Exam 1

Question 1

Punch Biopsy

Answer 1

Used for Squamous cells

Question 2

Shave Biopsy

Answer 2

Basal Cell Carcinoma

Question 3

Skin Excision

Answer 3

Melanoma

Question 4

Wood’s light examination

Answer 4

fungal or viral

Question 5

Pruritus

Answer 5

sunburn

Question 6

Urticaria

Answer 6

hives

Question 7

Furuncles

Answer 7

boils. caused by staphylococcus,Treatment- do not squeeze, do not keep covered, make sure to clean area before putting antibiotic ointment.

Question 8

Methicillin- Resistant Staphylococcus Aureus (MRSA)

Answer 8

spread by contact, treated with vancomyicin

Question 9

Herpes Simplex Virus

Answer 9

never goes away, Stress, dry lips, sunburn on lips, fatigue, trauma, girls on their periods, fever, seen on brides and nursing students

Question 10

Fungal infections

Answer 10

keep body dry, clean, and give antifungal cream

Question 11

Scabies

Answer 11

Treatment is scabicides, wash everything in hot water and detergent

Question 12

Bed bugs

Answer 12

topical antihistamine for itching, get rid of bugs, heat can kill insects and eggs

Question 13

Psoriasis

Answer 13

A chronic auto-immune disorder, noninfectious disease of the skin in which epidermal cells are produced at an abnormally rapid rate. Treatment; topical steroids UV light therapy

Question 14

Rosacea

Answer 14

Condition that causes red patches and visible blood vessels on face. No cure

Question 15

Stasis Ulcers

Answer 15

Causes- poor circulation, constant high pressure on veins. Risk factors- age, obesity, varicose veins, cigarette smoking. Lose weight, use compression socks, dont smoke

Question 16

Peripheral vascular disease

Answer 16

Bad blood circulation. Pain will go away with rest, check neuro, capillary refills, at risk for pressure ulcers

Question 17

Skin cancer

Answer 17

Risk factors- pale skin, overexposure of sun. Noses and ears are most common

Question 18

patient teaching for skin cancer

Answer 18

Teach patients- if they are out in sun they need to wear sunblock, reapply sunblock every 2 hours, apply 30 mins before going into water and reapply after getting out of water, stay out of the sun between 10am-2pm. Use light clothing to cover your skin, wear hats, use sunglasses (you can get cancer in your eyes from the sun), do not use tanning beds.

Question 19

reapply sunblock

Answer 19

every 2 hours, and 30 mins before going into water and reapply after getting out.

Question 20

Stay out of the sun during

Answer 20

10am-2pm

Question 21

Wounds

Answer 21

take pics, chart the location, length, width, depth, color, exudate, type of tissue involved, surrounding tissue, presence of foreign body

Question 22

Stage 1 pressure ulcer

Answer 22

Do not scratch or moisturize. Do not rub on skin
can send home on stage 1.
nonblanchable and skin is intact

Question 23

Stage 2 pressure ulcer

Answer 23

Skin not intact, partial thickness, crack in the skin, may look like a small blister

Question 24

Stage 3 Pressure ulcers

Answer 24

full skin loss, Subcutaneous tissue may be damaged or necrotic, Damage extends to underlying fascia. Does not expose muscle or bone

Question 25

Stage 4 pressure ulcers

Answer 25

Full thickness skin loss, Can see tendons, bones, muscles, Sloughing (dead tissue), scabbing (eschar), purulent drainage

Question 26

Unstageable pressure ulcers

Answer 26

Have an eschar (scab over it)

Question 27

Suspected deep tissue injury

Answer 27

No tears, no rips in skin, but have bruising (dark bruising) will be seen in traumas

