomycin, trimethoprim-sulfamethoxazole

A

MRSA

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9
Q

Top 2 nursing precautions for Impetigo:

A

1) Good hand hygiene is critical!!!

2) Wear gloves when coming into contact with lesions!!!

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10
Q

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

A

daily

fingernails

pick

mild soap

Daily, antibacterial

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11
Q

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

A

ostia

abscess

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12
Q

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

A

antibiotic

clindamycin

C & S (Culture and Sensitivity)

squeeze

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13
Q

1 thing to remember is to: _________. Why?

Cellulitis

Nursing Care:

If applying a compresses, assess for _____ ______!!

Educate pt. on keeping skin healthy. How??

A

Elevation of extremity (3-6”). Reduces inflammation, improves venous return = reduces risk for DVT.

sensory deficits

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14
Q

We use _____ _______ antibiotics for gram (+) & gram (-) cocci; and anaerobic bacteria.

A

Broad spectrum antibiotics

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15
Q

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.

A

varicella

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16
Q

How severe is Herpes Zoster Ophthalmicus (HZO)? It’s considered an __________ _________.

In this condition, which cranial nerve is affected?

A

ophthalmic emergency

The ophthalmic division (V1) of the trigeminal nerve

17
Q

Herpes Zoster:

Medical Management:

Goal: relieve pain & ↓ or avoid complications (infection, scarring & neuralgia), but definitely to _______ ___________ of infection.

A

prevent transmission

18
Q

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!!

A

acyclovir

24

19
Q

Acyclovir

Side effects:

Agitation, HA, N/V; diarrhea; _________; gingival hyperplasia, _________, phlebitis w/ IV adm.

A

dizziness

nephrotoxicity

20
Q

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.

A

Just relieves pain

1 hour, nephrotoxicity

Hydrate, 2. Dehydration can cause nephrotoxicity!!!

gloves

21
Q

Acyclovir

Nursing Management:

Isolate the client until ____ ______ _____ ________ ____.

_______ precautions too!! (CDC)

Maintain strict wound care precautions by ______ ______ & ____ _______.

A

the vesicles have crusted over

Airborne

Wearing gloves & hand hygiene

22
Q

Medical Management: Fungal infection

Monitor _____, kidney & bone marrow suppression

Which test do we do for this?

A

Liver

A hepatic pannel

23
Q

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)

A

Keep skin folds and feet dry

temporary

24
Q

Scabies:

Most obvious manifestation is _____.

Wear gloves when coming into contact with ______!!!

A

itching

burrows

25
Q

Psoriasis

Chronic, __________ over-production of_____ cells; plaques

How long does it last?

A

autoimmune, keratin

life-long

26
Q

Psoriasis Complications:

Arthritis of the joints that’s:

Symmetrical or Asymmetrical?

RF-positive or RF-negative?

A

Asymmetrical RF-negative arthritis of joints

27
Q

Psoriasis Manifestations:

What does the skin look like?

Unilateral or Bilateral symmetry?

Painful or painless?

A

Silvery, scaly skin plaques

Bilateral symmetry

Painful

28
Q

Psoriasis Medical Management:

Goal is to _________________

A

slow the rapid epidermal turnover.

29
Q

Psoriasis Medical Management:

For Tar Preparations, monitor for _______.

Why?

A

skin lesions (that looks like cancer)

Can cause skin cancer!

30
Q

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

A

Clients should use sunscreen and/or avoid sun exposure.

May worsen psoriasis

31
Q

Psoriasis Medical Management:

Cytotoxic meds: Methotrexate (Mexate), azathioprine (Imuran), cyclosporine (Neoral)

Reduces turnover of epidermal cells

Big One: Contraindicated in _____ _______. why?

A

pregnant women (cus it kills “cells” = birth defects)

32
Q

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??

A

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)

33
Q

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?

A

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.

Med Surg 1 (4 decks)

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