tissue integrity Flashcards
(82 cards)
1
Q
tissue integrity
A
state of structurally intact and physiologically functioning epithelial tissues
(integument and mucous membranes)
2
Q
epithelium
A
tissue that lines cavities and structure surfaces throughout the body
3
Q
debridement
A
removal of dead, damaged or infected tissue
4
Q
granulation
A
connective tissue that forms on the surface of a healing wound
5
Q
turgor
A
elastic state of tissue
6
Q
emollient
A
agents that soften skin or treat dry skin
7
Q
6 categories of impaired tissue integrity
A
- trauma or injury
- loss of perfusion
- immunological reaction
- infections and infestations
- thermal or radiation injury
- lesions
8
Q
4 steps of wound healing
A
- regeneration
- resolution
- repair
- healing
9
Q
resolution
A
returning injured tissue to original structure and function
10
Q
repair
A
replacement of destroyed tissue with scar tissue
11
Q
scar tissue
A
composed primarily of collagen to restore the strength of tissue but not function
12
Q
healing
A
filling in the wound
sealing wound
shrinking wound
13
Q
epithelialization
A
sealing the wound
14
Q
contraction
A
shrinking the wound
15
Q
three types of wound healing processes
A
primary intention
secondary intention
tertiary intention
16
Q
primary intention
A
margins well approximated
lacerations
surgical incisions
most rapid
17
Q
secondary intention
A
margins not well approximated. larger areas require formation of granulation tissue to fill in gaps
longer time period
18
Q
tertiary intention
A
healing delayed
occurs when wound was open and is now closed
associated with large infected contaminated wounds
19
Q
three phases of wound healing
A
inflammatory
granulation (proliferative)
maturation (remodeling)
20
Q
inflammatory phase
A
3-5 days
homeostasis develops
macrophages remove debris
21
Q
granulation phase
A
5-21 days
new blood vessels and tissue formed
22
Q
maturation phase
A
lasts months
collagen fiber remodelled
scar formation and contraction occur
23
Q
predisposing disorders to dysfunctional wound healing
A
diabetes obesity wound infection inadequate nutrients numerous medications tobacco smoke
24
Q
dysfunctional collagen synthesis results in
A
keloid scar
hypertrophic scar
25
increased dietary needs to promote wound healing
calories
protein
vitamins A and C
zinc
26
general health history
```
past/current conditions
family history
allergies
current/recent medications
history of skin disorders
```
27
problem based history
```
changes in skin condition/colour
new rash or lesion
changes in previous lesions
excessive bruising
loss of hair
changes of condition of nails
wounds slow to heal
```
28
examination of lesions
location, size, shape, colour, pattern, characteristics (raised, flat, dry, exudate)
29
assessment of wounds/ulcers
Acute wound or chronic wound
- Location
- Size (length, width, depth)
- Color (red, yellow, black)
- Cleanliness (clean, contaminated)
- Odor
- Presence of wound drains (type)
- Presence of drainage and exudate
- staging ulcers
30
common diagnostic tests
- Woods lamp testing
- Tissue biopsy
- Wound culture
- Patch testing
- Serum protein level
- CBC and WBC
31
primary and secondary prevention
- Skin hygiene
- Adequate nutrition
- Avoidance of excessive
sun exposure
- Burn safety precautions
- Dermal ulcer prevention
32
collaborative interventions
```
pharmacotherapy
phototherapy
surgical interventions
wound care
nutritional support
```
33
principles of wound care
initial and ongoing assessment
| cleaning and irrigation
34
cleansing and irrigation
cleaning performed to remove debris and exudate
| normal saline used, avoid harsh solutions
35
types of dressings
gauze, nonadherent dressings, occlusive, semiocclusive, hydrocolloid. hydrogel and alginate applied
vacuum-assisted systems used
36
primary lesions
- Macule (freckle)
- Papule (wart)
- Patch (vitiligo)
- Plaque (psoriasis)
- Wheal (insect bite)
- Nodule (lipomas)
- Tumour (Neoplasms)
- Vesicle (Varicella)
- Bulla (Blister)
- Pustule (acne)
- Cyst (sebaceous cyst)
- Telangiectasia
37
secondary lesions
- Scale (Dry skin)
- Lichenification (Chronic
dermatitie)
- Keloid (Scar that grows
beyond boundaries of
wound)
- Scar (Incision)
- Excoriation (Abrasion)
- Fissure (Dermatitis)
- Erosion (Chemical Injury)
- Ulcer (Pressure Ulcer)
- Atrophy (Aged Skin)
38
topical dermatological drugs
- Antibacterial drugs
- Antifungal drugs
- Antiviral drugs
- Anti-inflammatory drugs
- Antineoplastic drugs
- Antipruritic drugs (for itching)
39
acne vulgaris most
common skin disease
40
acne vulgaris occurs between what ages
12 to 15
41
acne vulgaris develops where
sebaceous follicles
