Tissue Integrity

Question 1

What are the layers of skin tissue?

Answer 1

Epidermis
Dermis
Subcutaneous

Question 2

Describe function of skin: protection

Answer 2

thickened areas of palms and soles d/t increased trauma

Question 3

Describe function of skin: Sensation

Answer 3

receptors located in skin- sense temperature, pain, light touch and pressure

Question 4

Describe function of skin: Fluid balance

Answer 4

can absorb water if necessary or excrete water as sweat. About 600 mL lost daily in average adult through sweat- known as insensible perspiration

Question 5

Describe function of skin: Temperature control

Answer 5

evaporation of sweat from skin or controlled by blood flow through the skin

Question 6

Describe function of skin: Vitamin production

Answer 6

Vitamin D made w/ melanin

Question 7

Describe function of skin: Immune Response

Answer 7

Langerhans cells facilitated uptake of allergens

Question 8

Conditions that cause changes in skin integrity

Answer 8

Very thin/very obese
Fluid loss
Excessive moisture
Jaundice: yellowing of skin resulting from bile products and salts in bloodstream; causes pruritis (itching)
Skin disorders

Question 9

Risk factors for impaired skin integrity

Answer 9

Lifestyle variables: smoking
Age
Changes in Health status
Illness: DM2 most common, HIV+ increases risk for sarcomas
Diagnostic procedures: GI Prep for colonoscopy, bedrest on purpose
Therapeutic measures: meds – many causes rashes and/or photosensitivity
Immobility

Question 10

Categories of Tissue Integrity Impairment

Answer 10

Trauma/Injury
Loss of Perfusion: pressure ulcers, venous stasis
Immunological Disorders: Steven Johnson’s Syndrome – potentially fatal skin condition caused by rxn to medications
Thermal/Radiation: cancer treatment
Infection: 
Bacterial
Fungal
Viral
Infestations
Lesions

Question 11

Stevens-Johnson Syndrome

Answer 11

potentially fatal skin disorder characterized by:
Widespread erythema
Macule formation
Blistering
Epidermal detachment and sloughing

Question 12

What is Stevens-Johnson Syndrome typically triggered by?

Answer 12

Antibiotics; some anti-seizure meds and NSAIDs

Allopurinol is risk factor: treatment for gout and kidney stone

Question 13

Treatment for Stevens-Johnson Syndrome

Answer 13

Discontinue meds causing reactions

Fluid and electrolyte replenishment

Question 14

Individuals with this may experience reactions to latex, jewelry, or poison ivy

Answer 14

Allergic Contact Dermatitis

Question 15

Caused by soap, detergents, caustic materials

Answer 15

Irritant Contact Dermatitis

Question 16

Which of the following are bacterial infections? Select all that apply.

a. Cellulitis
b. Impetigo
c. Contact Dermatitis
d. Tinea

Answer 16

Cellulitis

Impetigo

Question 17

Fungal, viral, or bacterial: Candida Albicans

Answer 17

Fungal

Question 18

Fungal, viral, or bacterial: Tinea

Answer 18

Fungal

Question 19

Fungal, viral, or bacterial: Shingles

Answer 19

Viral

Question 20

Fungal, viral, or bacterial: Herpes

Answer 20

Viral

Question 21

Fungal, viral, or bacterial: Impetigo

Answer 21

Bacterial

Question 22

Fungal, viral, or bacterial: Cellulitis

Answer 22

Bacterial

Question 23

Fungal, viral, or bacterial: Tinea

Answer 23

Fungal

Question 24

List the ABCDE skin lesion rule

Answer 24

Asymmetry
Border irregularity
Color change and variation
Diameter (6mm or more)
Evolving in appearance

Question 25

True or False: Scabies is contagious up to 4 weeks before symptoms appear.

Answer 25

True

Question 26

What are pediculosis humanus capitis and​ pediculosis pubis, respectively?

Answer 26

Head lice and pubic lice

Question 27

Which of the following are complications of uncontrolled diabetes? Select all that apply. a. Dermopathy b. Stasis dermatitis c. leg and foot ulcers d. frequent candida albicans infections

Answer 27

a. Dermopathy b. Stasis dermatitis c. leg and foot ulcers

Question 28

True or False. Karposi's sarcoma is an AIDS defining illness.

Answer 28

True

Question 29

Adequate _____ is essential to wound healing.

Answer 29

blood supply

Question 30

Normal healing is promoted when wound is ___________.

Answer 30

free from foreign debris

Question 31

What are the types of wounds?

Answer 31

Primary intention | Secondary intention

Question 32

Define primary intention wound and provide an example

Answer 32

would with little tissue loss; usually done on purpose ex. surgical incision

Question 33

Define secondary intention wound and provide an example

Answer 33

wound with loss of tissue; usually unintended ex. burn, pressure ulcer, severe laceration

Question 34

True or False. Shock is a phase of wound healing.

Answer 34

False. Shock is a state of cellular and tissue hypoxia.

Question 35

Which of the following are phases of wound healing? Select all that apply. a. Maturation b. hemostasis c. Fixation d. inflammatory e. proliferation

Answer 35

Maturation, hemostasis, inflammatory, proliferation

Question 36

T/ F. An embolus forms during the hemostasis phase of wound healing.

Answer 36

False. A clot forms during hemostasis as platelets aggregate at site of injury.

Question 37

True or False. Hemostasis is the last phase of wound healing because the bleeding has stopped.

Answer 37

False. Hemostasis is the first phase of wound healing.

Question 38

# Choose the correct order of wound healing phases. a. inflammation, hemostasis, proliferation, maturation b. inflammation, maturation, proliferation, hemostasis c. Fixation, inflammation, proliferation, maturation d. Hemostasis, inflammation, proliferation, maturation

Answer 38

d. Hemostasis, inflammation, proliferation, maturation

Question 39

True or False. The inflammatory phase is a local response to injury.

Answer 39

False. The inflammatory phase is a systemic response.

Question 40

What is true of the inflammatory phase? Select all that apply. a. Duration is 4-6 days. b. Macrophages begin to ingest debris and release growth factors c. Characterized by the 6 signs of inflammation d. Fibroblasts begin to secrete collagen.

Answer 40

a. Duration is 4-6 days. b. Macrophages begin to ingest debris and release growth factors C is incorrect bc there are 5 signs of inflammation. D is incorrect bc fibroblasts begin to secrete collagen & growth factors in the proliferation phase.

Question 41

What are fibroblasts?

Answer 41

sue cells that synthesize and secrete collagen and growth factors.​

Question 42

True or false. Granulation tissue is a sign of skin breakdown that needs to be monitored for infection.

Answer 42

False. Granulation tissue- new tissue that is pink/red and composed of fibroblasts and small blood vessels that fill an open wound when it starts to heal​

Question 43

True or False. Collagen synthesis peaks in 5-7 days.

Answer 43

True

Question 44

True or False. Scar tissue is stronger than normal tissue due to avascular collagen tissue.

Answer 44

False. Scar tissue is weaker than normal tissue due to avascular collagen tissue.

Question 45

Shallow wounds involving loss of epidermis & partial loss of dermis​

Answer 45

Partial thickness

Question 46

Wounds extends beyond epidermis and into deep layer of dermis​ Dermis does not regenerate; scar formation occurs

Answer 46

Full Thickness

Question 47

Select al that apply. Local factors affecting wound repair: Pressure Edema Oxygenation Bleeding

Answer 47

Pressure Edema Bleeding *Oxygenation is systemic