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Patient Care Theory (Sem 2) > Integumentary (W2) > Flashcards

Integumentary (W2) Flashcards

1
Q

What does a skin evaluation include

A

Inspection, palpation, colour, moisture, temp, texture, turgor, lesions

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2
Q

Eczema (atopic dermatitis)

A

Red, patchy, itchy skin (infections can be due to scratching/open sores)

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3
Q

Contact dermatitis (form of eczema)

A

In response to an allergen, due to mites under the skin and can spread rapidly; looks like itchy bumps/blisters, edema

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4
Q

Psoriasis

A

Red, thick areas covered with white/silver scales/skin lesions

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5
Q

Why does pemphigus vulgaris cause painful blisters that create new ones when pressed

A

Body mistakenly identifies proteins in skin as foreign and attacks

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6
Q

What can meningococcemia cause

A

DIC

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7
Q

What is the rocky mtn spotted fever transmitted by

A

Tick bites

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8
Q

What are the early s/s of rocky mtn fever

A

Flu-like, rash 2-4 days after fever

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9
Q

What is necrotizing fasciitis

A

Caused by group A strep, where the bacteria enters body through skin creating a deep infection (rare and can be fatal)

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10
Q

What are the s/s of necrotizing fasciitis

A

Fever, HoTN, redness, swelling/pain, changes to skin colour

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11
Q

What will a colostomy on the right side require to cover

A

Sometimes only a pad

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12
Q

What will a colostomy on the right require to cover

A

A bag or appliance

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13
Q

Why is the ileostomy bag filled with liquid

A

Because an ileostomy is the ileum brought to the surface of the abd, and there waste presents as liquid

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14
Q

What is the leading cause of death in a fire

A

Smoke inhalation

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15
Q

What is the most common chemical of combustion

A

Carbon monoxide

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16
Q

CO binding to Hb is ___x stronger than O2

A

200

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17
Q

What are the four questions you should always ask a pt in a fire

A

-length of exposure
-enclosed space
-what was burning
-any LOC?

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18
Q

What are the early s/s of CO poisoning

A

Headache (throbbing at the temples), altered mental status, N/V, tachypnea, tachycardia, collapse, seizure, coma

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19
Q

How does a hyperbaric chamber work

A

Increases atmospheric pressure, and helps to displace the CO and increase the amount of O2 dissolved and available to the tissue

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20
Q

What is the pathophysiology behind burns

A

-cell membranes are ruptured and destroyed
-blood coagulates
-proteins denature, skin layers coagulates
-histamines release = vasodilation causing capillaries to leak plasma which seeps into interstitial space
—>larger burn can cause mass fluid loss and hypovolemia

