MS Lecture 08.04.2015 Integument Flashcards Preview

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Flashcards in MS Lecture 08.04.2015 Integument Deck (21):

skin problems

xerosis: dry skin
pruritus: itching
urticaria: hives


process of wound healing

review first, second, and third intention of wound healing
first: edges brought together with skin lined


partial-thickness wounds vs full-thickness wounds

full thickness: have scar tissue that causes contracture of skin

look up


pressure ulcers

- compression of skin and underlying soft tissue between bony prominence and external surface for extended period
- mechanical forces create ulcers (pressure, friction, shear)f


pressure relieving techniques

wedge, pillows, rolled up blankets, specialty beds, boots, sacral pads, criticaid paste,


position changing for pressure ulcers

every 2 hours


review stages of pressure ulcers

stage 1: skin intact, area usually over bony prominence, does not blanch with external pressure
- observable pressure

stage 2: skin not intact, partial-thickness skin loss of epidermis or dermis
- ulcer is superficial, may appear as abrasion, blister, or shallow crater
- bruising not present

stage 3: full thickness skin loss, subq may be damaged or necrotic, damage extends to underlying fascia, NOT EXPOSED: bone muscle tendon

stage 4: full thickness with exposed muscle tendon or bone


wound assessment components

exudate, location, size color, extent of tissue involvement, cell types in wound base and margins


wound contamination

always contaminated but not always infected
contamination: presence of organisms without infection
infection: pathogenic organisms grow


wound management: nonsurgical

a) dressings (most common is wet-to-dry)
b) physical/drug/nutrition therapies
c) electrical stimulation
d) VAC
e) HBO
f) topical growth factors
g) skin substitutes
h) mist therapy:


wounds can be surgically managed

- debridement - want to be really careful with patient movement, do not disturb until surgeon's say it's appropriate
- skin grafting for large areas


know terms to describe skin stuff

like ferruncle, folliculitis, cellulitis


for 24 hours how much urine should we take

1 to 3 L per day


tests for urine

a) urinalysis: evaluate renal system and disease
b) urine culture and sensitivity
c) specific gravity : 1.005 - 1.030


diagnostic tests for renal stuff

a) creatinine: increase occurs when at least 50% of renal function is lost, reflects GFR; 0.6-1.2 ish or something
b) glomerular filtration rate (GFR): 125ml/min; estimates how much blood passes through tiny filters in kidneys each minute (the glomeruli)
c) BUN (blood urea nitrogen) - levels indicate the extent extent of renal clearance of urea nitrogenous waste products
- increase may occur from dehydration, high protein diet, infection, stress, corticosteroid use, GI bleed, factors that cause muscle breakdown
d) creatinine clearance: 24hr urine specimen and serum creatinine collection, determines how ewell kidneys excete creatinine


infectious disorders

1) urinary tract infections
a. lower tract - urethritis, cystitis, prostatitis
b. upper tract - pyelonephritis (kidney); usually begins in lower urinary tract

2) site of infection and specific type of bacteria determines treatment

3) risk factors

4) cystitis: inflammation of bladder
- infectious cystitis: most common UTI commonly from bacteria (90% E. Coli - intestinal tract) can lead to pyelonephritis and sepsis (urosepsis)


manifestations of a bladder infection/cystitis/UTI

lower abdominal discomfort, fever,burning on urination, foul odor to urine


recommendations for UTI

- try cranberry juice/acidify your urine
- remove foley immediately
- empty bladder after intercourse
- clean front to back
- increase fluid intake (2-3L)


how are UTIs treated



types of incontinence (look up treatment therapies)

1) stress incontinence: loss of small amounts of urine while coughing, sneezing, lifting, exercising
- common after childbirth and postmenopausal b/c lower estrogen levels lead to think/weak baginal, urethral, and pelvic floor muscles

2) urge incontinence: large amounts of urine released (eg overactive bladder, inability to relax the detrusor muscle leading to a stronge urge to void and often leakage of large amounts of urine)

3) mixed incontinence:

4) functional incontinence: due to loss of cognitive function
- women: intravaginal pessary: device supports the uterus and vagina and helps maintain the correct position of the bladder



- presence of calculi (stones) in the urinary tract
a) nephrolithiasis: formation of stones in the kidney
b) ureterolithiasis: formation of stones in the ureter

risk factors: urinary stasis, retention, immobility, and dehydration (incidence higher in men)

manifestations: sharp excrutiating pain that pt can n/v

a) hydroureter: ureter dilation may occur if the stone occludes the ureter and blocks the flow of urine
b) hydronephrosis: enlargement of the kidney with urine due to a blockage in the lower tract
- oliguria (100-400 ml/d) or anuria (