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NUR 334: exam 3 > integumentary > Flashcards

integumentary Flashcards

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1
Q

6 primary skin lesions

A
  1. macule
  2. papule
  3. plaque
  4. pustule
  5. vesicle
  6. wheal
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2
Q

macule

A

circumscribed, flat discoloration
blue, red, brown, hypo pigmented
<0.5cm (if >0.5 it is a patch)

examples: freckles, petechiae, measles, flat mole (nevus), vitiligo (complete depigmentation)

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3
Q

papule

A

elevated, solid lesion
<0.5cm (if >0.5 it is a nodule)

examples: wart, elevated moles, lipoma, basal cell carcinoma

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4
Q

plaque

A

circumscribed, elevated, superficial, solid lesion
>0.5cm

examples: psoriasis, seborrheic and actinic keratoses

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5
Q

pustule

A

elevated, superficial lesion filling with purulent fluid

examples: acne, impetigo

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6
Q

vesicle

A

circumscribed, superficial collection of serous fluid
<0.5cm (if >0.5, it is a bulla)

examples: varicella (chickenpox), herpes zoster (shingles), 2nd-degree burn

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7
Q

wheal

A

firm, edematous, irregularly shaped area
size varies + may only last a few hours

examples: insect bite, urticaria, angioedema

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8
Q

6 secondary lesions

A
  1. atrophy
  2. excoriation
  3. fissure
  4. scale
  5. scar
  6. ulcer
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9
Q

atrophy

A

depression in skin r/t thinning of epidermis or dermis

examples: aged skin, striae (stretch marks)

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10
Q

excoriation

A

epidermis is missing - dermis is exposed

examples: abrasion, scratch

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11
Q

fissure

A

linear crack or break from epidermic to dermis
dry or moist

examples: athlete’s foot, chapping, eczema

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12
Q

scale

A

excess, dead epidermal cells made by abnormal keratinization and shedding

examples: flaking of skin after a drug reaction, sunburn

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13
Q

scar

A

abnormal formation of connective tissue that replaces normal skin

examples: surgical incision, healed wound

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14
Q

ulcer

A

loss of epidermis and dermis
crater-like, irregular shape
heals with a scar

ex: pressure ulcer, chancre

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15
Q

cyanosis

A

blue
late sign of hypoxia

cause: heart or lung disease, cold environment

where: nail beds, lips, base of tongue, skin

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16
Q

pallor

A

decrease in color
reduced amt of hgb; decreased blood flow
caused by: anemia or shock
where: skin, nail beds, conjunctiva (line of demarcation), lips, face, palms

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17
Q

vitiligo

A

loss of pigmentation
caused by: congenital autoimmune condition
where: patchy areas on skin over face, hands, arms

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18
Q

jaundice

A

yellow-orange
increased deposits of bilirubin in tissues

caused by: liver disease, destruction of RBC
where: sclera, mucous membranes, skin

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19
Q

erythema

A

red
increased visibility of hgb d/t dilation or increased blood flow

caused by: fever, direct trauma, blushing, alc intake
where: face, area of trauma, areas at risk for pressure (sacrum, shoulders, elbows, heels)

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20
Q

tan-brown

A

increased amount of melanin
caused by: suntan, pregnancy
where: areas exposed to sun (face, arms), areolae, nipples

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21
Q

skin cancer

A

most diagnosed cancer
classified as non melanoma or melanoma
early detection more common bc of visible lesions

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22
Q

risk factors for skin cancer

A

-fair skin (blonde/red hair, blue eyes)
-hx of outdoor activities
-living near equator or high altitudes
-fam hx of skin cancer
-work outdoors
-tanning beds

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23
Q

non melanoma skin cancers

A

basal cell carcinoma

squamous cell carcinoma

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24
Q

basal cell carcinoma

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A

locally invasive cancer from basal cells (erythematous, pearly, sharply defined, barely elevated plaques, depression in middle)

