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Nur 336 > Skin/Burn - Unit 5 > Flashcards

Skin/Burn - Unit 5 Flashcards

1
Q

What is xerosis?

A

Dryness

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2
Q

What makes dryness worse?

A

Heat, harsh lotions.

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3
Q

What is pruritus?

A

Itching!

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4
Q

What is the itch-scratch-itch cycle?

A

The more you scratch, the more you itch!

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5
Q

What should we do for itching?

A

Avoid drying agents, keep fingernails trimmed short, make a cool sleeping environment, topical steroids, etc.

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6
Q

What are urticaria?

A

Hives

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7
Q

How do we treat urticaria?

A

Removal of triggering substances, antihistamines, avoid overexertion, alcohol consumption, warm environments, etc.

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8
Q

What is a pressure ulcer?

A

Skin and underlying soft tissue compressed between a bony prominence and an external surface for an extended period.

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9
Q

What is pressure?

A

Gravity.

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10
Q

What is shear?

A

Skin is stationary but muscle moves.

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11
Q

What do we look at during the wound assessment?

A

Location, size, color, extent of tissue involvement, cell types in the wound base and margins, exudate, condition of the surrounding tissues, presence of foreign bodies, etc.

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12
Q

Stage 1 Pressure ulcer - what happens?

A

Skin intact - redness does not blanch. Red/pinkness.

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13
Q

What happens in a stage 2 pressure ulcer?

A

Partial thickness loss into epidermis or dermis - abrasion, blister or shallow crater.

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14
Q

If the ulcer is fluid filled, it’s okay to pop it. T/F?

A

FALSE - do not pop it.

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15
Q

What happens in a stage 3 pressure ulcer?

A

Full thickness loss, no exposure of bone, tendon or muscle, though - but it has a deep crater that may tunnel!

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16
Q

What happens in a stage 4 pressure ulcer?

A

Full thickness loss of exposed muscle, tendon, or bone - tunneling, slough and eschar (dead, black) present

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17
Q

What are some surgical management options for pressure ulcers?

A

Debriedement, pedicle flap (maintains blood flow and is sutured down)

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18
Q

What is folliculitis?

A

Superficial infection involving the upper portion of the follicle (pimple, pustule) - usually caused by strep or staph!

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19
Q

Furuncle - what is it?

A

Boil - much deeper infection of the follicle.

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20
Q

Cellulitis - def

A

generalized infection with either staph, strep, or H flu involving deeper connective tissue. Usually has a border and will be red and tender. Treatment includes moist heat, antibiotics, and to elevate the legs.

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21
Q

What causes MRSA?

A

Long-term use of unnecessary antibiotics.

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22
Q

What are symptoms of MRSA?

A

small, red bumps

deep, painful abscesses on skin. If it burrows, it can cause sepsis.

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23
Q

What med treats mrsa?

A

Vancomycin.

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24
Q

What is herpes simplex virus 1?

A

A cold sore - red base around mouth or nose…it’s contagious!

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25
Q

What is herpes simplex virus 2?

A

Genital herpes.

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26
Q

What is the herpes zoster?

A

Shingles.

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27
Q

Shingles - what is it? How long does it last? Symptoms?

A

Reactivation of the dormant varicella zoster virus in patients who had chickenpox. Lasts several weeks with fever and malaise. Postherapeutic neuralgia - means pain can last for a long time - use gabapentin to treat! It can be contagious, too.

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28
Q

Tinea pedis =
Tinea corporis =
Tinea capitis =
Tinea cruris =

A

Tinea pedis = athlete’s food.
Tinea corporis = ring worm.
Tinea capitis = on the head.
Tinea cruris = jock itch.

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29
Q

Candida albicans (yeast infection) what should we avoid?

A

Warm, moist environments - watch skin folds, keep them clean/dry/open to air, etc.

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30
Q

What is burow’s solution for viral lesions?

A

Astringent/dries it out

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31
Q

What causes anthrax?

