Integumentary

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Author:
gemlnl862004
ID:
86507
Filename:
Integumentary
Updated:
2011-05-18 01:10:07
Tags:
skin integumentary rtw
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Description:
life span 2 study guide for care of client with integumentary disorder
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  1. A non-infectious, hereditary, chronic, proliferative disease involving the epidermis and can be mild or severe.
    Psoriasis
  2. Whats the treatment for psoriasis?
    • Steroids-tar preparation to decrease inflammation
    • Duvonex and Tazoric-cause upper cells to slough off faster so you dont get the build up
    • Light therapy-helps slow down psoriasis
  3. What are the 4 stages of pressure ulcers?
    • 1) Redness, nonblanchable intact skin
    • 2) Shallow crater, pink or red base
    • 3) into subq tissue, has lip or an edge, drainage
    • 4) deep into the muscle or bone
  4. How do you prevent pressure ulcers?
    • reposition every 2 hrs
    • use aids that minimize pressure w/o restricting circulation or creating pressure on surrounding areas
    • gentle handling is required
    • use mechanical lifts as assistant devices
    • remove urine/feces immediately-washing and patting the skin dry
  5. What is the treatment of pressure ulcers?
    • well balanced diet with attention to protein, vitamins and minerals
    • practice surgical asepsis when caring for a client to prevent secondary infection
    • monitor I/O, keep pt hydrated
  6. What are the functions of the skin?
    • synthesize vit D
    • protect organs against pathogens
    • excretion of fluids and waste
    • regulate body temp
    • detect sensation of touch, heat, and pain
  7. The outer layer of teh skin, contains melanin and sloughs off.
    epidermis
  8. Inner layer of the skin thats made up of elastic fibers and has hair follicles
    dermis
  9. Layer of the skin stores triglycerides, provides heat and cushioning
    subq layer (fat)
  10. Modifiable dead tissue and accessory organ
    hair
  11. Made of keratin and an accessory organ
    nail
  12. Secretes sweat everywhere except hands/feet-odorless and is an accessory organ
    sweat glands
  13. Secreted through hair follicles that keep skin from drying out and is an accessory organ
    sebum oil
  14. Nutrients that the skin requires
    Vit D, E, A, K and protien
  15. Redness of the skin caused by dialtion of the cappillaries and often a sign of inflammation or infection
    erythema
  16. Break in the skin surface usually covered in blood or serous fluid. Also known as a "scratch mark"
    excoriation
  17. Drainage of fluid rich in protein and cellular elements that oozes out of blood vessels
    exudate
  18. Type of skin cancer that is vicious and spreads fast, most deadly and has ability to metastasize to any organ.
    melanoma
  19. How do you prevent melanoma
    • limite exposure to sun-stay inside certain times of day
    • use sunblock-SPF 30 or greater
    • wear hat, long sleeves
    • avoid deoderant soap, antibacterial soap and cosmetics (all 3 bad for skin)
  20. Localized collection of pus anywhere on the body caused by any type of an infection
    abscess
  21. closed pocket of tissue with all sorts of stuff like air, fluid tissue filled, fat filled caused from a clogging of the sebacous glands
    cysts
  22. elevated lesion
    nodule
  23. small, flat, distinctly colored area of skin (freckle) less than 10mm around
    macule
  24. skin lesion that is generally small, solid and raised (ex:wart)
    papule
  25. long narrow opening of cracked dry skin (ex: athletes foot)
    fissure
  26. elevated, firm, and rough lesion with a flat top surface greater than 1cm in diameter (ex: psoriases, cradle cap)
    plaque
  27. elevated superficial lesion, similar to a vesicle but filled with purulent fluid (ex: impetgo, acne)
    pustules
  28. elevated, circumscribed, superficial, not into the dermis, filled with serous fluid, less than 1 cm in diameter (ex: varicella, herpes zoster)
    vesicle
  29. vesicle greater than 1cm in diamter (ex: blister)
    bulla
  30. loss of epidermis and dermis, concave, varies in size (ex: pressure sores)
    ulcer
  31. hardening of tissue thats raised above skin level and known as TB
    induration
  32. what are the 4 types of biopsies
    • punch biopsy-punch piece of skin out of body
    • excisional biopsy-cutting a piece of skin off the body
    • incisional biopsy-go inside the body and take a piece out
    • shave biopsy-shave a piece of skin off body
  33. what are some nursing interventions for biospies?
