UNIT 10 SKIN Disorders CHAPTER 23

Question 1

How would you prevent pressure ulcers?

Answer 1

. 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

Question 2

What are the 5 Cardinal signs of Inflammation

Answer 2

-Warmth
– Redness
– Swelling
– Pain
– Decreased function

Question 3

What is Urticaria

Answer 3

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.

Question 4

Cause of Urticaria

Answer 4

Common causes of urticaria include
drugs,
temperature extremes,
foods,
infection,
diseases
, cancer,
insect bites.

Question 5

What should the patient avoid to prevent the Urticaria from becoming worse?

Answer 5

Teach the patient to avoid overexertion, alcohol consumption, and warm environments, which further dilate blood vessels and make urticaria worse.

Question 6

What is Psoriasis

Answer 6

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.

Question 7

What can be a trigger for Psoriasis Exacerbation

Answer 7

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

Question 8

What is the length of therapy for Etanercept for Plaque Psoaris?

A, 6 Months
B. 3 months
C. 1 year
D. 7 months

Answer 8

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)

Question 9

Is Psoriasis Contagious

A. Yes
B. No

Answer 9

B. No

IT IS AUTOIMMUNE

Question 10

What is Cellulitis?

Answer 10

a common, potentially serious bacterial skin infection.

Question 11

What are the signs and symptoms of cellulitis

Answer 11

Warm
red
swelling
painful

Question 12

Can Cellulitis be life threatening

A. No
B. Yes

Answer 12

B. Yes

It can cause sepsis

Streptococcus may be positive with blood culture.

Question 13

What is the treatment for Cellutis?

Answer 13

IV antibiotics – i.e.
Ceftriaxone(cephalosporin)

Treatment – ABX (ceftriaxone) is an antibiotic/bacterial infection med
-Warm compress
-Elevation
-Ambulation
-Clean site with antibacterial soap

Question 14

What is Pediculosis?

Answer 14

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

Question 15

What is the signs and symptoms of Pediculosis?

Answer 15

• ITCHING OR pruritus

Question 16

Is Pediculosis Contagious?
A. No
B. Yes

Answer 16

B. Yes

Question 17

Treatment for Pediculosis?

Answer 17

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

Question 18

What is the appearance of Scabies

Answer 18

curved or linear ridges in skin

Question 19

What is Herpes Zoster

Answer 19

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

Question 20

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.

Question 21

Action of Zostavav vaccination

Answer 21

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.

Question 22

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.”

Question 23

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.

Answer 23

3. 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.