UNIT 3 SKIN Flashcards
1
Q
What is contact dermatitis?
A
Inflammatory reaction of the skin after contact with a irritant or allergen
2
Q
What is the therapeutic management of contact dermatitis?
A
- Rinse affected area
- Medicatons
- Skin patch testing
3
Q
What topical medications can be used for contact dermatitis?
A
- Corticosteriods (hydrocortisone)
- Lotions (calamine)
4
Q
What oral medications can be used for contact dermatits?
A
- Antihistamines (benadryl)
- Steriods
5
Q
How do we treat diaper dermatitis?
A
- Changing the diaper as soon as soiled
- Expose bottom to air
- Apply zinc oxide or petroleum ointment
- Wipes that are detergent and alcohol free
- Cornstarch powders
6
Q
How do babies get diaper dermatitis?
A
- Babies skin comes into contact with the chemicals of the diaper and urine and feces mix… and this causes this…
It is an inflammation response due to an irritant or allergic response
7
Q
What should we know about using cornstarch powders as a treatment for contact dermatitis?
A
Safe if put on hand and patted on
Tal can be dangerous if inhaled
8
Q
What should we know about desatin ointment for the treatment of diaper dermatitis tx
A
- Make sure area is clean, gently rinsing then apply the cream… “well covered”
- You do not have to remove the old cream as it serves as a barrier
9
Q
True or false: Skin infections can be viral, bacterial and fungal?
A
True
10
Q
What is atopic dermatitis (exzema)?
A
Chronic replapsing inflammatory skin disorder it is a result of genectic factors, enviromental agents
Result of genetic factors, enviromental agent
Majority have family history of eczema, asthma, food allergies (genetic link)
Symmetrical involement– location is important
11
Q
Ezema (atopic dermatitis) in infants is typically seen where?
A
- Face
- Inside elbows
- Behind knees
12
Q
Eczema (atopic dermatitis) is typically seen where?
A
- Antecubital and popliteal area
- Neck
- wrists
- feet
13
Q
How does eczema (atopic dermatitis) present in adolescents?
A
Lichenificaiton— leather like
14
Q
What is the therapeutic managment of eczema?
A
- Hydrate the skin (tepid or colloid bath)
- Emollient application immediately after bath
- Relieve pruritus
- Colloid bath, cool wet comressess, topical corticosteriods, oral antihistamines
- Reduce inflammation
- Topical corticosteroids
- Non-sterodial immunomodulator creams
- Prevent or control secondary infections
- Short/clean nails
- Antibiotics
15
Q
What is seborrheic dermatitis?
A
A harmless chronic, recurrent, inflammatory reaction of skin
16
Q
When is seborrheic dermatitis most common?
A
Early infancy “cradle cap”
17
Q
With seborrheic dermatitis “cradle cap” how does it present?
A
Thick, yellowish, scaly, oily patches that may or may not be pruritic
18
Q
How do we treat seborrheic dermatitis?
A
Shampoo daily
1. Allow the shampoo to sit for crusts to soften
2. Rince
3. Fine-tooth comb or soft brush to remove loosened crusts
19
Q
What is impetigo?
A
Common BACTERIAL skin infection that is HIGHLY contagious
20
Q
What bacteria is highly associated with impetigo?
A
Staphylococcus aureus
21
Q
Impetigo is most common on what part of the body?
A
Face around mouth–> spreads peripherally by DIRECT CONTACT
Can be itchy
22
Q
Impetigo can lead to what kidney disorder?
A
Glomlurlarnephritis secondary to impetigo
23
Q
What education should we provide a child/parent that has impetigo
A
- No school or daycare– contagious… can return 24 hours after starting antibiotics
- Handwashing before and after touching an infected area
- Seperate the childs clothes and linens and wash in hot water
- Keep fingernails short and clean (decrease infection)
- You gcan gently remove crusts but do not pick
24
Q
True or false: Impetigo can be a primary or secondary infection?
A
True
25
How do we treat impetigo?
1. Small areas can be treated with topical bacterial/ointments like Mupirocin (bactroban)
2. Widespread infections can be treated with penicillin
3. Gentle cleansing of crusted area
4. Dont rupture blisters can increase the risk of a secondary infection
26
What are some nursing interventions for Impetgio?
1. Institute strict contact precautions
2. Strict hygiene practices
3. Educate familly and visitors on necessary precaustion to prevent spread of infections
27
What is cellulitis?
Bacterial infection caused typically by staph, strep, hib
28
What are symptoms of cellulitis?
1. Inflammation with intense redness
2. pain
3. swelling and firm inflitration
4. warm to touch
5. lymphangitis "streaking"
6. Possible systemic affects (fever, malaise)
7. Swollen regional lymph nodes
29
What makes cellulitis an opportunistic infection?
