Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Old Tests > Nursing test three > Flashcards

Nursing test three Flashcards

(66 cards)

Start Studying
0
Q

What does what’s up stand for

A 
Where is it.
How does it feel. 
Aggravating and alleviating factors.
Timing. 
Severity. 
Useful other data. 
Patient's perception.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are some signs of aging in the integumentary system

A

Hair becomes gray and thin. Skin becomes thinner and more fragile. Healing is slower. Wrinkles develop. Temperature becomes harder to regulate. Skin becomes dry.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Subjective assessment information

A

History of skin disorders. Risk factors. Hair and nails. Medications. Exposures. WHAT’S UP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Physical assessment information of integumentary system

A

Inspection and palpitation. Color. Lesions. Moisture. Edema. Vascular markings. Integrity. Cleanliness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define turgor

A

Tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Things to consider when doing a hair assessment

A

Color, quantity, thickness, texture, alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Things to consider when doing a nail assessment

A

Color, shape, texture, thickness, abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define lesion

A

Any change or injury to tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define petechiae

A

Reddish purple reddish spots that are smaller than .5 mm in diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define ecchymosis

A

A bruise that changes from blue, black to greenish brown, or yellow overtime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define macule. Primary lesion

A

Flat, nonpalpable change in skin color, with different sizes, shapes, color. Rubella, scarlet fever, freckles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define papule. Primary lesion

A

Palpable solid raised lesion that is less than 1 cm in diameter due to superficial thickening in the epidermis. Ringworm, wart, mole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define nodule. Primary lesion

A

Solid elevated lesion that is larger and deeper then papule. Fibroma, intradermal Nevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define vesicle. Primary lesion

A

A small, blister like raised area of the skin that contains serious fluid, up to 1 cm in diameter. Poison ivy, shingles, chickenpox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define bulla Primary lesion

A

A fluid filled vesicle for blister larger than 1 cm. Burns, contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define pustule. Primary lesion

A

Small elevation of skin or vesicle or bulla that contains lymph or pus. Impetigo, scabies, acne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define wheal. Primary lesion

A

Round, transient elevation of the skin caused by dermal edema and surrounding capillary dilation. White in Center and red around. Hives, insect bite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define plaque. Primary lesion

A

patch or solid, raised lesion on the skin or mucous membranes that is greater than 1 cm in diameter. Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define cyst. Primary lesion

A

closed sac or pouch which consist of semisolid, solid, or liquid material. Sebaceous cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define scale. Secondary lesion

A

Dry exfoliation of dead epidermis that may develop as a result of inflammatory changes. Very dry skin, cradle cap, psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define crust. Secondary lesion

A

Hey scab formed by dry soon, plus, or blood. Infected dermatitis, impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define excoriation. Secondary lesions

A

Traumatized abrasions of the epidermis or linear scratch marks. . Scabies, dermatitis, Burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define fissure. Secondary lesion

A

A split or crack like sore that extends into dermis, usually due to continuous inflammation and drying. Athletes foot, anal fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define ulcer. Secondary lesion

