Skin Disorders Flashcards
1
Q
Fungal transmission
A
- implementation
- inhalation
- taking abx
2
Q
fungal infections most common in
A
elderly and immuno compromised
- proliferates more easily in pt w vascular indwelling catheters, organ transplant recipients, chemo pts
3
Q
superficial fungal infections organisms
A
- tinea pedis
- tinea captitis
- tinea versicolor
- canadiasis
4
Q
superficial fungal infections include
A
- mycoses or dermatophytes
- infect hair, skin, nails
5
Q
treatment of superficial fungal infections
A
topical
6
Q
yeasts
A
candida albicans
7
Q
superficial dermatophytes
A
tineas
8
Q
tinea pedis characteristics
A
- dry scaling pruritic lesions
- skin affected may only be in web spaces
9
Q
risk factors of tinea pedis
A
- coming into contact w infected skin or fungus in the env
10
Q
prevention of tinea pedis
A
- shower shoes
- cleaning tubs and showers after use
11
Q
treatment of tinea pedis
A
- topical antifungals usually
- systemic for resistance (oral/IV)
12
Q
tinea capitis characteristics
A
- scaly erythematous lesions and hair loss
- can cause permanent alopecia
- most common for peds dermatophyte
affects scalp, eyebrows, eyelashes
13
Q
treatment for tinea capitis
A
PO systemic antifungals bid 4-6 wks
- topicals not effective
14
Q
tinea vericolor patho
A
ring worm that affects skin of upper chest, back, arms
- rash occurs and then yeast grows out of control
15
Q
tinea vericolor risk factors
A
hot climate, sweating, oily skin, weakened immune system
- not contagious
16
Q
characteristics of tinea versicolor
A
acidic bleach that causes discoloration
- spots or patches that are white pink, red, brown
17
Q
treatment of tinea veriscolor
A
topical antifungals
- shampoo
- selsum blue
18
Q
candidiasis risk factors
A
immunosuppression or abx use
19
Q
candidiasis appearance
A
- white lesions in the mouth
- beefy red satellite lesions in intertrigous areas (skin on skin)
20
Q
candidiasis treatment
A
topical anti fungals
21
Q
systemic fungal infections where
A
- aggressive treatment
- affect internal organs (intestines, urinary, lungs, brain)
22
Q
systemic fungal infections lungs
A
- histoplasmosis
- blastomycosis
- pneumocystis
23
Q
systemic fungal infections lungs and meninges
A
cryptococcosis
24
Q
viral skin infections
A
- herpes zoster
- herpes simplex
25
herpes zoster
shingles
26
herpes zoster infections
- lies dormant on a dermatome segment after infection w chickenpox
- virus becomes reactivated by immunosuppression, stress, illness
27
prodrome
burning/tingling along dermatome
- rash develops with vesicles that dry and crust over
- usually unilateral
28
characteristics of shingles
vesicles on red base that follow dermatomal distribution asymmetric
- xtremely painful
- clear 2-3 wks
- typically over 50 but anyone w chicken pox
- most contagious when weeping
29
treatment for shingles
anti viral
30
complications of shingles
post herpetic neuralgia persistent pain in the area where rash was
31
bacterial skin infections
- impetigo
- abscess
- furuncle
- cellulitis
- MRSA
32
impetigo
acute and contagious infection where the organisms infect the nose
- cause vesicles, pustules, honey colored crust on red base
- staphylococcus and streptococcus
33
treatment for impetigo
topical antibacterial
- bactroban
34
abscess
inflamed, tender skin with redness and a collection of pus
- area often raised w palpable border
- may drain purulent discharge or feel fluctuant (fluid filled)
35
treatment for abscess
incision, drainage, abx
36
furuncle
bacterial infection of hair follicle
37
carbuncle
painful deep swelling of the skin caused by bacteria
38
treatment of furuncle and carbuncle
incision, drainage, abx
39
cellulitis cause
bacterial infection of the skin and surrounding tissue
- usually staph or strep
- may be initial injury or wound that becomes infected (animal or insect bites often on lower extremity
40
cellulitis: contagious?