| primarily on face and upper chest and back
42
acne vulgaris therapy targets what four factors responsible for lesion formation
- increased sebum production
- hyperkeratinization
- colonization by Propionibacterium acnes
- resultant inflammatory reaction
43
physiological factors of acne vulgaris
```
- Follicular
hyperkeratinization
- Excessive sebum
production
- Follicular proliferation
of Propionibacterium
acnes
- Inflammation secondary
to the action of
inflammatory products
produced by P. acnes
- Excessive production of
sebum is related to
androgenic hormones
```
44
acne vulgaris
| noninflammatory
blackheads (open)
| whiteheads (closed)
45
acne vulgaris
| inflammatory (cystic)
caused by follicular wall rupture in closed comedones
| cystic nodules develop when inflammation is deeper
46
clinical management of acne vulgaris
topical treatments
systemic treatments
surgery
scarring treated with dermabrasion, lasers, and resurfacing techniques
47
acne conglobata
highly inflammatory
| severe
48
acne conglobata characterized by
formation of communicating cysts and abscesses beneath the skin
49
hydradinitis suppurativa (inverse acne)
chronic inflammatory
recurrent abscesses, sinus tract infection formation, and scarring
hyperkeratosis and occlusion of the pilosebaceous follicular ducts
50
hydradinitis suppurativa is associated with
obesity, stress, and smoking
51
hydradinitis suppurativa is treated with
drainage and antibiotics
52
drugs used to treat acne
- benzoyl peroxide
- Erythromycin (Macrolide antibiotic drug class)
- tetracycline
- isotretinoin
- clindamycin
- vitamin A acid: retinoic acid
- Formulations of the antibiotics minocycline, doxycycline,
and tetracycline
- Oral contraceptives for female acne patients
53
benzoyl peroxide causes death of what
anaerobic Propionibacterium acnes bacteria by slowly releasing oxygen
54
benzoyl peroxide actions
antibacterial, antiseptic, drying, keratolytic
55
keratolytic action
softens scales and loosens outer layer of skin
56
benzoyl peroxide may cause
peeling skin, redness, warm sensation
57
Clindamycin phosphate
| Clindets®, Dalacin®
topical form of systemic antibiotic
58
adverse reactions to Clindamycin phosphate
| Clindets®, Dalacin®
minor local skin reactions: burning, itching, dryness, oiliness, and peeling
59
Clindamycin phosphate
| (Clindets®, Dalacin®) available in
cream, gel, lotion, suspension, and pledget formations
60
isotretinoin (Clarus®, Epuris®)
treatment of severe recalcitrant cystic acne
61
isotretinoin (Clarus®, Epuris®) inhibits
sebaceous gland activity and has anti-keratinizing and anti-inflammatory effects
62
pressure ulcers result from
unrelieved pressure on the skin
63
4 contributing factors to pressure ulcers
pressure
shearing forces
friction
moisture
64
4 prevention techniques of pressure ulcers
frequent skin assessment
repositioning
pressure reduction, removal, and distribution
elimination of moisture
65
stage 1
nonblanchable erythema of intact skin
66
stage 2
partial-thickness skin loss involving epidermis or dermis
67
stage 3
full-thickness skin loss involving damage or loss of subcutaneous tissue
68
stage 4
full thickness skin loss with exposure of muscle, bone or supporting structures
69
keloids
elevated, rounded, and firm
| clawlike margins that extend beyond the original site of injury
70
hypertrophic scars
elevated erythematous fibrous lesions that do not extend beyond border of injury
71
keloids and hypertrophic scars caused by
excessive collagen formation during dermal connective tissue repair
72
pruritus
itching
73
atopic dermatitis
most common form of eczema in children
| genetic link, altered immunity, and immune responses
74
clinical manifestations of atopic dermatities
severe pruritus, eczematoid appearance, and age dependent distribution of skin lesions
75
pimecrolimus (Elidel®)
immunomodulator
| treats atopic dermatitis
76
imiquimod
| Aldara P®, Vyloma®
immunomodulator
| treats actinic keratosis, basal cell carcinoma, and anogenital warts
77
diaper dermatitis
form of irritant contact dermatitis
78
diaper dermatitis caused by
prolonged exposure to irritation by urine and feces
79
clinical manifestations of diaper dermatitis
varies from mild erythema to erythematous papular lesions
80
treatment of diaper dermatitis
- frequent diaper changes
- regular exposure to air
- use of super absorbent diapers
- topical treatment with petroleum or zinc
- topical antifungal medications if C. albicans present
81
allergic contact dermatitis
caused by T-cell mediated or delayed hypersensitivity
82
manifestations of allergic contact dermatitis
erythema
swelling
pruritus
vesicular lesions
