Patient with Integument Problems

Question 1

What are the risk factors for skin cancer?

Answer 1

Fair Skin (blond/red hair, blue eyes)
History outdoor activities
Living near the equator or high altitudes
Family/Personal history of skin cancer
Having an outdoor occupation
Indoor tanning

Question 2

What is the name for nonmelanoma cancer that is locally invasive cancer from basal cells and how do they present?

Answer 2

Basal Cell Carcinoma

Erythematous, pearly, sharply defined, slightly elevated plaques

Question 3

What is the name for the nonmelanoma cancer that comes from keratinizing epidermal cells and how do they present?

Answer 3

Squamous Cell Carcinoma
Thin, scaly, erythematous plaque
Can be aggressive

Question 4

What features you would assess on the skin if you suspect it to be a malignant melanoma?

Answer 4

Asymmetry - Shape of one half does not match the other?
Border irregularity - Edges ragged, notched, blurred/pigment spread into surrounding skin?
Color uneven - black, brown, tan, white, gray, red, pink, blue?
Diameter changes in size and is larger than 6mm?
Evolving/Elevation - Has it changed over time?

Question 5

What are the risk factors for bacterial infections of the skin?

Answer 5

Excess moisture
Obesity
Atopic dermatitis
Systemic corticosteroid/ antibiotic use
DM

Question 6

True or False: Exudate from a bacterial infection is infectious

Answer 6

True

Question 7

Prevention for bacterial infections

Answer 7

Good skin hygiene

Infection control practices

Question 8

Cellulitis Manifestations

Answer 8

Inflammation of SQ tissue –> hot, tender, erythematous area with diffuse borders, chills, malaise, fever

Question 9

What is a potential complication of cellulitis if left untreated

Answer 9

Gangrene

Question 10

What kind of infection is cellulitis?

Answer 10

Bacterial infection

Question 11

Treatment for cellulitis?

Answer 11

Local –> moist heat, immobilization, and elevation to decrease swelling
Systemic –> antibiotics; hospitalize if severe (progression to gangrene possible if not treated)

Question 12

What is a symptom of Herpes Zoster (Shingles)?

Answer 12

Burning pain and neuralgia along dermatome

Question 13

How often should adults over 60 years old get the Zostavax vaccine to prevent shingles?

Answer 13

One time dose for adults > 60 yrs

Question 14

Why is the early detection of skin cancer more common?

Answer 14

Visible lesions

Question 15

Risk factors for malignant melanomas

Answer 15

Environmental and genetic factors contribute to the development

Question 16

Where can Candidiasis fungal infections be located?

Answer 16

Mouth
Vagina
Skin

Question 17

What integumentary structures are most susceptible to fungal infections?

Answer 17

Skin
Hair
Nails

Question 18

What are Stephen Johnson Syndrome and Toxic epidermal necrolysis a reaction to?

Answer 18

Allergy –> Immune response due to severe adverse reaction to medications or infection

Stephen Johnson Syndrome and TEN cause acute destruction of the epithelium of the skin and mucous membranes

Question 19

Symptoms of rare, life-threatening allergy skin problems (TEN, Stephen Johnson Syndrome)

Answer 19

Fever, cough, headache, anorexia, myalgia, nausea, precede skin and mucous membrane findings by 1-3 days

Question 20

Prevention of insect bites and infestations (examples: pediculosis/lice, bedbugs, ticks, scabies)

Answer 20

Meticulous hygiene (hair, skin, clothes, sexual partner, pets, bedding)
Prevent bites (avoidance repellents)
Routine skin inspections (esp. if traveling to high-risk areas)

Question 21

Causes of irritation of insect bites and infestations

Answer 21

Allergy to venom

Eggs, feces, or body parts of invading organism

Question 22

True or False: Psoriasis is a benign skin problem

Answer 22

True

Question 23

Most common form of psoriasis

Answer 23

Plaque psoriasis –> lesions are distinct, red, scaling

Question 24

Common groups that psoriasis presents in

Answer 24

15-35 years old

Family history

Question 25

Treatment for psoriasis

Answer 25

Phototherapy (UV light)

Question 26

Treatment for basal or squamous skin cancer

Answer 26

Radiation therapy

Question 27

Nursing Management of skin problems

Answer 27

Wet compresses (room temp)
Tepid water baths
Lotions while skin is damp
Topical medications
Control itching (cool environment, hydration, avoiding scratching, antipruritic creams, systemic antihistamines)

Question 28

Ringworm

Answer 28

Tinea corporis

Question 29

Jock itch

Answer 29

Tinea cruris

Question 30

Athlete’s foot

Answer 30

Tinea pedis

Question 31

HPV Symptoms

Answer 31

Warts in genital area or anywhere in body; usually preventable with vaccine

Question 32

Integument interprofessional care includes…

Answer 32

Phototherapy (UV light)
Radiation therapy (for basal or squamous cell cancer)
Laser technology
Drug therapy (antibiotics, steroids, antihistamines, immunomodulators)
Diagnostic/surgical therapy (scraping, punch biopsy, etc)

Question 33

What to keep in mind when using steroids for skin issues

Answer 33

Use judiciously, esp. if not low-potency

Question 34

What are antihistamines used for related to skin issues?

Answer 34

Urticaria

Pruritus

Question 35

What do immunomodulators do?

Answer 35

Suppress overreactive immune systems

Question 36

What type of disease is psoriasis?

Answer 36

Chronic autoimmune disease

Question 37

In what age group does psoriasis usually develop?

Answer 37

Usually develops in 15-35 year olds

Question 38

Is psoriasis familial?

Answer 38

Yes

Question 39

Can psoriasis be painful?

Answer 39

Yes

Question 40

Up to 40% of people with psoriasis develop psoriatic ______

Answer 40

Psoriatic arthritis

Question 41

Psoriasis can be emotionally disabling because…

Answer 41

Body image disturbance

Question 42

How are fungal infections usually treated?

Answer 42

Topical anti-fungal creams or solutions