UNIT 10 SKIN Disorders CHAPTER 23 Flashcards
How would you prevent pressure ulcers?
. Turn q2h, or 1 in the chair**
. Pad hard contact surfaces
. Heels off bed
. Nutrition -HIGH PROTEIN
. Assess skin q2hrs, or every shift
f. Use skin barriers
. Do not massage bony prominences
What are the 5 Cardinal signs of Inflammation
-Warmth
– Redness
– Swelling
– Pain
– Decreased function
What is Urticaria
Urticaria (hives) is a rash of white or red edematous papules or plaques of various sizes. This problem is usually caused by exposure to allergens, which releases histamine into the skin. Blood vessel dilation and plasma protein leakage lead to formation of lesions or wheals.
Cause of Urticaria
Common causes of urticaria include
drugs,
temperature extremes,
foods,
infection,
diseases
, cancer,
insect bites.
What should the patient avoid to prevent the Urticaria from becoming worse?
Teach the patient to avoid overexertion, alcohol consumption, and warm environments, which further dilate blood vessels and make urticaria worse.
What is Psoriasis
Psoriasis is a chronic autoimmune disorder marked by exacerbations and remissions in which T-lymphocytes, dendritic cells, and cytokines are involved. In the hyperproliferative state, plaques form on the skin (Fig. 23.5). Psoriasis lesions are scaled with underlying dermal inflammation from an abnormality in the growth of epidermal cells.
What can be a trigger for Psoriasis Exacerbation
Environmental factors can trigger outbreaks, yet these are very subjective to the individual person. Stress, skin injuries, certain medications (lithium, propranolol, indomethacin, quinidine, and antimalarials), and infection are known triggers. Smoking, alcohol use, and obesity have been shown to exacerbate symptoms
What is the length of therapy for Etanercept for Plaque Psoaris?
A, 6 Months
B. 3 months
C. 1 year
D. 7 months
B. 3 months
MUST TEST FOR TB before administering this medication
Given by SureClick auto-injector
Given twice weekly for 3 months
Black box warning: serious infection risk (especially for TB, Legionella, Listeria); risk for malignancy (lymphoma and other malignancies)
Is Psoriasis Contagious
A. Yes
B. No
B. No
IT IS AUTOIMMUNE
What is Cellulitis?
a common, potentially serious bacterial skin infection.
What are the signs and symptoms of cellulitis
Warm
red
swelling
painful
Can Cellulitis be life threatening
A. No
B. Yes
B. Yes
It can cause sepsis
Streptococcus may be positive with blood culture.
What is the treatment for Cellutis?
IV antibiotics – i.e.
Ceftriaxone(cephalosporin)
Treatment – ABX (ceftriaxone) is an antibiotic/bacterial infection med
-Warm compress
-Elevation
-Ambulation
-Clean site with antibacterial soap
What is Pediculosis?
Pediculosis is a lice infestation: pediculosis capitis (head lice), pediculosis corporis (body lice), and pediculosis pubis (pubic, or crab, lice). Human lice are oval and 2 to 4 mm long. The female louse lays many eggs (nits) at the hair shaft base in hair-bearing are
PARASITIC DISORDER
VERY CONTAGIOIUS
What is the signs and symptoms of Pediculosis?
- ITCHING OR pruritus
Is Pediculosis Contagious?
A. No
B. Yes
B. Yes
Treatment for Pediculosis?
The treatment of pediculosis involves chemical killing of the parasites with topical sprays, creams, and shampoos.
Topical agents include Permethrin cream or malathion lotion.
Oral agents such as ivermectin may also be used. Areas where the patient has slept or sat (e.g., pillows, bed, chairs, sofa) will also need to be treated.
Clothing and bed linens should be washed in hot water with detergent or dry cleaned.
The use of a fine-tooth comb helps remove nits from hair but does not cure the infection. For any louse infestation, social contacts should be treated when possible.
-nonwashable items should be placed in a bag for 2 weeks
What is the appearance of Scabies
curved or linear ridges in skin
What is Herpes Zoster
Reactivation of chicken pox
Multiple lesion group along nerve area, painful vesicles/blistered rash, lasts several weeks
* Transmission – direct contact with the rash fluid.
* Complications – Postherpetic Neuralgia
* Treatment – Prevention; Zostavax vaccine
Herpes Zoster
The nurse in a long-term care facility is teaching a group of new unlicensed assistive personnel. Which information regarding skin care should the nurse emphasize?13
1. Keep the skin moist by leaving the skin damp after the bath.
2. Do not rub any lotion into the skin.
3. Turn clients who are immobile at least every
two (2) hours.
4. Only the licensed nursing staff may care for
the client’s skin.
Action of Zostavav vaccination
Shingrix (recombinant zoster vaccine) and Zostavax (zoster vaccine live) are “shingles vaccines.” Shingrix should not be given to anyone with a history of having already had this vaccine delivered in a previous dose. Zostavax should not be given to patients with severe immunosuppression, those who are taking drugs that affect the immune system, persons who are undergoing radiation or chemotherapy, or those with cancer affecting the bone marrow or lymphatic system (Centers for Disease Control and Prevention [CDC], 2018). Always collaborate with the primary health care provider before giving any vaccines to ensure that the correct one has been prescribed.
The school nurse is assessing a teacher who has pediculosis. Which statement by the teacher makes the nurse suspect that the teacher did not comply with the instructions that were discussed in the classroom with the children?61
1. “I used the comb to remove all the nits.”
2. “I washed my hair with Kwell shampoo.”
3. “I removed all the sheets from my bed.”
4. “I had to fix my daughter’s hair with my
brush.”
The elderly client is admitted from the long- term care facility diagnosed with congestive heart failure. The client complains of severe itching on both hands and the nurse notes wavy, brown, threadlike lesions between the client’s fingers. Which comorbid condition would the nurse suspect the client of having based on these assessment data?63
1. Tinea capitis.
2. Herpes simplex 2.
3. Scabies.
4. Psoriasis.
- Scabies.
Scabies is an infestation of the skin by the itch mite (Sarcoptes scabiei). The female burrows into the superficial layer of skin, and burrows are found between the fin- gers and on the wrist.
