Skin and Systemic Conditions

Question 1

what is the largest organ in the body?

Answer 1

skin

Question 2

two layers of the skin

Answer 2

epidermis and dermis

Question 3

what layer of skin does not regenerate?

Answer 3

dermis

Question 4

what does the skin do?

Answer 4

protect against infection, prevents loss of body fluid, controls body temperature, and produces vitamin D

Question 5

superficial burn

Answer 5

first degree burn

Question 6

partial thickness burn

Answer 6

second degree burn

Question 7

full thickness burn

Answer 7

third degree burn

Question 8

first degree burn

Answer 8

only involves epidermal layer of skin, redness and pain, heals 3-6 days, sunburn

Question 9

second degree burn

Answer 9

extends down to dermal layer, large blisters, deep red to waxy white, heals 7-20 days, leaves scar

Question 10

third degree burn

Answer 10

destroys epidermal and dermal layers, charred black, cherry red, tan, or pearly white, small blisters, dry and leathery, and scar/risk of contracture

Question 11

TBSA

Answer 11

total body surface area

Question 12

measures of burn depth

Answer 12

rule of nines (not accurate), and lUnd and Browder chart (more accurate)

Question 13

thermal burns

Answer 13

flames, steam, hot liquids, hot metals, electricity, radiation, toxic chemicals, and extreme cold

Question 14

skin grafting

Answer 14

used for burns that take more than three weeks to heal - eschar is removed and graft is applied

Question 15

autograft

Answer 15

graft from person’s own skin

Question 16

role of OT in burns

Answer 16

help with education, exercise, positioning, adaptive equipment, ADLS, splinting, and scar management

Question 17

protective isolation

Answer 17

used for patients who are immunosuppressed (chemotherapy, transplant), and burn or wound patients

Question 18

pressure areas

Answer 18

They often form on skin that covers bony areas. The most common sites are the back of the head and ears, the shoulders, the elbows, the lower back and buttocks, the hips, the inner knees, and the heels

Question 19

stage 1 pressure ulcer

Answer 19

nonblanchable erythema usually over bony prominences or other pressure areas, warmth, tenderness, redness, texture changes, and probably won’t be ulcerated

Question 20

stage 2 pressure ulcer

Answer 20

loss of skin, blisters, shallow, reddish, may have some drainage

Question 21

stage 3 pressure ulcer

Answer 21

full-thickness skin loss down to subcutaneous fat or fascia

Question 22

stage 4 pressure ulcer

Answer 22

full thickness skin loss with exposure of bone

Question 23

cellulitis

Answer 23

bacterial infection of the skin, common in face and lower leg, skin checks vital, check extremities, back, buttocks, skin folds, and contractures

Question 24

places for bacteria to enter in cellulitis

Answer 24

recent surgery sites, pressure ulcers, cuts, ulcers, athletes foot, insect/animal bites

Question 25

Open wound treatments

Answer 25

wet and dry dressings, wound vac, and minimize moisture at area

Question 26

pressure areas in wheelchair

Answer 26

sacrum, heels, elbows, shoulder blades, side of hips, IT's (butt), low or mid back

Question 27

pressure areas in recliner/geri chair

Answer 27

sacrum, heels, elbows, shoulder blades, head/neck, calves, upper back, ankles

Question 28

pressure areas in wearing oxygen

Answer 28

cheek bones, ears, under nose/or bridge, under chin

Question 29

pressure areas wearing splints

Answer 29

foot, ankles, edges, hand, wrists, elbows, thumb, where strapping goes

Question 30

irritation

Answer 30

skin stays intact

Question 31

degrading

Answer 31

skin no longer intact

Question 32

Stasis (Venous) Ulcers

Answer 32

usually due to CHF or PVD, body not reabsorbing fluid so it pools in legs, weeps, can be acute or chronic

Question 33

Ehlers-Danlos Syndrome

Answer 33

overly flexible skin and joints, joints prone to injury, usually good at dance or gymnastics, can involve the heart or digestion

Question 34

Marfan Syndrome

Answer 34

affects heart, eyes, blood vessels, and bones, people are tall, thin, and have long arms, legs, fingers, and toes