A

Bacillus anthracis

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32
Q

How do we diagnose anthrax?

A

Appearance of lesions/blood cultures.

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33
Q

Who is at risk for anthrax?

A

Farm workers.

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34
Q

How do we treat anthrax?

A

Oral antibiotics for 60 days (cipro, doxy, vibramycin)

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35
Q

What is contact dermatitis?

A

Inflammatory skin reaction - poison ivy, etc. SS = itching, hives, plaque, etc.

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36
Q

Contact dermatitis - should those patients avoid oil based products?

A

Yes - but take antihistamines and give compresses and baths.

37
Q

Psoriasis - what is it?

A

increased epidermal growth that then shreads - it’s over the lifetime!

38
Q

Which is the most often seen form of psoriasis?

A

Psoriasis vulgaris

39
Q

How do we treat psoriasis?

A

Corticosteroids, UV light therapy, biologic agents, cytotoxic agents (watch for liver function here), immunosuppressants (humira affects the immune system!), emotional support.

40
Q

What are cysts?

A

Firm, flesh colored nodules.

41
Q

What are seborrheic keratoses?

A

Something older people get - papule that’s rough/dry and yellow/brown

42
Q

What’s a keloid?

A

Overgrowth of scar tissue - usually in darker skinned people. Removing can actually causing more scar tissue :(

43
Q

What is actinic karatoses cancer?

A

Rough, scaly patch of skin cancer

44
Q

What does actinic lead to?

A

Squamous cell.

45
Q

Squamous cell carcinomas - cancer of the ___. Can it be malignant?

A

epidermis. Can be malignant, found by ears, lips, genitalia, likely to spread, etc.

46
Q

Basal cell carcinomas - least or most common skin cancer?

A

Most common.

47
Q

Melanomas - deadly?

A

YES. some genetic parts to it, UV (artificial) increases risk. common on back, legs, head and neck (for men_)

48
Q

What are some treatment options for skin cancer?

A

Cyrosurgery, curettage and electrodesiccation (small skin lesions only, not melanoma), excision (melanoma), moh’s surgery - the layer one for basal/squam where they remove it layer by layer, laser, etc.

49
Q

Basal Cell - treated with an ointment called ______

A

5 Fluoro acid - placed on cancer!

50
Q

For burn patients, do we worry about F/E loss?

A

YES

51
Q

1st Degree burn/stage 1 - info? heal time?

A

Superficial thickness, heals in 3-6 days - red, mild discomfort. Peels on its own!

52
Q

2nd degree burn/stage 2 - info, heal time, etc.

A

Superficial/partial thickness. Heals in 10-20 days, or deep which heals in 2-6 weeks. IT IS VERY PAINFUL. Blanches slowly. All of the epidermis and some of dermis is lost.

53
Q

Full-thickness/3rd degree - info, heal time, etc.

A

Charred, brown, leathery. MUST BE GRAFTED. NO PAIN. Will not heal w/o graft.

54
Q

Size of burn area - % for each.

Head - 
Arms - 
Thorax - 
Legs - 
Perineum
A 
Head - 9%
Arms - 9% EACH
Thorax - 18% EACH SIDE
Legs - 18% EACH
Perineum - 1%
55
Q

What’s a circumferential burn?

A

A burn that goes all the way around. It becomes tight and edematous so we have to watch for problems in the area.

56
Q

What age group is the most at risk for complications from burns?

A

Ages 0-5 (don’t always have the best immune system, etc.) and Ages 60+ (immune problems, comorbidities, etc.)

57
Q

When is a smoke and inhalation burn common?

A

With thermal burns.

58
Q

What do we assess for smoke/inhalation burns?

A

Assess blackness around mouth/nares, may have pulmonary injuries, treat with O2, intubate, vent, steroids, etc.

59
Q

Carbon monoxide binds slowly with Hgb - T/F?

A

FALSE - it binds slowly!

