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NURS 302/ Med-Surg 2 > med surg test 2! Endocrine and integumentary > Flashcards

med surg test 2! Endocrine and integumentary Flashcards

1
Q

What are four different things that were discussed that have an effect on hormones?

A

Pain
Emotion
Sexual excitement
Stress

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2
Q

If a hormone acts in the opposite/inverse direction of another hormone, this is what kind of feedback system?

A

Negative feedback loop

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3
Q

What is an example of a negative feedback loop that was discussed in class?

A

Blood calcium levels and parathyroid levels

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4
Q

If the blood calcium levels are low in the body, parathyroid hormone will be ____

A

High

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5
Q

If parathyroid hormone is low in the body, blood calcium will be _____

A

High

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6
Q

If two hormones rise and fall together (move in the same direction) they are apart of what feedback system

A

Positive feedback loop

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7
Q

What are the examples of a positive feedback system that was discussed in class?

A

LH and Estrogen

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8
Q

LH and estrogen _____ and ____ together

A

RISE and FALL

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9
Q

What kind of hormones go in both directions (I really do not understand this)

A

Complex hormones

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10
Q

What two systems are super related when it comes to hormones?

A

Endocrine system and the Nervous system

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11
Q

What is the movement of calcium FROM the bones TO the bloodstream?

A

Reabsorption

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12
Q

What is the movement of calcium FROM the blood TO the bones for storage?

A

Absorption

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13
Q

_________ effects the absorption of what Calcium?

A

Cortisol

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14
Q

Cortisol is ________, so it is increased in the morning and then _________ in the evening

A

DIURNAL; decreased (peaks again by AM)

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15
Q

When do Cortisol levels need to be drawn?

A

Early at like 8am, because this is when it is at it’s highest

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16
Q

What two hormones peak during sleep?

A

Growth hormones and prolactin

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17
Q

What hormones are released in a cyclic fashion over approximately 28 days

A

Female reproductive hormones

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18
Q

What hormones are secreted from the anterior pituitary?

A

Prolactin, FSH, ACTH, GH, TSH, and LH

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19
Q

Hormones from the anterior pituitary are “trophic” hormones and are secreted into the ___________

A

Bloodstream

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20
Q

The posterior pituitary STORES what two hormones?

A

ADH and Oxytocin

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21
Q

ADH and oxytocin are made where?

A

In the hypothalamus

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22
Q

What three hormones are secreted from the adrenal cortex
sugar, salt, and sex

A

Cortisol, aldosterone and androgens

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23
Q

What hormones are released from the adrenal medulla?

A

Catecholamines (Epi and NorEpi)

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24
Q

What are the targets organs that are associated with the hormones of the hypothalamus?

A

Thyroid
Kidneys
Bones
Gonads
Mammary glands
Smooth muscles
Tissue

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25
Q

ADH is a ______________

A

Vasoconstrictor

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26
Q

ADH is AKA “_________” hormones

A

No pee

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27
Q

ADH stimulates the ____________ of water into the renal tubules

A

Reabsorption

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28
Q

LOTS of ADH =

A

LITTLE URINE OUTPUT

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29
Q

LITTLE ADH=

A

LOTS OF URINE OUTPUT

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30
Q

Increased ADH, little urine output will lead to?

A

Fluid overload

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31
Q

Decreased ADH, and lots of urine output will lead to

A

excessive output (Dry Inside)

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32
Q

Disorder when the body has too little ADH

A

Diabetes Insipidus

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33
Q

Disorder when the body has too much ADH?

A

SIADH

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34
Q

What hormones stimulates the ejection of milk and the contraction of smooth muscles?

A

Oxytocin

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35
Q

What inhibits Oxytocin?

A

Alcohol

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36
Q

Growth hormone targets which body cells?

A

All of them

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37
Q

What are the normal ranges of GH for a male

A

4-5

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38
Q

What are the normal ranges of GH in a female

A

10-18 (We need more because of menstration)

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39
Q

What are the normal ranges of GH after exercise

A

> 20

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40
Q

What is the diagnostic range of GH seen in acromegaly?

