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Med surg integumentary > integument > Flashcards

integument Flashcards

1
Q

Epidermis

A

outer layer of mostly dead skin cells-stratum corneum. provides protective hardened layer of keratin.

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2
Q

what is our first line of defense?

A

Intact skin.

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3
Q

dermis

A

“true skin” consists of connective tissue, blood vessels, hair follicule, sweat glands, elastic fibers, nerves.

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4
Q

subcutaneous tissue.

A

layer of tissue that attaches to muscle and bone. connective tissue and fat cells.

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5
Q

what gives skin color

A

melanin

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6
Q

production of melanin is determined by what gland

A

pituitary

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7
Q

the more melanin the darker the skin

A

know

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8
Q

protection is the most important thing

A

know

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9
Q

areas of intense friction causes a ___ usually has fluid underneath it

A

blister.

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10
Q

Temperature regulation is done by which four ways

A

radiation, conduction, evaporation, convection.

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11
Q

sensory processing

A

helps our body process warning signs. Monitors outside enviorment. Specialized nerve endings that respond to pressure, pain, heat and cold.

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12
Q

our skin helps us sythesize certain chemicals of mainly vit d we need UV light so sun exposure is needed

A

for healthy bones and teeth

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13
Q

where are hair follicles located

A

in the dermis

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14
Q

humans have hair everywhere but

A

the palms of their hands, soles of feet, nipples, lips, penis and labia.

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15
Q

hair is formed by hundreds of strands of keratin with amino acids.

A

scalp hair grows the fastest.

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16
Q

when does hair life slow down and texture change?

A

midlife.

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17
Q

decreased melanin production results in

A

gray hair

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18
Q

we inherit our hair type.

A

know

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19
Q

age, nutrition, wellness, illness, and hormonal levels affect hair production

A

know

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20
Q

Sebum

A

lubricates skin and hair from drying out and cracking

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21
Q

sebaceous glands can become blocked. Mostly during puberty.

A

blockage can appear to be light then later dark. Black head and can turn into a pestual and can be inflammed and cause acne.

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22
Q

finger and toe nails are considered an organ in the integumentary system.

A

hardened layers of kertain, provide protection, all use them as tools to grasp and pick things up.

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23
Q

assess color, texture and distrubution. know if there is any lesions present and measure them, chart location. Look for abnormal findings like lice or scaling skin.

A

look at nails and nail beds. note any kind of changes in the color of the nail bed and capillary refill time.

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24
Q

most useful tools when assessing skin and risks is the BRADEN SCALE

A

it is scored by numbers then add the numbers with a total and will help you design interventions

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25
Q

Pressure sore staging

Stage 1

A

redness

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26
Q

Pressure sore staging

Stage 2

A

blistering or skin tear.

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27
Q

Pressure sore staging

Stage 3

A

shallow crater with drainage.

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28
Q

pressure sore staging

Stage 4

A

deeply ulcerated tissue, exposed muscle and bone, sepsis.

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29
Q

Assessing nails will give us an idea of

A

Oxygenation

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30
Q

clubbing indicates

A

a long term condition that leaves them with poor oxygenation

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31
Q

Integumentary diagnostic tests

A 
C&S
visual inspection
allergy test
Woods light test 
potassium hydroxide test
fungal cx 
skin biopsy.
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32
Q

Wood’s light exam

A

a type of blacklight that will show us 10% of types of fungal inf. that can be in the hair and scalp but can be used for other areas.

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33
Q

potassium hydroide test

A

for fungal inf. they do a scraping of the inf skin and bathe it with potassium hydroxide and itll produce heat and itll dissolve itself and itll show filament threads between cells to show type.

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34
Q

Drug therapy.

A 
Corticosteroids, antihistamines
antibiotics, antiseptics
scabiecidies, pediculocides
antiseborreic agents
keratolytics
standard precautions when applying topical med over impaired skin.
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35
Q

Wet dressings

A

cooling soothing effect.
sterile procedure for broken skin
dry gauze placed on area, saturated with prescribed solution.
left in place until dry as a method of debridement.

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36
Q

Therapeutic baths

A 
no soap, warm water. 
Gentile application to submerged parts.
Inflammation and itching relief.
aid in removal of crusts and scales. 
products used: oatmeal, cornstarch, baking soda, mineral oil.
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37
Q

surgical excision

A

laser therapy
can reduce highly pigmented undesireable areas. can coag vessels to stop bleeding, to remove tattoos. to remove excessive hair.

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38
Q

LASER acronym

A 
LIGHT
AMPLIFICATION
STIMULATION
EMISSION
RADIATION
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39
Q

when present for the removal of lesions be sure your wearing a

A

mask
eye protection
to prevent ploom in the air so you dont contract a fungal inf.

