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Med Surge I > Med Surge I Objective 2 > Flashcards

Med Surge I Objective 2 Flashcards

Needs Of Clients With Integumentary Disorders

1
Q

What are the functions of the skin?

A

Protection - Against bacteria, foreign matter, water loss
Sensation - Pain, temperature, touch
Fluid Balance - Absorbs water, prevents excessive loss
Temperature Regulation - Heat dissipation, evaporation
Vitamin Production - Vitamin D
Immune Response Function - Dermatitis, asthma. Cells in the skin are different in people with allergies than those who are healthy

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2
Q

Ecchymosis

A

Bruising

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3
Q

Petechiae

A

Red, pinpoint spots from blood leakage

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4
Q

Pruitis

A

Itchy skin

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5
Q

Erythema

A

Redness

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6
Q

Cyanosis

A

Bluish skin

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7
Q

Pallor

A

Pale skin

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8
Q

Jaundice

A

Yellowing of the skin

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9
Q

Turgor

A

Ease of rising of skin

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10
Q

Mobility

A

Ability of skin to return in place

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11
Q

Nevus

A

Mole

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12
Q

Factors that affect skin integrity: 1. Physical, emotional and lifestyle

A

Detailed history of general health. Diabetes, age, peripheral artery disease, collagen vascular disease cancer, chemotherapy, among others

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13
Q

Factors that affect skin integrity: 2. Environmental: socio-economic, care setting, potential for self-management

A

Income, working conditions, food, housing/environment, early childhood development, education/literacy, social supports, health behaviours/ access to health care

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14
Q

Factors that affect skin integrity: 3. Systems: Health care support and communication

A

Access to funding, access to services and wound-related products. Diagnostic services, service delivery personnel

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15
Q

What are the are related effects?

A

Skin dryness, wrinkling, thinning, decreased turgor, increased skin fragility
Loss of subcutaneous tissue - decrease protective cushioning
Decreased blood supply - delays wound healing
Thinning hair
Photoaging - Loss of elasticity (damage from excessive sun)

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16
Q

What is the SMART principle?

A

S - Specific: what needs to be accomplished (how, when, where)
M - Measurable: How much, how many, how often
A - Attainable: Realistically achievable
R - Rewarding: All should feel good when the goal is achieved
T - Timely: Realistic timeframe (short, intermediate and long)

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17
Q

What is debriding?

A

Act of removing necrotic material, eschar, infected tissue, slough, foreign bodies, debris from a wound

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18
Q

Biological debridement

A

Maggots liquify necrotic tissue and secrete substances that destroy bacteria

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19
Q

Mechanical debridement

A

Applying moistened gauze and periodically removing it (wet to dry dressing); non-traumatic irrigation systems (syringe and needle) 19 gauge needle gives 15 pounds of pressure; ultrasound (sound waves through saline)

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20
Q

Hydrosurgical debridement

A

Specialized, powered surgical tool

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21
Q

Chemical debridement

A

Sodium hypochlorite

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22
Q

Autolytic Debridement

A

Self-digestion of by enzymes naturally present in the wound

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23
Q

Enzymatic debridement

A

Application of proteolytic substances to breakdown tissue

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24
Q

Surgical debridement

A

Fastest way to remove devitalized (slough), contaminated or infected tissue

25
Q

Conservative sharp wound debridement

A

Removal of only devitalized tissue with scalpel or scissors

26
Q

ABCDE method for screening moles

A

A: Asymmetry: one half is not like the other
B: Borders: Irregular edges, ragged, notched and not well-defined
C: Colour: Variation or change
D: Diameter: Growth in size larger than a pencil
E: Evolution: Change in size, shape, symptoms (itchiness, tenderness), surface elevation, bleeding, colour

27
Q

Immunofluorescence

A

Identifies site of immunologic reaction using dye

28
Q

Patch testing

A

Applying suspected allergens to healthy skin

29
Q

Skin scrapings

A

Tissue samples and scraped from suspected fungal lesions and examined under microscope (scabies)

30
Q

Pruritis

A

General itching. A common symptom of dermatological disorders. Occurs with rash or lesion but may without

31
Q

Allergy contact dermatitis (ACD)

A

Inflammatory reaction of the skin. Absorbed agent - nickel and gold jewellery, balsam of Peru (found in perfumes)

32
Q

Antibiotic and allergic contact dermatitis

A

Neomycin: most frequently used antibiotic to treat skin, ear and eye infections. Found in OTC creams/lotions
Bacitracin: Most likely antibiotic to cause anaphylaxis

33
Q

Nurses are at most risk of what and why?