not contagious but can become dangerous if spreads to lymph nodes and blood stream
41
cellulitis appearance
- red, painful, swollen, warm to touch
- blisters sometimes form
*mark to make sure not spreading*
42
treatment of cellulitis
PO systemic antibiotics
IV depending on severity
43
MRSA
bacteria that is resistant to many abx
- can be hospital associated from invasive procedures like surgery, IV tubing, artificial joints
- can be community acquired which often begin as a pain full boil spread by person to person contact (wrestlers, child care workers, crowded conditions)
44
symptoms of MRSA
- warm to touch
- purulent draining
- fever
- abscess can develop quickly
*potentially life threatening, infection can burrow deep in body, in bones, joint, surgical wounds, bloodstream, heart valves, lungs*
45
treatment of MRSA
- hospital acquired: IV vancomycin, Zyvox
- community acquired: bactrim, dicloxacillin
- prophylaxis: bactroban nasal ointment prior to surgery
46
types of skin cancer
- basal cell
- squamous cell
- melanoma
47
precancerous lesions
- actinic keratosis
- solar lesions
48
actinic keratosis
- benign lesions due to damage from UV rays
- common in fair skin
- rough, scaly, red plaques
49
solar lesions
- benign lesions also known as liver/age spots
50
basal cell
most common but often least malignant
- most curable and usually non metastasizing
51
squamous cell
2nd most common, can metastasize to remote areas
- curable w early treatment
- can metastasize to lymph nodes and internal organs
- inc risk w sun exposure
52
melanoma
cancer of melanocyte
- rarer but high rate of metastasizing
- grows radially in epidermis but can go vertically deep into the dermis
53
skin lesion characteristics
- asymmetry
- border
- color
- diameter
- evolution/elevation
54
characteristics of basal cell
nodular form that begins as small flesh colored or pink dome shaped bump
- translucent, shiny, pearly nodule
*ulcer w shiny border
55
characteristics of squamous cell
red and scaling
- keratotic, slightly elevated lesion w irregular border, usually shallow chronic ulcer
56
risk factors of melanoma
fam history
- red/blond hair
- freckling of upper back
- blistering sun burns before 20
- 3 or more years of outdoor job as teen
57
where does melanomas invade
- blood and lymphatic vessels
- metastasizes to distant sites
58
melanoma characteristics
- A: lesions vary in size and shape
- B: irregular
- C: varies, brown, black, tan, sometimes red, white, blue
- D: greater than 6 mm (size of pencil eraser)
- E: looks different that the rest and can change in size, color, shape
59
most deadly type of skin cancer
- superficial spreading type= 70%
- nodular form = most aggressive
60
eczema
group of skin conditions that cause skin to be inflamed or irritated
- not contagious
- thought to be caused by overactive immune system
61
atopic eczema
- most common type
- inherited tendency to develop eczema, asthma, hay fever
62
characteristics of eczema
puritis, rash on face back knees wrists hands feet, skin thickens or becomes scary
- lesions appear red then burn, can ooze and crust over
- can be exacerbated by heat, cold, detergents, URI, stress
63
treatment of eczema
relieving ithcing/preventing infection
- lotions and creams to keep skin moist
- cold compress
- OTC hydrocortisone cream or prescription strength
- immune modulator meds
64
psoriasis
long term chronic condition that typically begins in young adult caused by an overactive immune system
- not contagious
- 1-3% of population
- caused by overactive immune system, may be autoimmune
- link btw obesity, cardiovascular disease
65
characteristics of psoriasis
skin cells grow too quickly causing skin to be thick, white, silvery, or have red patches of skin
- plaques
- normal skin cells grow gradually and flake off about q 4 wks
66
treatment of psoriasis
- keep skin moist
- uv light phototherapy
- corticosteroid cream
- topical med
- imune modulating meds
67
four major classes of anti fungal
- polyenes
- pyrmidine
- azoles
- mics agents
68
nystatin class
polyene
69
nystatin indications
- superficial candida infections of mouth, oral mucosa, vagina, skin
70
forms of nystatin
- creams
- powders
- topical
- vaginal
71
can nystatin be given parenteral
NO too toxic
72
side effects of nystatin
not many
- mild skin irritation
- NDV if oral
- poor GI absorption
73
amphotericin B class
polyene
74
amphotericin B indication
more often used for systemic mycoses
75
amphotericin B MOA
binds to ergosterol causing cell wall o become leaky and ultimately destroy it
76
amphotericin B route
- PO
- parenteral (usually IV)
77
amphotericin B nursing considerations
- high alert drug
- iv admin must be diluted and admin slowly
- monitor BUN, Cr, cardiac
- must be given q other day for several months
- pre treat w diphenhydramine, acetaminophen, aspirin to dec fever, pain, N, headache
78
amphotericin B synergetic w
flucytosin
- allows to dec dose which allows a dec symptoms associated
79
flucytosine class
pyrimidine
80
flucytosine moa
inhibits fungal DNA synthesis
81
flucytosine indications
allows for lower dose of amphotericin B to help dec se
82
azoles meds
- ketoconzaole
- miconazole
- clotrimazole
- itraconazole
- fluconazole
83
azoles moa
interrupts the integrity of the cell wall by interfering w synthesis of ergosterol
84
azoles indications
superficial and less serious fungal infections
85
azoles side effects
topical
- redness, buring, itching
systemic
- severe GI upset (NVD)
- liver toxicity
86
azoles admin
- take w food
- oral: separate at least 2 hours from antacids
87
fluconazole advantages
- rapidly and completely absorbed when given orally so able to reach bones, CNS, eyes, respiratory, urinary track
* much less toxic than amphotericin *
88
fluconazole disadvantages
- narrow spectrum
- many drug interactions (CYP450 pathway)
89
nursing implications fluconazole
- do not mix IV fluconazole
- monitor coags
- watch for hypoglycemia
- inc haldol and dilantin levels
90
grisefulvin/fulvicin moa
inhibits fungal mitosis by binding to keratin
- does not affect the cell wall or membrane
91
grisefulvin/fulvicin side effects
- bone marrow suppression
- rash
- CNS changes
- NVD
- anorexia
92
grisefulvin/fulvicin indications
- resistant germatophyte infection of scalp, skin, nails
