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U of R SCHOOL OF NURSING > NUR 370 SKIN > Flashcards

NUR 370 SKIN Flashcards

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1
Q

Functions of the skin

A
  • immunity
  • temperature regulation
  • water balance
  • excretory organ (urea, water, salt)
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2
Q

Epidermis layer

A
  • outermost layer of skin
  • squamous epithelia
  • flat sheets of cells
  • outer layer contains 25 sheets of dead cells continuously shed
  • melanin and keratin production
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3
Q

Dermis layer

A
  • middle layer
  • dense, irregular connective tissue
  • nerves
  • hair follicles
  • smooth muscle
  • glands
  • blood vessels
  • lymphatic vessels
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4
Q

Subcutaneous layer

A
  • innermost layer of skin
  • soft, fatty tissue
  • immune cells
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5
Q

Cause of pressure ulcers

A
  • pressure
  • shear
  • friction
  • moisture
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6
Q

Prevention of pressure ulcers

A
  • identify at risk persons
  • improve tissue tolerance
  • linens dry
  • skin dry
  • stop chafing
  • protect against external mechanical forces
  • reduce incidence through education
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7
Q

Stage I pressure ulcer

A
  • persistent red

- no broken skin

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8
Q

Stage II pressure ulcer

A
  • partial thickness loss in epidermis/dermis or both

- peri-wound involvement

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9
Q

Stage III pressure ulcer

A
  • full thickness skin loss
  • damage to subcutaneous tissue
  • peri-wound involvement
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10
Q

Stage IV pressure ulcer

A
  • damage to subcutaneous tissue involving muscles, tendon, and bone
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11
Q

Unstageable pressure ulcer

A
  • necrotic tissue and slough
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12
Q

Treatment of pressure ulcers

A
  • barrier creams: moisture to maintain skin flexibility
  • wound vac
  • antibiotic solutions
  • heat/cold
  • oxygen
  • specialized beds
  • silver oxide dressings
  • surgical debridement
  • “black box”: honey, albumin
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13
Q

Topical agents for pressure sores

A
  • emollients (aquaphor)
  • lotions
  • antiseptics
  • antibiotics
  • side effects: local irritation, stinging, burning
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14
Q

Birthmarks

A
  • skin anomalies present at birth or shortly after

- vascular or pigmented

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15
Q

Vascular birthmark

A
  • arise from blood vessels that have not formed correctly
  • generally red color
  • types: macular stains, hemangioma, port-wine stains
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16
Q

Macular stain vascular birthmark

A
  • “stork bites”
  • most common type of vascular birth-mark
  • flat
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17
Q

Hemangiomas vascular birthmark

A
  • “strawberries”
  • bright red patch or nodule
  • superficial or deep
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18
Q

Port-wine stains vascular birthmark

A
  • discolorations that look like wine was spilled

- face, neck, arms, legs

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19
Q

Pigmented birthmarks

A
  • made of a cluster of pigment cells, causing color in the skin
  • cafe au lait spots
  • mongolian spots
  • mole
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20
Q

Cafe au lait pigmented birthmark

A
  • color of coffee with milk
  • anywhere in the body
  • if child has > 6 at birth, evaluated for signs of neurofibromatosis
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21
Q

Mongolian spots pigmented birthmark

A
  • flat, bluish-gray patches often found on lower back or buttocks
  • ALWAYS DOCUMENT THESE! if not, can look like child abuse
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22
Q

Albinism

A
  • recessive condition that results in little or no melanin production
  • lack of pigment in skin, hair, and iris of eye
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23
Q

Vitiligo

A
  • small patchy areas of hypo pigmentation
  • cells that produce melanin die or no longer form melanin, causing slowly enlarging white patches of irregular shapes on the skin
  • one part of skin or spreading
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24
Q

Pharmacotherapy of vitiligo

A
  • topical corticosteroid agents
  • topical repigmenting agents
  • skin graft
  • sun safeguards
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25
Q

Lentigo

A
  • large pigmented spots

- aka age spots

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26
Q

Skin tags

A
  • benign, soft brown or flesh colored masses that usually occur on the neck, armpit or groin
  • more common in persons who are obese or have diabetes
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27
Q