A

> 50

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41
Q

How is lab testing done for Growth Hormone

A
  • Done with a treadmill test
  • NPO night before
  • 20-30 minutes of exercise
  • lab draw STAT
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42
Q

While looking at GH levels, and they have a heart issue, then what do you do to assess GH levels

A

They will take 50 grams of PO glucose (because they can’t really do the treadmill thing)

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43
Q

How do you interpret lab draw results for GH?

A

GH will stay increased in they have acromegaly

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44
Q

What is a common reason why there is a GH increase?

A

Pituitary tumor

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45
Q

________ occurs BEFORE growth plate closure

A

Gigantism

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46
Q

_________ occurs AFTER growth plate closure

A

Acromegaly

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47
Q

What are the manifestations of GH excess
essentially everything keeps growing and changing

A

Enlarged bony structures
Enlarged soft tissue
Change in shoe size, change in voice, sleep apnea, HTN, cardiomegaly, and joint pain.

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48
Q

What are some ways that GH excess is tested for?

A

In a normal glucose test, the GH will fall but it won’t if they have too much GH
An MRI will show a pituitary tumor
Increased IGF and GH

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49
Q

Surgery is used to remove a pituitary adenoma if it is <

A

10 mm

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50
Q

What is the basic outline of the surgery for a pituitary adenoma?

A
  • Make incision of upper lip and gingiva
  • Approach sella turcica thru the floor of the nose and sphenoid sinuses
  • TRY TO ONLY REMOVE TUMOR AND NO GLAND
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51
Q

When a patient is having surgery for their pituitary adenoma removal, they surgeon had to remove the whole gland, what would the lifestyle change be?

A

He would need replacement hormones for life
(ADH, CORTISOL, THYROID, SEX HORMONES)

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52
Q

What are the 6 pre-op considerations before a pituitary adenoma surgery

A

Bacitracin nose drops
Education about mouth breathing (post-op their nose will be packed)
They need oral care Q4 hours 6x daily
Avoid coughing, sneezing, and Valsalva maneuvers
Cluster care; Don’t stimulate
Watch for clear liquid and test for CSF

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53
Q

What are the post-op considerations for a patient who just had a pituitary adenoma removed?

A
  • Increase HOB to decrease HA
  • Oral care Q 4 hours
  • No brushing teeth for 10 days (suture line)
  • Test any drainage for CSF
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54
Q

What are some additional post-op considerations for a pituitary adenoma removal?

A
  • Persistent or severe generalized or supraorbital HA can indicate spinal fluid leakage into sinuses (usually resolves in 72 hours with HOB elevated and bed rest)
  • Possible daily spinal taps to decrease pressure and to help stop leaks
  • IV abx: decreases risk of infection if persistent leak or > 72 hours after surgery
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55
Q

What is used in conjunction with surgery for large pituitary adenomas?

A

Radiation therapy

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56
Q

What is the nursing care for radiation therapy?

A

Hold overnight for observation
Monitor VS
Monitor I and O
Neuro checks

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57
Q

What are possible complications after radiation therapy?

A

N/V, HA, Seizures, DI, or SIADH (Because of a change in sodium levels)

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58
Q

What are the drug therapies that can be used for Pituitary adenomas

A

Dopamine agonist (decreased GH levels)
Somatostatin (Decreases GH levels)

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59
Q

What is a decrease in one or more pituitary hormone?

A

Hypopituitarism

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60
Q

What are the causes for primary hypopituitarism?

A

Developmental, AI disorders, infections, vascular disease and destruction of a gland

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61
Q

What are the manifestations of primary hypopituitarism?

A

Weakness, fatigue, HA, dry skin, decreased stress tolerance, mental slowness, orthostatic hypotension, blindness and growth retardation

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62
Q

What is the post partum syndrome that affects the pituitary gland?

