Integumentary and Sensory
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Severe itching which is subjective data a symptom of skin problem or general disease process (Cancer, jaundice or DM)
Tx: Antipruitics (Benedryl), therapeutic baths.
Gross swelling of lips, eyes, larynx. (Which can lead to resp. distress)
Tx: antihistamines, Epinephrine
Small vesicles of red, itchy skin, vesicles burst, ooze and crust forms.
Cause by stress, hereditary, allergies, irritant contact, etc.
Tx: antihistamines, wet dressings, bath, anti-inflammatory
Parasites move from person to person and are mostly found between fingers and toes. (burrows in the skin)
Causes severe itching which can become infected
Tx: Kwell lotion/shampoo
Shingles (Herpes Zoster)
caused by chicken pox virus (Varicella)
s/s: pruritis, intense pain, malaise and usually affects only one side of the body (rash lasts 3-4 days)
Herpes Simplex I
Fever blisters and cold sores that last up to a week
Dry flakes on scalp or cheese-like plugs
Tx: Shampoos (Selsan Blue)
Excess sebacious drainage, scales, or cheese-like plugs on the body.
s/s: yellowish greasy scales.
Tx: no cure; steroids, low FAT diet, sunlight, exercise.
no known cause
s/s: red patches-silvery scales-that shed constantly
Tx: wet drgs, salicylic acid, steroids, sun, Vit A
Inflammation of the skin where two surfaces touch. (ex: axillary, abdomen, legs, etc)
Tx: decrease friction, keep clean
fungal infection casued by yeast (mouth, vagina,colostomy site)
Tx: antifungal cream, wet compress, Nystatin.
small flesh/brown colored papules cause by HPV.
Tx: ketolytic agents, liquid nitrogen, electrodesication (scrape and suction)
Cluster of boils
Tx: warm wet dressing, lance.
- Borders (irregular)
- Color (uneven)
- Diameter (large)
Rule of Nines for burns
- head = 9%
- ant/post torso =36%
- ant/post arms (both)= 18%
- groin = 1%
- ant/post legs (both) = 18%
1st degree burns
burns the epidermis and causes the dermis to swell
2nd degree burns
Superficial partial- burns the first and second layer of skin
Deep partial- burns deeper skin layers
3rd degree burns
Injures all layers of the skin and the tissue underneath.
Can destroy fats and muscles.
4th degree burns
burns extend thru the skin down to the muscles, ligaments, tendons, blood vessels and bones.
Seen in nuclear radiation and usually fatal
Healing of burns in 4 stages
- 1. neurogenic shock (airway)
- 2. fluid loss (foley and I&O's)
- 3. infection
- 4. repair (graft)
- Silver Nitrate
- Diet high in CAL, PRO, Vit C
- G.I. disturbance
- Hypostatic pneumonic
- Kidney failure
- Low Self- Esteem
Conductive hearing disorder
Affects the bone in the middle ear; sound waves are blocked as they move thru the auditory canal or middle ear and cant reach the inner ear. (cause by disease or malformation/damage to outer or inner ear).
s/s: muffle or faint sound, may have earache or discharge.
Sensorineural hearing disorder
Sound waves are conducted normally, but the messages are not transmitted properly to the brain. (caused by head injuries, old age, loud noises, hereditary, etc.)
s/s: sounds are muffled or distorted, high tones are inaudible, dizziness or nausea and ringing or buzzing noise.
Central hearing disorders
Sound signals are transmitted normally but interupted incorrectly by the brain (caused by damage or malfuction to the brain).
s/s: communication difficulties, difficulty hearing speech in a noisy enviroment
temp is 98.6; aseptic technique unless tympanic membrane is damaged
pt should lie on the affected side for 5 minutes (fluid should flow from gravity)
feeling of being "rotated" when you are not. (caused by viral infection, otitis media, migraine, labrynthitis, stroke, tumor or MS)
s/s: dizziness, N/V
Tx: –Antibiotics, Antivert, Klonopin, Phenergran, Radiation or Surgery
External otitis (swimmers ear)
Chronic external ear inflammation caused by prolonged exposure to water.
- Tx: Antibiotics, antifungals, ear plugs
- Prevention: Acetic Acid (Alcohol/Vingear solution)
Occurs in warm, damp climates especially when auditory canal hasn't been completely dried; fungus grows
Tx: ear drops, antifungal meds, alcohol and glycerin, long term treatment
Perforated Tympanic Membrane
caused by extremely loud noises, internal infection and increased pressure.
Tx: depends on the amount of damage, heals spontaneously or myringotomy
Serous Otitis Media
Fluid collects in the middle ear as a result of obstruction of Eustachian Tube (infection, allergy, tumor or change in altititude)
s/s: crackling sensation, fullness in ear or hearing loss
Acute Purulent Otitis Media
Pus collects in the tympanic membrane
s/s: inflamed or bulging tympanic membrane, fever, HA, hearing impaired.
Tx: myringotomy to prevent rupture of eardrum.
Complications of Purulent Otitis Media
- 1. can lead to otitis media
- 2. mastoiditis
- 3. meningitis
- 4. brain abscess
Chronic otitis media
Associated with punctured ear drum or complications of acute otitis media.
s/s: ringing of the ear, drainage, HA, N/V, pain, increased temp, chills and dizziness.
Tx: antibiotics and mastoidectomy may be necessary
A surgical incision is made into the tympanic membrane to drain the fluid from the ear and tubes are placed in the ear to drain excess fluid which releases pressure and pain.
Post op: small cotton ball in ear (do not plug tightly), antibiotics, rest and adequate diet
Polyethyline Tubes (PE tubes)
placed in eardrums and allows continuous drainage from the middle ear.
post op: do not put water into ears.
Reconstruction of the middle ear to preserve vital parts with less impairment of hearing (reconstruction of bones).
done instead of radical mastoidectomy
bony fixations of stapes which interfers with vibrations of stapes.
s/s: tinnitus, slow loss of hearing
Tx: surgery (stapidectomy)
Stapes removed and replaced by a small piece of wire or plastic piston
post op: watch for injury potential, do not blow nose violently, no water in ears, back to normal activity in 2 weeks.
Removal of infected mastoid cells and to ensure drainage. (mastoid bone contains facial nerve and inner ear).
Constructing a new window to replace natural window that connects the middle ear to the inner ear so that vibrations can be carried.
post op: instruct pt to move slowly (may have N/V), hearing takes 4-6 weeks to improve and avoid blowing nose.
Disturbance of semi-circular canals in the inner ear (cause is excess fluid).
s/s: vertigo, n/v, fall risk, hearing loss, tinnitus and aural fullness
Tx: Benadryl, Dramamine, antihistamine, antiemetic, sedatives, tranquilizers, bedrest, low Na diet, fluid restriction, omit ETOH, caffeine and smoking.
Chronic inflammatory process of the eyelid (common cause is bacteria, Staph, allergies)
s/s: red inflammed crust like scales at the base of the lid, may or may not burn or itch.
Tx: no cure; keep eyelids clean, warm compress, topical antibiotic ointment
Infection of the eyelid that starts at the hair follicle or sebacious gland.
s/s: pain, red, swelling, rupture with discharge.
Tx: usually clears up on own, don't touch, hot wet compress, antibiotics,
inflammation of conjunctiva (spread by droplet)
s/s: pain, redness, swelling, lacrimation
Tx: hot moist compress, no corticosteroids and do not cover.
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