25
squamous cell carcinoma
comes from keratinizing epidermal cells, can be aggressive (thin, scaly erythematous plaque)
26
malignant melanoma
*tumors come from melanocytes *genetic and environmental factors contribute to development --> 5-10% have 1st-degree relative *treatment depends on depth of lesion (correlation between survival and depth of lesion) *poor prognosis unless diagnosed and treated early *may metastasize to any organ, if untreated
27
lesion > 1.5 mm
would require treatment after surgical removal
28
how do we evaluate lesions with malignant melanoma?
ABCDE asymmetry border irregularity color diameter (>6mm) evolving or elevated
29
interprofessional care for integumentary problems
skin integrity care anxiety/coping issues with diagnosis teach related care of biopsy annual dermatology checkups
30
what is most likely to occur for lesions?
biopsy
31
bacterial skin infections
impetigo + cellulitis *staph aureus or B-hemolytic streptococci usually responsible *if exudate present, drainage also infectious
32
risk factors for bacterial skin infections
excess moisture obesity atopic dermatitis (eczema) systemic corticosteroid or antibiotic use chronic diseases (T2DM)
33
cellulitis
inflammation of SQ tissue
34
manifestations of cellulitis
hot tender erythematous area w/ diffused borders fever and chills malaise
35
treatment of cellulitis
localized: moist heat (warm compress to reduce swelling), immobilization, elevation systemic: antibiotics --> hospitalize if severe; progression to gangrene, if not treated
36
viral infections
more difficult to treat lesions can result from inflammatory response to systemic viral infections
37
systemic viral infections
herpes simplex herpes zoster (shingles) HPV (human papillomavirus) warts
38
herpes zoster
activation of varicella-zoster virus (chickenpox) incidence increased with age potentially contagious if haven't had chickenpox yet
39
herpes zoster manifestations
burning pain and neuralgia along dermatome
40
prevention of herpes zoster
vaccine (Zostavas) to prevent shingles *one time dose for adults > 60
41
HPV
human papillomavirus warts in genital area or anywhere on body usually preventable with vaccine
42
fungal infections examples
candidiasis -mouth -vagina -skin tinea corporis (ringworm) tinea cruris (jock itch) tinea pedis (athletes foot)
43
fungal infections
most are harmless - can be embarassing skin, hair, nails more susceptible to fungal infections usually treat with topical anti-fungal creams or solutions
44
allergic skin problems
irritant or allergic dermatitis --> benign (contact dermatitis) vs life-threatening (Stephen johnson syndrome and toxic epidermal necrolysis)
45
Stephen Johnson Syndrome and Toxic epidermal necrolysis
rare, LIFE-THREATENING skin conditions - immune responses are generally due to a severe adverse reaction to medication or infection - causes acute destruction of epithelium of skin and mucous membranes
46
Stephen Johnson Syndrome and Toxic epidermal necrolysis: S/S?
fever cough HA anorexia myalgia nausea precede skin and mucous membrane findings by 1-3 days
47
examples of infestations and insect bites
ex: pediculosis (lice), bed bugs, ticks, scabies
48
what plays a key role in insect bites?
allergy to venom sometimes, clinical manifestations are related to eggs, feces, or body parts of invading organism
49
how to prevent insect bites?
avoid + repellants
50
what is important to do with insect bites
meticulous hygiene --> hair, skin, clothing, bedding, pets, sexual partners routine skin inspections --> especially if traveling to high-risk areas (ESP TICK BITES)
51
psoriasis
benign skin problem *chronic autoimmune disease *usually develops in those 15-35 *familial *up to 40% develop psoriatic arthritis *can be painful and emotional disabling r/t body image disturbance
52
most common form of psoriasis
plaque psoriasis lesions are distinct, red, intact *located: knees, elbows, hands, lower back
53
types of psoriasis
plaque (MOST COMMON) -guttate -pustular -inverse -nail -psoriatic arthritis
54
care for psoriasis
phototherapy (UV light) : psoriasis
55
care for basal/squamoous cell carcinoma
radiation
56
drug therapy for skin conditions
antibiotics steroids (NOT long-term) antihistamines immunomodulators (suppress overreactive immune system)
57
therapy for malignant melanoma
diagnostic/surgical therapy (punch biopsy, scraping)
58
nursing management of skin problems
-wet compresses (room temp tap water w/ possible additive) --> ASSESS for maceration -baths: tepid (lukewarm) *too hot makes itchy -hygienic practices: lotions while skin still damp; seals in moisture -topical meds -control of itching

NUR 334: exam 3 (11 decks)

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