60
Q

What happens with a thermal burn? What percent?

A

Dry, moist, contact. Comes from gas, liquid, or solid. It’s 95%! get them away from flame/source asap.

61
Q

Chemical burns - what percent, comes from where, what to do, etc.

A

2%. Contact/inhalation. Comes from direct contact with gas, liquid or solid. You need to neutralize chemical - flush with H2O or other liquid quickly. Acidic chemical is like a heavy metal, alkalitic is like cement, etc.

62
Q

Electrical burn - what percent? What do we look for?

A

3%. Look for entrance and exit site. Watch for cardiac changes/arrest. Remove them from the area, but be safe so you don’t get shocked, too.

63
Q

What’s a radiation burn?

A

High doses of radioactive energy, it’s very rare though. Patient must be decontaminated before giving care

64
Q

How does the body compensate for a severe burn injury? (2 things)

A
  1. Inflammation - immediate response. Tissues heal from this but causes vessel leakage, which is why people become edematous.
  2. Sympathetic system increases - so it’s flight or fight.
65
Q

What’s the biggest intervention we can do for burn patients?

A

MONITOR AIRWAYS

66
Q

Should we put heat on the burn or use warm compresses and lotion?

A

NO. COLD AND NOOOOOOO OINTMENTS AND SHIT

67
Q

Do we need to do fluid resuscitation for burn patients?

A

YES

68
Q

No iv/sub q injections for burn patients. T/F?

A

True

69
Q

What’s th emergency phase #1?

A

First 48 hours, secure airway then do fluid replacement and CV function then prevent infections, maintain body temp, etc.

70
Q

Parkland equation for burns - what is if?

A

4mg/kg/percent burn - then you give the first half of the total fluid in the first 8 hours, then 1/4 the next 8, then the final 4th the next 8.

71
Q

What are some symptoms of carbon monoxide poisoning?

A

Headache, days ones, nausea, committing, lightheaded-ness and confusion in the later stage.

72
Q

What are some electrolyte imbalances for burn patients?

A

Hyperkalemia, hyponatremia, hemoconcentration

73
Q

For fluid resuscitation, urine output is the best tell for fluid status. T/F ?

A

True

74
Q

Fluid resuscitation starts at the time of hospital admission or the burn?

A

The burn. So if they were burnt two hours ago, you count that and get the fluid in!

75
Q

Are lactated ringers preferred for fluid status?

A

Yea.

76
Q

Are IV narcotics the preferred method for pain relief in burn patients?

A

Yes

77
Q

What’s acute phase number 2 in burn injuries?

A

Begins 36-48 hours after the burn until the wound closure is completed. It can take 6-8 weeks. We focus on maintenance of CV/RR, prevent shock, pain control, psycho social problems, etc.

78
Q

How do we do a debridment?

A

Mechanical by water or enzymes.. Or surgical with a knife!

79
Q

What’s a homograft?

A

Human cadaver skin (allograft)

80
Q

What’s an autograft?

A

Patients own skin, preferred area taken from = the back or thigh.

81
Q

What’s a heterograft?

A

Comes from pig skin or another species.

82
Q

How long does an amniotic membrane graft last?

A

48 hours.

83
Q

Should we wear gloves/masks/gowns with burn patients?

A

Yes, because they are at a high risk for infection.

84
Q

What are some topical antibiotics for burn patients?

A

Silvadene (it can decrease leukocytes, and WBC level), flamazine, sulfamylon

85
Q

Might burn patients need enteral tube feedings or TPN?

A

Yes

86
Q

Are contractures a complication for burn patients?

A

Yes, so get them moving and such.

87
Q

What’s phase 3 of the burn process?

A

Rehabilitative. Begins with wound closure and ends with patient returning to highest functioning. Psychosocial, preventing scars, finish cosmetic grafting.

88
Q

Should patients with burns have increased protein?

A

Yes yes yes

Nur 336 (26 decks)

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