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Patient Care Theory (Sem 2) > Integumentary (W2) > Flashcards

Integumentary (W2) Flashcards

1
Q

What does a skin evaluation include

A

Inspection, palpation, colour, moisture, temp, texture, turgor, lesions

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2
Q

Eczema (atopic dermatitis)

A

Red, patchy, itchy skin (infections can be due to scratching/open sores)

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3
Q

Contact dermatitis (form of eczema)

A

In response to an allergen, due to mites under the skin and can spread rapidly; looks like itchy bumps/blisters, edema

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4
Q

Psoriasis

A

Red, thick areas covered with white/silver scales/skin lesions

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5
Q

Why does pemphigus vulgaris cause painful blisters that create new ones when pressed

A

Body mistakenly identifies proteins in skin as foreign and attacks

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6
Q

What can meningococcemia cause

A

DIC

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7
Q

What is the rocky mtn spotted fever transmitted by

A

Tick bites

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8
Q

What are the early s/s of rocky mtn fever

A

Flu-like, rash 2-4 days after fever

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9
Q

What is necrotizing fasciitis

A

Caused by group A strep, where the bacteria enters body through skin creating a deep infection (rare and can be fatal)

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10
Q

What are the s/s of necrotizing fasciitis

A

Fever, HoTN, redness, swelling/pain, changes to skin colour

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11
Q

What will a colostomy on the right side require to cover

A

Sometimes only a pad

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12
Q

What will a colostomy on the right require to cover

A

A bag or appliance

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13
Q

Why is the ileostomy bag filled with liquid

A

Because an ileostomy is the ileum brought to the surface of the abd, and there waste presents as liquid

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14
Q

What is the leading cause of death in a fire

A

Smoke inhalation

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15
Q

What is the most common chemical of combustion

A

Carbon monoxide

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16
Q

CO binding to Hb is ___x stronger than O2

A

200

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17
Q

What are the four questions you should always ask a pt in a fire

A

-length of exposure
-enclosed space
-what was burning
-any LOC?

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18
Q

What are the early s/s of CO poisoning

A

Headache (throbbing at the temples), altered mental status, N/V, tachypnea, tachycardia, collapse, seizure, coma

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19
Q

How does a hyperbaric chamber work

A

Increases atmospheric pressure, and helps to displace the CO and increase the amount of O2 dissolved and available to the tissue

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20
Q

What is the pathophysiology behind burns

A

-cell membranes are ruptured and destroyed
-blood coagulates
-proteins denature, skin layers coagulates
-histamines release = vasodilation causing capillaries to leak plasma which seeps into interstitial space
—>larger burn can cause mass fluid loss and hypovolemia

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21
Q

Zone of coagulation

A

Dead cells! White/charred appearance

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22
Q

Zone of stasis

A

Red cells! Blood supply is precarious

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23
Q

Zone of hyperemia

A

Intact circulation! Blanches, heals within 7 days

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24
Q

What are the body’s four staged responses to trauma

A
  1. Emergent
  2. Fluid shift
  3. Hypermetabolic
  4. Resolution
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25
Q

What is the emergent phase/stage 1

A

IMMEDIATELY AFTER, pain response, catecholamine release, tachycardia, tachypnea, mild HTN

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26
Q

What is the fluid shift phase/stage 2

A

18-24 HR AFTER, reaches peak in 6-8 hr, fluid shifts from intravascular to extravascular [massive edema] damaged cells initiate inflammatory response = increased BF to cells,

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27
Q

What is the hypermetabolic phase/stage 3

A

DAYS-WEEKS, is a large increase in the body’s need for the nutrients as it repairs itself

28
Q

What is the resolution phase/stage 4

A

Scar formation/rehabilitation

29
Q

What are some complications of burns

A

Hypothermia, hypovolemia, eschar, infection, organ failure

30
Q

Cyanide is a product of what materials burning

A

Nylon, wool, polyurethane, urea formaldehyde, hydrogen chloride, plastics

31
Q

It takes more __ current to have the same affect of __ current

A

DC, AC

32
Q

How many amps does a standard household circuit carry

A

15 or 20

33
Q

How does 1-10mA affect the body

A

Almost no shock/hardly felt

34
Q

How does 10-20mA affect the body

A

Painful shock, full muscle control

35
Q

How does 20-47mA affect the body

A

Serious shock, asphyxiation

36
Q

How does 55-100mA affect the body

A

VF can occur (death at 100-200mA)