Question 28

Non surgical wound treatment for pressure ulcers

Answer 28

Dressings, electrical stimulation, wound irrigation, drugs, hyperbaric chambers

Question 29

wound vacs cannot be used on patients

Answer 29

patients on blood thinners or if they have an anticoagulant problem) Skin grafts

Question 30

Braden Scale

Answer 30

tells us the risk for pressure ulcers, higher the number the lower the risk, patient with 2-3 is high risk, 20 is no risk

Question 31

Factors affecting wound healing

Answer 31

Nutrition- high protein good carbs good fat Tissue perfusion (do they have good circulation Infection (are there any other infections) Age (younger people heal faster, older takes longer) Psychosocial (impact of the wound, diabetic patients not following doctors orders)

Question 32

Phases of wound healing

Answer 32

Hemostasis (fibrin) sends fibrogen to that area to clot Inflammatory phase when white blood cells go to the area Proliferation phase- fills up with tissues Remodeling- collagen goes to area to repair skin,etc

Question 33

Primary intention

Answer 33

can be sutured up. An incision the physician makes during surgery

Question 34

Secondary intention

Answer 34

burn, laceration, will scar

Question 35

Tertiary intention

Answer 35

delayed wound closure, may need wound vacs

Question 36

Cellulitis

Answer 36

Strep or staph involved deeper connective tissue, non compliant diabetics, Infection elsewhere in body that has moved to another portion.

Question 37

Isotonic exercises

Answer 37

exercises that have muscle shortening with active movement (ex. Bicep curls, squats, climbing up the steps, etc)

Question 38

Isometric exercises

Answer 38

muscle contractions without shortening ( there is no movement or only a minimum shortening of the muscle fibers) (ex. planks)

Question 39

Isokinetic

Answer 39

Muscle contractions with resistance provided by an external device (working on a machine)

Question 40

Mobility

Answer 40

ability to move about freely

Question 41

Immobility

Answer 41

inability to move about freely

Question 42

Bed Rest

Answer 42

an intervention that restricts patients for therapeutic reasons

Question 43

Metabolic changes

Answer 43

decrease in amount of nutrition intake, this decrease causes a decrease in the necessary amount for our body, calcium decreases and our body doesn’t get enough

Question 44

Respiratory Changes

Answer 44

Immobility causes an increase of a chance of pneumonia (we can use an incentives spirometer to decrease the chance of pneumonia) ( can teach them to deep breath, cough, and turn in bed. This helps relieve the particles in or lung)

Question 45

Cardiovascular

Answer 45

blood vessels constrict, patient may develop orthostatic hypotension, we may dangle patients at the bedside for 15 mins, increased cardiac workou

Question 46

Musculoskeletal

Answer 46

Muscle atrophy develops with decreased use of the musculoskeletal system. To determine if they have even muscle mass on both sides we will do exercises bilaterally. Skeletal changes- disuse osteoporosis, joint contracture. Passive range of motion- someone else moving the body part, active motion- patient moving the body part themselves. Always tent up the blankets on the feet to prevent foot drop.

Question 47

Urinary elimination changes

Answer 47

urinary stasis ( gravity pulls your urine down when standing up, when laying down your bladder stays in one spot can cause utis, kidney infections, stones, etc.) offer bedpan every 2 hours, insert an indwelling catheter (48 hours is the max a catheter can stay in. If it stays in longer it can cause infections which can lead to sepsis, and death). Leading sign of elderly uti is confusion. You can bladder scan patients and straight cath.

Question 48

Integumentary changes

Answer 48

too much pressure in one spot will cause a pressure ulcer. Turn the patient every 2 hours, increase fluid intake, good protein and carb diet, if incontinent check beds, keep clean, use purewick. Pad bony prominences (the coccyx, elbows, knees, knuckles, etc.)

Question 49

Psychosocial

Answer 49

What has happened to the patient's mental health. Many patients become depressed, do not get enough sleep. Patients may become hostile, giddy, fearful, anxious, etc. It is important to know how someone copes.

Question 50

GI system

Answer 50

Constipation- increase fluids, increase movement as much as possible, increase fiber.