A

Sheehan’s syndrome

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63
Q

What are risk factors for Sheehan’s syndrome?

A

history of hemorrhage
History of hypoxemic episodes during delivery

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64
Q

What are manifestations of Sheehan’s syndrome?

A

Scant or Irregular menses
Decreased secondary sex characteristics
Hypothyroidism s/sx
Glucocorticoid insufficiency s/sx

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65
Q

Pituitary dwarfism is when there is decreased GH levels, how is this fixed?

A

Give GH

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66
Q

What is the disorder caused by too much ADH and results in urine retention, but there is normal renal function?

A

SIADH

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67
Q

Manifestations of SIADH?

A
  • Serum hypoosmolality
  • Hyponatremia and Hypochloremia
    -Weight loss (if you - edema)
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68
Q

Nursing care for SIADH?

A
  • Declomycin (blocks ADH)
  • Fluid restriction 800-1000 cc/day
  • 3-5% hypertonic saline
  • Daily weight
  • Lasix-> If there is an intravascular overload
  • Albumin and then Lasix –> If extracellular overload
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69
Q

What is a normal serum osmolality?

A

285-295

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70
Q

What is the normal urine specific gravity?

A

1.005-1.030

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71
Q

If a patient has a high specific gravity, their urine will be ______

A

Dark/amber

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72
Q

If a patient has a low serum osmolality, their urine will be ______

A

Clear

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73
Q

In a patient with SIADH, their serum osmolality will ___ and their specific gravity will be ____

A

Serum osmolality will be LOW because there is fluid overload
Specific gravity will be HIGH because they are putting out so little urine

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74
Q

Diagnostic Lab Tests for SIADH

A

Serum Sodium less than 134-135
Serum Osmolality is less than 280
Urine Specific Gravity greater than 1.025-1.030

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75
Q

A patient has Diabetes Insipidus, you will want to make them a priority and see them first, WHY?

A

Because it can cause clinically significant electrolyte abnormalities.

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76
Q

What are the clinical manifestations of diabetes insipidus

A

Polyuria (5-20 L/day) and polydipsia
Urine specific gravity less than 1.005 (diluted)
Elevated serum osmolality greater than 295 (concentrated)
Fatigue, nocturia, and weakness

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77
Q

Central DI is _________ and there is increased ADH synthesis (in the hypothalamus) or release (in the pituitary)

A

Nerogenic

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78
Q

Nephrogenic DI is when the _______ do not respond to ADH like they are supposed to

A

KIDNEYS

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79
Q

Psychogenic DI is when there is a ______ disorder or a lesion in the thirst center

A

Psych

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80
Q

Nursing care for Diabetes Insipidus?

A
  • Vasopressin- mimics ADH
  • IV D5W and gluc checks
  • Thiazide diuretics (nephrogenic)
  • UA to assess specific gravity
  • Daily weight and I&Os
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81
Q

What is used to determine the cause of DI?

A

Water deprivation Test

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82
Q

Steps to a water deprivation test

A
  • Hold all fluids at midnight and get baseline SG and osmolality
  • Take 3 postural BP per hour/ hourly urine analysis
  • Weights at hours 4,6,7, and 8
  • Give IV ADH
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83
Q

After a water deprivation test, if the urine SG and SO are normal it is _______

A

Psych; they need to stop drinking so much

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84
Q

After a water deprivation test, is the urine SG and SO are greater than 300 it is _______ and they need ___

A

Central; they need ADH

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85
Q

After a water deprivation test, if there is no or very little response, it is ________

A

Nephrogenic; total kidney issue so messing with ADH will do nothing

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86
Q

What is the normal T4 levels?

A

4.6-11

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87
Q

What are the normal T3 levels?

A

70-204

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88
Q

What are the normal TSH levels?

