Med Surg Final Exam

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t053171p
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149495
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Med Surg Final Exam
Updated:
2012-04-23 08:05:00
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Integumentary
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  1. the nurse is instructing the pt on proper skin protection from the sun. what are the instructions she/he should give the pt?
    wear a wide brim hat, long sleeves, sunscreen with spf 15 or higher 15 mins before going in sun or swimming. avoid direct sunlight from 10am to 4pm
  2. what is the purpose of wet drssings and Burrows solution? when would cold compresses be applied and why?
    promote healing and vasoconstriction
  3. how would you assess a cyanotice pt with dark skin
    lips, mucous membranes
  4. what is malignant melanoma and how does it appear on the skin? what is a nevous?
    • cancer
    • moles
  5. how do you prevent malignant melanoma?
    sunscreen, avoid exposure
  6. how would you know if a pt's respiratory system has been affected if they are burned? what would you assess frequently?
    • singed facial hair, soat in throat, hoarseness, burnt face, black tinged sputum, stridor
    • airway
  7. what kind of care would you plan for a pt with eczema?
    treat symptoms, use wet dressings to maximize hydration, apply topical steroids, coal tar, lotion
  8. when a pt has over 24% of his body burned, the nurse needs to assess the pt for fluid overload. describe what happens.
    • initiate IV fluid-amt r/t burn %-weight pt so dr can determine amount
    • insert foley cath for hrly output-hourly output of 30-50mL recommended
    • IV fluids given to maintain renal profusion
  9. what is the tx for genital herpes? how would you know if the tx is effective?
    • no cure, Acyclovir-inhibits viral reproduction
    • lesions present 7-14 days
  10. describe the nursing assessement for tinea corporis.
    extreme pruritus and tenderness, lesions flat with clear centers and erythematous borders on nonhairy body parts
  11. what are the nursing interventions for dermatitis venenata?
    wash affected part ASAP after contact with allergan. cool open dressings
  12. what is wound debriding? why is it so important?
    removal of damaged tissue and cellular debris from a wound or burn to prevent infection and promote healing
  13. what are the txs for severe pruritis with generalized macular papular skin eruptions?
    apply anesthetic, loose clothing
  14. what is herpes zoster and how is it spread? who has the greatest risk for infection of herpes zoster?
    • shingles
    • physical contact
    • young and elderly
  15. what is impetigo and what does it look like? who is more prone to impetigo?
  16. what is tinea capitis? what causes tinea capitis?
    ringworm on the scalp, warm soak, Borrows solution, antifungal
  17. what is urticaria? what does it look like? and what usually causes it?
    hives, wheals, histamine
  18. what is acne vulgaris? how does it affect people who have it?
    • acne
    • self-esteem
  19. what ethinic culture is more likely to develop a keloid? what does keloids look like and what causes keloids?
    • dark skin
    • overgrowth of scar tissue
  20. when does the greatest fluid loss occur in a pt who has been badly burned?
    12 hours
  21. most deaths occur (in the emergent phase of a burn) due to what? why would they be transferred to a burn center?
    • hypovelmic shock
    • further shock
  22. how do you get carbon monoxide poisoning? what does carbon monoxide do to hemoglobin?
  23. what is the most common complication of burns? when does it occur?
    • infection
    • 72 hours after burn
    • acute
  24. what is Curling's ulcer? when does it develop? what is the first sign?
    duodenal ulcer, 8-14 days after burn, blood
  25. how do you prevent chilling in a burned pt?
    keep room at 85 degrees
  26. what is a carbuncle? how is a carbuncle treated? how do you know if tx is successful?
    • cluster of boils
    • warm compresses
    • after rupture pain is decreased
  27. know the rule of 9's.
    • each part of the body is divided into 9%
    • see p. 1332

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