Week 9: Skin Care Flashcards
Functions of the Skin
- Protect underlying structures
- Regulate body temperature
- Sensory input
- Stores fat
- Metabolism of salt and water
- Gas exchange
- Production of vitamin D
Xerox is
Extremely dry, cracked and itchy skin.
Xerosis is caused by
-Decrease in epidermal filaggrin, which is a protein required for binding of keratin into macrofibrils.
Xerosis is primarily found on the
- Extremities (mostly the legs)
- May affect trunk and face
Pruritus
- Itchy skin
- Can cause skin injury secondary to scratching
Pruritus can be aggravated by
- Perfumed detergents
- Fabric softeners
- Heat
- Sweating
- Restrictive clothing
- Exercise
- Medications
Pruritis may result from
-Systemic disease such as chronic renal failure, biliary or hepatic disease.
Failure to control pruritus can increase the risk for what?
- Eczema excoriation
- Cracks
- Infection
Scabies
- Causes intense itching
- Caused by tiny mite (sarcoptes Scabiei)
- Contagious, easily transmitted through close physical contact; intimate or casual.
How is scabies diagnosed?
Visually or via skin scraping
How is scabies treated?
- Prescribed lotions and creams
- Clothes and linens need to be washed in hot, soapy water and dried with high heat.
- Rooms need to be cleaned and vacuumed.
Purpura
- Fragility of dermal capillaries secondary to dermal thinning causing blood vessels to rupture -> extravasation of blood into surrounding tissue.
- Increases with age.
- Commonly seen on dorsal forearm and hands.
What makes a person more susceptible to purpura?
Blood thinners
Skin Tears
- Occurs because the skin is thin and fragile.
- Painful, acute, accidental in nature.
Management of Skin Tears
- Proper assessment
- Control of bleeding
- Cleanse with nontoxic solution
- Appropriate dressing
- Management of exudate
- Prevention of infection
What are types of keratosis?
- Seborrheic Keratosis
- Actinic Keratosis
Seborrheic Keratosis
- Benign growth
- Mainly see on trunk, face, scalp, and neck
- Waxy, raised, stuck-on appearance
- Flesh colored or pigmented, various sizes
Actinic Keratosis
- Precancerous
- Related to exposure to UV light
- Rough scaly sandpaper patches
- Pink to reddish brown with erythematous base
What increases the risk for actinic keratosis?
- Increased age
- Fair complexion
Herpes Zoster (Shingles)
-Viral infection caused by reactivation of the varicella-zoster (chicken pox) virus
Herpes Zoster (Shingles) are preceded by
- Itching
- Tingling
- Rash along the dermatology prior to outbreak of vesicular lesions
Signs of Herpes Zoster (Shingles)
- Lesions that rupture, crust over and heal
- Infectious until crusts over
Treatment for Herpes Zoster (Shingles)
- Analgesics
- Calamine lotion
- Antiviral agents
- Zoster vaccine if greater than 60 years old
What are complications of Herpes Zoster (Shingles)?
- Postherpetic neuralgia
- Eye involvement
Candidiasis
- Caused by fungus Candida albicans found on the skin
- Found in warm, moist areas of the skin, like skin folds, axillae and groin.
What are risk factors for candidiasis?
- Obesity
- Malnourishment
- Antibiotic or steroid use
- Immunocompromised
- Chemotherapy
- Diabetes
Candidiasis is commonly called what when inside the mouth?
Thrush
Skin cancer: Basal Cell
- Most common malignant skin cancer
- Slow growing and metastasis is rare.
- Early detection and treatment minimizes damage.
Skin Cancer: Basal Cell is triggered by what factors?
- Extensive sun exposure
- Burns
- Chronic irritation
- Ulceration
Skin cancer: Squamous cell
- Aggressive and high incidence of metastasis
- Slightly different clinical manifestations and may be overlooked
What are major risk factors for squamous cell skin cancer?
- Sun exposure
- Fair skin
- Immunosuppression
Treatment for squamous cell skin cancer depends on
Size
Histology
Patient preference
Melanoma
- Neoplasm of the melanocytes
- Multicolored, raised, asymmetrical, irregular borders.
What are risk factors for melanoma?
- More than 50 moles
- Sun sensitivity
- History of excessive sun exposure
- Severe sunburns
- Tanning beds
Indoor Tanning
Increases the risk for melanoma by 75% when started before age 35.
Pressure Ulcers
A localized injury to the skin and/or underlying tissue, usually over a bony prominence as a result of pressure or pressure in combination with shear.
What are characteristics of pressure ulcers?
- Most frequently occur on the posterior aspects of the body, especially sacrum, heels and greater trochanter.
- May also e seen on lateral knees and ankles, pinna of the ears, occiput, elbows and scapulae.
Skin Changes at the End of Life
- Skin failure is defined as “an event in which the skin and underlying tissue die due to hypoperfusion that occurs with severe dysfunction or failure of other organs”
- Occurs during the last days or weeks of life
- Unavoidable part of dying and occur even if evidence-based strategies are employed
What are risk factors for pressure ulcers?
- Changes in skin
- Comorbid illnesses
- Nutrition status
- Frailty
- Surgical procedure (orthopedic/cardiac)
- Cognitive deficits
- Incontinence
- Reduced mobility
Pressure ulcers in darker skinned patient’s
Redness or blanching may NOT be the first sign of PU in darker pigmented persons but may look purplish in color or look like a bruise
Prevention of PU
-Addressing limited mobility, compromised skin integrity and nutritional support
Assessment of PU
- Thorough assessment of skin: Braden Scale
- Nutritional evaluation
- Laboratory studies
- Positioning
- Incontinence care
Know factors for Braden scale
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