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NCLEX > Integumentary System > Flashcards

Integumentary System Flashcards

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1
Q

What are the functions of the Epidermis (6)

A
  • protection from injury
  • stops proliferation of microorganisms
  • prevents dehydration and electrolyte loss
  • temp regulation controlled by sweat glands
  • transmits tactile stimulation by neuroreceptors
  • synthesizes Vitamin D
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2
Q

What are the functions of the Hypodermis (2)

A
  • protects from injury by absorbing mechanical shock
  • temperature regulation by fat cells
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3
Q

what are the Indications for Topical Antimicrobials?

A

Treatment of bacterial, fungal or viral infections of the skin

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4
Q

The following drugs are classified as?

Bacitracin
Neomycin
Mupirocin

A

Antibacterials

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5
Q

The following drugs are classified as?

Clotrimazole,
Ketoconazole,
Miconazole,
Nystatin

A

Antifungals

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6
Q

What are the Indications for Topical Corticosteroids?

A
  • Inflammation
  • redness
  • Itching
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7
Q

The following drugs are classified as?

Triamcinolone,
Hydrocortisone

A

Topical Corticosteroids

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8
Q

Lesion

A

Area of tissue that has suffered damage

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9
Q

Primary Lesion is caused by?

A

result of a disease process

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10
Q

Pruritus

A

Itching

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10
Q

Secondary Lesion is caused by?

A

developed by consequence of a clients activity

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11
Q

Urticaria

A

Hives

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12
Q

Lichenified

A

Thickened

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13
Q

Annular

A

Ringlike with raised boarders about flat centers of normal skin

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14
Q

Circinate

A

circular

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15
Q

Circumscribed

A

Well defined, sharp boarders

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16
Q

Clustered

A

Several lesions grouped together

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17
Q

Diffuse

A

Widespread

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18
Q

Linear

A

Occurs in a straight line

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19
Q

Macular

A

Flat

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20
Q

Papular

A

Raised

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21
Q

Macule

A

Discoloration of the skin that is flat and level with the skin
- Primary Lesion

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22
Q

Fissure

A

Cleft or groove in the skin
- Primary Lesion

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23
Q

Nodule

A

Small, node-like structure that is solid and elevated
- Primary Lesion

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24
Q

Papule

A

Small, solid and raised caused by thickened epidermis
- Primary Lesion

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25
Q

Vesicle

A

Small bladder or blister containing clear fluid
- Primary Lesion

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26
Q

Polyp

A

Growth that forms on mucous membrane or other surface inside the body
- Primary Lesion

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27
Q

Cyst

A

Closed pouch under the skin that contains a fluid of a semisolid substance
- Primary Lesion

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28
Q

Pustule

A

Small elevated on the skin containing pus
- Primary Lesion

29
Q

Wheal

A

Area of the skin slightly raised and appears either redder or paler then the surrounding skin
- Primary Lesion

30
Q

Scales

A

Flakes of cornified Skin
-Secondary Lesions

31
Q

Crust

A

Dried exudate on Skin
- Secondary Lesions

32
Q

Ulcer

A

Areas of destruction of the epidermis
- Secondary Lesions

33
Q

Scar

A

Area with excess collagen formation present after an injury has healed
- Secondary Lesions

34
Q

Dermatitis

A

Inflammation of the dermis

35
Q

Contact dermatitis

A

Hypersensitivity when exposed to a certain allergen

36
Q

Atopic dermatitis (eczema)

A
  • Intense itching, red, dry, scaly skin.
  • Can have flare ups
  • More common in children and people with allergies
37
Q

Psoriasis

A
  • Chronic autoimmune T-cell mediated inflammatory skin disease
  • Periods of exacerbations and remissions
  • Thickening of epidermis and dermis
    Scaly, erythematous, pruritic plaques
38
Q

Stevens-Johnson Syndrome

A
  • Cytotoxic T-cell drug reaction
  • Keratinocyte cell death
  • Causes extensive blistering
39
Q

Psoriasis Interventions

A
  • Light therapy
  • Systemic therapy
    -> Methotrexate
    -> Folic acid
    -> Systemic retinoids
    -> Infliximab
40
Q

