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Advanced Med Surg > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

three layers of the skin are?

A

epidermis
dermis
subcutaneous tissue/hypodermis

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2
Q

larges portion of the skin, connective tissue between the epidermis and subcutaneous tissue

A

dermis

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3
Q

involved in producing the pigment melanin (brown) which colors the skin and hair?

A

melanocytes

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4
Q

roles as receptors that transmit stimuli to the axon

A

merkel cells

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5
Q

role in cutaneous immune system reactions and protects against microorganism against injury

A

langerhans cells

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6
Q

function of the dermis includes:

A

Provides strength and structure in the form of collagen and elastic fiber
Strength and structure in the form of collagen and elastic fiber

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7
Q

subcutaneous tissue functions

A

innermost layer of the skinprimarily composed of adipose and connective tissue
provides a cushion between the skin layers and the muscles and bones
protects the nerve and vascular structures that transect the layers
subcutaneous tissues and the amount of fat deposited are important factors in body temperature regulation

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8
Q

Hair growth from most rapid:

A
  1. beard
  2. hair on scalp
  3. axillae
  4. thighs
  5. eyebrows
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9
Q

term for excessive hair growth

A

hirsutism

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10
Q

term for hair loss

A

alopecia

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11
Q

glands associated with hair follicleslubricating the hair and rendering the skin soft and pliable

A

sebaceous glands

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12
Q

Thin, watery secretion calledsweatis produced in the basal coiled portion of the eccrine gland and is released into its narrow duct

A

eccrine glands

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13
Q

Regeneration of the nails:

how long for fingernails and toenails?

A

Fingernails – 6 months
Toenails – 18 months

Growth is faster in fingernails than toenails and tends to slow with aging

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14
Q

functions of the skin

A

Protection
Sensation
Receptors in the skin are to sense temperature, pain, light touch, and pressure
Fluid balance
[prevents dehydration] –> Epidermis—has the capacity to absorb water, thereby preventing an excessive loss of water and electrolytes
Severe burn, large quantities of fluids and electrolytes may be lost rapidly
Temperature regulation
Vitamin Production
Immune response function

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15
Q

Bluish discoloration that results from a lack of oxygen in the blood

A

cyanosis

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16
Q

Purple, black which fades to green, yellow, or brown hues over time;most often seen following trauma

A

ecchymosis

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17
Q

Redness of the skin caused by the dilation of capillaries

A

erythema

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18
Q

Yellowing of the skin

A

jaundice

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19
Q

Inflammatory response

A

-A sequential reaction to cell injury.

-Neutralizes and dilutes the inflammatory agent, removes necrotic materials, and establishes an environment suitable for healing and repair.
Inflammationis not similar with infection.

-Inflammation is always present with infection, but infection is NOT always present with inflammation

  • Mechanism of inflammation is basically the same regardless of the injuring agent
  • Intensity of the response depends on the extent and severity of injury and on the injured person’s reactive capacity
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20
Q

Inflammatory response can be divided into

A

Vascular response
Cellular response
Formation of exudate
Healing.

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21
Q

Results from outpouring of fluid. Seen in early stages of inflammation or when injury is mild ex. Skin blisters, pleural effusion

A

serous

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22
Q

Found during the midpoint in healing after surgery or tissue injury
Composed of RBCs and serous fluid, which is semi-clear pink and may have red streaks ex. surgical drain fluid

A

serosanguineous

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23
Q

Occurs with increasing vascular permeability and fibrinogen leakage into interstitial spaces
Excessive amounts of fibrin that coats tissue surfaces may cause them to adhere.

A

fibrinous

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24
Q

Results from rupture or necrosis of blood vessel walls

A

hemorrhagic

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25
Q

Consists of WBCs, microorganisms (dead and alive), liquefied dead cells, and other debris

A

purulent (pus)

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26
Q

Found in tissues where cells produce mucus

Mucus production is accelerated by inflammatory response

A

catarrhal

27
Q

cause of manifestation of redness

A

Hyperemia from vasodilation

28
Q

cause of manifestation heat

A

Increased metabolism at inflammatory site

ex. vasodilation

29
Q

cause of manifestation of pain

A

Change in pH. Nerve stimulation by chemicals (e.g., histamine, prostaglandins). Pressure from fluid exudate

30
Q

cause of manifestation of swelling

A

Fluid shift to interstitial spaces. Fluid exudate accumulation

31
Q

loss of function

A

swelling and pain ex. calf enlarged -> compartment syndrome

32
Q

localized area of necrotic soft tissue that occurs when pressure applied to the skin usually a bony prominence

A

pressure ulcer

33
Q

Braden Scale used for Predicting Pressure Injury Risk

A

Sensory Perception, Moisture, Activity,Mobility,Nutrition

34
Q

Most common site for pressure ulcers

A
  1. sacrum

2. heels

35
Q

Intact skin with non-blanchable redness of a localized area

Area may be painful, firm, soft, warmer, or cooler as compared to adjacent tissue.