    • need informed consent
    • pre-cleanse the site as prescribed
    • assist during the procedure
    • label all specimens
    • dress the site per order
    • watch for drainage, bleeding and infection
  34. When starting a pt on antibiotics, when should you get a skin culture?
    before starting antibiotic
  35. scraping of the sore and put under a slide to determine if its chicken pox or herpes
    Tzanck test
  36. used to identify certain things under the skin using an ultraviolet light in the dark that will make the lesion glow and help identify what it is
    woods light
  37. used for fungal infections by scraping the infection off of the nail and then dropping potassium hydroxide on it to show if its fungal
    Kott test
  38. puncturing the skin
    allergy testing
  39. what the ABCDE of moles?
    • A=Assymmetry of the lession
    • B=Border irregularity
    • C=Color variation
    • D=Diameter, if greater than 6mm needs dr to look at
    • E=elevated and enlarged
  40. Treatment for herpes simplex 1 and 2
    • no cure
    • can use anti-viral med "acyclovir"
  41. education on herpes simplex 1 and 2
    • no cure-painful
    • type 1: fever, blister-above the waist
    • type 2: blister below the waist (most common in women), seen on vulva and cervix, reoccurs more than type 1
    • both types are contagious and spread by direct contact with open lesion
    • dont have unprotected sex/oral sex if have cold sore above/below waist
  42. treatment of impetigo
    • antibiotics-erythromycin, cephalosporins, topical antibiotic, steroids
    • wash rash with antiseptic soap
  43. education on impetigo
    • contagious until 48 hrs after med is applied
    • highly contagious
    • most important:WASH HANDS
    • use seperate towels, washclothes, etc.
    • wash clothes, & linens in HOT water
  44. treatment for tinea
    antifungal meds-creams, powders, lotion, oral meds, topical "tinactin" (OTC), "griseofulvin"
  45. education on tinea
    • apply topicals 2x per day, washing and drying area thoroughly before applying
    • hand washing is important
    • clothing washed/dryed well
    • wash feet thoroughly-apply clean cotton socks
  46. treatment for contact dermatitis
    • antihistamines and steroids
    • possible allergy testing
    • use burrows solution-drys out rash
  47. education on contact dermatitis
    • cause could be detergents, plants, flowers
    • terapeutic baths
    • wash clothes
  48. treatment for lice
    antiparasitic (Rid or Nix)
  49. education on lice
    • after treating, must retreat entire family 2 weeks later
    • hot soapy water for all linens/clothing, and hot dry
    • stuffed animals should be put in garbage bag and sealed for 1 month
  50. what is the causitive agent of herpes zoster (shingles)
    chickenpox
  51. what are the symptoms of herpes zoster (shingles)
    • painfulo burning sensation
    • itchy
    • usually occurs on 1 side of the body
    • causes flu-like symptoms
  52. treatment for herpes zoster
    • analgesics for pain (narcotic strength)
    • antihistamines (topical or oral)
    • keep clear
    • contact isolation
    • zostrex cream or IV/oral acyclovir
  53. What type of isolation requires mask, private room, usually for pts with dipthoria, meningitis, or flu
    droplet isolation
  54. What type of isolation requires mask, gown, gloves, shoe covers and dont want to carry anything into them ex: aids, leukemia
    immune compromised/reversed isolation
  55. Signs and Symptoms of scabies
    • greyish lines on the hands
    • itching, vesicles, lesions and crust
  56. education on scabies
    • caused by a mite
    • contagious-spread by direct contact
    • usually affects the whole family
    • female mite burrows into skin laying eggs
  57. treatment for scabies
    • topical medication: elimite/scaben cream (stays on 12-24 hrs)
    • treat whole family-may need more than 1 treatment
    • must wash everything
  58. signs and symptoms of eczema
    • causes red crusty layers
    • may be result of an allergic reaction
  59. treatment of eczema
    • antihistamines
    • steroids
    • topical corticosteroids
    • tar compound (acts as a inflammatory)
    • Elidel cream
    • Treat symptoms:
    • dry skin makes it worse
    • dont wash with soap everyday
    • use moisturizer
    • avoid extreme temp change
  60. signs and symptoms of latex allergies
    • redness
    • itching
    • allergies
    • bronchospasms
  61. treatment of latex allergies
    • administer prophylactic treatment with steroids and antihistamines preoperatively
