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NUR 502 > Skin > Flashcards

Skin Flashcards

1
Q

Functions of the Skin

A

-PROTECTION FROM ENVIRONMENT
* BODY TEMPERATURE REGULATION
* PREVENTS PENETRATION
* PERCEPTION
* TEMPERATURE REGULATION
* PSYCHOSOCIAL
* IDENTIFICATION
* COMMUNICATION
* SENSATION
* VITAMIN D PRODUCTION
* IMMUNOLOGIC
* ABSORPTION
* ELIMINATION

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2
Q

MUCOUS MEMBRANES (functions)

A
  • LINE BODY CAVITIES
  • DIGESTIVE TRACT, RESPIRATORY PASSAGES, URINARY AND REPRODUCTIVE TRACTS
  • SECRETE MUCOUS
  • HAVE RECEPTORS THAT OFFER PROTECTION
  • INSENSITIVE TO TEMPERATURE, BUT SENSITIVE TO PRESSURE
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3
Q

What are the two layers of the skin

A

Epidermis
Dermis

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4
Q

Epidermis layers and characteristics

A
  • BASAL CELL LAYER- FORMS NEW SKIN CELLS- CONTAINS THE PROTEIN ‘KERATIN’
  • MELANOCYTES – DERIVATION OF SKIN COLOR
  • OUTER HORNY CELL LAYER OF DEAD KERATINIZED CELLS (OUTER LAYER)
  • REPLACED Q4 WKS
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5
Q

Dermis layers and characteristics

A

INNER SUPPORTIVE LAYER
* CONNECTIVE TISSUE (COLLAGEN)
* ELASTIC TISSUE

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6
Q

Types of hair

A
  • VELLUS HAIR
  • TERMINAL HAIR
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7
Q

Types of glands

A
  • SEBACEOUS GLANDS-SEBUM SECRETION
  • SWEAT GLANDS: IMPORTANT FOR FLUID BALANCE AND THERMOREGULATION
    * ECCRINE GLANDS
    * APOCRINE GLANDS
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8
Q

Functions of the skin

A
  • SKIN IS WATERPROOF, PROTECTIVE, AND ADAPTIVE
  • PROTECTION FROM ENVIRONMENT
  • PREVENTS PENETRATION
  • PERCEPTION
  • TEMPERATURE REGULATION
  • IDENTIFICATION
  • COMMUNICATION
  • WOUND REPAIR
  • ABSORPTION AND EXCRETION
  • PRODUCTION OF VITAMIN D
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9
Q

Factors affecting the skin

A
  • UNBROKEN AND HEALTHY SKIN AND MUCOUS MEMBRANES ACT AS A DEFENSE
  • RESISTANCE TO INJURY IS AFFECTED BY AGE, AMOUNT OF UNDERLYING TISSUE, AND ILLNESS.
  • ADEQUATELY NOURISHED AND HYDRATED BODY CELLS ARE RESISTANT TO INJURY.
  • ADEQUATE CIRCULATION IS NECESSARY TO MAINTAIN CELL LIFE.
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10
Q

Risk factors affecting the skin

A
  • IV DRUG USE
  • PROLONGED SUN EXPOSURE
  • BODY PIERCING
  • INCREASED AGE
  • DEHYDRATION AND MALNUTRITION
  • REDUCED SENSATION
  • DIABETES
  • GI PREPARATIONS FOR TESTING
  • BEDREST
  • CASTS
  • MEDICATIONS
  • RADIATION THERAPY
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11
Q

DEVELOPMENTAL CONSIDERATIONS

A
  • UNDER AGE 2 THE SKIN IS THINNER, BUT BECOMES INCREASINGLY RESISTANT TO INJURY AND INFECTION AS CHILDREN AGE
  • AGING CHANGES OF SKIN:
    • THINNER, MORE EASILY DAMAGED
    • DECREASED SENSATION OF PRESSURE
    • DECREASED SWEAT GLAND ACTIVITY – DRIER SKIN
    • DECREASED CELL RENEWAL – DELAYED HEALING
    • DECREASED MELANOCYTES – GRAY/WHITE HAIR AND UNEVEN PIGMENTATION OF SKIN
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12
Q

DEVELOPMENTAL COMPETENCE: INFANTS

A

NEWBORN INFANTS:

  • LANUGO: FINE DOWNY HAIR OF NEWBORN INFANT
  • VERNIX CASEOSA: THICK, CHEESY SUBSTANCE
  • SEBUM: HOLDING WATER IN THE SKIN PRODUCING
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13
Q