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40
Q

cryosurgery

A

liquid nitrogen used to remove lesions.

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41
Q

Phototherapy

A

UV lights can be used for psorisis.that will dry up itchy scaling skin.

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42
Q

lifestyle changes

A

stress worsens conditions. Stay out of sun,

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43
Q

a physical force that separates layers of tissue in opposite directions such as seated client slides downward by using a lift sheet and encouraging the use of a trapeze

A

shearing

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44
Q

a general term that refers to an inflammation of the skin, common sign in skin disorders accompanied by red rash

A

dermatits.

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45
Q

itching

A

pruritus.

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46
Q

blackhead

A

comedome

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47
Q

a method of removing surface layers of scarred skin

A

dermabrasion

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48
Q

the nose becomes pernamently enlarged, red, nodular, and bulbous

A

rhinophyma

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49
Q

a chronic, noninfectious inflammatory disorder of the skin that affects both men and women- onset young and middle adult hood

A

psoriasis

50
Q

a combo of UV light therapy and photo sensitizing psoralen drug used for severe , diabling psoriasis that does not respond to tx

A

photochemotherapy

51
Q

is caused by an infestation with tiny itch mites (sarcoptes scabei)

A

scabies.

52
Q

are superficial fungal inf.

A

Dermatophytoses (tinea) also commonly called ring worm

53
Q

Dermatophytes (tinea)

A

are parasitic fungi that invade the skin, scalp, and nails.

54
Q

also known as shingles, a skin disorder that develops years after an inf with varicella (chicken pox) more frequent with middle aged to older adults as well as those immunocompromised.

A

herpes zoster.

55
Q

typically with those who have a darker skin pigment skin tend to form this. its an overgrowth of scar tissue.

A

keloids.

56
Q

a dermatologic condition associated with an excessive production of secretions from the sebaceous glands. not always confined to the scalp but usually there.

A

seborrhea.

57
Q

___ ___ is red areas covered by yellowish, greasy-appearing scales.

A

seborrheic dermatitis.

58
Q

baldness. a condition that affects the hair follicles and results in partial or total hair loss.

A

alopecia

59
Q

__ eggs, laid by adult females, are tightly cemented to the side of hair shafts. small yellow-white ovals

A

nits

60
Q

is a fungal dermatophyte infection of the fingernails or toenails

A

Onychomycosis

61
Q

is the med term for an ingrown toenail.

A

Onychocryptosis

62
Q

a professional trained to care for feet. Typically for clients with diabetes or peripheral vascular disease.

A

podiatrist.

63
Q

a chronic skin disorder that manifests in a variety of ways, generally a rosy appearance.

A

Rosacea.

64
Q

redness of the skin

A

Erythema

65
Q

means of removing tissue by applying extreme subfreezing cold with a probe or agent such as liquid nitrogen

A

cryrosurgery

66
Q

a procedure that uses electrical energy converted to heat to destroy or remove superficical growths from the skin

A

electrodessication

67
Q

an inflammatory disorder that affects the sebaceous glands and hair follicules

A

acne vulgaris

68
Q

infestation with lice

A

pediculosis

69
Q

practitioner who specilizes in care for feet

A

podiatrist.

70
Q

The skin is composed of two layers; epidermis, the outermost layer and the dermis. the epidermis contains an outer layer of dead skin cells, the stratum corneum, that forms a tough protective protein called keratin.

A

The epidermis is contantly shed and replaced with epithelial cells from the dermis every day. The epidermis is replaced every 35-45 days.

71
Q

small, brown, pigmented spots known as liver spots form in the hands, and forearms of older ppl.

A

senile lentigines.

72
Q

small,yellow or brown pigmented raised lesions that appear on face and trunk-some a precancerous.

A

senile keratoses

73
Q

what gland releases water and electrolytes

A

Eccrine gland

74
Q

what gland is found around nipples, in the anogenital region, in the eyelids, in the mammary glands of breasts and in the external ear canals-where secretion is called cerumen

A

Apocrine gland

75
Q

three things to document during assessment

A

if they have lesions, how long theyve been present, exposed to new products etc.
assess color, distrubution, and texture.

76
Q

pressure sores, also known as decubitus ulcer, occurs when capillary blood flow to an area is reduced. may happen when skin over a bony prominence is compressed between the weight of the body and a supporting surface 4 a prolonged period.

A

common locations is over the coccyx and sacrum in lower spine, the hips, heels, elbows,shoulder blades, ears and back of head. Braden scale determines risk.

77
Q

elevated, obvious raised boarder, solid

A

papule

78
Q

elevated round, filled with serum

A

vesicle

79
Q

elevated irregular boarder, no free fluid.