    • use latex-free pharmaceutical measures to prepare the patients medication
  62. failure to distinguish "self" protein from "foreign" protein
    autoimmune disorders
  63. removal of plasma that contains components causing, or thought to cause disease
    plasmapheresis
  64. examples of autoimmune illnesses
    • diabetes
    • addisons
    • rheumatoid arthritis
    • glomerulonephritis
    • thromocytopenic
    • guillan barre syndrome
  65. Autograft
    self to self
  66. allograft
    from one species to another of the SAME species
  67. isograft
    between identical twins (monozygotic)
  68. exograft/heterograft
    animal to human
  69. what does RACE stand for
    • R=Rescue
    • A=Alert
    • C=Contain
    • E=Evacuate
  70. type of acquired immunity and an example of one
    Adaptive, ex: vaccinations
  71. when the immune system is not doing its job
    immune compromised
  72. being insusceptible or uneffected by a particular disease
    immunity
  73. to hurry up and protect against acute, rapidly developing infection mediated by B-cells and produced antidbodies and an example
    • humural immunity
    • ex: 2nd exposure to a disease you have already had (chicken pox)
  74. body forms antibodies against the disease and an example
    • active immunity
    • ex: chicken pox
  75. newborns recieve this immunity from their mother and only lasts a certain amount of time
    passive immunity
  76. what types of cells produce antibodies
    B lymphocytes (B cells)
  77. whats the purpose of hydrotherapy
    to soften the eschar with water to make removal less painful
  78. what is black leathery crust that the body forms over burned tissue, and what is often done to relieve the circulatory constriction
    • eschar
    • escharotomy
  79. what procedure goes deeper than escharotomy to prevent internal compartment syndrome
    faciotomy
  80. priority interventions in the emergent phase of burns
    • watch airway
    • edema, external and internal
    • assess decreased B/P
    • fluids to shift to burns
  81. priority interventions in the intermediate/acute phase of burns
    watch for fluid overload
  82. priority interventions in the long term rehabilitation phase for burns
    • pain control
    • watch for secondary infections
  83. whats the nutrition for HIV and AIDS
    high calorie and high protein
  84. what should you watch for with a transfusion reaction
    • change of greater than 2 degrees in temp
    • flank pain, fever, blood in urine
  85. how do you prevent transfusion reactions
    • 6 checks on blood (2x at bank, 2x at nurse station, 2x by patient)
    • monitor for 1st 15 min after administration
  86. why are electrical burns so dangerous
    they have a current that burns internally and externally, following the whole path, and interferes wtih the electrical current of the heart
  87. what is caused by normally non-pathogenic organisms and give examples
    • oppurtunistic
    • ex: PCP, thrush, herpes
  88. signs and symptoms of analphylactic reaction
    • drop in B/P
    • laryngal edema
    • bronchospasm
    • cardiovascular collapse
    • MI
    • respiratory failure
    • swelling of face
  89. treatment of analphylactic reaction
    • ABC
    • give epinephrine-15 min intervals of bendryl
  90. interventions for analphylactic reactions
    • educate
    • medical alert bracelet
  91. Rule of 9s (burns)
    • front leg=9%
    • back leg=9%
    • head and neck=9%
    • anterior trunk=18%
    • posterior trunk=18%
    • front of arm=4.5%
    • back of arm=4.5%
  92. 3 types of skin cancer
    • melanoma
    • basal cell carcinoma
    • squamos cell carcinoma
  93. type of cancer that can metastaize quickly via lymphatic system, early detection important. It is a firm, nodular lesion topped with a crust or cental area of ulceration and indurated margins
    squamous cell carcinoma
  94. type of skin cancer that rarely metastasizes, may appear as a pearly papule with a central crater and waxy pearly border. Related to frequent contact with certain chemicals, overexposure to sun, and radiation treatment
    basal cell carcinoma
  95. side effects of antihistamines
    • drowsiness
    • dizziness
    • confusion
    • dry mouth
    • urinary retention
  96. side effects of steroids
    • increase in appetite
    • difficulty sleeping (insomnia)
    • changes in mood and behavior
    • flushing (redness) of the face
    • short-term weight gain due to increased water retention
    • increase in their blood sugar readings
    • elevated B/P

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