A

0.4-4.2

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89
Q

What is the hypermetabolism because of an excess of T3, T4, or both

A

Thyrotoxicosis

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90
Q

What is when there are antibodies that develop antigens to fight against the thyroid (TSAbs) and they produce more thyroid hormones

A

Hyperthyroidism/ Graves Disease

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91
Q

What is the kind of hyperthyroidism that nodules secrete extra thyroid hormones and a toxic goiter

A

Nodular goiter

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92
Q

Nodular goiter can be caused after what?

A

A stressful event like a car crash, having a baby, chronic illness etc.

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93
Q

What are the diagnostic tests that are seen in hyperthyroidism?

A

High T3 and T4 and low TSH

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94
Q

What is the most sensitive indicator of thyroid function?

A

Free T4

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95
Q

What are some clinical manifestations of hyperthyroidism?

A
  • Increased HR, palpitations, Afib, angina, increased RR and DOE
  • Increased appetite, thirst, decrease weight, diarrhea, increased bowel movements, splenomegaly and hepatomegaly
96
Q

What are some manifestations of Thyroid Storm?

A
  • Severe tachycardia (Betablockers)
  • Heart failure
  • Shock
  • Hyperthermia
  • Agitation and deliruim
97
Q

What are drug therapy options for a patient with hyperthyroidism

A
  • PTU
  • Taprazole (see benefits in 1-2 weeks and max effects in 4-8 weeks)
  • Iodine (benefits in 1-2 weeks)
  • Beta blockers
  • Radioactive Iodine- Given to the 2/3 who do not go into remission after normal meds
98
Q

Med considerations for hyperthyroidism?

A

They are not long term solutions. 1/3 of patients will return to normal thyroid function after meds but 2/3 will need surgical resection etc.

99
Q

What is the nutrition therapy for hyperthyroidism?

A
  • 4000-5000 calories day
  • 6 meals a day
  • High protein and low caffeine
  • Avoid lots of spices and high fiber foods
100
Q

What is the sign when there is carpal spasm when there is increased pressure in the BP cuff?

A

Trousseau’s sign

101
Q

What is the sign when there is facial spasm with a stroke or tap on the facial nerve?

A

Chvostek’s sign

102
Q

If meds do not put a hyperthyroidism patient back into remission, they will need surgery. If too much of the gland is removed, they can be sent into _______________

A

Hypothyroidism

103
Q

What are some complications of thyroid surgery?

A

Laryngeal Nerve Damage

104
Q

What are post op considerations for a thyroid removal surgery?

A

Fix the dressing for the family
High semi-fowlers
Assess for bleeding
Q2 checks
Urine output
Low BP and assess H&H

105
Q

What are some warning signs after a thyroidectomy?

A
  • Paralysis of cords
  • Swelling -ABC’s
  • Stridor- tetany –> Treat with Ca+ gluconate
  • Assess for bleeding.
106
Q

Pre-op considerations for before a thyroidectomy?

A

They need to hold their neck when they turn
Do neck ROM
Place O2, suction, and trach set in room just in case.

107
Q

What are the diagnostics that you will see in hypothyroidism?

A

High TSH, low T3 and T4

108
Q

Primary hypothyroidism is caused by what?

A

Destructed thyroid tissue, genetic issues, and AI disease

109
Q

Secondary hypothyroidism is caused by what?

A

Disease of the pituitary with low TSH or hypothalamic disease with abnormal TRH

110
Q

What are the manifestations of hypothyroidism?

A

Bradycardia
Lethargy and cold intolerance
Bad memory and dry/brittle nails
Amnesia and menorrhea
weight gain and constipation
Possible myxedema

111
Q

What is the emergency that is associated with low thyroid hormone?

A

Myexedema coma

112
Q

What are the manifestations of myxedema coma?

A

Subnormal temperature
Hypotension
Low RR

113
Q

Treatment for Myxedema coma?

A

Life support
IV thyroid hormone

114
Q

Treatment for hypothyroidism?