Aging adults considerations/Changes

A

ELASTICITY
* LOSES ELASTICITY; SKIN FOLDS AND SAGS
* SWEAT AND SEBACEOUS GLANDS
* DECREASE IN NUMBER AND FUNCTION, LEAVING SKIN DRY
* SKIN BREAKDOWN DUE TO MULTIPLE FACTORS
* CELL REPLACEMENT IS SLOWER WOUND HEALING IS DELAYED
* SENILE PURPURA
* DISCOLORATION DUE TO INCREASING CAPILLARY FRAGILITY
* HAIR MATRIX
* FUNCTIONING MELANOCYTES DECREASE, LEADING TO GRAY FINE HAIR
* KERATOSES
* RAISED THICKEND AREA OF PIGMENTATION-CRUSTY OR WARTY IN APPEARANCE
* SKIN TAGS
* OVERGROWTH OF SKIN WITH A STALK.

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14
Q

Risk factors for skin issues

A
  • HIGH EXPOSURE TO UV RADIATION (SUN\TANNING BEDS)
  • FAMILY HISTORY OF MELANOMA
  • ATYPICAL OR NUMBERS MOLES (>50)
  • INCREASE RISK FOR: EASY BURNERS, NATURAL BLOND\RED HAIR
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15
Q

Subjective Data: Health history questions

A
  • PAST HISTORY OF SKIN
    DISEASE, ALLERGIES, HIVES, PSORIASIS, OR ECZEMA?
  • CHANGE IN PIGMENTATION OR COLOR?
  • CHANGE IN MOLE SIZE, SHAPE, COLOR, TENDERNESS?
  • EXCESSIVE DRYNESS OR MOISTURE?
  • PRURITUS OR SKIN ITCHING?
  • EXCESSIVE BRUISING?
  • RASH OR LESIONS?
  • MEDICATIONS: PRESCRIPTION and OTC drugs
  • HEALTH HISTORY
  • HAIR LOSS?
  • CHANGE IN NAILS’ SHAPE, COLOR, OR BRITTLENESS?
  • ENVIRONMENTAL OR OCCUPATIONAL HAZARDS?
  • SELF-CARE BEHAVIORS?
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16
Q

Objective data when assessing the skin

A
  • PREPARATION
    * CONSCIOUSLY ATTEND TO SKIN CHARACTERISTICS; THE DANGER IS ONE OF
    OMISSION
  • EQUIPMENT NEEDED
    * STRONG DIRECT LIGHTING, GLOVES, PENLIGHT, AND SMALL CENTIMETER RULER
  • COMPLETE PHYSICAL EXAMINATION
    * SKIN ASSESSMENT INTEGRATED THROUGHOUT EXAMINATION
    * SCRUTINIZE THE OUTER SKIN SURFACE FIRST BEFORE YOU CONCENTRATE ON
    underlying structure
  • SEPARATE INTERTRIGINOUS AREAS (AREAS WITH SKINFOLDS) SUCH AS UNDER LARGE BREASTS, OBESE ABDOMEN, AND GROIN AND INSPECT THEM THOROUGHLY
    * THESE AREAS ARE DARK, WARM, AND MOIST AND PROVIDE PERFECT CONDITIONS
    FOR IRRITATION OR INFECTION
  • ALWAYS INSPECT FEET, TOENAILS, AND BETWEEN TOES
17
Q

Objective inspection of the skin

A
  • COLOR-KNOW BASELINE!
  • GENERAL PIGMENTATION, FRECKLES, MOLES, BIRTHMARKS
  • WIDESPREAD COLOR CHANGE
    * NOTE COLOR CHANGE OVER ENTIRE BODY SKIN, SUCH AS PALLOR (PALE), ERYTHEMA
    (RED), CYANOSIS (BLUE), OR JAUNDICE (YELLOW)
  • WHITE (PALLOR)
    * REFLECTS ANEMIA
  • RED
    * ERYTHEMA
  • BLUE
    * CYANOSIS
  • YELLOW-ORANGE
    * JAUNDICE
18
Q

Objective Palpation of the skin

A
  • TEMPERATURE
    * USE BACKS OF HANDS TO PALPATE PERSON
    * SKIN SHOULD BE WARM, AND TEMPERATURE EQUAL BILATERALLY; WARMTH
    SUGGESTS NORMAL CIRCULATORY STATUS
    * HANDS AND FEET MAY BE SLIGHTLY COOLER IN A COOL ENVIRONMENT
    * HYPOTHERMIA
    * HYPERTHERMIA
    * MOISTURE
    * DIAPHORESIS
    -Dehydration
    * TEXTURE
    * THICKNESS
    * EDEMA (0-4)
    * MOBILITY AND TURGOR
19
Q

