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What are some environmental hazards of the integumentary system?
- Sun exposure
- Irritants and allergens
Ways to promote a good integumentary system?
- Rest and sleep
_______ ________ is always present on skin?
List bacteria that is present on the skin?
- Non-Hemolytic Streptococcus
- Group A Hemolytic Streptococcus
The organisms are shed with _______ ________ of skin.
How often do skin cells regenerate?
approximately every 4 weeks
What is the best way to remove bacteria from the skin?
Bathing, Rubbing, friction
Normal ph of skin is _______ which naturally retards the growth of bacteria
4.2 – 5.6
What is a portal for bacterial infections?
Break in skin integrity
List 3 Nonmelanoma Skin Cancers
- Actinic keratosis
- Basal cell carcinoma
- Squamous cell carcinoma
What is Actinic Keratosis ?
- “pre-malignant” lesion
- What does actinic keratosis look like?
- Small dry rough yellowish brown scales
What is a common cause of Actinic keratosis ?
Skin cancer occurs most commonly in ______ ______, especially in the _______ and in young people who have ______ ______.
Fair Skin, elderly, light skin
Which cancer may slowly progress to squamous cell carcinoma?
What is a malignant skin neoplasm ?
Malignant primary tumor of the epidermal layer of skin
List three types of skin cancers (3)
- Basal Cell
- Squamous Cell
The biggest cause of skin cancer is?
Prolonged exposure to UV rays
Other risk factors of skin cancer?
- Precancerous lesions
- Chemical irritants
- Friction or chronic irritation
Pathophysiology of skin cancer?
- Unregulated cell growth
- “cells gone wild”
- Uncontrolled cell division
- Results in development of a “neoplasm”
Basal Cell Carcinoma
Tumor growth in the basal layer of epidermis
Do the basal cell carcinoma mastatsize?
What does the basal cell carcinoma look like?
Small, waxy nodule with a translucent pearly border
Where does the basal cell carcinoma appear more frequently?
on the face, usually between hairline and lip
The 2nd most common skin cancer is?
Squamous Cell Carcinoma
What is squamous cell carcinoma?
Tumor arises from epidermis damaged by sun or skin that has been irradiated or excessive scarred
_______ ________ _________ rarely occurs in dark skinned individuals.
Squamous cell carcinoma
Squamous cell carcinoma is considered an ______ cancer.
Where does the squamous cell carcinoma usually show up?
- Usually on sun-damaged skin
- Rim of the ear
- on the face
- frequently on lips
- in the mucus layer of the mouth.
Risk factors for squamous cell carcinoma?
- UV exposure
- cigarette smoking
- cigar smoking
Characteristics of squamous cell carcinoma
- May metastasize
- Appears as a firm nodule with an indistinct border
- Border may be opaque
what does squamous cell carcinoma look like?
- poorly marginated
- blend in to surrounding skin
- can matastisize into the lympth system
are squamous cell carcinoma painful?
Early detection parallels ________
early treatment and cure rate
Treatments for squamous cell carcinoma?
- MOH's - scooping it out
- electrically disect it
Which skin cancer is a tumor that arises from melanocytes of the epidermis?
Of all cancer related deaths, _____ % die from melanoma?
Which skin cancer has the highest mortality rate of any form of cancer?
There is a higher incidence of malignant melanoma is persons using the tanning bed more than _______ x per year.
What does a malignant malenoma look like?
- Often appears in pre-existing moles
- Irregular-circular bordered lesion with hues of tan, black, or blue
What are the risk factors for malignant malenoma?
- fair skin
- blue-eyed people
- excessive childhood sun exposure
- increase of dysplastic moles
What are some common sites for malignant malenoma
back and legs
What are the ABCDs of assessing malenoma’s?
- A= ASYMMETRY
- B= BORDER IRREGULARITY
- C=COLOR VARIEGATION
- D=DIAMETER > 6 mm
What are some danger signs for melanoma’s?
- Change in color of mole over last 3-8 mths
- Size or shape of pre-existing lesion
- crusting lesion
- involve lymph nodes
Clincial manifestations of malignant malenomas
- involve lymph nodes
- matastasize to brain
- other skin surfaces
Diagnostic tests used for determining skin cancer?
- Skin Biopsy: Cytology positive for cancer cells
- thorough history and physical
- if possible to remove that is preferred
Survival is directly related to the ______ of tumor invasion.
Where does the malignant malenomas show up in dark-skinned people?
- palms of hands
- sole of feet
- mucus membranes
- areas less pigmented
Medical management of malenomas
- topical immune therapy
What is a topical immune therapy used for malignant malenoma?
The most common bacterial skin infections are _________ & ____________.
Impetigo & folliculitis
What are impetigo & folliculitis caused by?
- usually caused by Staphylococcus
- can be caused by strep
Impetigo is a _______ infection of the skin.
Most common parts for impetigo infections
- exposed areas of the body
Impetigo is often followed by infestations of (6).
- head lice
- scabies (itch mites)
- herpes simplex
- insect bites
- poison ivy
Chronic Health problems, poor hygiene and malnutrition predispose an adult to _______.
Overuse of _________-________ ______ may create resistant bacteria
Clinical Manifestations of Impetigo
- Small lesions
- Red macules (flat)
- Become thin walled vesicles that rupture forming a honey colored crust
The crusty skin when removed reveals what?
smooth red moist surface on which new crusts begin to develop
What therapy would you anticipate to use for impetigo?
- systemic antibiotic therapy (ceph)
- Topical antibiotic therapy
- Remove the lesion crust with soap and water
- Topical antibiotic is applied WITH GLOVES!!!
What would a nurse teach pt about impetigo?
- HIGHLY CONTAGIOUS
- avoid contact with other people until the lesion is healed
- family and client to bathe once daily with bacteria-cidal soap
- Each family member needs a separate towel and washcloth
- wash linens separately use mixture of Clorox to kill bacteria