A
  • Low calorie
  • Levothyroxine
  • Monitor cardiac changes
  • Increase hormones at weeks 1 and 4 intervals
  • Supportive care
115
Q

What causes primary hyperparathyroidism?

A

Increased secretion of PTH

116
Q

What causes secondary hyperparathyroidism?

A

Compensatory response to other causes of hypocalcemia
(Because calcium and parathyroid hormone of in a negative feedback loop, if ca is consistently low the body is secreting a lot parathyroid hormone)

117
Q

What are the manifestations of hyperparathyroidism?

A

Dysrhythmias, HTN, delirium, confusion, stupor, coma, hyperreflexia, kidney stones, UTI, osteoporosis, skeletal pain and long bone fractures.

118
Q

What are the causes of Iatrogenic Hypoparathyroidism?

A

Removal of the parathyroid glands during a thyroidectomy

119
Q

What causes idiopathic hypoparathyroidism?

A

Unknown

120
Q

What are the manifestations of hypoparathyroidism?

A

+ Chvostek sign and Trousseau’s sign.
Disorientation, HA, seizures, depression
Urinary frequency, low CO, low cardiac contractability

121
Q

What is the treatment for tetany?
Caused by low Ca+, so give __________

A

Calcium Gluconate

122
Q

What is the syndrome where there is too much glucocorticoid in the body?

A

Cushing’s

123
Q

What are some possible causes of Cushing’s?

A

Pituitary tumor
Adrenalectomy

124
Q

What are the manifestations of Cushing’s syndrome?

A
  • Weight gain, HTN, weakness, virilization
  • Moon face and buffalo hump and red striae
  • Hirsutism, abnormal periods, thick skin, and bruising.
  • Osteoporosis and increased blood glucose.
125
Q

How is Cushing’s syndrome diagnosis?

A

24 hour urine (free cortisol) and Dexamethasone suppression test.

126
Q

How is a Dexamethasone suppression test done?
Done to test for Cushing’s

A
  • 2mg Dexamethasone given at 11 pm to suppress CRH
  • Plasma cortisol levels are drawn at 0800
  • Cortisol levels should be low
127
Q

What are the possible results of a Dexamethasone suppression test?

A

Cortisol < 3 mcg- 50% suppression
Normal cortisol- 5-23
If there is no suppression of Cortisol they likely have Cushing’s

128
Q

What is the drug therapy where it is considered a “medical adrenalectomy”

A

Lysodren

129
Q

What drug is used for Cushing’s and inhibits cortisol synthesis?

A

Cytadren

130
Q

What is some nursing care for Cushing’s syndrome?

A

Q8 VS
Daily weights
Infection
Gluc checks
Change in LOC
Assess for bone pain and possible falls

131
Q

What is the disorder where there is an under functioning of the adrenal cortex?

A

Addison’s

132
Q

What are the manifestations of Addison’s Disease?

A
  • Hyperpigmentation in skin folds
  • Low BP, low Na, high K+, N/V, diarrhea
133
Q

What is the sudden intense drop in hormones after a stressful event?

A

Addison’s Crisis

134
Q

How is Addison’s diagnosed?

A
  • Low cortisol levels
  • Low Na, high K+
  • ACTH stimulation test
135
Q

What are the steps to a ACTH stimulation test?
This is done to test for Addison’s

A

-Draw levels at 60 minutes and they should be higher than baseline by >7 mcg/dL. If a patient has an insufficiency the levels won’t rise at all…

136
Q

What is the treatment for Addison’s disease?

A
  • Daily cortisol replacement
  • Daily mineralocorticoid replacement
  • Salt additives in excess heat and humidity
137
Q

What are patient education points for Addison’s disease

A
  • Wear a medical alert bracelet
  • Increase medication at times of stress and infection
  • Educate about the s/sx of the meds
138
Q

What is the disorder where there is too much salt and is also known as primary hyperaldosteronism?

A

Conn’s syndrome

139
Q

What is the hallmark of Conn’s syndrome?