37
Q

How does over 200mA affect the body

A

Severe burns, muscle contraction, internal organ damage

38
Q

Why is CA good for a pt w electrical burns

A

Heart muscle stopped due to pressure on chest prevents VF which improves survival odds

39
Q

What is different about triaging if pts have been struck by lightening

A

It is reversed (those who are alive are likely to stay alive)

40
Q

How do you treat a chemical burn (step by step)

A

-dust off powders
-irrigate for 10-20 mins (unless hydrofluoric acid)
-cover with dry dressing
**aim to get SDS and more info about the substance)

41
Q

How long do you irrigate an acidic burn

A

10 mins

42
Q

How long do you irrigate an alkaline burn

A

20 mins

43
Q

How do you treat a burn from hydrofluoric acid

A

Topical calcium gluconate gel (or injection directly into the skin)

44
Q

What are the most common injuries associated with burns

A

, TBI, thoracic or abd injuries

45
Q

Superficial thickness are AKA

A

First degree burns

46
Q

What are the characteristics of superficial burns

A

Only epidermis is affected, may be red and dry, will likely blanch with pressure but will never blister [heals over a few days]

47
Q

Superficial partial thickness burns are AKA

A

2nd degree burns

48
Q

What are the characteristics of superficial partial thickness burns

A

Demis is slightly affected, hair and sebaceous glands are affected, can look cherry red or pale, sluggish cap refill, can have blisters [healing can take up to 6w]

49
Q

Full thickness burns are AKA

A

3rd degree burns

50
Q

What are the characteristics of full thickness burns

A

Subcutaneous and fatty layers of skin are affected, appears pearly white/charred/any colour, usually painless, no capillary refill

51
Q

Full thickness burns can ALSO be called ___ if ___ is involved

A

4th degrees burns // muscle or bone

52
Q

What are some key details about full thickness burns with eschar

A

It appears dry/chalky, inelastic/swelling beneath the eschar can cause compartment syndrome

53
Q

If chemicals are inhaled, what is a major issue it may cause

A

Pulmonary edema and ultimately difficulty in ventilations

54
Q

What are some S/S of AW involvement of burns

A

Burns to face/neck, singed facial hairs, soot around mouth/nose, black tongue, hoarse voice, stridor, respiratory distress

55
Q

What qualifies as a major burn

A

> 25% TBSA 2nd degree burn in adult
20 TBSA 2nd degree burn in child
10% TBSA 3rd degree burn in adult
-any 3rd degree burn in child
-any AW burn

56
Q

If a burn pt has an altered LOA, what are some differential diagnosis for causes

A

Hypoxia from partial AW occlusion, CO poisoning, cyanide poisoning, head trauma

57
Q

What are some things you may see if a pt has been abused can result is a burn

A

Uniform burn depth/size, pattern consistent with splattering liquids, burn is in shape of objects

58
Q

What should you do if clothing has adhered to skin

A

Cut around/away [do not rip or tear it off]

59
Q

What is the parkland formula

A

Fluid to give pt = 4mL x %TBSA x Kg of pt (1/2 in first 8h, 1/2 over following 16h)

60
Q

What drugs may you consider for a burn pt

A

Acetaminophen, NSAIDs, narcotics (low dose)

61
Q

When would you consider calling ORNGE for a burn pt

A

-pt entrapment
-pt req definitive AW management or significant fluid resuscitation
-eschar poses threat to life/limb

62
Q

When would you transfer your burn pt to a Burn Facility

A

-full thickness any age
-partial thickness >10%TBSA any age
-any burn involving critical areas (face/hands/feet/genitalia/perineum/skin of truck)
-presence of inhalation injury

63
Q

How do you treat 1st degree burns

A

Moist sterile dressings

64
Q

How do you treat 2nd degree burns <15% TBSA

A

Moist sterile dressings

65
Q

How do you treat 2nd degree burns <15% TBSA

A

Dry sterile dressings

66
Q

How do you treat 3rd/4th degree burns

A

Dry sterile dressings

Patient Care Theory (Sem 2) (10 decks)

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