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thin layer of squamous epithelium, 0.1 mm thickness, has a stratum corneum and basal cell layer. this is what layer of skin?
thick, deeper layer, 15-40 x thicker, has a connective tissue and reticular layer, has blood vessels, nerves, hair follicles, sweat glands, sebaceous glands. this is what type of layer of skin?
What is the function of adipose tissue?
- cushion between skin & bone
- insulates the body
What are the 6 functions of the skin?
- 1. protection
- 2. heat regulation
- 3. prevent fluid loss
- 4. synthesis vitamin D
- 5. excrete H20 & waste
- 6. senses
What infection is a staphylococci or strep infection. Contagious by touching the skin. shows up as small red macules, yellow crust?
How do you treat impetigo?
- use topical or systemic antibiotics
Which infection is a hair follicle infection?
Which infection is seen as a boil and a deep infection?
Which infection is seen as an abscess to subcutaneous tissue?
What type of infection is a soft tissue infection, organisms proliferate rapidly in the fascia, and the excreting tissue destroys enzymes?
What are possible ways a person can get necrotizing fasciitis?
- drug injection
- minor/major trauma
- skin abscess
- diabetes mellitus
- intra-abdominal infections
- peripheral vascular disease
What are signs/symptoms of necrotizing fasciitis?
- increased WBC
How do you treat necrotizing fasciitis?
- antibiotics IV
- surgical debridement
What infection is an inflammatory viral condition that has painful vesicular eruptions along sensory nerve tracks from posterior ganglia?
herpes Zoster (shingles)
herpes zoster is seen after what virus has been dormant in nerve ganglia and has become reactivated?
Varicella zorter virus- chicken pox
what is one major factor that can case chicken pox to be reactivated to cause shingles?
what are signs/symptoms of shingles?
painful blisters and red rashes
If a patient has shingles and has been treating it for at least one week and wondering why it has not gone away how can the nurse respond to their question?
it usually last 1-3 weeks or longer and need to keep taking medication as prescribed
What type od medication is prescribed to a patient with shingles?
- anti viral agents
What type of infection is a chronic inflammatory infection where the skin reproduces at 6-9 x normal rate. shows on skin as scales & plaque that is red and itchy usually caused by genetic and stress?
How can we treat Psoriasis?
- anthralin salicyclic acid (corticosteroid)
- Tar formula followed by ultra violet light
- decrease stress
What type of parasitic infection is found in hair follicles, seen as tiny with grains that are contagious and causes itching?
What type of parasitic infection is found under the skin as red lines, is itchy and very painful and most seen in patients the live in close quarters with others and have poor hygiene?
What type of fungal infection is found in the perineal area, is communicable, seen as a circular rash?
tinea (ring worm)
Which type of skin cancer is the most common seen as waxy looking found in the eye, lip, and tip of nose?
basal cell carcinoma
Which type of skin cancer is the most invasive seen as rough, thickened, scaly, and may bleed.
Squamous cell carcinoma
what is the treatment for basal and squamous cell carcinomas?
- surgical excision
- Moh's micrographic (remove layer by layer)
- electro cryo (freezing)
- liquid nitrogen
Which type of skin cancer arises from pigment producing cells melanocytes. evolves from existing moles?
What is the ABCD's of detecting a malignant mole?
- A- asymmetry
- B- borders
- D- diameters
Based on the ABCD's of detection what describes a suspicious mole?
- Asymmetry of one half unlike the other half or one side partially flat
- Borders are ill defined margins, may fade into surrounding skin, or look red or irritated
- Colors are red, white, blue, brown, black, or tan
- Diameter is greater than 5 mm, bigger than the size of a pencil eraser
What are s/sx of malignant melanomas?
- itching, tender, painful moles
- moles are new color and spread beyond borders
- oozing/bleeding from pigment area
- scaly texture
- mole change in size
A mole that is well defined, symmetrical, uniform in color, entirely flat or raised, has hair growth would be considered a normal or suspicious mole?
If a patient has malignant melanoma where are possible sites that it can metastasize to?
What are ways to treat malignant melanoma?
- chemotherapy & biotherapy
What is the purpose of chemotherapy & biotherapy with interferon alfa-2b & interleukin 2 treating malignant melanoma?
to slow the disease progress
What is the purpose of radiation in treating malignant melanoma?
to shrink the tumor
Which eye problem is a progressive disease involving small vessel damage & occlusion causes the vessels to hemorrhage and can cause retinal detachment?
Which type of individuals are more likely to develop diabetic retinopathy?
- pregnant women
- Type 2 diabetics
- African americans
What are ways to prevent diabetic retinopathy?
early and often eye exams
What are s/sx of a patient with diabetic retinopathy?
- sudden visual loss
- flashing lights
- shadow or curtain like darkness
What are treatments in treating diabetic retinopathy?
- Argon laser-treats focal hemorrhagic areas
- Pan retinal photo coagulation
If there is a tear or hole in the eye and liquid vitreous gains access to the subretinal space that will cause what major problem to happen?
What are risk factors to developing retinal detachment?
