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Med Surg 2 > Quiz 4 > Flashcards

Quiz 4 Flashcards

1
Q

What diagnostic studies can be done for the skin?

A

Wood’s light exam (UV light for fungal)
Skin and culture sensitivity
Biopsy (punch/shave/excisional)
Patch test

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2
Q

Why are biopsies done?

A

to confirm or rule out malignancy

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3
Q

What is psoriasis?

A

chronic autoimmune skin disease

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4
Q

What happens if psoriasis is not controlled?

A

can lead to psoriatic arthritis

xray of the hands show pencil in cup deformities

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5
Q

What are the risk factors of psoriasis?

A

infections
stress
hormones
obesity
skin trauma
seasons
meds
genetics

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6
Q

What are the clinical manifestations of psoriasis?

A

scaly, thick, silvery, elevated lesions (plaque) on scalp, elbows, or knees

bilateral distribution
pruritic (itchy)
bleeding w/ removal of scales

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7
Q

What therapeutic procedure can be done for psoriasis?

A

photochemotherapy and ultraviolet light (PUVA)

  • methoxsalen 1 hr before (makes skin sensitive to radiation)
  • tx 2-3x/week (not consecutive)
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8
Q

What should a nurse teach a patient who is receiving PUVA?

A

eye and skin care

SE:
- more easily burned
- cataracts
- skin malignancies

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9
Q

What topical medications are used for psoriasis?

A

corticosteroids (triamcinolone, betamethasone)
tar (coal tar)
vitamin D analog (calcipotriene, calcitriol)
vitamin A (tazarotene)
anti-psoriasis agent (anthralin)

everything except corticosteroids decrease cell turnover = less scales

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10
Q

What systemic medications are used for psoriasis?

A

cytotoxic meds
- methotrexate (immunosuppressant)
- acitretin (slows autoimmune reactions)

biologics
- etanercept
- infliximab

immunosuppressants
- cyclosporine
- azathioprine

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11
Q

What are the nursing interventions for psoriasis?

A

teach lifestyles modifications
teach not to scratch/pick (tx: mittens but don’t tie down)
use emollient thick/oily
provide emotional support

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12
Q

What is acne?

A

acne vulgaris

obstructed sebaceous glands where bateria settles in and causes inflammation/whiteblackheads

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13
Q

What are the risk factors of acne?

A

puberty/pregnancy
bacteria overgrowth (sweat)
genetics
stress

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14
Q

How is acne classified?

A

noninflammatory: comedones (blackhead)

inflammatory: papules/pustules (whitehead), nodular, cystic

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15
Q

What topical medications are used for acne?

A

benzoyl peroxide
antimicrobials (erythromycin/clinda)
retinoid (isotretinoin - accutane)
intralesional corticosteroids

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16
Q

What systemic medications are used for acne?

A

oral antibiotics
combined contraceptives
anti-androgen agent (spironolactone)
retinoid

17
Q

What are the side effects of spironolactone?

A

larger breast
orthostatic hypotension
hyperkalemia

18
Q

What are the nursing interventions for acne?

A

use mild, moisturizing, lipid-free cleansers
avoid hot water and scrubbing
practice hand hygiene
don’t pick or squeeze
8 oz of water

19
Q

What is contact dermatitis?

A

one time event
caused by direct exposure to allergen, chemical, or mechanical irritation

ex: nickel based jewelry

20
Q

What is the clinical manifestation of contact dermatitis?

A

demarcated localized rash

21
Q

What is atopic dermatitis?

A

aka: eczema
caused by allergens or chronic skin disease

22
Q

What are the risk factors of atopic dermatitis?

A

genetics
stress

23
Q

What are the clinical manifestations of atopic dermatitis?

A

infancy:
- red rash w/ serous exudate
- face, shoulder, chest

adults:
- dry, scaly, pruritic rash
- elbows/knees (on or behind)

acute stage:
- bright red
- oozing vesicles
- extremely itchy

chronic stage:
- chronic rash
- lichenification (skin turns dense/leathery)
- face, neck, upper torso, skin folds)

24
Q

What medications are used for atopic dermatitis?

A

steroids
- hydrocortisone
- prednisone
- betamethasone
- triamcinolone

antihistamines
- diphenhydramine
- cetirizine

immunosuppressants
- tacrolimus
- pimecrolimus

25
Q

What are the nursing interventions for atopic dermatitis?

A

elimination of allergen
trim nails
lukewarm baths
pat dry
moisturize immediately
cotton clothing (not tight)
humidifier

26
Q

What is urticaria?

A

the result of type 1 hypersensitivity
standard allergic reaction
often part of anaphylaxis
highly pruritic

27
Q

What medications are used for urticaria?

A

epinephrine (only buys time, pt needs to go to hospital to completely stop allergic reaction)

antihistamines
- diphenhydramine
- hydroxyzine
- loratadine
- cetirizine
- fexofenadine

corticosteroids
- prenidolone
- methylprednisolone ( IV acute attacks)

immunosuppressants
- cyclosporine

28
Q

What are the nursing interventions of urticaria?

A

check for angioedema (anaphylactic reaction)
administer epinephrine if angioedema present
teach client to avoid triggers

Med Surg 2 (7 decks)

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