Flashcards in Integ Deck (49):
mgmt of cellulitis includes:
antibiotics, elevation, & cool wet dressings
herpes zoster p/w ..
pain and tingling along a dermatome; progression to red papules along distrib of infected nerve
-postherpetic neuralgia pain
what modalities are contraindicated with herpes zoster?
heat or US (can incr severity of sx)
PT intervention for psoriasis?
itching and pain from cracked, dry lesions (chonic AUTOIMMUNE disease)
the LONG TERM side efx of corticosteroid use include:
osteoporosis, immunosuppression, tendon ruptures, DM, GI irritation, myopathy, low K+
an autoimmune chronic diffuse disease of CT causing fibrosis; can be lmtd or diffuse systemic
tx for scleroderma
corticosteroids, immunosuppressive agents, vasodilators, analgesics
PT precautions when dealing w scleroderma?
pt will be sensitive to pressure; acute HTN may occur so monitor BP closely
CT disease causing degen of ms
-affects proximal ms mostly
rapid onset, may even req MV ; cardiac involvement
PT for polymyositis
fatigue mgmt, conservation of nrg principles, exercise at LOW levels of resistance/intensity, AVOID OVERWORK/FATIGUE
benign skin cancer includes:
seborrheic keratosis, actinic keratosis, and benign nevus
of the carcinomas of the skin, which has a higher risk of metastasizing?
squamous cell (poorly defined margins) >> basal cell (raised patch)
what are the steps to clinical exam of malignant melanoma?
color (black/blue/red esp)
diameter (> 6mm)
what are petechiae?
tiny red/purple hemorrhagic spots on the skin
excessive dryness of skin with shedding of epithelium
brown skin is indicative of..
burns which require removal of eschar and skin grafting to heal are..
3rd degree and above (full-thickness)
what is the rule of nines?
head & neck = 9%
ant trunk = 18%
post trunk = 18%
arms = 9% each
legs = 18% each
perineum = 1%
3 zones of burn wounds:
1. zone of coagulation: cells irreversibly injured
2. zone of STASIS : cells partially damaged, still may die (usually within 1-2 days)
3. zone of hyperemia: cells very minimally injured
critical burn involves:
10% of body with 3rd deg burns & >30% w 2nd deg
leading cause of death after a burn:
phases of healing after a burn:
1. inflammatory phase (3-5 days)
2. proliferative/granulation/fibroblastic phase
3. maturation phase : tissue remodeling lasts up to 2 YEARS
--scar immature at 6-12 weeks (bright pink)
emergency care for a burn:
immersion in cold water, cover burn with sterile bandage or clean cloth NO OINTMENTS
what are the common topical medications (antibacterial agents) used in burn management?
1. Ointments : bacitracin, polymyxin B, Neomycin
2. Silver sulfadiazine: AVOID at term pregnancy
3. Sulfamylon : penetrates thru eschar
dressings for burns include:
silver impregnated, hydrogels (min to mod exudate), petroleum-impregnated and gauze
hydrotherapy immersion is contraindicated for..
pts w severe cardio renal or pulmonary restrictions
after a graft, how long should you hold PT?
to reduce scar formation after a burn, manual techniques include..
deep friction massage
compression is contraindicated if..
if a pressure ulcer has penetrated bone, it is considered..
negative pressure wound therapy (open-cell foam dressing) helps to ..
maintain a moist wound environment, control edema, increase localized blood flow, and reduce infectious materaial
hyperbaric oxygen therapy is contraindicated when?
untreated pneumothorax & some antineoplastic meds
for most ulcers, you should clean with..
Normal saline (0.9% NaCl)
irrigation pressure to clean a wound should be..
hydrotherapy is indicated for pressure ulcers with..
large amt of exudate, slough and necrotic tissue
if using e-stim to encourage wound healing, you should..
use CONTINUOUS waveform application with DIRECT current; place cathode in wound
hydration for a pt with a wound =
types of selective debridement:
if a pt p/w a wound w moist, necrotic tissue , the best form of debridement would be..
mechanical, sharp OR enzymatic
after eschar has been cross hatched, how should you debride the wound?
via enzymatic debridement
what type of wounds are contraindicated to use autolytic debridement?
infected, dry gangrene, if pt is immunosuppressed
for stage I & II pressure ulcers withOUT exudate, the best dressing would be..
if a wound has a moderate to large amount of exudate and is infected, the best dressing would be..
alginate OR continuous dry gauze (heavily exudating wound)
if a wound has only minimal/mild exudate , what type of dressing should be used?
hydrocolloids ; possibly foams
hydrogels should be used..
in partial and full thickness wounds with necrosis and slough; also BURNS and tissue damaged by radiation but NOT for heavily exudating wounds