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FOUNDATIONS EXAM 3 > Skin Integrity > Flashcards

Skin Integrity Flashcards

1
Q

What are the layers of the skin?

A

Epidermis, Dermis, Subcutaneous Tissue

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2
Q

What are the functions of the integumentary?

A

Protection, metabolism, thermoregulation, elimination, sensation, psychosocial, absorption

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3
Q

How does the integumentary protect?

A

-from physical and chemical injury
USING sebum and normal flora

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4
Q

How does the integumentary metabolize

A

Vitamin D

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5
Q

How does integumentary thermoregulate

A

The dilation and constriction of blood vessels

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6
Q

How does the integumentary eliminate?

A

Water, electrolytes, and wastes

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7
Q

How does the integumentary control sensation?

A

Nerve endings

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8
Q

How does the integumentary relate to psychosocial

A

Facial expressions and hair distribution

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9
Q

How does the integumentary control absorption

A

Substances can be absorbed from vascularity

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10
Q

What factors affect the integumentary

A

Circulation, nutrition, skin condition (wet dry), allergy, infection, abnormal growth rate, systemic diseases

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11
Q

Signs of altered integumentary function

A

Pain, pruritus, rash, lesions

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12
Q

What is pruritus

A

Itching

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13
Q

List alterations to the integumentary

A

Intentional/unintentional
Open/closed
Acute/chronic

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14
Q

Integumentary concerns with children under 2

A

-skin is thinner and weaker
-does not have good adhesion between skin layers
-skin/mucous membranes are easily injured and subject to infection
-will become increasingly resistant

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15
Q

Integumentary concerns of elderly

A

-maturation of epidermal cells is prolonged, causing thin and easily damaged skin
-circulation and collagen formation are impaired, causing decreased elasticity and increased risk for pressure injury

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16
Q

What is the largest organ that provides sensory and a regulatory process

A

Skin/integumentary

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17
Q

Key points of the epidermis

A

-replaced monthly
-outer skin layer
-no blood vessels

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18
Q

Facts about the dermis

A

-cares for the epidermis
-has blood vessels, nerves, lymph and connective tissues

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19
Q

How does circulation effect the skin

A

The skin needs oxygen, waste removal and nutrition. If the body has impaired circulation resources will be given elsewhere

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20
Q

What nutrients affects the skin

A

Vitamin C, protein, carbs

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21
Q

Key point about skin and allergies

A

Skin will be the first response to allergy

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22
Q

Most common infections to the skin, and what do viruses and fungi cause?

A

Strep and Staph
-Virus=Warts
-Fungus=Yeast

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23
Q

Systemic diseases that affect the skin

A

PVD, HF, kidney failure (toxins), liver failure, peripheral neuropathy, diabetes

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24
Q

Symptoms of psoriasis and aggregators

A

-skin will regenerate every 3-4 days
-chronic condition
-red scaly plaques (scalp, elbows, knees, feet)
Effected by stress and environment

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25
Q

Concern with unintentional wound

A

More prone to infection, with longer healing time

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26
Q

What makes something an intentional wound

A

Created under ideal conditions for therapeutic conditions

27
Q

What makes a wound open/closed

A

Open=skin is broken
Closed=trauma is under the surface

28
Q

Difference between acute/chronic wounds

A

Acute=predictable pattern
Chronic=inflamed, stuck in the inflammatory stage and will heal slowly

29
Q

Define Laceration, puncture, abrasion, and exposure wound

A

L=tearing of skin, normally loose skin
P= increased infection risk, contaminated object enters skin
A= rubbing/scraping
E= temperature, pH, chemicals, electricity (causing skin cell death)

30
Q

What is the primary intervention for pressure injuries

A

Prevention

31
Q

What is the difference between pressure injuries, decubitus ulcers and bed sores

A

Nothing, they are all the same

32
Q

What is a pressure injury

A

Death of tissue, caused by external pressure over a bone

33
Q

Common causes and risk factors to pressure injuries

A

C= pressure intensity and duration
R= impaired tissue tolerance, nutrition, moisture, age, friction, shear, Braden score less than 18

comorbid conditions: quadriplegic, unaware, dementia, ICU pts. Stroke, anything effecting consciousness, sensory, mobility