A

Of allergic contact dermatitis due to frequent exposure to topical antibiotics

34
Q

Bacterial infections

A

Impetigo, folliculitis, furuncles, and carbuncles

35
Q

Impetigo

A

Infection of the skin caused by staph, strep or multiple bacteria. Usually on exposed areas of the body

36
Q

Clinical manifestations for impetigo

A

Small red macules which become discrete, thin-walled vesicles that soon rupture and become covered with a honey-yellow crust

37
Q

Nurse management for impetigo

A

Antibiotic, topical antibacterials
Bathe daily, and have separate combs/towels
Avoid direct contact

38
Q

Folliculitis

A

Bacterial (staph) or fungal infection of the hair follicles (razor rash)

39
Q

Furuncles

A

(boil) acute inflammation deep in one or more hair follicles and spreads to surrounding dermis (back of neck, axillae, and buttocks)

40
Q

Carbuncle

A

Abscess of the skin and subcutaneous tissue that represents an extension of the furuncle (back of neck and buttocks)

41
Q

Folliculitis, furuncles, and carbuncles: Nursing management

A

Never squeeze
Treat staph infection with antibiotic
IV fluids, fever reduction
Warm moist compresses, antibacterial soap

42
Q

Tinea Pedis (Athletes foot)

A

Fungal infection of the foot

43
Q

Tinea Pedis (Athletes foot): Clinical manifestations

A

Found on soles of feet or between toes (scaling or moist)

44
Q

Tinea Pedis (Athletes foot): Nursing management

A

Topical antifungals
Keep feet clean and dry
Cotton socks

45
Q

Tinea Corporis

A

Ringworm of the body - ringed lesions appear on the face, neck, trunk and extremities (contact with pets)

46
Q

Tinea Capitis

A

Ringworm of the scalp - round scaling patches on the scalp

47
Q

Tinea Cruris

A

Ringworm of the groin (jock itch)

48
Q

Ringworm: Nursing mangement

A

Antifungal ointments - oral and topical
Separate combs/towels
Keep skin folds and feet dry
Examine household pets

49
Q

Cellulitis

A

The most common infectious cause of limb swelling. Entry point through the skin allows bacteria to enter

50
Q

Cellulitis: Clinical manifestations

A

Deep inflammation of subcutaneous tissue, hot, red, tender, swollen, malaise, fever

51
Q

Cellulitis: Nursing management

A

Oral antibiotics
Affected area above heart level
Warm, moist pack Q 4-6 hours

52
Q

Shingles

A

Infection caused by the varicella-zoster virus. Reactivation of latent varicella virus infection and reflects lowered immunity

53
Q

Shingles: Clinical manifestations

A

Painful vesicular eruptions, pain which may radiate to areas supplied by affected nerves
Burning, stabbing or aching
Itching, tenderness
Vesicles contain serum, and later become purulent, rupture and crusts

54
Q

Shingles: Nursing management

A

Oral antiviral agents, pain medications
Apply wet dressings or medications
Diversionary activities and relaxation techniques

55
Q

Scabies

A

Infestation of the skin by the itch mite. Mites involve the fingers and hand contact may spread infection. Rash on elbows, knees, edge of feet, nipples, axillae, groin

56
Q

Scabies: Clinical manifestations

A

4 weeks after contact for symptoms to appear
Small raised burrows, brown or black thread-like lesions
Severe itching at night
Vesicles, papules, excoriations and crusts

57
Q

Basal cell carcinomas (BCC) and Squamous cell carcinomas (SCC)

A

Most common types of skin cancer
Diagnosed by biopsy and histologic evaluation
BCC prognosis is usually good - SCC prognosis depends on metastasis

58
Q
A

Med Surge I (2 decks)

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