Integumentary System Final Review

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Author:
dmshaw9
ID:
301676
Filename:
Integumentary System Final Review
Updated:
2015-04-28 00:37:47
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Integumentary System Final Review
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NPTE,Final Review
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NPTE: Final Review
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  1. Dermatitis (Eczema)
    • Inflammation → itching, redness, skin lesions
    • Allergic, actinic, atopic causes
    • Avoid use of alcohol
  2. Bacterial Infections: 3 Types
    • Impetigo = superficial skin infection, small pus-filled vesicles, itching 
    • Cellulitis = widespread inflammation of cellular/connective tissue
    • Abscess = cavity containing pus, surrounded by inflamed tissue
  3. Cellulitis: Treatment
    • Antibiotics
    • Elevation of part
    • Cool/wet dressings
    • Untreated → lymphangitis, gangrene, abscess, sepsis
  4. Herpes Zoster: Symptoms
    • Pain/tingling in spinal/CN dermatome → progresses to red papules along infected nerve
    • Fever, chills, malaise, GI disturbances
    • CN III (ocular complications) and V (loss of vision) involvement
  5. Contraindications with Herpes Zoster
    Heat/ultrasound
  6. Lupus Erythematosus: Definition and Characteristics
    • Chronic, progressive, autoimmune disorder
    • 2 types: discoid lupus and systemic lupus
  7. Discoid Lupus
    • Affects only skin
    • Flare ups with sun exposure
  8. Systemic Lupus Symptoms
    • Fever 
    • Malaise
    • Butterfly rash
    • Chronic fatigue
    • Arthralgia
    • Arthritis
    • Skin rashes
    • Photosensitivity
    • Anemia
    • Hair loss
    • Raynauds
  9. Scleroderma: Definition
    • Fibrosis of skin, joints, blood vessels, and internal organs
    • 2 types = limited and diffuse
  10. Limited Systemic Sclerosis/Scleroderma
    • Symmetrical
    • Skin involvement of distal extremities and face
    • Slow progression of changes
    • Late visceral and pulmonary HTN
    • CREST
  11. Diffuse Systemic Sclerosis/Scleroderma
    • Symmetrical
    • Distal and prox extremities
    • Face and trunk
    • Rapid progression of skin changes
    • Early appearance of visceral involvement
  12. Scleroderma Precautions
    • Skin sensitive to pressure
    • Acute HTN may occur
    • Pulm HTN → R sided HF in severe cases
  13. Polymyositis: Definition and Characteristics
    • Edema, inflammation, degeneration of muscle
    • Prox muscles (shoulder and pelvic girdle, neck, pharynx), symmetrical
    • Rapid, severe onset
    • Cardiac involvement (may be fatal)
  14. Polymyositis: Precautions
    Additional muscle fiber damage with too much exercise
  15. 1st Degree Burns
    • Epidermis damage
    • No blistering
    • Min edema
    • Tenderness/delayed pain
    • Spontaneous healing 3-7 days
    • No scarring
  16. 2nd Degree Burns: Superficial Partial Thickness
    • Epidermis and upper dermis
    • Blanching with brisk cap refill
    • Blisters, moist surface
    • Mod edema
    • Painful/sensitive
    • Spontaneous healing 7-21 days
  17. 2nd Degree Burns: Deep Partial Thickness
    • Epidermis and dermis with injury to nerve endings, hair follicles and sweat glands
    • Blanching with slow cap refill
    • Broken blisters/wet surface
    • Mixed red, waxy white appearance
    • Marked edema
    • Sensitive to pressure, insensitive to light touch/pinprick 
    • Healing through scar formation and re-epithelialization
  18. 3rd Degree Burns
    • Full thickness = epidermis, dermis and subcutaneous tissue
    • White (ischemic), charred, tan or black
    • No blanching, poor distal circulation
    • Little pain
    • Hypertrophic scarring and wound contracture without preventative measures
  19. 4th Degree Burns
    • Subdermal = involvement of subcutaneous muscle and tissue
    • Charred appearance
    • Amputation may be necessary
  20. Additional Complications with Electrical Burns
    • V fib
    • Acute kidney damage
    • SC damage
  21. Arterial Ulcers
    • Irregular, smooth edges
    • Min-no granulation
    • Deep
    • Lateral malleolus, ant tib
    • Decreased/absent pulses
    • Painful with LE elevated
    • Severe, intermittent pain → progresses to pain at rest
    • No drainage
    • Gangrene may be present
    • Intermittent claudication
    • Trophic changes
    • Cool temp 
    • Pallor with elevation, rumor on dependency
  22. Venous Ulcers
    • Dark pigmentation (hemosiderosis) 
    • Fibrotic (liposclerosis)
    • Good granulation
    • Shallow
    • Med malleolus
    • Present pulses
    • Little pain, aches in dependent position
    • Lg amounts of exudate
    • No gangrene
    • Marked edema
    • Stasis dermatitis
    • Cyanosis in dep. position
    • Normal temperature
  23. Compression with Venous Ulcer
    Compression contraindicated with ABI < 0.7 or active DVT
  24. Diabetic Ulcers
    • Associated with arterial disease and peripheral neruopathy 
    • No pain, sensory loss present
    • Present/diminished pulses
    • Absent ankle jerks with neuropathy
    • Monofilament testing
    • Classified with Wagner system
  25. Ulcer Grading: Stage 1
    • Nonblanchable erythema of intact skin
    • May include changes in skin temp, tissue consistency and/or sensation
  26. Ulcer Grading: Stage II
    • Partial-tickness skin loss
    • Superficial ulcer
  27. Ulcer Grading: Stage III
    • Full thickness (subcutaneous tissue involvement 
    • Seep crater
  28. Ulcer Grading: Stage IV
    • Full thickness, involves muscle, bone, or supporting structures
    • Undermining/sinus tracts may be present

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