A

An open sore or lesion that extends to the dermis. Pressure sores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Define lichenification. Secondary lesion
Thickening and hardening of skin from continuing irritation such as From intense scratching
25
Define scar. Secondary lesion
Mark left in the skin due to fibrotic changes following healing of a wound or surgical incision
26
Explain woods light examination
Involves the use of ultraviolet rays to detect fluorescent materials in the skin and hair present in certain diseases such as Ringworm. Performed with a handheld black light in a dark room
27
Which protein in epidermal cells makes the skin relatively waterproof
Keratin.
28
What are the functions of subcutaneous tissue
cushions bony prominences. It provides insulation. stores energy.
29
What are risk factors for pressure ulcers
Immobility, impaired circulation, impaired sensory perception, elderly, very thin or obese
30
Ways to prevent pressure ulcers
Asses daily, cleanse and dry daily, lubricate daily, using moisture barrier, do not massage red areas, shift weight every 15 minutes
31
What is the Braden scale
An instrument used to find all risk factors associated with the development of pressure ulcers. Assesses sensory perception, activity, mobility, nutrition, friction and shear
32
When it comes to pressure ulcers, how can they be described according to the three colors system
Black wounds indicate necrosis. Yellow may be infected. Red wounds are pink or red and are in the healing stage
33
What are the different types of debridement
Mechanical, enzymatic, autolytic, surgical
34
Describe a stage one ulcer
An area of red, deep pink, or molted skin that does not Blanche with fingertip pressure. In people with darker skin discoloration of the skin, warm, edema, or induration maybe signs
35
Describe stage to ulcer
Partial thickness skin loss involving epidermis and or dermis. It may look like an abrasion, a blister, or a shallow crater. The area surrounding the damage skin may feel warmer.
36
Describe a stage III ulcer
Full thickness skin loss that looks like a deep crater and may extend to the fascia. Subcutaneous tissue is damaged or neurotic. Bacterial infection of the ulcer is common and causes drainage from the ulcer. There maybe damage to the surrounding tissue
37
Describe stage lV Ulcer
Full thickness skin loss with extensive tissue necrosis or damage to muscle, bone, or supporting structures. The ulcer may appear dry and black, with a buildup of tough neurotic tissue or it can appear wet and oozing
38
define pallor cyanosis, jaundice, erythema and what they indicate
pallor=loss of color=anemia or lack of blood flow cyanosis=bluish=hypoxia or impaired venous return jaundice=yellow=liver dysfunction, red blood cell destruction erythema=redness=inflammation
39
describe serous drainage
portion of the blood (serum) that is watery and clear or slightly yellow in appearance
40
describe sanguineous drainage
contains serum and red blood cells. it is think and appears reddish
41
describe serosaguineous draingage
contains both serum and blood. it is watery and appears blood-streaked or blood tinged
42
describe purulent drainage
result of an infection. it is think and contains white blood cells, tissue debris, and bacteria. maybe have a foul odor and its color reflects the type of organism present
43
what interventions do you take for a suspected deep tissue injury and stage 1 ulcer
``` relieve pressure encourage frequent turning/repositioning use pressure-relieving devices implement pressure-reduction surfaces keep clients dry, clean, well-nourished, and hydrated ```
44
what interventions are taken for a stage II ulcer
maintain a moist healing environment promote natural healing while preventing the formation of scar tissue provide nutritional supplements as prescribed administer analgesics as prescribed
45
what interventions are taken for stage III ulcers
``` clean and/or debride prescribed dressing surgical intervention proteolytic enzymes provide nutritional supplements as prescribed administer analgesics as needed administer antimicrobials as prescribed ```
46
what interventions are taken for a stage IV ulcer
clean and/or debride perform nonadherent dressing changes every 12 hours treatment may include skin grafts provide nutritional supplements as prescribed administer analgesics as prescribed administer antimicrobials as prescribed
47
what are interventions taken for an unstageable ulcer
eschar should cover wound s protective barrier provide nutritional supplements as prescribed administer analgesics as prescribed administer antimicrobials as prescribed
48
after discharge-client education about wound care
instruct clients how to perform wound care encourage to eat a diet high in protein and vegetables to promote wound healing encourage to take vitamins and supplements to promote wound healing remind clients to keep skin clean and dry remind clients to report any signs of infection or further skin breakdown
49
in wounds, what are signs of infection (sepsis) that need to be monitored
``` level of consciousness persistent recurrent fever tachycardia tachypnea hypotension oliguria increased WBC ```
50
what is the difference between dehiscence and eviscertaion
dehiscence is a partial or total rupture of a sutured wound, usually with separation of underlying skin layers. evisceration is a dehiscence that involves the protrusion of visceral organs through a wound opening
51
define psoriasis
a skin disorder that is characterized by scaly, dermal, patches and is caused by an overproduction of keratin. thought to be autoimmune disorder
52
define seborrheic dermatitis
a skin disorder caused by inflammation of areas of the skin that contain a high number of sebaceous glands. characterized by papulopustules (oily form) or flaky plaques (dry form) that form on the surfaces of the skin. dandruff is a type.
53
risk factors for psoriasis
genetics stress seasons hormones
54
medications used for psoriasis
``` topical corticosteroids (kenalog) tar preparations topical epidermopoiesis suppressive medications(dovonex) cytotoxic medications (mexate) ```
55
therapeutic procedures for treating psoriasis
ultraviolet light A | oil or coal tar baths
56
risk factors for seborrheic dermatitis
genetics stress hormones older adults can develop seborrheic keratoses, which are more plaque-like in appearance
57
physical findings in seborrheic dermatitis
waxy or flaky-appearing plaques and/or scales skin lesions primarily on the oily areas of the body (scalp, forehead, nose, axilla, groin) lesions may be pigmented tan, brown, or black
58
medications used for caring for seborrheic dermatitis
topical corticosteroids-reduces secondary inflammatory response of lesions antiseborrheic shampoos-contain selenium, sulfur, or salicylic acid
59
what is the leading cause of skin cancer
sunlight exposure
60
what are precancerous skin lesions called
actinic keratoses
61
what are the three types of skin cancer
squamous cell carcinoma=cancer of the top layer of the epidermis that can be localized, but it may metastasize to other tissues and organs basal cell carcinoma=cancer of the basal cell layer. can damage surrounding tissue and can advance to include underlying structures. usually not metastatic malignant melanoma=aggressive, metastatic cancer that originates in the melanin-producing cells of the epidermis
62
health promotion and disease prevention of skin cancer. advise clients to do what
limit exposure to sunlight use sunblock with APF of at least 15 with both UVA and UVB wear protective clothing avoid tanning beds/equipment examine body monthly for suspicious lesions
63
risk factors of developing skin cancer
exposure to ultraviolet light chronic skin irritation and burn scars fair complexion with tendency to burn easily presence of several large or many small moles family or personal history of melanoma living in locations in upper elevations or close to equator
64
what are the ABCD's of suspicious skin cancer lessions
Asymmetry-one side does not match the other Borders-ragged, notched, irregular or blurred edges Color-lack of uniformity in pigmentation (shades of tan, brown, or black) Diameter-width greater than 6mm or about the size of a pencil eraser
65
What are the three phases of wound healing
Inflammatory phase. Proliferation or reconstruction phase. And then maturation Or remodeling phase

Old Tests (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions