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NCLEX > Integumentary > Flashcards

Integumentary Flashcards

(75 cards)

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1
Q

what are wounds

A

break or opening in the skin

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2
Q

factor sthat delay wound healing

A

think “ DID NOT HEAL”

drugs
infection
ischemia
diabetes
nutrition
oxygen 
toxins
hyperthermia/hypothermia
ETOH - ethanol
acidosis 
local anesthetics

and then meds and age
- immunosuppressants and corticosteroids

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3
Q

primary intetnion

A

method of wound healing

used when wound edges can be closed by stitches, staples skin glue or steri strips

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4
Q

secondary intention

A

method of wound healing

cannot be brought together by wound edges
- example: pressure ulcers

wound healing occurs through slow, gradula filling in lost tissue

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5
Q

tertiary intetnion

A

when a delay in closing the wound is NEEDED to allow for drainage and swelling to subside

surgical debridement, skin grafts and flaps are additional interventions used for certain wounds

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6
Q

wound management

A

successful wound management includes:
- removing or eliminating causative factors, preventing infection, using the appropriate type of dressing and ensuring systemic support

maintain adequate hydration and nutrition

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7
Q

what is atopic dermatitis

A

chronic, inhertied skin disorder

eczema

exacerbated by stress and certain foods

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8
Q

atopic dermatitis manifestation

A

acute:

  • dry skin
  • itching
  • erythema
  • macules
  • papules
  • pustules and/or vesicles

subacute and chronic stages:

  • scaly, dry skin
  • skin color changes
  • lichentification: thickened or leather like areas
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9
Q

atopic dermatitis diagnostic studies

A

med history
physical exam
skin biopsy
allergy skin testing

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10
Q

atopic dermatitis nursing management

A

lubriacation of dry skin
administration of corticosteroids, topical immunomodulators

stress reduction
phototherapy when inflammation is severe

antibiotics for secondary infections

soaking the hands in lukewarm water will debrider the crust and scales and soft the skin

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11
Q

what is seborrheic dermatitis

A

recurrent inflammatory reaction of the skin that causes flaky, white to yellowish scales to form on oily areas like:

  • scalp
  • external ear canal

aka: dandruff or “cradle cap” in infants

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12
Q

seborrheic dermatitis manifestation

A

observe non-pruritic, oily scales on scalap, forehead and eyebrows or behind ears

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13
Q

seborrheic dermatitis nursing management

A

cradle cap in infants:

  • massage baby’s scalp gently with your gfingers or soft brush
  • shampoo daily with mld baby shampoo
  • use hydrating creams or mineral oils

dandruff:

  • recommended OTC or medicated shampoos
  • prescription or lotions are available to severe cases
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14
Q

what is incontinence associated dermatitis

A

aka diaper rash

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15
Q

incotinence associated dermatitis nursing management

A

maintain perineal skin integrity

minimize episodes of incontinence
treat any underlying cause of loose stools

apply barrier cream.ointment

treat any underlying skin infections

prompt changing of wet, soiled clothing or incontinence products

using a fecal management system if appropriate
ensuring adequate hydration and nutrition

supporting diligent perineal hygiene with pH-based cleansers

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16
Q

what is contact dermatitis

A

inflammatory reaction of the skin to a chemical substance, whether natural or synthetic

ex: posison ivy

foods, solutions, allergens, plants are factors

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17
Q

contact dermatitis manifestations

A

irritant:

  • dry, inflamed
  • pruritic lesions wherever the irritant touched

allergic:
- “weeping blisters” as well as pruritic lesions

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18
Q

contact dermatitis management

A

topical application like anti-inflammatory and anti-pruritics
- topical corticosteroids are preferred for mild, localized cases of allergic dermatitis

try not to too frequently hand wash because itll become dry

systemic corticosteroids and antihistamines might be required if dermatitis is severe and widespread

exposure to heat or cold may cause or exacerbate symptoms

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19
Q

what is candidiasis

A

bacteria that causes candidiasis normally live in the body without any problems

its if they grow out of control that can lead to candida albicans

develops in the mouth or throat and is called thrush
in vagina = yeast infection

tends to appear in warm, moist areas and inhales steroids
- commonly seen in cancer and HIV/AIDs people

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20
Q

candidiasis manifestations

A

white plagues on the tongue, gums or buccal mucosa
- inner lining of the cheeks and back of lips where they touch teeth

ulcerations in oral mucosa

may also complain of itching

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21
Q

candidiasis management

A

oral anti-fungals will be prescribed
- either use swish and swallow after feeding or through topical application

those who use inhaled steroids should rinse their mouth after to avoid candidiasis

be sure to monitor whether infection has spread to groin or buttocks

can be prescribe prophylactic probiotic
- Florastor

eating products with live cultures of lactobacillus acedophillus like some yogurts can be beneficial