Objective Inspection- VASCULARITY OR
BRUISING

A
  • CHERRY ANGIOMAS
  • MULTIPLE BRUISES AT DIFFERENT STAGES OF HEALING AND EXCESSIVE BRUISES ABOVE KNEES OR ELBOWS SHOULD RAISE CONCERN ABOUT PHYSICAL ABUSE
  • NOTE TATTOOS
  • NEEDLE MARKS OR TRACKS FROM INTRAVENOUS INJECTION OF STREET DRUGS MAY
    BE VISIBLE ON ANTECUBITAL FOSSAE.
  • PROMOTING HEALTH AND SELF-CARE
    * SELF INSPECTION
    * SUNSCREEN
    * HATS, CLOTHING
  • EMOLLIENTS/LUBRICANTS
20
Q

ABCDE-EFG (name them, not specific)

A

TEACH SKIN SELF-EXAMINATION USING ABCDEF RULE TO DETECT SUSPICIOUS LESIONS
* A – ASYMMETRY
* B – BORDER
* C – COLOR
* D – DIAMETER
* E – EVOLVING

21
Q
  • A – ASYMMETRY
  • B – BORDER
  • C – COLOR
  • D – DIAMETER
  • E – EVOLVING
A

-ELEVATED
* FIRM TO PALPATION
* GROWING PROGRESSIVELY OVER SEVERAL WEEKS
* LESIONS: IF ANY ARE PRESENT ALSO NOTE:
* PATTERN OR SHAPE
* SIZE
* LOCATION AND DISTRIBUTION ON BODY
* ANY EXUDATE: NOTE COLOR AND ODOR
* PALPATE LESION
* ROLL FOR DEPTH
* BLANCHING

22
Q

LESIONS- SHAPES AND CONFIGURATION

A
  • ANNULAR OR CIRCULAR
  • CONFLUENT
  • DISCRETE
  • GROUPED
  • TARGET OR IRIS “BULLS EYE”
  • LINEAR
  • ZOSTERIFORM
  • CONFLUENT
  • DISCRETE
  • GROUPED
23
Q

SECONDARY SKIN LESIONS: How do they develop?

A

RESULTING FROM A CHANGE IN A PRIMARY LESION FROM THE PASSAGE OF TIME; AN EVOLUTIONARY CHANGE

23
Q

Types of Primary Skin Lesions

A
  • MACULES: FLAT
  • PAPULES: SOLID, RAISED
  • PUSTULES: PUS
  • VESICLES/ BULLA: TRAPPED FLUID UNDER SKIN
  • URTICARIA (HIVES): RED, ITCHY WELTS
    CYST: BENIGN, ROUND, DOME-SHAPED ENCAPSULATED LESION, CONTAINS FLUID OR SEMI-
    FLUID MATERIAL
  • NODULE: SOLID, ELEVATED, HARD OR SOFT.
  • WHEAL: SUPERFICIAL RAISED, TRANSIENT AND REDDENED, IRREGULAR SHAPE FROM EDEMA.
23
Q

PRIMARY SKIN LESIONS: Where do they develop?

A

PRIMARY LESIONS DEVELOP ON PREVIOUSLY UNALTERED SKIN

24
Q

Types of secondary skin issues

A
  • DEBRIS ON SKIN SURFACE:
    * CRUSTS: DRYING OF PLASMA OR EXUDATE ON THE SKIN
    * SCALES: FLAKES REPRESENTING COMPACTED DESQUAMATED LAYERS
  • BREAK IN CONTINUITY OF SKIN SURFACE
    • FISSURES: LINEAR CLEAVAGE OF SKIN
    • EROSIONS: SLIGHTLY DEPRESSED AREAS
    • ULCERS: NECROSIS
    • EXCORIATIONS: ABRADED SKIN
    • SCARS: PERMANENT FIBROTIC
  • LICHENIFICATION: THICK AND LEATHERY SKIN
25
Q

ABNORMAL FINDINGS: VASCULAR AND PURPURIC

A
  • VASCULAR LESIONS
    • PORT-WINE STAIN (NEVUS FLAMMEUS)
    • STRAWBERRY MARK (IMMATURE HEMANGIOMA)
  • SPIDER ANGIOMA
  • TELANGIECTASIA
  • PURPURIC LESIONS
  • PETECHIAE
  • PURPURA
    LESIONS CAUSED BY
    TRAUMA OR ABUSE
  • PATTERN INJURY
  • HEMATOMA
  • CONTUSION
    (BRUISE)
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NUR 502 (13 decks)

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