Med Surg Ch 53
Card Set Information
Med Surg Ch 53
Which of the following is protein in epidermal cells that makes the skin relatively waterproof?
Innermost epidermal layer
where mitosis takes place to produce new epidermal cells
prevents the loss of water and dehydration
prevents the entry of excess water through the body surface
Outermost epidermal layer
Consists of many layers of dead cells; all that remains is keratin
barrier against pathogens and most chemicals
Cells in the lower epidermis
Protein that is a genetic characteristic
Gives color to the skin and hair
when exposed to UV rays, melanin increases
pigment barrier to protect further exposure of living cells in the stratum germinativum to UV rays
Located in the epidermis
type of macrophage that presents foreign antigens to helper T cells
first step in destruction of pathogens that have penetrated the epidermis
Produce the protein fibers collagen and elastin
located in the dermis
Form the strength of the dermis
Capable of recoil and make the dermis somewhat elastic
Function of eyelashes and eyebrows and nostril hair
Eyelashes and eyebrows - keep dust and sweat out of eyes
nostril hair - filters air entering the nasal cavities
Sensory receptors in the dermis
For cutaneous senses
free nerve endings
heat, cold, itching, pain
encapsulated nerve endings
touch and pressure
How is the sensitivity of an area of the skin determined?
By the density of receptors present
Secreted by the sebaceous gland
A lipid substance that inhibits the growth of some bacteria
prevents drying of skin and hair
AKA sweat glands
apocrine and eccrine
Apocrine Glands (what, where, activated by?)
Modified scent glands
axillae and genital area
activated by stress and emotions
Eccrine glands (where, activated by, function)
Faces, palms, soles
activated by high temperature and exercise
cooling mechanism but can lead to dehydration
What are the functions of subcutaneous tissue?
Cushions bony prominences
Older adults have fewer fibroblasts, and epidermal division slows. How do these changes affect nursing care?
The nurse should take care to protect fragile skin
Which term should be used to document a raised, fluid filled lesion smaller than 1 cm?
What equipment is most important to have readily available when a patient is undergoing skin testing for allergies?
Why should wet dressing be applied only to one third of the body at one time?
To prevent chilling the patient
increased blood flow
Paleness or decrease in color
can be caused by:
decreased blood flow
decreased hemoglobin levels from amenia
Between the dermis and muscles (connects skin to muscle)
made of areolar and adipose connective tissue
contains numerous wbcs that destroy pathogens that have entered by way of broken skin
may result from liver disease
check in the sclera of the eye
Any change or injury to tissue
Documenting skin lesions
Provides clues to the pts level of hydration
normal / abnormal
petechiae and ecchymosis
Reddish purple hemorrhagic spots
smaller than 0.5 mm in diameter
Bruise that changes color from blue black to greenish brown or yellow over time
raised less than 1 cm in diameter due to superifical thickening in the epidermis
Normal nail characteristics
What should you assess when examining a patients nails?
Transverse depressions in the nails
could indicate systemic illnesses or nail injury
Inflammation of the skin at e base of the nail
could indicate local infection or trauma
Three common types of skin biopsies
Uses a small round cutting instrument to cut a cylinder shaped plug of tissue for a full thickness specimen
Removes just the area that has risen above the rest of the skin
Performed with a scalpel to make a deep incision and almost always requires sutures for closure
What is the most uncomfortable part of a biopsy procedure?
the injection of local anesthesia
Wood's light examination
Involves the use of ultraviolet rays to detect fluorescent materials in the skin and hair present in certain diseases
example tinea capitis (ringworm)
What test should be performed when allergic contact dermatitis is suspected?
Patch and scratch tests
performed by dermatologist on uninvolved skin
What is the purpose of wet dressings?
cleanse and dry a wound
How long should wet dressings be perscribed and why?
No longer than 72 hours because the skin may be too dry or macerated
When would you avoid using a topical powder?
Powders would be avoided for pts with respiratory disease or tracheostomies
What can an overuse of topical steroids cause?
Thinning of the skin
How long should plastic wrap dressings be applied?
For no longer than 12 hours a day
How should skin tears be covered?
With a non-adherent dressing such as xeroform and wrapped with gauze
When collecting a wound culture, what should you not swab?
Do not swab over the eschar (scabby black part)
What are the two layers of the skin?
T or F: the skin is an organ
what is the innermost layer of the skin?
What happens in the stratum germinativum?
Production of new epidermal cells
production of the protein keratin
function of keratin
prevents the entry of pathogens
What is the outermost layer of the epidermis?
what is the function of melanin?
Genetic characteristic that gives color to skin and eyes
production increases when skin is exposed to UV rays
What is langerhan's cells?
Macrophages that destroy pathogens that enter the epidermis
why do we need some uv rays?
enables the formation of vitamin d from cholesterol
What do fibroblast cells produce?
the Protein fibers: collagen and elastin
Where are ceruminous glands found and what do they secrete?
Dermis of the ear canal
secretes cerumen or earwax to prevent drying of outer surface of the ear drum
What is the function of the blood vessels in the dermis?
Provide tissue nourishment
maintain body temp
dilation of the blood vessels in the dermis in warm environment increase blood flow and heat loss to air
constriction of the blood vessels in cold environment decreases blood flow to skin to conserve body heat
What happens to blood vessels during stressful situations?
cause vasoconstriction in the dermis, allowing blood to flow to more vital organs, heart, liver, brain, muscles
Between the dermis and muscle
made of areolar and adipose connective tissue - cushions, insulates, stores energy
consists of numerous WBCs to destroy pathogens that enter the cracks in the skin
May result from liver disease
check the sclera of the eye
Blush discoloration may indicate a cardiac pulmonary or perfusion problem
assess lips, nailbeds, conjunctivae, and palms
Erythema in dark skin pts
Shows as purpleish gray color
thickening and hardening of skin due to fibrotic changes following healing of a wound or surgical incision
Abnormal nail features
Clubbing - hypoxia
spoon /concave - anemia
thick - fungal
A scab formed by dry serum, pus, or blood