Question 35

temporary skin conditions

Answer 35

dermatitis (eczema, hives, and rashes are all under this)

Question 36

eczema

Answer 36

allergic dermatitis, due to topical irritants, people with asthma and allergies more prone to this

Question 37

Psoriasis

Answer 37

overgrowth of skin, creates plaques of skin, immune problem, and can lead to arthritis

Question 38

congenital amputation

Answer 38

absence of limb or part at birth

Question 39

acquired amputation

Answer 39

loss of limb due to surgery or trauma

Question 40

lower extremity amputations

Answer 40

82% of these caused by diabetes or peripheral vascular disease, surgical amputations a last resort

Question 41

postoperative complications of amputations

Answer 41

neuroma, phantom sensation, phantom pain, weakness, skin breakdown, and falls

Question 42

autoimmune disorder

Answer 42

illness that causes the immune system to produce antibodies that attack normal body tissues

Question 43

scleroderma

Answer 43

autoimmune disorder, causes hardening of skin and organs, a skin, immunologic and systemic disorder, causes raynaud's syndrome, causes scarring and contractures, fingers can become claw position

Question 44

raynaud's syndrome

Answer 44

vasospasms, intolerance of temperature changes

Question 45

fibromyalgia

Answer 45

client hurts all over, feels exhausted, doctor can't find anything specifically wrong with client, is chronic, hurts all the time

Question 46

etiology of fibromyalgia

Answer 46

unknown, sleep disturbances, injury, infection, most common in females, 20-60 years old

Question 47

symptoms of fibromyalgia

Answer 47

achy pain, widespread pain in muscles, ligaments, and tendons, fatigue and multiple tender points, sleep problems, tension headaches, IBS, numbness/tingling in arms and hands, depression, and mood changes

Question 48

treatment of fibromyalgia

Answer 48

antidepressants, muscle relaxants, stress reduction, healthy lifestyle, exercise, relaxation techniques

Question 49

chronic fatigue syndrome

Answer 49

unknown cause, could be related to Lyme disease, causes fevers, fatigue, achiness, poor activity tolerance, frequent infections possible, enlarged lymph nodes, encephalopathy possible (also known as systemic intolerance disease or myalgic encephalomyelitis)

Question 50

systematic lupus erythematosus

Answer 50

impacts joints like RA, has systemic impact on heart, liver, and kidneys

Question 51

signs/symptoms of systematic lupus erythematosus

Answer 51

arthritis inflammatory response, rashes (butterfly, across cheeks and nose), joint pain, renal or CNS involvement, blood disorders, depression, exacerbation and remissions, cardiac systems, photo sensitivity, and oral ulcers

Question 52

renal disease

Answer 52

usually related to diabetes, there are four stages, OT usually works with end stage

Question 53

end stage renal disease

Answer 53

client usually doesn't urinate, every other day dialysis, fluid intake limitations, prone to weakness, blood pressure changes, infections, and cognitive changes if toxins build up in body

Question 54

amyotrophic lateral sclerosis (ALS)

Answer 54

it is a progressive neuromuscular disease that destroys the body's functional capabilities, attacks spinal cord but not brain, starts at lower spinal cord, is usually sporadic, men 2x more likely than women, onset usually between 40 and 60 but can be as early as 16

Question 55

Multiple Sclerosis

Answer 55

exact cause unknown, immunologic or autoimmune disease of the CNS, body attacks the myelin sheath around brain and spinal cord neurons, characterized by demyelination in white matter, gray matter, and axon sites, can affect visual, motor, sensory, cognitive, psychological and bowel and bladder systems

Question 56

symptom management for fatigue

Answer 56

energy conservation, task simplification, pacing, prescribed exercise, and sleep hygiene techniques

Question 57

symptom management for wound healing

Answer 57

good nutrition, asses for pressure areas and teach positioning, minimize skin shearing, ADLS with wounds

Question 58

symptom management for scar management

Answer 58

scar massage, teach self scar massage, and gentle stretching and PROM

Question 59

Edema control methods

Answer 59

measure via volumeter or circumference/lag, use compression garments, retrograde massages, and lymphedema