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22
Q

what is acne vulgaris

A

skin condition in which pores becomes clogged and inflamed

acne breakouts may be exacerbated by emotional stress

sebaceous glands secrete more sebum and pores become more plugged and dilated

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23
Q

acne vulgaris manifestation

A 
whiteheards (close comedones)
blackheads (open comedone)
papules
pustules
nodules

red and excoriated skin

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24
Q

acne vulgaris management

A

good cleansing of the skin
nutrition
avoiding squeezing or picking at lesions
teach about resulting body image users

pharmacological intervention:

  • Vit A
  • benzoyl peroxide
  • antibiotics
  • isotretinoin: generic only- available as Accutane
  • photodynamic therapy
  • dermabrasion or chemical skin peels
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25
what is impetigo
highly contagious, bacterial infections of the skin infective agents: - Staph A - group A beta hemolytic streptococcus MRSA is becoming a common cause will invade broken skin are and is highly contagious for 7-10 days most common in young children
26
impetigo manifestations
primary phase: pustules or vesicles ``` secondary phase: honey-colored crusts for strep clear for staph superficial erosion pustules that easily bleed and itche ``` skin does tend to heal without scarring unless there is a secondary infection
27
impetigo diagnostic studies
based on the appearance of skin lesion maybe skin culture
28
impetigo nursing management
priority interventions should focus on preventing transmissions: - careful removal of lesions crusts or debris with warm soapy solution - cutting childrens fingernails pharmacological interventions: - apply topical antibiotics for early small lesions - systemic antibiotics are treatment of choice teach caregiver that infection is HIGHLY CONTAGIOUS good handwashing is essential - sharing towels and eating utensils should be AVOIDED
29
what is cellulitis
infection of the dermis and or subcutaneous tissue causative agents: - streptococcal bacteria - Group A strep - streptococcus pyogenes - staph aureus - Haemophilus influenza
30
cellulitis manifestation
affected area: - red, edematous - tender - occasional discoloration enlarged lymph nodes fever malaise headache streaking is frequently seen
31
cellulitis diagnostic studies
CBC blood culture possible skin culture
32
cellulitis nursing management
administer prescribed antibiotics apply warm compress inciision and drainage may be needed monitor size of area by marking and dating reddened area monitor for secondary infection and any lateration in skin integrity if cellulitis is not diagnosed and treated correctly, it can progress to gangrene
33
what is tinea
ringworm can be transmitted person to person, through animal contact or through contact with contaminated feces can be associated with poor hygiene and friction from tight clothing
34
type of tinea
capitis: - hair, scalp corporis: - body cruris: - perineum pedis "athletes foot": - feet or ankles
35
capitis manifestation
``` scaly, circular patches "blood dot" alopecia red area pruritus fever ```
36
capitis treatment
antifungals, shampoos
37
corporis sxs
erythematosus scaling patches round or oval shaped
38
corporis treatment
local therapy with antifungal creams or powders
39
cruris sxs
similar to corporis pink papules pruritus in genital fold
40
cruris treatment
local therapy with antifungal creams or powders aka jock itch
41
pedis sxs
lesions pruritus maceration between toes burning sensation
42
pedis treatment
local thearpy with antifungal spray or lotion possibly Burow's solution
43
tinea management
antifungals meds need to be taken for several week or months encourage good hygiene products do not share clothing, hair brushes, linens and towels avoid overuse of OTC products, esp for their feet
44
what is pediculosis capitis
head lice live only humans and are transmitted by direct and indirect contact other types of lice: - body lice - pubic area - eyebrows and eyelashes
45
pediculosis capitis manifesation
nits - tiny silvery or grayish white specks pruritius rose-colored dermatitis
46
pediculosis capitis management
topical medicated shampoo or body ointments - an OTC cream rinse petroleum for infants and children or lindane shampoo contact precautions prevent transmission and spread by washing clothes in hot water o not share clothes or hair brushes
47
what are scabies
contagious skin infection of mites causative agent = mites - female mite s burrow into the epidermis and lay eggs
48
scabies manifestation
pruritus burrows - fine grayish brown threadlike lines intense itching especially at night papule-like eczema in infants
49
scabies diagnostic studies
history clinical symptoms microscopic visualization of skin scrapings
50
scabies management
pharmacological interventions: - topical scabicide medications or creams - treatment of choice = permethrin - anti-steroidal creams for itching - systemic anti-infectives used for secondary infections wash cloths and bedding in hot water - all persons in close contact with affected person will need treatment
51
what is frostbite
occurs when ice crystals form in the tissue causing tissue damage
52
frostbite manifestations