A

pressure ulcer stage 1

36
Q

Partial-thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed, without slough
May also present as an intact or open/ruptured serum-filled or serosanguineous-filled blister
Presents as a shiny or dry shallow ulcer without slough or bruising

A

pressure ulcer stage II

37
Q

Full-thickness tissue loss. Subcutaneous fat may be visible but bone, tendon, or muscle are not exposed
May include undermining and tunneling

A

stage III

38
Q

Full-thickness tissue loss with exposed bone, tendon, or muscle. Slough or eschar may be present.
Often includes undermining and tunneling

A

stage IV

39
Q

Full-thickness tissue loss in which actual depth of ulcer is completely obscured by slough (yellow, tan, gray, green, or brown) and/or eschar (tan, brown, or black) in wound bed

A

unstageable

40
Q

Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear.

A

suspected deep tissue injury

41
Q

nursing interventions for pressure ulcers:

A 
Relieve Pressure
Positioning the patient
Use pressure-relieving devices
Improve mobility
Improve sensory perception
Improve tissue perception
Improve nutritional status
Reduce friction and shear
Minimize moisture
Promote pressure injury healing
42
Q

nutritional deficiences for delaying wound healing

A
  • vitamin c
  • protein
  • zinc
  • inadequate blood suppy
  • corticosteroid drugs
43
Q

factors that delay wound healing include:

A
  • infection
  • smoking
  • mechanical friction on wound
  • advanced age
  • obesity
  • diabetes mellitus
  • poor general health
  • anemia
44
Q

dressing generally composed of polyurethane. transparency allows visualization of the wound.
used for dry, uninfected wounds or wounds with minimal drainage

A

transparent films

45
Q

Film-coated gel or polyurethane. Able to hold large amounts of exudate; used for Wounds with moderate to heavy drainage. Often used on new wounds

A

foam dressing

46
Q

Gelatin, pectin, or carboxymethylcellulose bonded to a film or sheet. Produce a flat occlusive dressing that forms a gel on wound surface; used for wounds with light to moderate drainage

A

hydrocolloids dressing

47
Q

gels, gel-covered gauze, or sheets. Donate moisture to a dry wound and maintain a moist environment. Can rehydrate wound tissue
Dry wounds. Wounds with minimal drainage. Necrotic wounds

A

hydrogels

**used to soften hard scabs that will help it fall off

48
Q

Derived from seaweed or kelp. Form a non-sticky gel on contact with draining wound. Easy to use over irregular-shaped wounds

A

alginates

49
Q

Wound covers that deliver agents such as silver and iodine, and polyhexamethylene biguanide (PHMB), which have antibacterial properties.

A

antimicrobials dressing

50
Q

complications of wound healing

A 
Adhesion
Contractions
Dehiscence
Evisceration
Excess Granulation Tissue (Proud Flesh)
Fistula Formation
Infection
Hemorrhage
Hypertrophic Scars
Keloid Formation
51
Q

A chronic suppurative folliculitis of the perianal, axillary, and genital areas or under the breasts

A

Hidradenitis Suppurativa

52
Q

Management of Hidradenitis Suppurativa

A

Warm compresses
Loose-fitting clothes over the nodules or lesions
NSAIDs to relieve the pain
Oral antibiotic
Incision and drainage of large suppurating areas

53
Q

a common disorder affecting hair follicles and sebaceous glands.

A

acne vulgaris

54
Q

mangement of acne vulgaris

A 
Nutrition
Avoid sugary food products
Hygiene
Washing twice a day with soap and water
Phototherapy
Surgical Management
Medication
Benzoyl peroxide
Topical retinoids
Topical antibiotics
Oral isotretinoin + oral ATB
55
Q

Contagious bacterial infection of superficial layers of skin of
honey colored crusts; Lesions common on face, hands, neck, extremities, perineum

A

impetigo

56
Q

1-2 mm erythematous papules or pustules, progress to vesicles or bullae which rupture

A

nonbullous

57
Q

Contagious bacterial infection of superficial layers of skin of honey colored crusts; Lesions common on face, hands, neck, extremities, perineum

A

impetigo

58
Q

management of impetigo

A

Topical antibiotics if superficial, nonbullous, localized
Oral antibiotics for multiple lesions, spread of infection to family members
Bullous impetigo in infant – parenteral beta-lactamase-resistant antistaphylococcal penicillin
Obtain culture if no response in 7 days
Educate about hygiene
Exclude from day care until treated for 24 hours

59
Q

clinical findings folliculitis and furuncle

A

Discrete, erythematous 1-2 mm papules or pustules on inflamed base near follicle
Face, scalp, extremities, buttocks, back
Nodules with furuncles
Pruritus papules, pustules, deep red/purple nodules in areas under swimsuit

60
Q

HSV 1

A

Gingivostomatitis
Herpes labialis
Herpetic whitlow

61
Q

HSV 2

A

Grouped vesicopustules/ulceration
Vaginal mucosa, labia, perineum, cervix in females; penile shaft and perineum in males
Regional lymphadenopathy

62
Q

HSV type 1

A

oral mucosa, pharynx, lips

63
Q

HSV type 2

A

neonatal infection, vulvovaginitis or genital infection

64
Q

Herpetic whitlow

A

fingers, thumb are swollen and painful

Advanced Med Surg (2 decks)

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