Test 3 Flashcards
What are the two main functions of the skin
Protect and regulate
Another term for skin system
Integumentary system
True of false the skin is the largest organ
True
what layer is the epidermis
Outer layer
Where is the dermis found
Part of the skin as the inner layer. (has blood supply and follicles)
Primary function of the dermis is to do what
Add support and rigidity to the skin giving nutrients to epidermis via blood vessels
primary function of the epidermis
Protection of the body from outside antigens
Where in the skin are nerve and adipose tissue found?
subcutaneous layer which is under the dermis.
abbreviation for subcutaneous tissue
SQ
Purpose of the subcutaneous tissue
gives the body thermal regulation via adipose tissue with insulation and added protection.
how would you categorize skin infections
Based on the depth of the infection, the location as well as the sore they produce a culture will tell if it is a bacterial infection or viral.
Types of uncomplicated skin infections
Cellulitis, folliculitis, impetigo, furuncles, simple abscesses
How are most uncomplicated skin infections treated
usually, antibiotics alone cure this infection.
Impetigo
Most common in children highly contagious. reddish sores around the face that turn to a honey-colored crust after a week.
Furuncles
Boils
Folliculitis
Inflammation of hair follicles. Usually due to hot tubs or baseball caps.
Cellulitis
spreading infection of the skin of the dermis and SQ tissue layers. edema, inflammation, warm to touch, erythema.
What is the one of the classifications to be a complicated skin infection?
The depth of the infection reaches past the SQ into the fascia and muscle. Can have Necrotizing soft tissue
Necrotizing soft tissue infections (NSTI)
infection where part of the wound had dead tissue. This is a problem because this decaying tissue is perfect for bacterial growth.
What is one of the first treatments done with a complicated skin infection with NSTI?
Surgical debridement to remove all of the dead tissue to facilitate healing.
Do you have to act quick with NSTI?
Yes, if you don’t get rid of the decaying tissue the infection can spread so instead of a finger you can lose a hand.
infection of bacteria that reaches the blood stream
bacteremia
MRSA
methicillin-resistant staphylococcus aureus
How is MRSA primarily acquired
Community or healthcare acquired. while in the hospital.
Majority of MRSA cases are uncomplicated true or false?
True
Which bacteria is the primary for soft tissue infections gram positive or gram negative?
Gram positive bacteria
Such as staphylococcus aureus and streptococcus pyogenes.
How do you get an infection with these bacteria if they live on your skin?
They are opportunistic infecting you when introduced with a break in the protection of the skin.
What would you look at during an assessment of a skin infection
vital signs (tachycardia, change in LOC)
Labs WBC
establish baseline for skin
culture for ABx
nutritional status- how do they eat and how much.
What kind of nutrition do you need to look for during an infection?
Protein as well as fluids
protein helps with tissue growth
fluid loss can happen with an open sore and needs to be increased.
What are the basic labs drawn with an infection
CBC, serum electrolytes, c-reactive proteins.
What does the lab value for C-reactive protein tell you?
this is a protein that you watch that can be a monitor for inflammation.
What are the three ways to make a diagnosis of an infection?
Laboratory data,
biopsies such as needle or punch.
nasal swabs/ wound swab.
What can an infection do to your blood pressure
the infection can lead to less fluid in the intravascular space causing hypotension.
MRSA usually causes skin infections in the community what can it cause in a medical facility?
Sepsis, pneumonia, surgical site infections.
What is the isolation for MRSA
Contact precautions, Gown, gloves, hand washing.
What is the highest at risk population for MRSA
kids, prisoners, athletes, patients. Sharing of items such as hats or cups.
Direct contact so anything that is easily touched and shared.
How does MRSA present itself?
Most of the time CA- MRSA is an uncomplicated skin infection. showing as an infection at the site of impaired skin integrity.
(Cellulitis, folliculitis, impetigo, abscess).
Signs and diagnosis of MRSA
Like cellulitis redness, warmth, and swelling to area.
Need culture to tell MRSA
How did MRSA become a thing?
Overuse or misuse of antibiotics not taking all led to a resistance in bacteria.
Treatment for MRSA
elevation to help with the swelling.
Antibiotics to fight the infection.
keep area clean/ dry
What should you always do with MRSA
Contact precautions
stop the spread
What is the “big gun” antibiotic used for MRSA
Vancomycin
used only when SIRS is met to avoid VRSA
What are some antibiotics that are used for MRSA
Bactrim
Clindamycin
Minocycline
Doxycycline
vancomycin
Can folliculitis happen anywhere?
Yes this can happen to any hair follicle.
What can folliculitis lead to if untreated?
Cellulitis, Furuncle, scaring, hair loss.
What can Folliculitis be mistaken for?
Acne
What is the common way to get folliculitis?
it is idiopathic. any sort of trauma to hair follicle.
Untreated hot tubs
What are the two treatments for Folliculitis?
Bactroban as an ointment
Clindamycin 1% for body washes.
How far does a Furuncle go into the skin?
In the dermis to the subcutaneous tissue where it forms an abscess.
What is the treatment for a small Furuncle?
Moist heat
Can a Furuncle occur anywhere with a hair follicle?
Yes it can occur anywhere with hair follicles mostly in areas with lots of friction.
What does a Furuncle turn into?
Cellulitis, large abscess.
What is the start of a Furuncle?
Always starts out as folliculitis.
Where is cellulitis usually seen?
Extremities
what are common causative agents for cellulitis
staphylococcus, group A streptococcus
How is cellulitis seen in the clinical setting?
Hot warm to the touch.
tender, red, swollen
skin like an orange.
petechiae (from bleeding under the skin)
endocarditis
infection of teh heart
What are most cellulitis cases caused by?
Bacteria so they antibiotics.
Why do you watch the trend of WBC as well as neutrophils?
To track infection and effectiveness of treatment.
What are the common complications related to cellulitis?
Endocarditis
bacteremia
osteomyelitis
necrotizing fasciitis
serious cellulitis infections can lead to NSTI what are the symptoms?
Grows rapidly
tissue death (necrosis)
quick changes in appearance
small painful lump
sweating, chills, fever.
What to watch for in NSTI?
signs of sepsis.
immediate broad-spectrum antibiotics. (Clindamycin, penicillin)
How many different kinds of fungal
2 kinds tinea/ candida
Candida fungus
Yeast
Dermatophytosis
tinea
aerobic fungi
How can fungal infections present?
Skin rash
Skin lesions
Nail bed infection
Oral thrush