first degree: blanching decreased sensation mottling second degree: blisters with possible bulla - large blisters that are filled with clear fluid ``` third degree: cyanosis mottling then red with swelling local necrosis hemorrhagc vessels ``` fourth degree complete necrosis gangrene loss of affected body part
53
frostbite nursing management
cover the area immediately but do not apply massage rewarm the affect part gradually by immersing in water heated to 100 to 108 (38 - 42 degrees celsius) give analgesics and sedatives for severe pain during rewarming srugery (escharotomy) may be required
54
what is hypothermia
when body's core temp is below 95 degrees celsius
55
hypothermia manifesations
body's core temp cools to injurious levels below 95
56
hypothermia management
3 categories of rewarming 1. for mild hypothermia - passive external rewarming - place client in a warm environemtn and covered with insulation 2. active external rewarming - heat is applied to skin over the trunk of the body only 3. active core rewarming - most effective way to rapidly increase core temp - warm humidified air - diathermy: ultrasound and low- frequency microwave radiation extracorporal- most rapid means of rewarming
57
what is hyperthermia
can occur with exposure to air temp over 85 farneheit (29 celsius) and humidity above 50%
58
hyperthermia tyeps
heat cramps: - involuntarily spams of the large muscles of the body - least severe type of hyperthermia more common in athletes heat exhaution - commonly affects firefighters, construction or factory workers heat stroke - least common but most life-threatening - body's cooling system fails
59
hypothermia manifestations
heat cramps - painful muscle spams, may include abdominal cramps - face will be red, flushed and sweating - oral temp can be 98.6 - 100 heat exhaustion - cool, moist - pale and ahsen skin - headache - nausea - dizziness - oral temp: above 100 ``` heat stroke - red skin but without perspiration - rapid but weak pulse - shallow breathing body temp right to 106 farenheit ```
60
sunburn management
broad spectrum protection, protect against UVA and UVB rays SPF 30 or higher water resistance avoid exposure to direct sunlight between 10am and 3 pm
61
factors influencing degree of sunburn
genetic makeup and skin type season of year, altitude and time of day whether burn took place through window or glass or cause by light reflected by snow or water meds underlying conditions topcial products
62
classification of burns
``` local response: increased capillary permability fluid leaks into interstitial space edema surround burned area pain ``` ``` systemic response: hypovolemic shock resp distress ARDs anemia aspiration pneumonia decreased bowel sounds possible ileus AKI decreaed level of consciousness encephalopathy seizures coma ``` it can also cause curlings ulcer
63
curlings ulcer
stress ulcer that occur within 24 hours of injury administer proton pump inhibitors to prevent these like: pantoprazole others that might help prevent these ulcers: - early enteral feeding - H2 histamine blaockers - NSAIDs - should be used with caution - diuretics: furosemine, bumetianide = CONTRAINDICATED
64
burns manifestations
``` 1st degree - superficial: localized pain dry surface blanches with pressure redness and possible blisters ``` ``` 2nd degree - partial thickness: open wound very painful denuded skin blistered and moist ``` ``` 3rd degree - full thickness: tough leathery dull and dry with variable pain color may be brown, tan, black or red ``` 4th degree - full thickness: dull and dry ligaments, tendons, and bone may be exposed
65
burns managements
acute phase: priority is stop the burning process superficial burns: - cleanse with solutions ordered and debride loose debris and ncrotic tissue may receive prophylactive tetanus immunizations and mild analgesics
66
parkland formula
4 mL x TBSA % x body weight in kg 50% given in first 8 hours other 505 given in the next 16 hours
67
risk factors for melanoma skin cancer
``` fair skin tone blonde or red hair blue or green eyes people who work outdoors age (>50, <30) ``` ``` immunosuppressant therapy drug therapy history of burns indoor tanning fam history of skin cancer ``` high altitudes live in sunny climates
68
non melanoma skin cancer
basal cell carinoma squamous cell caricnoma
69
what is basal cell carcinoma
abnormal, uncontrolled growths or lesions from skin basal cell cumulative ltraviolet exposure and intense or occasional UV exposure
70
basal cell carcinoma manifestations
open sore red patches pink growth shiny bumps or scars
71
basal cell carcinoma treatment
surgery: - Mohs micrographic surgery - excisional surgery - cryosurgery - curettage and electrodesiccation radiation imiquimod - for superifical BCC 5 Fluoruracil Vismodegib - ALL 3 HAVE BLACK BOX WARNING
72
basal cell carcinoma management
skin cancer prevention
73
what is squamous cell carcinoma
uncontrolled growth of abnormal cells arising in squamous cells caused by cumulative UV exposure over the course of a lifetime can be disfiguring and may be deadly if allowed to grow
74
swuamous cell carcinoma manifestations
scaly red patches open sores elevated growth with central depression occurs on any area exposed to skin
75
squamous cell carcinoma treatment
surgery: same ones as BCC radiation 5 Fluorouracil

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