A

HTN, increase Na, low K, and alkalosis

140
Q

What normally causes Conn’s syndrome?

A

Adrenalcorticol tumor

141
Q

How is Conn’s disease treated?

A

Adrenalectomy.

142
Q

what is the disorder where the adrenal medulla tumor produces too many catecholamines (Epi and Norepi)

A

Pheochromocytoma

143
Q

How is pheochromocytoma treated and cared for?

A

Remove the tumor and care for the patient emotionally and physically

144
Q

What is the leading cause of adult blindness, kidney disease and amputations?

A

DIABETES

145
Q

Diabetes is a contributing factor to what diseases?

A

Heart disease
Stroke
HTN
Lipid metabolism

146
Q

What disorder is characterized by a total absence of insulin and beta cells and an autoimmune disease?

A

type 1 DM

147
Q

What is the disorder where there is some insulin but it is poorly used?

A

type 2 diabetes

148
Q

What are the 4 aspects of diabetes patho?

A
  1. Insulin resistance
  2. Low insulin production
  3. Inappropriate hepatic glucose production
  4. Altered production of hormones and cytokines by adipose tissue
149
Q

What labs characterize prediabetes

A

IGT= 140-199
IFG= 100-125

150
Q

What is the A1C diagnostic for DM2

A

6.5% or higher

151
Q

What is the fasting glucose for DM

A

Higher than 126

152
Q

What is the OGTT for DM?

A

200 mg/dL

153
Q

What are the treatments for DM1

A
  • they are insulin dependent
  • ADA diet
  • exercise
  • check glucs and A1C
  • FOOT CARE
  • medical alert bracelet
154
Q

What are the treatment for DM2

A
  • ADA diet
  • lifestyle changes
  • PO hypoglycemics
  • insulin
  • glucs and monitoring A1C
  • FOOT CARE and medical alert braclet
155
Q

WHAT IS THE ANNUAL TESTING FOR A DIABETIC

A

A1C
Albumin-to-Creatinine Ratio and eGFR (kidney damage)
Ankle-Brachial Index (PAD)
BP (Heart disease)
Bone Mineral Density (Osteoporosis)
Cholesterol and Triglycerides
Dilated eye exam

156
Q

What are some problems with insulin therapy?

A

Possible allergy
lipodystrophy
Somogyi effects
Extreme hypoglycemia and rebound effects.

157
Q

If a patient complain of HA on awakening with nightmares, night sweats, you should do what?

A

This is the Somogyi effect… Treatment is to lower insulin dose

158
Q

What is the phenomenon that releases GH/cortisol and it leads to increased BG and ketonuria on awakening

A

Dawn Phenomenon; Need to increase insulin or alter the timing of the insulin

159
Q

What is the treatment for the Dawn phenomenon?

A

Increase of change the insulin dosing

160
Q

DKA is more common in what DM?

A

type 1

161
Q

What are the manifestations of DKA?

A
  • dehydration
  • N/v
  • Kussmalls breathing and fruity breath
  • renal failure and electrolyte imbalances
  • coma and death.
162
Q

What is the treatment for DKA?

A
  • insulin
  • fluid replacement
  • electrolytes
  • K+ imbalances- THIS IS CRITICAL
163
Q

What are the labs that are used to diagnose DKA

A

BG > 250 mg
blood pH < 7.30
Bicarb < 16
KETONES IN URINE ADN DEHYDRATION

164
Q

Hypoglycemia is when there is a BG of less than

A

50!!

165
Q

What are the manifestations of hypoglycemia

A

numbness, high HR, unsteady gait, coma and seizures

166
Q

What are possible causes of hypoglycemia

A

Too much insulin
Too much exercise

167
Q

What is the treatment for hypoglycemia

A

Immediate ingestion of 5-20 grams of simple carbs. Repeat as needed as call for medical help if it presists.

168
Q

What are environmental hazards to the skin?