A

wheal

80
Q

elevated raised boarder filled with pus

A

pustule

81
Q

elevated solid mass extends to deeper tissue

A

nodule

82
Q

encapsulated round, fluid filled, or solid mass beneath skin

A

cyst

83
Q

two types of dermatitis
+allergic contact dermatitis develops in people who are sensitive to one or more substances such as drugs. fibers in clothes, cosmetics, plants, and dyes.
+irritant dermatitis.

A

know

84
Q

factors that contribute to acne vulgaris

A

rise in androgen hormone levels that occur when secondary sex characterisitics are developing. androgens increase the size and activity of sebaceous glands and provides an ideal area for bacteria overgrowth.

85
Q

tx for psoriasis
Psoriasis is characterized by patches of erythema covered with silvery scales usually on the exterior surfaces of the elbows, knees, trunk, and scalp. The lesions are obvious and unsighty, scales tend to shed.

A

The cause is unknown, but a genetic predisposition is likely bc many report a family hx of the disorder. it requires a systemic inf, injury to the skin, vaccination, or inj. also links with immune system.
TX: no cure. symptomatic tx to control scaling and itching

86
Q

meds for psoriasis

A

coal tar extract, corticosteroids, or anthralin, and methotrexate.

87
Q

how to remove head lice

A

do not shampoo or condition hair before applying the pediculicide. Conditioner coats the hair and protects nits. instruct the client to follow labeled instrutions. leave the chemical on for longer than 10 mins or covering head with a shower cap does NOT increase effectiveness.may increase potential for toxicity.

88
Q

what can u use to remove head lice

A

nonprescription shampoos, gels and liquids containing pediculcides are effective. Permethrin liquid NIX kills adult forms of lice. RID, Pronto, A-200 contain pyrethrin K well

89
Q

factors that promote skin cancer.

A 
increased exposure to UV radiation, esp ultraviolent B UVB or ultraviolet V UVC, harmful components in the spectrum of sun light. fair skin is more at risk
thinning ozone layer
residense in high altitude areas
decreasede melanin in skin
prolonged repeated exposure to uv rays
90
Q

appearance of headlice

A

lice are brown crawling insects about the size of sesame seed. dont jump or fly. NYMPHs look like moving dandruff, they appear red after feeding

91
Q

appearance of nits

A

small yellowish-white ovals

92
Q

S&S of scabies

A

itching is intense, esp at night. common affected areas include the webs and sides of fingersand around the wrists elbows, armpits, waists, thighs, genitalia, nipples breasts, and lower buttocks

93
Q

prevention of reinfestation of scabies

A

thoroughly wash clothes, bathe, and avoid contact with others with scabies.

94
Q

cause of scabies

A

by an infestation of tiny itch mites, anyone can get them but it is to assume ppl with poor hygeine. Skin to skin contact.- rare but they can be got by handling clothing and linen from a recent person

95
Q

tx of scabies

A

Scabicides, chemicals that destroy mites. such as lindane (cream or lotion) permethrin cream, crotamiton cream, applied to skin in a thin layer 8-12 hr then removed by washing it off. itching can continue 2-3 wk

96
Q

S&S of herpes zoster (Shingles), cause, treatment, anatomy affected.

A

S&S: low grade fever, headache, and malaise, red blotchy appearance that begins to itch or feel numb, 24-48 hours later vesicles appear on the skin along the nerve’s pathway.

  • it develops years after an infection with varicella (chicken pox) and it lies dormant in the nerve roots.
  • usually the eruptions are unilateral (one side) on the trunk, neck, or head. They become severely painful, and severe itching soon follows. In a few days the lesions rupture and crusts form. Pain and itching can persist for months or as long as 2 years or more.
  • viral reactivation produces an inflammatory symptoms in the dermatome, a skin area supplied by the nerve. Raised, fluid-filled, and painful skin eruptions accompany the inflammation.
  • Treatment:oral acyclovir (Zovirax), when taken within 48 hours of the appearance of symptoms, reduces their severity and prevents the development of additional lesions. Topical acyclovir can also be used on the lesions. Corticosteroid therapy can reduce the pain. Analgesics and liquid preparations with a drying or antipruritic effect are applied to the area after the crusts fall off. Codeine is often needed the first few days to weeks.
  • if youre 60 years old or older you should receive a single dose of Zostavax vaccine regardless if youve had chicken pox or not. The vaccine reduces the risk and severity of shingles and postherpetic neuralgia.
97
Q

intervention to relieve pruritis

A
  • corticosteroids
  • antihistamines
  • local (Topical) anesthetics
  • emollients, ointments, powders, and lotions
  • therapeutic bath
98
Q

