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N116 > tissue integrity > Flashcards

tissue integrity Flashcards

1
Q

tissue integrity

A

state of structurally intact and physiologically functioning epithelial tissues
(integument and mucous membranes)

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2
Q

epithelium

A

tissue that lines cavities and structure surfaces throughout the body

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3
Q

debridement

A

removal of dead, damaged or infected tissue

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4
Q

granulation

A

connective tissue that forms on the surface of a healing wound

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5
Q

turgor

A

elastic state of tissue

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6
Q

emollient

A

agents that soften skin or treat dry skin

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7
Q

6 categories of impaired tissue integrity

A
  1. trauma or injury
  2. loss of perfusion
  3. immunological reaction
  4. infections and infestations
  5. thermal or radiation injury
  6. lesions
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8
Q

4 steps of wound healing

A
  1. regeneration
  2. resolution
  3. repair
  4. healing
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9
Q

resolution

A

returning injured tissue to original structure and function

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10
Q

repair

A

replacement of destroyed tissue with scar tissue

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11
Q

scar tissue

A

composed primarily of collagen to restore the strength of tissue but not function

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12
Q

healing

A

filling in the wound
sealing wound
shrinking wound

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13
Q

epithelialization

A

sealing the wound

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14
Q

contraction

A

shrinking the wound

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15
Q

three types of wound healing processes

A

primary intention
secondary intention
tertiary intention

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16
Q

primary intention

A

margins well approximated
lacerations
surgical incisions
most rapid

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17
Q

secondary intention

A

margins not well approximated. larger areas require formation of granulation tissue to fill in gaps
longer time period

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18
Q

tertiary intention

A

healing delayed
occurs when wound was open and is now closed
associated with large infected contaminated wounds

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19
Q

three phases of wound healing

A

inflammatory
granulation (proliferative)
maturation (remodeling)

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20
Q

inflammatory phase

A

3-5 days
homeostasis develops
macrophages remove debris

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21
Q

granulation phase

A

5-21 days

new blood vessels and tissue formed

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22
Q

maturation phase

A

lasts months
collagen fiber remodelled
scar formation and contraction occur

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23
Q

predisposing disorders to dysfunctional wound healing

A 
diabetes 
obesity
wound infection
inadequate nutrients 
numerous medications 
tobacco smoke
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24
Q

dysfunctional collagen synthesis results in

A

keloid scar

hypertrophic scar

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25
Q

increased dietary needs to promote wound healing

A

calories
protein
vitamins A and C
zinc

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26
Q

general health history

A 
past/current conditions
family history
allergies
current/recent medications
history of skin disorders
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27
Q

problem based history

A 
changes in skin condition/colour
new rash or lesion
changes in previous lesions 
excessive bruising 
loss of hair 
changes of condition of nails 
wounds slow to heal
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28
Q

examination of lesions

A

location, size, shape, colour, pattern, characteristics (raised, flat, dry, exudate)

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29
Q

assessment of wounds/ulcers

A

Acute wound or chronic wound

  • Location
  • Size (length, width, depth)
  • Color (red, yellow, black)
  • Cleanliness (clean, contaminated)
  • Odor
  • Presence of wound drains (type)
  • Presence of drainage and exudate
  • staging ulcers
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30
Q

common diagnostic tests

A
  • Woods lamp testing
  • Tissue biopsy
  • Wound culture
  • Patch testing
  • Serum protein level
  • CBC and WBC
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31
Q

primary and secondary prevention

A
  • Skin hygiene
  • Adequate nutrition
  • Avoidance of excessive
    sun exposure
  • Burn safety precautions
  • Dermal ulcer prevention
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32
Q

collaborative interventions

A 
pharmacotherapy
phototherapy
surgical interventions
wound care
nutritional support
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33
Q

principles of wound care

A

initial and ongoing assessment

cleaning and irrigation

34
Q

cleansing and irrigation

A

cleaning performed to remove debris and exudate

normal saline used, avoid harsh solutions

35
Q

types of dressings

A

gauze, nonadherent dressings, occlusive, semiocclusive, hydrocolloid. hydrogel and alginate applied
vacuum-assisted systems used

36
Q

primary lesions

A
  • Macule (freckle)
  • Papule (wart)
  • Patch (vitiligo)
  • Plaque (psoriasis)
  • Wheal (insect bite)
  • Nodule (lipomas)
  • Tumour (Neoplasms)
  • Vesicle (Varicella)
  • Bulla (Blister)
  • Pustule (acne)
  • Cyst (sebaceous cyst)
  • Telangiectasia
37
Q

secondary lesions

A
  • Scale (Dry skin)
  • Lichenification (Chronic
    dermatitie)
  • Keloid (Scar that grows
    beyond boundaries of
    wound)
  • Scar (Incision)
  • Excoriation (Abrasion)
  • Fissure (Dermatitis)
  • Erosion (Chemical Injury)
  • Ulcer (Pressure Ulcer)
  • Atrophy (Aged Skin)
38
Q

topical dermatological drugs

A
  • Antibacterial drugs
  • Antifungal drugs
  • Antiviral drugs
  • Anti-inflammatory drugs
  • Antineoplastic drugs
  • Antipruritic drugs (for itching)
39
Q

acne vulgaris most

A

common skin disease

40
Q

acne vulgaris occurs between what ages

A

12 to 15

41
Q

acne vulgaris develops where

A

sebaceous follicles

primarily on face and upper chest and back

42
Q

acne vulgaris therapy targets what four factors responsible for lesion formation

A
  • increased sebum production
  • hyperkeratinization
  • colonization by Propionibacterium acnes
  • resultant inflammatory reaction
43
Q

physiological factors of acne vulgaris

A 
- Follicular
hyperkeratinization
- Excessive sebum
production
- Follicular proliferation
of Propionibacterium
acnes
- Inflammation secondary
to the action of
inflammatory products
produced by P. acnes
- Excessive production of
sebum is related to
androgenic hormones
44
Q

acne vulgaris

noninflammatory

A

blackheads (open)

whiteheads (closed)