Stevens-Johnson Syndrome Treatment

A
  • Stop all possible medications
  • Fluids
  • Nutrition
  • Wound care
  • Pain control
  • Corticosteroids
41
Q

Cellulitis

A

Bacterial Skin Infections
- Diffuse infection of dermis and hypodermis
- Red, warm, swollen, and painful skin
- Most common cause - staph, MRSA, or group B strep
- Systemic treatment with antibiotics needed

42
Q

Impetigo

A

Bacterial Skin Infections
- Bullous or ulcerative
- Cause - staph or strep
- More common in children

43
Q

Methicillin-resistant Staphylococcus Aureus (MRSA)

A

Bacterial Skin Infections
- Ranges from mild to moderate
- Contact precautions

44
Q

HSV

A

Viral Skin Infections
- Type 1- mouth and face
- Type 2 - Genital lesions
- Groups of vesicles on an erythematous base
-> Vesicles can turn into pustules, rupture, and form crusts
-> Last 2 to 6 weeks
- Topical/oral antiviral drugs

45
Q

Herpes Zoster

A

Viral Skin Infections
- Grouped lesions with weeping and crusting
-> Unilaterally along segment of skin that follows a cranial nerve
- Pain and paresthesia
- Antiviral drugs
- Vaccination

46
Q

Tinea

A

Fungal Skin Infections
- Classified by location
-> Tinea pedis (Athlete’s foot)
-> Tinea corporis
-> Tinea capitis
- Annular patches with elevated borders and scaling
- Client education: keep areas clean and dry, no public showers or pools, don’t share footwear
- Topical antifungal therapy

47
Q

Candidiasis

A

Fungal Skin Infections
- Yeast like fungal infection
- Erythematous macular eruption with isolated pustules at the border
- Burning and itching
- Common in skin folds
- Oral lesions (thrush) are creamy white

48
Q

Squamous cell carcinoma (Cancer)

A
  • Very top layer of the epidermis grows out of
  • Form on areas of the body exposed to sun (Face, Ears, Neck)
  • Treatment: Removal
  • More likely to grow into deeper layers of the skin
49
Q

Basal cell carcinoma (Cancer)

A
  • Most common type of skin cancer
  • Start in the basal cell layer (bottom layer) of the epidermis
  • Form on areas of the body exposed to sun - head, face, neck
  • Slow growing and rarely spread
  • Treatments
    ○ Surgery
    ○ Local therapies
    § Cryotherapy
    □ Topical chemotherapy
    □ Immune response modifiers
    □ Laser surgery
    □ Chemical peeling
    § Radiation
    § Chemotherapy
    § Targeted therapy
    Immunotherapy
50
Q

Melanoma (cancer)

A
  • Melanocytes grow out of control
    • The cells that produce melanin
  • Less common; more dangerous - can spread more easily
  • Appearance: dark brown or black
    ○ The cells are making lots of melanin!
    ○ Most commonly located on trunk or legs
  • Treatments
    ○ Surgery
    ○ Immunotherapy
    ○ Targeted therapy drugs
    ○ Chemotherapy
    Radiation
51
Q

1st degree burn

A
  • Most superficial burn
  • The skin remains intact; no break in integrity of epidermis
  • Redness (erythema)
  • No blisters
  • Can be painful to the touch
52
Q

2nd degree burn

A
  • Partial thickness burn
  • Blisters form
  • Affects the epidermis and dermis
  • Skin is moist and red
  • These burns are very painful
53
Q

3rd degree burn

A
  • Full thickness burn
  • Penetrate all the way from the epidermis to the dermis and down into the subcutaneous tissue
  • Destroy the nerve endings, so are not as painful as 2nd degree burns
  • Appear red, tan, or black
  • Are dry and leathery
  • Areas of eschar
54
Q

4th degree burn

A
  • Full thickness, plus involvement of bone and muscle underneath
  • These burns are dry and dull
  • Exposed tissue may include bones and muscles as well as ligaments and tendons
55
Q

Emergent Burn management

A
  • First 24-48 hours
    * Large shift in capillary membrane permeability
    ○ Capillary membrane becomes more permeable
    ○ Fluid shifts from the intravascular space into the interstitial space
    * Client is at high risk for hypovolemic shock, electrolyte imbalances, and renal failure
    * Fluids are the priority intervention
    ○ Parkland burn formula
56
Q