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21
Q

Zone of coagulation

A

Dead cells! White/charred appearance

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22
Q

Zone of stasis

A

Red cells! Blood supply is precarious

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23
Q

Zone of hyperemia

A

Intact circulation! Blanches, heals within 7 days

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24
Q

What are the body’s four staged responses to trauma

A
  1. Emergent
  2. Fluid shift
  3. Hypermetabolic
  4. Resolution
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25
What is the emergent phase/stage 1
IMMEDIATELY AFTER, pain response, catecholamine release, tachycardia, tachypnea, mild HTN
26
What is the fluid shift phase/stage 2
18-24 HR AFTER, reaches peak in 6-8 hr, fluid shifts from intravascular to extravascular [massive edema] damaged cells initiate inflammatory response = increased BF to cells,
27
What is the hypermetabolic phase/stage 3
DAYS-WEEKS, is a large increase in the body’s need for the nutrients as it repairs itself
28
What is the resolution phase/stage 4
Scar formation/rehabilitation
29
What are some complications of burns
Hypothermia, hypovolemia, eschar, infection, organ failure
30
Cyanide is a product of what materials burning
Nylon, wool, polyurethane, urea formaldehyde, hydrogen chloride, plastics
31
It takes more __ current to have the same affect of __ current
DC, AC
32
How many amps does a standard household circuit carry
15 or 20
33
How does 1-10mA affect the body
Almost no shock/hardly felt
34
How does 10-20mA affect the body
Painful shock, full muscle control
35
How does 20-47mA affect the body
Serious shock, asphyxiation
36
How does 55-100mA affect the body
VF can occur (death at 100-200mA)
37
How does over 200mA affect the body
Severe burns, muscle contraction, internal organ damage
38
Why is CA good for a pt w electrical burns
Heart muscle stopped due to pressure on chest prevents VF which improves survival odds
39
What is different about triaging if pts have been struck by lightening
It is reversed (those who are alive are likely to stay alive)
40
How do you treat a chemical burn (step by step)
-dust off powders -irrigate for 10-20 mins (unless hydrofluoric acid) -cover with dry dressing **aim to get SDS and more info about the substance)
41
How long do you irrigate an acidic burn
10 mins
42
How long do you irrigate an alkaline burn
20 mins
43
How do you treat a burn from hydrofluoric acid
Topical calcium gluconate gel (or injection directly into the skin)
44
What are the most common injuries associated with burns
#, TBI, thoracic or abd injuries
45
Superficial thickness are AKA
First degree burns
46
What are the characteristics of superficial burns
Only epidermis is affected, may be red and dry, will likely blanch with pressure but will never blister [heals over a few days]
47
Superficial partial thickness burns are AKA
2nd degree burns
48
What are the characteristics of superficial partial thickness burns
Demis is slightly affected, hair and sebaceous glands are affected, can look cherry red or pale, sluggish cap refill, can have blisters [healing can take up to 6w]
49
Full thickness burns are AKA
3rd degree burns
50
What are the characteristics of full thickness burns
Subcutaneous and fatty layers of skin are affected, appears pearly white/charred/any colour, usually painless, no capillary refill
51
Full thickness burns can ALSO be called ___ if ___ is involved
4th degrees burns // muscle or bone
52
What are some key details about full thickness burns with eschar
It appears dry/chalky, inelastic/swelling beneath the eschar can cause compartment syndrome
53
If chemicals are inhaled, what is a major issue it may cause
Pulmonary edema and ultimately difficulty in ventilations
54
What are some S/S of AW involvement of burns
Burns to face/neck, singed facial hairs, soot around mouth/nose, black tongue, hoarse voice, stridor, respiratory distress
55
What qualifies as a major burn
>25% TBSA 2nd degree burn in adult >20 TBSA 2nd degree burn in child >10% TBSA 3rd degree burn in adult -any 3rd degree burn in child -any AW burn
56
If a burn pt has an altered LOA, what are some differential diagnosis for causes
Hypoxia from partial AW occlusion, CO poisoning, cyanide poisoning, head trauma
57
What are some things you may see if a pt has been abused can result is a burn
Uniform burn depth/size, pattern consistent with splattering liquids, burn is in shape of objects
58
What should you do if clothing has adhered to skin
Cut around/away [do not rip or tear it off]
59
What is the parkland formula
Fluid to give pt = 4mL x %TBSA x Kg of pt (1/2 in first 8h, 1/2 over following 16h)
60
What drugs may you consider for a burn pt
Acetaminophen, NSAIDs, narcotics (low dose)
61
When would you consider calling ORNGE for a burn pt
-pt entrapment -pt req definitive AW management or significant fluid resuscitation -eschar poses threat to life/limb
62
When would you transfer your burn pt to a Burn Facility
-full thickness any age -partial thickness >10%TBSA any age -any burn involving critical areas (face/hands/feet/genitalia/perineum/skin of truck) -presence of inhalation injury
63
How do you treat 1st degree burns
Moist sterile dressings
64
How do you treat 2nd degree burns <15% TBSA
Moist sterile dressings
65
How do you treat 2nd degree burns <15% TBSA
Dry sterile dressings
66
How do you treat 3rd/4th degree burns
Dry sterile dressings

Patient Care Theory (Sem 2) (10 decks)

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