Contact dermatitis

A
  • acute inflammation reaction from exposure to irritant or allergen-producing substance
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28
Q

Common causes of contact dermatitis

A
  • latex
  • poison oak
  • laundry detergent
  • soap
  • nickel
  • jewelry
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29
Q

Treatment for contact dermatitis

A
  • wet compresses
  • avoid soaps (use dove unscented)
  • antihistamine to stop itching
  • anti-inflammatory creams
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30
Q

Atopic eczema

A
  • chronic inflammation perhaps due to hypersensitivity of immune system
  • may be accompanied by asthma and allergic rhinitis
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31
Q

Signs/symptoms of atopic eczema

A
  • red to brownish-gray colored skin patches
  • pruritus at night
  • vesicles
  • thickened, cracked, or scaly skin
  • irritated, sensitive skin from scratching
  • rash will bleed if scratched
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32
Q

Treatment of atopic eczema

A
  • avoid baths
  • avoid scratching
  • keep water contact brief
  • apply lubricating creams
  • antihistamine
  • corticosteroid
  • antibiotics
33
Q

Urticaria

A
  • hives
  • raised erythematous skin lesions
  • inflammation reaction related to histamine
  • often triggered by food or medication
34
Q

Psoriasis

A
  • common, chronic inflammatory condition that affects life cycle of the skin cells
  • t-cells mistake normal skin as foreign
  • skin cells rapidly turn over and slough off skin to make “scaley” cells
35
Q

Signs/symptoms of psoriasis

A
  • silvery scales (can often peel them away without bleeding because cells are dead)
  • pustules
  • pruritus
  • joint pain or aching
  • severe dandruff on scalp
36
Q

Bacterial folliculitis

A
  • infections involving the hair follicles

- tender, swollen areas that form around hair follicies

37
Q

Furuncles

A
  • boils
  • infections that begin in the hair follicles and spread into the surrounding dermis
  • firm, red, painful nodule developing into a large, painful mass draining pus
  • face, neck, axillae, groin, buttocks, back
38
Q

Impetigo

A
  • infection typically arises from break in the skin from staphylococci
  • spread easily through direct contact with skin or contaminated objects
  • honey-colored crusts
39
Q

Cellulitis

A
  • infection deep in the dermis and subcutaneous layer

- direct invasion of the pathogens through a break in the skin (IV and bites)

40
Q

Symptoms of cellulitis

A
  • fever
  • leukocytosis
  • arthralgia
  • swollen, warm, tender area of erythema
  • “tracking” - leaking of infection into blood vessels
41
Q

Necrotizing fascitis

A
  • “flesh-eating bacteria”
  • strain of gram-positive group A, beta-hemolytic streptococcus
  • invades through cut or scape
  • bacteria releases toxins directly destroying tissue, blood vessels
42
Q

Symptoms of necrotizing fascitis

A
  • first signs: small, reddish, painful area
  • later: bronze or purple-colored patch
  • center lesion becomes black and necrotic
  • pus present
  • wound may grow in less than an hour
  • fever
  • tachycardia
  • hypotension
  • gangrene
  • shock
43
Q

Herpes simplex type I virus

A
  • cold sore
  • viral infection typically affecting the lips, mouth, face
  • transmitted by contact with infected saliva
  • when active: painful blisters or ulcerations
44
Q

Herpes simplex type II virus

A
  • genital herpes
  • can transmit to baby if in active state
  • “swiss cheese brain” when born under outbreak
45
Q

Herpes zoster

A
  • chickenpox or shingles
  • hallmark shingles rash will not cross midline of body
  • antivirals (for duration), antidepressants/anticonvulsant (relieving neuralgia)
46
Q

Verrucae

A
  • warts
  • viral infection of skin caused by human papillomaviruses
  • transmitted through direct skin contact
47
Q

Treatment of verrucae

A
  • freezing
  • liquid nitrogen
  • large areas - chemo drugs
48
Q

Tinea

A
  • parasitic infection occurring anywhere in the body where fungi grows (warm, moist places)
  • circular erythematous rash
49
Q

Tinea capitis

A
  • infection of the scalp
50
Q

Tinea corporis

A
  • ringworm
51
Q

Tinea pedis

A
  • athlete’s foot
52
Q

Tinea unguium

A
  • infection of the nails, typically toenails
53
Q

Treatment of tinea

A
  • anti fungal cream or agent
  • griseofulvin
  • give with full fat milk or ice cream
54
Q

Candidiasis

A
  • yeast infection

- aka thrush

55
Q

How to detect if a baby has thrush?

