Week 9: Skin Care

Question 1

Functions of the Skin

Answer 1

• Protect underlying structures
• Regulate body temperature
• Sensory input
• Stores fat
• Metabolism of salt and water
• Gas exchange
• Production of vitamin D

Question 2

Xerox is

Answer 2

Extremely dry, cracked and itchy skin.

Question 3

Xerosis is caused by

Answer 3

-Decrease in epidermal filaggrin, which is a protein required for binding of keratin into macrofibrils.

Question 4

Xerosis is primarily found on the

Answer 4

• Extremities (mostly the legs)

- May affect trunk and face

Question 5

Pruritus

Answer 5

• Itchy skin

- Can cause skin injury secondary to scratching

Question 6

Pruritus can be aggravated by

Answer 6

• Perfumed detergents
• Fabric softeners
• Heat
• Sweating
• Restrictive clothing
• Exercise
• Medications

Question 7

Pruritis may result from

Answer 7

-Systemic disease such as chronic renal failure, biliary or hepatic disease.

Question 8

Failure to control pruritus can increase the risk for what?

Answer 8

• Eczema excoriation
• Cracks
• Infection

Question 9

Scabies

Answer 9

• Causes intense itching
• Caused by tiny mite (sarcoptes Scabiei)
• Contagious, easily transmitted through close physical contact; intimate or casual.

Question 10

How is scabies diagnosed?

Answer 10

Visually or via skin scraping

Question 11

How is scabies treated?

Answer 11

• Prescribed lotions and creams
• Clothes and linens need to be washed in hot, soapy water and dried with high heat.
• Rooms need to be cleaned and vacuumed.

Question 12

Purpura

Answer 12

• Fragility of dermal capillaries secondary to dermal thinning causing blood vessels to rupture -> extravasation of blood into surrounding tissue.
• Increases with age.
• Commonly seen on dorsal forearm and hands.

Question 13

What makes a person more susceptible to purpura?

Answer 13

Blood thinners

Question 14

Skin Tears

Answer 14

• Occurs because the skin is thin and fragile.

- Painful, acute, accidental in nature.

Question 15

Management of Skin Tears

Answer 15

• Proper assessment
• Control of bleeding
• Cleanse with nontoxic solution
• Appropriate dressing
• Management of exudate
• Prevention of infection

Question 16

What are types of keratosis?

Answer 16

• Seborrheic Keratosis

- Actinic Keratosis

Question 17

Seborrheic Keratosis

Answer 17

• Benign growth
• Mainly see on trunk, face, scalp, and neck
• Waxy, raised, stuck-on appearance
• Flesh colored or pigmented, various sizes

Question 18

Actinic Keratosis

Answer 18

• Precancerous
• Related to exposure to UV light
• Rough scaly sandpaper patches
• Pink to reddish brown with erythematous base

Question 19

What increases the risk for actinic keratosis?

Answer 19

• Increased age

- Fair complexion

Question 20

Herpes Zoster (Shingles)

Answer 20

-Viral infection caused by reactivation of the varicella-zoster (chicken pox) virus

Question 21

Herpes Zoster (Shingles) are preceded by

Answer 21

• Itching
• Tingling
• Rash along the dermatology prior to outbreak of vesicular lesions

Question 22

Signs of Herpes Zoster (Shingles)

Answer 22

• Lesions that rupture, crust over and heal

- Infectious until crusts over

Question 23

Treatment for Herpes Zoster (Shingles)

Answer 23

• Analgesics
• Calamine lotion
• Antiviral agents
• Zoster vaccine if greater than 60 years old

Question 24

What are complications of Herpes Zoster (Shingles)?

Answer 24

• Postherpetic neuralgia

- Eye involvement

Question 25

Candidiasis

Answer 25

- Caused by fungus Candida albicans found on the skin | - Found in warm, moist areas of the skin, like skin folds, axillae and groin.

Question 26

What are risk factors for candidiasis?

Answer 26

- Obesity - Malnourishment - Antibiotic or steroid use - Immunocompromised - Chemotherapy - Diabetes

Question 27

Candidiasis is commonly called what when inside the mouth?

Answer 27

Thrush

Question 28

Skin cancer: Basal Cell

Answer 28

- Most common malignant skin cancer - Slow growing and metastasis is rare. - Early detection and treatment minimizes damage.

Question 29

Skin Cancer: Basal Cell is triggered by what factors?

Answer 29

- Extensive sun exposure - Burns - Chronic irritation - Ulceration

Question 30

Skin cancer: Squamous cell

Answer 30

- Aggressive and high incidence of metastasis | - Slightly different clinical manifestations and may be overlooked

Question 31

What are major risk factors for squamous cell skin cancer?

Answer 31

- Sun exposure - Fair skin - Immunosuppression

Question 32

Treatment for squamous cell skin cancer depends on

Answer 32

Size Histology Patient preference

Question 33

Melanoma

Answer 33

- Neoplasm of the melanocytes | - Multicolored, raised, asymmetrical, irregular borders.

Question 34

What are risk factors for melanoma?

Answer 34

- More than 50 moles - Sun sensitivity - History of excessive sun exposure - Severe sunburns - Tanning beds

Question 35

Indoor Tanning

Answer 35

Increases the risk for melanoma by 75% when started before age 35.

Question 36

Pressure Ulcers

Answer 36

A localized injury to the skin and/or underlying tissue, usually over a bony prominence as a result of pressure or pressure in combination with shear.

Question 37

What are characteristics of pressure ulcers?

Answer 37

- Most frequently occur on the posterior aspects of the body, especially sacrum, heels and greater trochanter. - May also e seen on lateral knees and ankles, pinna of the ears, occiput, elbows and scapulae.

Question 38

Skin Changes at the End of Life

Answer 38

- Skin failure is defined as “an event in which the skin and underlying tissue die due to hypoperfusion that occurs with severe dysfunction or failure of other organs” - Occurs during the last days or weeks of life - Unavoidable part of dying and occur even if evidence-based strategies are employed

Question 39

What are risk factors for pressure ulcers?

Answer 39

- Changes in skin - Comorbid illnesses - Nutrition status - Frailty - Surgical procedure (orthopedic/cardiac) - Cognitive deficits - Incontinence - Reduced mobility

Question 40

Pressure ulcers in darker skinned patient’s

Answer 40

Redness or blanching may NOT be the first sign of PU in darker pigmented persons but may look purplish in color or look like a bruise

Question 41

Prevention of PU

Answer 41

-Addressing limited mobility, compromised skin integrity and nutritional support

Question 42

Assessment of PU

Answer 42

- Thorough assessment of skin: Braden Scale - Nutritional evaluation - Laboratory studies - Positioning - Incontinence care

Question 43

Know factors for Braden scale

Answer 43

..