Chapter 49-Integumentary Disorders

Question 1

What are the five major functions of the skin?

Answer 1

protection, temperature regulation, vit D metabolism, sensation and excretion

Question 2

What is the integumentary system comprised of?

Answer 2

Hair, skin & nails

Question 3

What is the major source of vitamin D for the body?

Answer 3

Epidermis, vit D enters by UV light that enters through circulation & GI system to facilitate calcium absorption

Question 4

where is sensation controlled?

Answer 4

Dermis - many nerve receptors that communicate with the CNS

Question 5

Where are eccrine sweat glands?

Answer 5

most of the body’s surface

Question 6

Where are apocrine sweat glands?

Answer 6

hair follicles of the armpits and genitalia

Question 7

What are Langerhans cells?

Answer 7

outermost cells of the immune system located in the epidermis. They ingest foreign substances and present the antigen to the body’s T cells which destroy the pathogen if needed.

Question 8

What does the 3rd layer of skin, the subcutaneous tissue, contain?

Answer 8

adipose tissue, connective tissue, nerves and blood supply.

Question 9

When complete death of a hair follicle is induced by heredity, stress or illness, what is this called?

Answer 9

Alopecia (baldness)

Question 10

Coloration of this body part provides information about the perfusion status of the distal regions of the body.

Answer 10

nailbeds

Question 11

All of the skin’s primary functions are affected by what?

Answer 11

age

Question 12

What is included in the history assessment?

Answer 12

Demographics (age/race), personal history-comorbid conditions/medications, family history (many skin conditions are genetically linked), diet and environmental factors

Question 13

What is included in a physical assessment of the skin?

Answer 13

color & temperature, moisture, integrity, cleanliness, tissue changes, vascular markings and lesions

Question 14

Give an example (s) of a macule.

Answer 14

freckles, flat moles, petechiae (non-blanching, red to purple flat lesions)

Question 15

An example of a patch.

Answer 15

port-wine stain, mongolian spots, vitiligo (irregularly shaped)

Question 16

An example of a papule

Answer 16

lichen planus, elevated moles, warts

Question 17

Example of a plaque

Answer 17

Atopic dermatitis, psoriasis, mycosis fungoides, eczema

Question 18

Example of a wheal

Answer 18

Insect bites, allergic reaction

Question 19

Example of a nodule

Answer 19

lipoma (fatty, benign tumor)

Question 20

examples of a tumor

Answer 20

lipoma, cancer, benign growth.

Question 21

What is a cyst?

Answer 21

elevated growth in the dermis or subQ tissue filled with a liquid or solid substance
ex: epidermoid or sebaceous cyst

Question 22

A vesicle?

Answer 22

elevated, filled with serous fluid and located in the epidermis. less than 1 cm
ex: small blister, varicella (chickenpox), herpes zoster, herpes simplex

Question 23

What is a bulla?

Answer 23

filled w/ serous fluid, greater than 1 cm

ex: large blister, partial-thickness burns, pemphigus vulgaris (autoimmune disorder, large breakout of blisters)

Question 24

a pustule?

Answer 24

filled with purulent fluid, size varies

ex: acne, folliculitis (inflammation of follicle)

Question 25

a scale?

Answer 25

flakes of stratum corneum, may be dry or oily | ex: skin flaking after a drug rash, scaly dermatitis

Question 26

a lichenification?

Answer 26

caused by excessive manipulation of skin (scratching, causing epidermis to become rough and thick ex: chronic dermatitis

Question 27

an excoriation?

Answer 27

linear, hollowed out appearance, wound bed is dry | ex: abrasions from scratching

Question 28

fissure?

Answer 28

linear, cracked tissue that may extend into the dermis, wound bed dry or moist ex: athlete's foot

Question 29

what is an erosion?

Answer 29

limited to epidermis, red/moist & concave wound bed, heals without scar formation ex: open vesicles or bullae

Question 30

what is a crust?

Answer 30

dried exudate from a wound bed (serum, blood or pus) | ex: eczema, scab, impetigo (bacterial infection in children, school sores)

Question 31

what is an atrophy?

Answer 31

thinning epidermis or dermis or both, skin appears thin and tears easily ex: skin in older adults, striae (stretch marks)

Question 32

For pt's in acute or long-term care, this risk assessment tool predicts the risk for skin changes caused by immobility, moisture and inadequate nutrition.

Answer 32

Braden Scale

Question 33

What is onycholysis?

Answer 33

The nail plate detaching from the nailbed

Question 34

What are the nursing implications for a skin biopsy?

Answer 34

Monitoring and supporting the patient's response to the procedure, then biopsy care instructions

Question 35

What lab studies are done to identify a pathogen?

Answer 35

culture, site biopsy, CBC, chemistry screening, blood cultures and ultrasound

Question 36

What are the infectious sources to the skin?

Answer 36

fungal, bacterial, or viral