A
  • take piece of gauze and wipe tongue

- if it comes off it’s milk solids from breast/bottlefeeding

56
Q

Thrush in adults

A
  • immunocompromised
  • inhaled steroids that aren’t washed out
  • HIV virus in men
57
Q

Hallmark of thrush

A
  • fire engine red lesions that cross inguinal folds
58
Q

Treatment of thrush

A
  • topical/systemic effect (niastatin)
  • ointment/oral preparation
  • anti-yeast agent (fluconazole)
59
Q

Scabies

A
  • result of mite infestation
  • “tracks” of light brown streaks in the skin after mite has gone to lay new eggs
  • pruritus, erythema
60
Q

Types of traumatic wounds

A
  • abrasion
  • laceration
  • avulsion
  • penetrating wound
  • burn
61
Q

Burns

A
  • skin injury that results from exposure to either a thermal heat or non thermal source
62
Q

First-degree burn

A
  • affects only the epidermis
63
Q

Second-degree burn

A
  • burns affect epidermis and dermis (partial-thickness)

- erythema, edema, blistering

64
Q

Third-degree burn

A
  • burns extend into deeper tissues (full-thickness)
  • white or black
  • charred skin that may be numb (destroyed nerve endings)
65
Q

Systemic complications with burns

A
  • hemodynamic fluid loss from blood vessels (hypotension)
  • respiratory distress: inhaling hot air or smoke burns tissues - inflammation)
  • hyper metabolic - increase in metabolic/nutrition needs
  • sepsis
  • local infection
  • shock: sepsis or hypovolemia
66
Q

Treatment for burns

A
  • wet towel with clean water
  • sterile saline or sterile bandage
  • maintain normal temperature: losing so much temperature from evaporative losses (usually cold)
  • trendelenberg position
  • FLUID (4 ml/kg x TBSA in 24 h)
  • intubation
  • Silvadene
  • fasciotomy
  • skin graft
  • physical therapy
67
Q

Stages of wound healing

A
  • inflammatory
  • proliferative
  • wound contraction
68
Q

Inflammatory phase of wound healing

A
  • histamine
  • hangman factors
  • swelling, redness, heat, pain
  • blood clot
  • neutrophils
  • macrophages after 24 hrs.
69
Q

Proliferative phase of wound healing

A
  • building new tissue
70
Q

Wound contraction phase of wound healing

A
  • 3 weeks to 6 months

- development and re-modeling of scars

71
Q

Factors that affect wound healing

A
  • impaired blood flow/oxygen delivery
  • malnutrition
  • impaired inflammatory response
  • impaired immune response
  • infection
  • wound separation
  • foreign bodies
  • age
72
Q

Acne vulgaris

A
  • clogging of skin pores with oil, debris, or bacteria

- can develop into a pustule, nodule, or cyst

73
Q

Treatment for acne vulgaris

A
  • pH neutral soaps (cetaphil, dove unscented)
  • benzoyl peroxide
  • retin-a
  • accutane
  • shampoo hair daily
  • comb or pull back hair
  • avoid squeezing or rubbing acne
74
Q

Rosacea

A
  • chronic, inflammatory skin condition that affects the face
  • more common in older population and caucasians
  • sweating, stress, wind exposure exacerbates rosacea
75
Q

Actinic keratosis

A
  • small patches on sun-exposed parts of body
  • premalignant
  • asymptomatic
  • precursor to squamous cell carcinoma
76
Q

Seborrheic keratoses

A
  • benign
  • asymptomatic
  • beige/brown/black plaques
77
Q

Squamous cell

A
  • from actinic keratosis
  • firm irregular papule or nodule
  • scaly bleeding
78
Q

Basal cell

A
  • most common
  • slow growing
  • waxy “pearly” appearance
  • central depression
79
Q

Malignant melanoma

A
  • highest mortality rate

- can metastasize to any organ

U of R SCHOOL OF NURSING (12 decks)

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