Therapeutic baths and Wet dressings

A
  • **Therapeutic baths
  • various solutions, powders, and oils, but no soap, are added to water into which the client’s entire body or a part is submerged. They remove inflammation and itching and to aid in the removal of crusts and scales. Products used: corn starch, sodium bicarbonate (baking soda), oatmeal colloidal bath preparations, and mineral oil. The tub is filled with lukewarm water, then you add the product and stir.
  • **Wet dressing
  • used to apply a solution to a skin lesion for a cooling and soothing effect. First you apply a dry dressing (dont use cotton), then you saturate the dressing with the prescribed liquid. A moist environment promotes healing, an occlusive hydrocolloid dressing that contributes water to the impaired skin can achieve the same objective.
99
Q

end chapter questions:

A
  1. sweat glands that release water and electrolytes in the form or perspiration? Eccrine glands
100
Q

type of protein that forms protective layers? keratin

A

hormone like chemicals that communicate reproductive and social information among species? Pheromones

101
Q

decubitus ulcers of the skin over bony prominences? Pressure sores

A

a pigment that determines the color of the skin? melanin

102
Q

sweat glands that secrete cerumen in the external eat canals? apocrine glands

A

lubricant that prevents drying and cracking of the skin and hair? sebum

103
Q

structures that cover the exterior surface of the body, including the skin, hair, and nails? Integument

A

the “true” layer of skin? Dermis

104
Q

term meaning to remove damaged tissue from a wound? debridement

A

a freckles is an example of a? macule

105
Q

a cyst is an encapsulated, round, fluid filled or solid mass beneath the skin.

A

a hive is an example of a? wheal

106
Q

a wart is an example of a? papule

A

an example of a pustule is a boil.

107
Q

clients with enlarged lymph nodes are said to have a? nodule

A

a fluid filled blister is called a? vesicle.

108
Q

Functions of the skin: protective barrier, temp regulation, chemical synthesis.

A

Heat loss through the transfer or surface heat within the environment is termed? radiation.

109
Q

when drying a client after a therapeutic bath the nurse should? pat the skin gently with towel until dry.

A

a client with stage 4 pressure ulcer on the coccyx, with necrotic tissue? debrid the wound.

110
Q

a client has a small pressure ulcer of the heel. The tendon and bone are visible and the drainage is copious. What stage is the ulcer? 4

A

a nurse assesses a client who has yellow tinge to the skin and sclera of the eye. What do you think the problem is? renal disease or liver failure.

111
Q

if a clients skin is ecchymotic the nurse should assess for? trauma to the area.

A

a stage 2 pressure ulcer exists when the client has? redness accompanied by blistering or a break in the skin.

112
Q

concave (spooning) nail shape are a sign of iron deficiency.

A

clubbing of the nails is indicative of? cardiovascular disease.

113
Q

acne vulgaris is believed to be related to hormonal changes

A

carbuncles are usually treated with antibiotic therapy

114
Q

severe psoriasis is treated with methotrexate (folex)

A

intense itching of the skin especially at night is symptomatic of scabies.

115
Q

tinea pedis is best treated wiht topical tolnaftnate (tinactin)

A

skin is the primary site of cancer in the US

116
Q

ecchymosis

A

bruising

117
Q

Xeroderma pigmentosum (XP) is a very rare skin disorder where a person is highly sensitive to sunlight, has premature skin ageing and is prone to developing skin cancers. Xeroderma pigmentosum is caused by cellular hypersensitivity to ultraviolet (UV) radiation, as a result of a defect in the DNA repair system

A

vesiculation: the presence or formation of vesicles.

118
Q

Scleroderma or systemic sclerosis: is a chronic connective tissue disease generally classified as one of the autoimmune rheumatic diseases. Overproduction of collagen. Local or systemic. Tight, shiny skin and dilation of the blood vessels.

A

Postherpetic neuralgia (PHN): is a painful, chronic condition that can occur following shingles, a viral infection that causes a mildly itchy to intensely painful rash

119
Q

Which of the following nursing assessment techniques is best for determining the quality of the client’s skin turgor? Grasping a fold of skin over the sternum

A

An elderly bedridden client frequently slides to the bottom of the bed with the feet touching the footboard. When the nurse analyzes the observation, which one of the following is the most likely outcome of the client’s downward movement in bed? The client is at risk for skin impairment because of shearing forces

120
Q

During a routine assessment, the nurse notes that a client’s fingernails have a clubbed appearance. What is the nurse’s most valid interpretation regarding this finding? The client may have chronic cardiopulmonary disease.

A

Which area of health teaching is essential when a female client is prescribed isotretinoin (Accutane) for treating acne vulgaris? Techniques for avoiding pregnancy.

121
Q

What is the best nursing advice for people who have frequent outbreaks of tinea pedis (athlete’s foot)? Wear different shoes each day.

A

When a client with shingles (herpes zoster) asks the nurse about what causes the disease, what is the most correct reply? It is caused by the reactivation of a dormant virus.

Med surg integumentary (1 decks)

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