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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
Conservative sharp wound debridement
Removal of only devitalized tissue with scalpel or scissors
26
ABCDE method for screening moles
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
Immunofluorescence
Identifies site of immunologic reaction using dye
28
Patch testing
Applying suspected allergens to healthy skin
29
Skin scrapings
Tissue samples and scraped from suspected fungal lesions and examined under microscope (scabies)
30
Pruritis
General itching. A common symptom of dermatological disorders. Occurs with rash or lesion but may without
31
Allergy contact dermatitis (ACD)
Inflammatory reaction of the skin. Absorbed agent - nickel and gold jewellery, balsam of Peru (found in perfumes)
32
Antibiotic and allergic contact dermatitis
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
Nurses are at most risk of what and why?
Of allergic contact dermatitis due to frequent exposure to topical antibiotics
34
Bacterial infections
Impetigo, folliculitis, furuncles, and carbuncles
35
Impetigo
Infection of the skin caused by staph, strep or multiple bacteria. Usually on exposed areas of the body
36
Clinical manifestations for impetigo
Small red macules which become discrete, thin-walled vesicles that soon rupture and become covered with a honey-yellow crust
37
Nurse management for impetigo
Antibiotic, topical antibacterials Bathe daily, and have separate combs/towels Avoid direct contact
38
Folliculitis
Bacterial (staph) or fungal infection of the hair follicles (razor rash)
39
Furuncles
(boil) acute inflammation deep in one or more hair follicles and spreads to surrounding dermis (back of neck, axillae, and buttocks)
40
Carbuncle
Abscess of the skin and subcutaneous tissue that represents an extension of the furuncle (back of neck and buttocks)
41
Folliculitis, furuncles, and carbuncles: Nursing management
Never squeeze Treat staph infection with antibiotic IV fluids, fever reduction Warm moist compresses, antibacterial soap
42
Tinea Pedis (Athletes foot)
Fungal infection of the foot
43
Tinea Pedis (Athletes foot): Clinical manifestations
Found on soles of feet or between toes (scaling or moist)
44
Tinea Pedis (Athletes foot): Nursing management
Topical antifungals Keep feet clean and dry Cotton socks
45
Tinea Corporis
Ringworm of the body - ringed lesions appear on the face, neck, trunk and extremities (contact with pets)
46
Tinea Capitis
Ringworm of the scalp - round scaling patches on the scalp
47
Tinea Cruris
Ringworm of the groin (jock itch)
48
Ringworm: Nursing mangement
Antifungal ointments - oral and topical Separate combs/towels Keep skin folds and feet dry Examine household pets
49
Cellulitis
The most common infectious cause of limb swelling. Entry point through the skin allows bacteria to enter
50
Cellulitis: Clinical manifestations
Deep inflammation of subcutaneous tissue, hot, red, tender, swollen, malaise, fever
51
Cellulitis: Nursing management
Oral antibiotics Affected area above heart level Warm, moist pack Q 4-6 hours
52
Shingles
Infection caused by the varicella-zoster virus. Reactivation of latent varicella virus infection and reflects lowered immunity
53
Shingles: Clinical manifestations
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
Shingles: Nursing management
Oral antiviral agents, pain medications Apply wet dressings or medications Diversionary activities and relaxation techniques
55
Scabies
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
Scabies: Clinical manifestations
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
Basal cell carcinomas (BCC) and Squamous cell carcinomas (SCC)
Most common types of skin cancer Diagnosed by biopsy and histologic evaluation BCC prognosis is usually good - SCC prognosis depends on metastasis
58

Med Surge I (2 decks)

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