1. Any area of broken skin
2. Immunocompromised diabetics
30
True or false: Cellulitis is contagious?
False
31
How do we treat cellulitis?
1. Antibiotics-- oral (because infection is deeper into tissue)
2. Elevation, immobilization
3. pain relievers and antipyretics
32
What is dermatophytosis-tinea?
AKA "ringworm"
It is a fungal infection that lives on, Not in the skin or nails
32
What is tinea capitis?
Ring work on the head
33
How is tinea capitis spread?
1. Person to person
2. Animal to person
34
True or false: Hairloss from tinea captis is permenant?
False
35
What oral medications are used to treat tinea capitus?
Grisofulvin or tervinafine
Grisiofulvin is the most common and might be used along witha topical creame as well.
Make sure to take as prescribed. It is recommended to be taken with high fat foods for better absorption and less GI upset
36
What shampoo might be used for tinea captis treatment?
1. Selenum sulfide shampoo (antifungal)
2. Used 2-3 tx per week. Apply to the scalp and let sit for at least 5-10 mins. for atleast 2 weeks
3. Can cause severe drying and has a strong smell
37
What is a Kerion?
Ringworm that extends deeper into the tissue... will cause scarring
38
What is tinea corporis?
Ringworm of the body
39
How is tinea corporis spread?
1. Usually by infected pet
2. Can be human, soil or fomites?
40
What are the symptoms of tinea corporis?
1. Begins as a small lesion that enlarges, leaving a scaly patch
2. Center usually clears leaving the "ring" apperance
41
What is tinea cruris?
'Jock itch"
42
What are the symptoms of tinea cruris?
1. Pruritic
2. Medial proximal aspect of the thigh/crural fold (may involve the scrotum in males)
43
How is tinea cruris treated?
Local application of antifungal creams
44
What is tinea pedis?
Athletes foot
45
What are the symptoms of Tinea pedis?
1. Pruritis
2. Lesions on plantar surface of foot, between toes
46
How can you get tinea pedis?
1. Shower
2. Swimming pool
3. Mosit environment
47
How do we treat tinea pedis?
1. Local application of antifungal creams
2. Oral antifungals
3. Soaks with burrow solution-- contains aluminum acetate
48
What education can we provide to help with treatment/prevention of tinea pedis?
1. Shower shoes
2. Well ventilated shoes
3. Light socks
4. Airflow to the feet is important
49
How do you get lyme disease?
You get bit by a tick infected w/ Borrelia Burgdoferi
50
What are s/s of lyme disease?
1. Rash "bulls eye" common but not always present
2. Fatigue
3. Cognitive decline
4. Fever accompanied by headache
5. Sensitivity to night and light visions
6. Disturbance in sleep in combonation with night sweats
7. Neuro problems
8. Skin outbreaks
9. Heart problems
10. Mood swings
51
How/when does lyme disease present?
1. Can present 3 to 30 days after bite
2. if it is left untreated the bacteria can migrate to other parts of the body and become severe. It will settle into the nerbous system
3. Usually a firm discrete nodule at site
52
When removing a tick make sure....
You remove the entire tick
53
How is lyme disease diagnosed?
Blood test + symptoms
54
How long after a tick bite should you observe a person?
30 days
55
How is lyme disease treated?
| Important that I know these meds
If lyme disease is suspected or if it has been confirmed with lab test
1. A single dose of antibiotic
- ** Doxycycline for children older than 8 **
- ** Amoxicillian or ceftrioxime for children older than 8 **
2. If confirmed lyme disease and/or for more severe cases of lyme diseases longer antibiotics may be ordered
56
What are ways we can prevent lyme disease?
1. Water repellant
2. Check for ticks daily
3. Showers soon after being outdoors
4. Call for doctor if you get a rash or fever esp. if you know you have had a tick bite
57
What is Sarcoptes Scabiei?
Scabies-Scabies is a skin infestation w/ a microscopic mite
57
58
How is scabies transmitted?
1. Spread by direct contact w/infected person (prolonged)
59
What is the lifespan of a scabies mite?
1. The mite can live up to 1-2 months on a person and up to 48-72 hours off of a person
2. The mite burrows into the skin and lays eggs. The time between infestation and symptoms presenting is 30-60 days
3. All people in contact w/someone who has scabies will need to be treated
60
What are symptoms of scabies?
1. Severe pruritis
2. Small lesions develope into blisters usually on hands, wrists, feet or ankles.
3. Burrow tracts--- presents w/rash
61
How do we treat scabies?
Treatment will need to include the entire family and anyone who has been in close contact with the infected person
Medication
1. Scabicide- Permethrin (Elimite)
2. Lotions
3. Tpoical steriod for itch
4. Antibiotics for secondary infections
62
What should we teach familys about scabicide (permethrin- Elimite) administration?