34
Q

What is shear

A

Epidermal and dermal layer moving in opposite direction

35
Q

What is a stage 1 pressure injury

A

Non blanchable erythema of intact skin

36
Q

What is a stage 1 pressure injury

A

Non blanchable erythema of intact skin

37
Q

What is a stage 2 pressure injury

A

Partial thickness skin loss
Looks like abrasion or blister

38
Q

What is a stage 3 pressure injury

A

Full thickness skin loss with damage or necrosis of SQ tissue

Presents as a deep crater

39
Q

What is a stage 4 pressure injury

A

Full thickness skin loss with extensive destruction, necrosis, damage to muscle, bone or tendons

40
Q

What is slough

A

Non viable tissue
-yellow, tan, gray, green, brown
WOUND WILL NOT HEAL WITH IT

41
Q

What is Escher

A

Dark brown or black
-crust like, non viable tissue
WOUND WILL NOT HEAL WITH IT

42
Q

What is an unstageable pressure injury

A

Full thickness tissue damage, base of the wound is covered with slough or Escher
-will be a 3-4 once dead tissue is removed and depth can be determined

43
Q

What is a suspected deep tissue injury SDTI

A

Purple or maroon localized area of intact skin
-can be confused to be stage one, but is 3-4

44
Q

What is autolytic debridement

A

Used of hydrocolloid or foam dressings

Body’s enzymes and defense mechanisms will remove necrotic tissue

-dressings stay on for 3-7 days

45
Q

What is enzymatic debridement

A

Application of prepared enzymes

-most common treatment

46
Q

What is sharp/surgical debridement

A

Use of a scalpel, done by physicians or advance practice can be done bedside or OR

47
Q

What is mechanical debridement

A

Use of physical force, painful and old fashioned style
-pressure wash, wet/dry dressing

Can have pain meds or surgery to perform

-ex. hydrogen peroxide

48
Q

What is bio-surgical debridement

A

Use of surgical grade larvae, secretes enzyme that eats necrotic tissue
-can be last option before amputation
-can also be non therapeutic

49
Q

List types of debridement in order of least to most severe

A

Autolytic, enzymatic, sharp, mechanical, bio-surgical

50
Q

Define hemostasis healing

A

Controls bleeding and lasts 48 hours

-vasoconstriction
-exudate production
-clot formation

51
Q

Define hemostasis healing

A

Controls bleeding and lasts 48 hours

-vasoconstriction
-exudate production
-clot formation

52
Q

What is exudate

A

Plasma/clear fluid

53
Q

What is exudate

A

Plasma/clear fluid

54
Q

What is inflammatory response in terms of wound healing

A

WBC are working (with temporary increase) lasting 4-6 days
-vasodilation
-phagocytosis (digestion of foreign substances)
-localized response — redness/heat

55
Q

What is proliferative in terms of wound healing

A

New tissue is being formed, lasts 3-24 days
-fibroblasts and growth factor create collagen and blood vessels
-granulation formation —small/fragile skin cells

56
Q

What is maturation in terms of wound healing

A

Can take 2 years
-collagen matures and scar tissue is created
-A vascular and less elastic
-10-12 weeks to reach 70-80% strength

57
Q

Describe primary intention wound healing

A

Most common process and the goal
-think surgical wound

58
Q

Describe secondary intention wound healing

A

What pressure injury would be

59
Q

Describe tertiary intention wound healing

A

Delayed closure intentionally
Least common healing process

60
Q

Systemic factors effecting wound healing

A

Age,
nutrition (protein/albumin, vitamin A/C, zinc)
Circulation/oxygenation
Health status- diabetes, shock, obesity, suppressed immune system (neutropenic)

61
Q

What are some local factors effecting wound healing

A

Moisture
-desiccation—DRY
-maceration —MOIST
Trauma (injury that got injured)
Edema (impaired blood flow)
Infection (competition)
Bleeding
Necrosis
Biofilm (thick, slimy, sugar proteins of bacteria, resistant and tricky to manage)

62
Q

Common complications of wound healing

A

Hemorrhage -bleeding in or out
-hematoma (inside, collecting blood, watch for pressing on nerve or vessel)
Dehiscence (caused by infection, bleeding, strength)
Evisceration
Infection
Fistula - passage between surfaces dont connect
(Wound healing, trauma, cancer)

63
Q

Signs of localized infection

A

Redness — cant happen in late healing
Heat
Edema
Pain
Altered function

Drainage and dehiscence

FOUNDATIONS EXAM 3 (6 decks)

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