MS Lecture 08.04.2015 Integument Flashcards Preview

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Flashcards in MS Lecture 08.04.2015 Integument Deck (21):
1

skin problems

xerosis: dry skin
pruritus: itching
urticaria: hives

2

process of wound healing

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

3

partial-thickness wounds vs full-thickness wounds

full thickness: have scar tissue that causes contracture of skin

look up

4

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

5

pressure relieving techniques

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

6

position changing for pressure ulcers

every 2 hours

7

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

8

wound assessment components

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

9

wound contamination

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

10

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:

11

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

12

know terms to describe skin stuff

like ferruncle, folliculitis, cellulitis

13

for 24 hours how much urine should we take

1 to 3 L per day

14

tests for urine

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

15

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

16

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)

17

manifestations of a bladder infection/cystitis/UTI

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

18

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)

19

how are UTIs treated

antibiotics

20

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

21

urolithiasis

- 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

complications
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 (