A

Sun exposure
Irritants and allergens
RAdiation

169
Q

What are healthy factors that help the skin?

A

Rest and sleep
Exercise
Hygiene
Nutrition
Self treatment and SPF

170
Q

What is the minimum SPF?

A

15; reapply every 2-3 hours

171
Q

Cancer of the _______is the most common malignant condition and accounts for 40% of all new cancer diagnosis

A

Skin

172
Q

What are risk factors for skin cancer?

A

Fair skin
Chronic sun exposure
Smoking/carginogen
Family history

173
Q

Pale white skin (type 1) is extremely _______ always burns and never tans…. Score is 0-____

A

EXTREMELY SENSITIVE! Score 0-6

174
Q

White skin (type 2) is still very sensitive skin. Burns _________ and tans __________; score 7-__

A

Burns easily and tans minimally; score 7-13

175
Q

Light brown (type 3) skin is sensitive, sometimes ____ and slowly tans to light brown… Score 14-20

A

Sometimes burns

176
Q

Moderate brown skin (type 4) is mildly sensitive and _______ tans to moderate brown! Score 21-27

A

ALWAYS TANS

177
Q

Dark brown skin (type 5) is resistant skin and ____ well! Score 28-34

A

TANS

178
Q

Deeply pigmented dark brown to black skin (type 6) is very _________! Very rarely burns and is deeply pigmented. Score 35+

A

Resistant

179
Q

What skin condition is a precursor to cancer?

A

Actinic Keratosis

180
Q

Where does squamous cell carcinoma begin?

A

In the squamous layer of the skin

181
Q

Where does basal cell carcinoma start?

A

In the basal cell layer of the skin

182
Q

Where does melanoma start?

A

In the melanocytes

183
Q

What is the condition that is characterized by papules and plaques that occur on sun exposed areas?

A

Actinic Keratosis

184
Q

Actinic Keratosis is also known as _______ ______

A

solar keratosis

185
Q

Actinic keratosis is the premalignant form of _______ cell carcinoma

A

squamous

186
Q

What do lesions in actinic keratosis look like?

A

Irrugular shaped
flat and red
indistinct borders
with a hard keratotic scale

187
Q

What is the treatment for actinic keratosis?

A
  • Cryosurgery
  • 5-FU
  • Surgical removal
  • dermatological agents
188
Q

What is a malignant neoplasm of keratinizing epidermal cells?

A

Squamous cell carcinoma

189
Q

Where does SCC occur?

A

In sun exposed areas

190
Q

Superficial SCC is when there is ____ scaly erythematous without invasion of the dermis

A

THIN

191
Q

Early SCC included firm nodules with ________ borders; scaling and ulceration?

A

INDISTINCT

192
Q

Late SCC is the covering of lesion with scale or horn from ______________?

A

Keratinization

193
Q

Where is late SCC normally occur?

A

Face and hands

194
Q

What is the treatment for SCC?

A

Electrodessication
Radiation
5-FU
Surgery

195
Q

What is the locally invasive malignancy arising from epidermal basal cells?

A

Basal cell carcinoma (BCC)

196
Q

What is the most common type of skin cancer and the least deadly?

A

BCC

197
Q

Nodular BCC is small slow growing papules; with _____ boarders, erosion, ulceration and depression at the center?

A

Rounded?

198
Q

Superficial BCC is erythematous, sharply defines, barely _______ multinodular plaques with varying scaling and crusting? (Looks like eczema)

A

elevated

199
Q

What is the treatment for BCC?

A

Electrodessication
Surgical excision
Cryosurgery
5-FU
Intralesional alpha-interferon

200
Q

What is a tumor arising in melanocytes and has the ability to metastasize to any organ in the body?

A

Malignant Melanoma

201
Q

Malignant Melanoma is __ times more prevalent in white people than African Americans

A

10

202
Q

What are the clinical manifestations of Malignant Melanoma?

