integumentary (class 4)

Question 1

epidermis

Answer 1

five layers. melanin. keratin.

Question 2

dermis

Answer 2

capillaries & pain/touch receptors. blood vessels, sweat/sebaceous glands, collagen fibers.

Question 3

skin assessment history

Answer 3

onset/duration of problem.
characteristics.course. severity. precipitating/relieving factors. timing and circumstances. history of associated illness. presence of risk factors.

Question 4

physical assessment

Answer 4

private room. patient comfort. systematic head to toe. compare symmetry. general inspection. lesion-specific inspections: measure with metric system, appropriate terminolgy, remove cosmetics, oils, location, distribution, color, pattern, edges, size, elevation, exudate.

Question 5

primary lesions

Answer 5

caused directly by disease. present at onset of disease.

Ex. vesicles RT chicken pox. nodules RT RA.

Question 6

secondary lesions:

Answer 6

result from changes over time caused by disease progression, manipulation, or treatment.
ex: crusted, excoriated or infected lesion caused by scatching the vesicle, pressure ulcers, vascular ulcers RT PVD, scars, keloids.

Question 7

macule

Answer 7

flat, nonpalpable change in color

Question 8

papule

Answer 8

small elevated, solid mass, < 0.5 cm

Question 9

plaque

Answer 9

raised, flat lesion-groups of papules

Question 10

nodule

Answer 10

larger than a papule (more than 1 cm) raised solid lesion extending deeper into the dermis.

Question 11

vesicle

Answer 11

elevated, fluid-filled, thing wall

Question 12

pustule

Answer 12

elevated, pus-filled

Question 13

cyst

Answer 13

elevated, encapsulated in the SQ, fluid or semi-solid

Question 14

ulcer

Answer 14

deep, irregularly-shaped area of skin loss, dermis or SQ.

Question 15

pruritus

Answer 15

variable size of area. itch-scratch-itch cycle.

causes: may or may not be associatd with rash. environmental factors & allergies. emotional distress. secondary to systemic disease.
management: identify eliminate cause, meds to manage itch, secondary effects.

Question 16

Xerosis

Answer 16

common in older adults due to decrease lubrications and reduced moisture retention.
manifestations: pruritis, flaking of skin surfaces, secondary lesions & liechenification.

Question 17

nevi

Answer 17

macules and papules with defined borders. arise from melanocytes early in life and migrate up. dysplastic nevi- can become malignant.
management: monitor for changs in size, thickness, color, bleeding, or itching.

Question 18

keratoses

Answer 18

generally benign overgrowth and thickening. adults>50. tan, waxy, can appear greasy, commonly on face or trunk. seborrheic ketatoses: waxy or warty, uneven pigment, can be malignant.

Question 19

psoriasis

Answer 19

chronic, immune characterized by raised red round circumscribed plaques covered by silvery white scales.

Question 20

psoriasis: medication

Answer 20

steroids, topical: tar preps, calcipotriene.

Question 21

furuncle

Answer 21

inflammation of hair follices. deep firm rea painful nodule 1-5 cm.
contributing factors: trauma, poor hygeine, systemic disease.

Question 22

carbuncle

Answer 22

group of infected hair follices. multiple openings to skin surface, firm mass in SQ/dermis. common on neck, upper back, thighs. s/s: swelling & pain, systemic: chills, fever, malaise.
* usually staph aureus.

Question 23

cellulitis

Answer 23

localized infection of dermis & SQ tissue. area is red, swollen, and painful, diffuse borders. s/s fever, chills, HA, swollen lymph nodes. MRSA: HA-MRSA, CA-MRSA, 1/3 population+ is colonized.

Question 24

cellulitis treatment

Answer 24

culture to identify correct antibiotic. assess local and systemic symptomrs. cover draining lesions. handwashing & isolation. moist heat. immobilize & elevate, hospital for severe case. can progress to gangrene or sepsis.

Question 25

non-melanoma cancers:

Answer 25

fair skin, freckles, blond or red hair, blue or green eyes.

family hx. unprotected excessive exposure to uv radiation.

Question 26

actinic keratosis

Answer 26

sun damage, 20% convert to squamous cell carcinoma. erythematous rough macules shiny or scaly.