- increase age
- family history
If a patient is complaining of seeing flashing lights, loss of peripheral vision, sudden shadow or curtain in vision, loss of vision gradual these are signs of what problem the patient is having?
Which disorder of the eye is the most common of the anterior segment and due to increased intraocular pressure?
What are the two different types of glaucoma?
- primary open angle glaucoma (POAG)
- Acute primary closed angle
Which type of glaucoma caused 80,000 blind people in USA and is the most common, preventable and slowly develops?
Primary open angle glaucoma
What is the difference between primary open angle and acute primary closed angle?
- primary open angle is simple and wide angle
- acute primary closed angle is narrow angle
What are the causes of primary open angle glaucoma?
- clogged by deposits
- build up slowly
What are some signs/symptoms of a patient with primary open angle glaucoma?
- cloudy vision
- less accommodation
- loss of peripheral vision
- vague aching discomfort
What are signs/symptoms of acute primary closed glaucoma?
- sudden blurred vision
- rainbow halos around lights
What are causes of acute primary closed glaucoma?
Which type of glaucoma is an rapid onset, causes blockage of all outflow, the iris acts like a sheet of paper and folds back covering the drainage?
Acute primary closed glaucoma
What is the best way to prevent glaucoma?
early screenings at age 35
What are risk factors to developing glaucoma?
- near sighted
- family history
A patient has increased intraocular pressure what is the best treatment for this patient?
What is the purpose of using beta blockers in treating glaucoma?
decreases aqueous production
What is the purpose of miotics in treating glaucoma?
- constrict the pupils
- opens outflow
- decrease aqueous output
What is the purpose of carbonic anhydrase inhibitors in treating glaucoma?
decrease aquius production
Which type of glaucoma is a medical emergency and is primarily treated with miotics & surgery?
acute primary closed angle
Which eye disorder causes opacity or cloudiness in the normally transparent lens and reduces visual acuity. It is the leading cause of curable blindness?
What are risk factors to developing cataracts?
- increase age
- radiation damage
What are signs/symptoms of a patient with cataracts?
- decreased visual acuity
- blurred distorted vision
- glare, less contrast sensitivity
- amber, brown discoloration
- difficulty reading and seeing at night
What is the primary treatment in treating cataracts?
surgery to remove lens
What are some complications a nurse needs to be aware of that can occur after surgery to correct cataracts?
- rupture of the posterior capsule with vitreous loss
After a patient has had surgery to correct cataracts what is important for the nurse to tell the patient they cant do?
bend over it increases intraocular pressure
What is the purpose of miotics in the treatment of cataracts?
- decrease intraocular pressure
- dilate pupils
- prevents adhesions form forming
A nurse is educating a patient on how to give themselves eye medication. what is the correct way to do this?
- occlude nasolacrimal duct while instilling medication
- wait three minutes between giving different eye medications
Which ear disorder involves inflammation or infection of the auricle and ear canal epithelium due to infection?
What are symptoms of external otitis?
- ear canal swelling
What are the three important treatments for external otitis?
Which ear disorder that when untreated or repeated attacks in early childhood cause chronic middle ear infections?
acute otitis media
What are symptoms of acute otitis media?
- purulent exudate
- inflammation in the ossicles, Eustachian tube, and mastoid bone
What are the likely treatments for acute otitis media?
Which ear disorder is characterized by symptoms of inner ear disease with episodic vertigo, tinnitus, fluctuating sensorineural hearing loss, and aural fullness?
What can Meniere's disease turn into?
excessive accumulation of endolymph
When a patient is having an attack with Meniere's disease what will they complain of?
- sense of ear fullness
- decreased hearing acuity
How long does an attack happen with Meniere's disease?
- hours to days
- occurs several times a year
During an attack besides sense of ear fullness, decreased hearing acuity, and tinnitus what are other symptoms the patient may complain of?
When a patient has several attacks and their hearing loss fluctuates what could eventually happen?
permanent hearing loss
When a patient is having an attack with Meniere's disease what is the priority of the nurse?
- minimize vertigo
- patient safety
Which hearing disorder occurs in outer and middle ear and impairs the sound being conducted from outer to inner ear?
conductive hearing loss
What types of things cause conductive hearing loss?
- conditions that interfere with air conduction otitis media with effusion
- impacted cerumen and foreign bodies
- middle ear disease
Which hearing disorder is due to impairment of inner ear or vestibulocochlear nerve?
Sensorineural hearing loss
What are causes of sensorineural hearing loss?
- congenital and hereditary factors
- noise trauma
- Meniere's disease
If a patient has sensorineural hearing loss what does the patient mainly complain about?
able to hear sound but cant understand speech
What are some indications that a person may be having hearing loss?
- asking people to speak up
- answering questions inappropriately
- not responding when not looking at speaker
- straining to hear
- increasing sensitivity to slight increase in noise level
What are ways a nurse can educate a patient on preventing hearing loss?
- participate in hearing conversation programs in the work place
- monitoring for side effects and level of ototoxic drugs
- avoid continual exposure to high noise levels
- avoid industrial drugs and chemical
Which ear disorder is associated with aging and includes loss of peripheral auditory sensitivity, decline in word recognition ability, and associated psychological and communication issues?
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