A

Approximately 1/4 in the existing nevi
Often brown or black

203
Q

What are the things that need to be monitored for in Melanoma (ABCDE)

A

Asymmetry
Border
Color
Diameter
Evolving Appearance

204
Q

What are the care considerations for melanoma

A

Assess any progressive changes
Excisional biopsy
Removal
Chemo, radiation, alpha interferon

205
Q

Bacterial skin infections are usually caused by what bacteria?

A
  • Staph. A
    Group A beta hemolytic strep
206
Q

What are predisposing factors for bacterial infections?

A

Moisture
Obesity
Skin disease
Corticosteroids
Chronic disease
Diabetes

207
Q

What are common infections of the skin?

A

Impetigo
Folliculitis
Furnicle
Erysipelas
Furunculosis
Carbucle
Cellulitis

208
Q

What are the most common viral skin infections?

A

HS 1
HS 2
Herpes Zoster
Warts- if its not getting better in 72 hours go to provider. If self treatment is making it worse go to provider

209
Q

A patient think he may have been exposed to Herpes Simplex, the nurse should educate that the first symptoms will occur how many days after contact?

A

3-7 days

210
Q

Reoccurrence of HSV is secondary to what?

A

Stress
Sunlight
Trauma
Menses
Infection

211
Q

HSV lasts a ________

A

LIFETIME

212
Q

How is HSV transmitted by what?

A

Respiratory droplets or virus containing fluid (Saliva or cervical secretions)

213
Q

What is the treatment/managment for HSV?

A

Antiviral agents
Soothing creams
Compresses

214
Q

Herpes Zoster is _______

A

Shingles

215
Q

Herpes Zoster is the _______ of varicella zoster as an adult?

A

activation

216
Q

Herpes Zoster looks like what?

A

Linear distribution along a dermatome of vesicles on a red base along trunk, face, or lumbosacral areas

217
Q

What are the manifestations for Herpes Zoster?

A

Burning pain
Neuralgia
Pain
Rash- obviously.

218
Q

How is Herpes Zoster treated?

A

Antivital agents
Topical creams
Mild sedation at bedtime

219
Q

A 50 y/o patient presents and says that he had chicken pox when he was a kid and is concerned about getting shingles. What is something you could recommend him talking to a provider about?

A

Vaccine!!

220
Q

What is a common fungal infection?

A

Candiadiasis (caused by candida albicans)

221
Q

Where does thrush normally occur?

A

Mouth
Vagina
Skin

222
Q

Thrush is associated with _____ mediated immunity depression

A

cell-mediated

223
Q

Tinea Unguium is fungus of the

A

nail bed

224
Q

Tinea Corporis is

A

ringworm

225
Q

Tinea Cruris is

A

Jock itch

226
Q

Tinea Pedis is

A

On the foot/ Athlete’s foot

227
Q

Just be aware that bug bites can lead to

A

Anaphylaxis

228
Q

What is the condition where there are red papules 3-7 days after contact with a allergen?

A

Allergic Contact dermatits

229
Q

What is an allergic phenomenon caused by the histamine response?

A

Urticaria

230
Q

Some _______ reactions can cause rashes

A

Drug interations

231
Q

What is an immunologic inflammatory response?

A

Atopic Dermatitis

232
Q

What are methods of collaborative care of dermatologic problems?

A
  • Phototherapy
  • Radiation therapy
  • Laser technology
233
Q

What are some drug therapy options for skin problems?

A
  • ABX
  • Corticosteroids
  • Antihistamines
  • 5FU
  • Immunomodulators
234
Q

What are possible diagnostic/surgical therapy for skin probems?

A
  • Skin scraping
  • Electrodessication
  • Curettage
  • Punch biopsy
  • Cryosurgery
  • Excision
235
Q

Nursing care for skin problems?

A

Wet dresssings
Baths
Topical meds
Control of proritus
Stop secondary infection
Specific skin care
Psych and physiologic effects of chronic skin issues

NURS 302/ Med-Surg 2 (5 decks)

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