Wounds, Ulcers, and skin conditions Flashcards
(33 cards)
Woundsmodifiable risk factors
- autonomic dysreflexia
- Incontinence
- smoking
- obesity
- poor nutrition
- comorbidities (renal, cv, pulmonary, diabetes)
- depression
Wounds non-modifiable risk factors
- Decreased sensation
- activity, and mobility
- muscle atrophy
- completeness of injury
- Age
- history of previous wounds
- Increased tissue temp, moisture
- spasticity
What areas are at risk of a wound when in lying
- occiput
- elbows
- sacrum and coccyx
- heel
What areas are at risk of a wound when in side lying
- shoulder
- greater trochanter
- anterior knee
- malleolus
What areas are at risk of a wound when in sitting
- shoulder blade
- sacrum and coccyx
- ischial tubs
- posterior knee
- foot
What causes an ulcer
- Pressure (round sore)
- shearing (abrasion/scrape)
- friction (blisters can be a sign, spasticity are common causes)
- Deep tissue damage from banging or bumping (purple or bruising)
What are the 4 stages of wounds
Stage 1: reddened (non-blanchable)
Stage 2: skin is broken, small crater
Stage 3: deep crater, might be infected, may be black, dead tissue
Stage 4: deep through muscle to the bone or joint
What are 7 components used in describing wounds
location, size, wound base, wound edges, surrounding skin, stage, photos
Client education for wound prevention
- look at skin 2X/day, check all bony prominences, use a mirror and attendants
- look for change in temp, colour, temperature, texture, persistent erythema, discolouration
Tool for assessing risk of wound
Braden Scale
Wound Rx
- multidisciplinary team, dressings, mobility restrictions
- PT: HVPC level 1 evidence for wound healing
What is Psoriasis? What causes it?
- autoimmune disease that affects the skin
- faulty signals that speed up the growth cycle of skin cells: profound cutaneous inflammation and epidermal hyperproliferation
What are the 5 cardinal signs of psoriasis
- plaque (raised lesion)
- well circumscribed margins
- bright salmon red colour
- silvery micaceous scale
- symmetrical distribution
Common sites for psoriasis
- Extensor surfaces over bony prominences (elbows, knees)
- scalp
- retroauricular, ears
- palms and soles
- umbilicus
- penis
- lumbar
- shins
- nails plaques
…but can affect any area
Does psoriasis normally affect the inside or outer side of the joint
outer side - unlike eczema
Complications associated with psoriasis
- physical (pruitis, bleeding of lesions)
- emotional and psychological (isolation, loss of self-esteem)
- economic (cost of meds, time away from work)
- severe psoriasis is associated with risk of cardiovascular disease and death, psoriatic arthritis
Psoriasis Rx
- Topical creams containing glucocorticoids
- Tars
- vitamin D or A
- phototherapy with UV light
- systemic therapy with immunosuppressive drugs
What is eczema? What is it’s apperance?
- form of dermatitis or inflammation of the epidermis (skin outer layer)
- itchy, red, scaly disorder
2 types of eczema
Atopic dermatitis
Contact dermatitis
Atopic dermatitis is also referred to as _____
Endogenous eczema
What is atopic dermatitis? What is the underlying cause?
intensely itchy inflammatory skin disorder associated with “atopy”
- predisposition toward developing certain allergic hypersensitivity reactions
- asthma, hay fever, and allergic conjunctivitis
Presentation of atopic dermatitis
- itchiness is the most outstanding feature (pruitis)
- lichenification (thickening skin lines)
- excoriations (scratching or picking at skin)
- crusting
3 phases of atopic dermatitis and their corresponding distributions
- Infantile (2mo-2years)-facial and extensor distribution
- Childhood-dry skin, flexural distribution (popliteal and cuboid fossa)
- Adult-atopic dermatitis generally improves with age, less flexural distribution, primarily affect the hands
Atopic dermatitis Rx
- avoid irritating factors
- Use moisturizers, topical glucocorticoids, oral antihistamines, UV therapy for resistant or severe cases