Acute Burn management

A
  • 48-72 hours after injury until the wounds heal
    * Capillary membrane permeability is stabilized
    * Focus on healing
    ○ Prevent infection
    ○ Alleviating pain
    ○ Nutrition
    ○ Wound care
57
Q

Rehabilitative Burn management

A
  • Burn is now healed
    * Focus is on regaining function
    ○ Psychosocial care
    ○ ADL assistance
    ○ Physio/occupational therapy
    Cosmetic correction
58
Q

Hypovolemic Shock

A
  • Increase in capillary permeability
  • Third spacing occurs
    ○ Plasma moves from the intravascular space, to the interstitial space
    ○ Sodium
    ○ Albumin
  • Decreased intravascular volume = decreased BP = hypovolemia
  • Cardiovascular system recognizes hypovolemia - increases HR to compensate
    ○ Increased HR
    ○ Decreased cardiac output
    ○ Decreased blood pressure
    Hypovolemic shock leads to decreased perfusion of kidneys and renal damage
59
Q

Renal Failure

A
  • Decreased perfusion to the kidneys
  • Insufficient UOP
    • <30 ml/hr
  • Increased
    • BUN
    • Cr
  • Monitor UOP closely
    • Foley catheter
      Fluid adjustments as needed
60
Q

Hyperkalemia

A
  • Most potassium is stored in the cells
  • Injury causes lysis of cells, which then release potassium into bloodstream
  • Causes hyperkalemia
  • K >5.5
  • Signs and symptoms:
    ○ Muscle weakness
    ○ Cramps
    ○ Nausea
    ○ Chest pain
    ○ Arrhythmias
    Tall, peaked T-waves
61
Q

Hyponatremia

A
  • Water follows sodium
  • Sodium is leaving the intravascular space and going to the interstitial space
  • Due to increased capillary membrane permeability
  • Water follows this sodium and the client becomes hyponatremic
  • Na < 135
  • Signs and symptoms:
    • Headache
    • Confusion
    • Restlessness
    • Irritability
    • Seizures
      Coma
62
Q

Fluid Replacement

A
  • Crucial in the first 24 hours
  • Due to the increase in capillary permeability, this is when the client is losing large volumes of fluid and is at risk for hypovolemic shock
  • Fluids:
    • Lactated Ringers
      ○ Expands the intravascular volume
    • Colloids
      ○ Albumin
      § Helps pull fluids back into the intravascular system
  • Monitor urine output
  • Fluids are titrated to ensure adequate UOP (30 mL/hr)
  • Correction of imbalances
    Sodium? Potassium?
63
Q

Parkland Formula for burns

A

Total value to be infused:
4ml x TBSA(%) x Weight (Kg)

64
Q

Pressure Ulcers Stage 1

A

red, blue, or purplish area first appears like a bruise on the skin. It may feel warm to the touch and burn or itch.

65
Q

Pressure Ulcers Stage 2

A

bruise becomes an open sore that looks like an abrasion or blister. The skin around the wound can be discolored. The area is painful.

66
Q

Pressure Ulcer Stage 3

A

The sore deepens and looks like a crater. There are often dark patches of skin around the edges.

67
Q

Pressure Ulcer Stage 4

A

damage spreads to the muscle, bone, or joints. It can cause a serious bone infection called osteomyelitis. It can also lead to a possibly life-threatening blood infection called sepsis.

68
Q

Unstageable

A

covered with black dead tissue (eschar) or creamy yellow, gray/black, or white, thick slimy tissue (slough). It is difficult to see the severity of the injury because of the covering.

69
Q

Deep tissue injury

A

very dark red, maroon, or purple colored area of the skin that doesn’t disappear when pressed on or a dark deep wound or blister filled with blood that is seen through a separation in the skin.

70
Q

Rule of 9s

A
  • chest 9%
  • belly 9%
  • anterior arm 4.5%
  • Posterior arm 4.5%
  • anterior leg 9%
  • posterior leg 9%
  • anterior head 4.5%
  • posterior head 4.5%
  • penis/vagina 1%
  • upper back 9%
  • lower back 9%

NCLEX (22 decks)

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