45
Q

acne vulgaris

inflammatory (cystic)

A

caused by follicular wall rupture in closed comedones

cystic nodules develop when inflammation is deeper

46
Q

clinical management of acne vulgaris

A

topical treatments
systemic treatments
surgery
scarring treated with dermabrasion, lasers, and resurfacing techniques

47
Q

acne conglobata

A

highly inflammatory

severe

48
Q

acne conglobata characterized by

A

formation of communicating cysts and abscesses beneath the skin

49
Q

hydradinitis suppurativa (inverse acne)

A

chronic inflammatory
recurrent abscesses, sinus tract infection formation, and scarring
hyperkeratosis and occlusion of the pilosebaceous follicular ducts

50
Q

hydradinitis suppurativa is associated with

A

obesity, stress, and smoking

51
Q

hydradinitis suppurativa is treated with

A

drainage and antibiotics

52
Q

drugs used to treat acne

A
  • benzoyl peroxide
  • Erythromycin (Macrolide antibiotic drug class)
  • tetracycline
  • isotretinoin
  • clindamycin
  • vitamin A acid: retinoic acid
  • Formulations of the antibiotics minocycline, doxycycline,
    and tetracycline
  • Oral contraceptives for female acne patients
53
Q

benzoyl peroxide causes death of what

A

anaerobic Propionibacterium acnes bacteria by slowly releasing oxygen

54
Q

benzoyl peroxide actions

A

antibacterial, antiseptic, drying, keratolytic

55
Q

keratolytic action

A

softens scales and loosens outer layer of skin

56
Q

benzoyl peroxide may cause

A

peeling skin, redness, warm sensation

57
Q

Clindamycin phosphate

Clindets®, Dalacin®

A

topical form of systemic antibiotic

58
Q

adverse reactions to Clindamycin phosphate

Clindets®, Dalacin®

A

minor local skin reactions: burning, itching, dryness, oiliness, and peeling

59
Q

Clindamycin phosphate

(Clindets®, Dalacin®) available in

A

cream, gel, lotion, suspension, and pledget formations

60
Q

isotretinoin (Clarus®, Epuris®)

A

treatment of severe recalcitrant cystic acne

61
Q

isotretinoin (Clarus®, Epuris®) inhibits

A

sebaceous gland activity and has anti-keratinizing and anti-inflammatory effects

62
Q

pressure ulcers result from

A

unrelieved pressure on the skin

63
Q

4 contributing factors to pressure ulcers

A

pressure
shearing forces
friction
moisture

64
Q

4 prevention techniques of pressure ulcers

A

frequent skin assessment
repositioning
pressure reduction, removal, and distribution
elimination of moisture

65
Q

stage 1

A

nonblanchable erythema of intact skin

66
Q

stage 2

A

partial-thickness skin loss involving epidermis or dermis

67
Q

stage 3

A

full-thickness skin loss involving damage or loss of subcutaneous tissue

68
Q

stage 4

A

full thickness skin loss with exposure of muscle, bone or supporting structures

69
Q

keloids

A

elevated, rounded, and firm

clawlike margins that extend beyond the original site of injury

70
Q

hypertrophic scars

A

elevated erythematous fibrous lesions that do not extend beyond border of injury

71
Q

keloids and hypertrophic scars caused by

A

excessive collagen formation during dermal connective tissue repair

72
Q

pruritus

A

itching

73
Q

atopic dermatitis

A

most common form of eczema in children

genetic link, altered immunity, and immune responses

74
Q

clinical manifestations of atopic dermatities

A

severe pruritus, eczematoid appearance, and age dependent distribution of skin lesions

75
Q

pimecrolimus (Elidel®)

A

immunomodulator

treats atopic dermatitis

76
Q

imiquimod

Aldara P®, Vyloma®

A

immunomodulator

treats actinic keratosis, basal cell carcinoma, and anogenital warts

77
Q

diaper dermatitis

A

form of irritant contact dermatitis

78
Q

diaper dermatitis caused by

A

prolonged exposure to irritation by urine and feces

79
Q

clinical manifestations of diaper dermatitis

A

varies from mild erythema to erythematous papular lesions

80
Q

treatment of diaper dermatitis

A
  • frequent diaper changes
  • regular exposure to air
  • use of super absorbent diapers
  • topical treatment with petroleum or zinc
  • topical antifungal medications if C. albicans present
81
Q

allergic contact dermatitis

A

caused by T-cell mediated or delayed hypersensitivity

82
Q

manifestations of allergic contact dermatitis

A

erythema
swelling
pruritus
vesicular lesions

N116 (11 decks)

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