Applied to the entire body chin down...under the nails and needs to be left on for atleast 8-14 hours. Best applied at night and removed in the morning with shower.
63
What education should we provide to a family treating scabies?
Wash clothes seprately in HOT water. Any items that cannot be washed place in tied bag for 48-72 hours to suffocate them
64
What is peiculosis capitus?
Head life--- very common, parasitic infection. The lice feed off of the blood supply on the scalp. Lice tend to be very abudnant as they hatch eggs contantly
65
How is head lice (pediculosis capitus) transmitted?
1. Person to person (very common in school-aged children)
2. Object to person
3. NOT CARRIED BY ANIMALS
66
What is the life span of pediculosis capitus (head lice) and what do they look like?
1. Small, grayish-tan wingless insects
2. Visible
3. Can live up to 2 days away from a human host
4. Life span of a female is 1 month
5. Use claws to hold to hair shaft
67
How do we treat head lice (pediculosis capitus)?
1. Medicated shampoos (prometrin)
2. Mechanical removal of nits (MUST DO)
3. Wash all linens
4. Vaccum/dry clean non laundry items
5. Repeat treatment in 7 days
6. Treat secondary infection as needed
68
What are symptoms of head life?
1. Small red lesions
2. Itchy scalp
69
Where do lice like to hide?
1. Behind ears
2. Around the nap of the neck
but can be anywhere
70
What is acne vulgaris (acne)?
It is an overgrowth of P.acnes it is a common skin problem in adolesents. Thought to have a genetic link
71
Comedome formation can be....
Open (whitehead)
Closed (back head)
72
What are the causes of acne vulgaris?
1. Hormones,
2. cosmetics,
3. exposure to oils,
4. possible link to dairy
73
How do we treat acne vulgaris?
1. General health promotion
2. Gentle cleansing, hair and scalp hygiene
3. Oil-free make-up
4. Keep your hands off
5. Lotions and creams
74
What medications can be used to help treat acne vulgaris?
1. Retinoids
2. Topical antibacterial agents
3. Systemic antibiotics
4. Oral contraceptives
75
If a patient is using topical creams for the treatment of acne vulgaris what should we educate them on?
Avoid sun or use sunscreen when outside.
76
What specific areas guide our treatment of burns? 3 major areas
1. Extent- Total body surface area (TBSA)
2. Depth
3. Severity
77
In terms of extent of burns what tools can we utilize to determine the extent?
Rules of nine burn scale
Lund browder brun scale
78
What are the 3 "depth categories" in burns?
1. Superficial (1st degree)
2. Partial thickness (2nd degree)
3. Full thickness (3rd and 4th degree)
79
Severity of a burn depends on the....
1. Percentage of total body surface area (TBSA) burned
2. Location
3. Child's age
4. General health
80
What layer of skin does a suferfical 1st degree burn effect, what is its appearance and is sensory intact?
1. Comparable to a really bad sunburn.
2. Destruction of the epidermis only.
3. Sensor intact (painful)
81
What layer of skin does a partial thickness (2nd degree) burn effect, what is its appearance and is sensory intact?
1. Red and moist blisters
2. Destruction of the epidermis and some of the dermis
3. Blisters w/in mins
4. Sensory intact
82
What layer of skin does a full thickness (3rd or 4th degree) burn effect, what is its appearance and is sensory intact?
3rd degree
1. Destruction of the epidermis, the dermis and the underlying subq tissue
2. Skin will apear charry black
3. May have visible veins involved
4. Sensory not intact
4th degree
1. effects All layers plus fasha and muscle & bone
2. Sensory not intact
83
What s/s might you have with a superficial burn?
1. Painful
2. No edema
3. Redness
4. blanches with pressure
84
True or false: Most accidental burns are a mixture of degrees?
True
85
What s/s might we see with a partial thickness burn?
1. Blistered
2. Moist
3. Painful
86
What s/s might we see with a full thickness burn
1. Dry
2. Discolored
3. No pain
87
Care of a minor burn includes?
1. Apply cold compress/cold rinse. NO ICE
2. Analgesia
3. Cleanse with soap/water-avoid friction
4. Tetanus-- Wound infection caused by a bacterial infection. If pt is up to date with immunization this is something to consider
5. Antimicrobial ointment
6. Loose clothing
7. Sunburn- Apply moisturizer
88
What is our primary concern with burns?
Airway managment and smoke inhalation
89
Care of a moderate and severe burn includes?
1. Assess, maintain airway, oxygen
2. Large bore IV access/fluids
3. Observe closely for s/s shock
4. Pain management
5. Wound care/ escharotomy (removal of eschar)
6. Nutritional support
7. Skin and musculoskeletal care
8. Emotional/Psychosocial support
90
