List the 3 major functions of the skin | 1. Protection
2. Temperature regulation
3. Vitamin D synthesis |
What do cholesterol compounds in the skin convert to when exposed to the sun? | Vitamin D |
Which layer of the epidermis is able to undergo cell division and reproduce? | Stratum germinativum |
What is the outermost epidermal layer? | Stratum corneum |
The dermis, or corium is also known as: | The true skin |
What are the small finger-like projections located in the upper portion of the dermis? | Papillae |
The epidermis would be unable to survive without: | Dermal papillae |
Which layer connects the skin to the muscle surface? | Subcutaneous layer |
What are the 4 important functions of the subcutaneous layer? | 1. Stores water and fat
2. Insulates the body
3. Protects the organs lying beneath it
4. Provides a pathway for nerves and blood vessels |
What are the coiled tube-like structures located in the dermal and subcutaneous layers? | Sudoriferous glands |
What is sweat composed of? | Water, salt, urea, uric acid, ammonia, sugar, lactic acid, ascorbic acid |
What are modified sudoriferous glands? | Ceruminous glands |
Clubbing of the fingertips can indicate: | Hypoxemia |
Dark skin is predisposed to certain conditions, including: | Pseudofolliculitis, keloids, mongolian spots |
What does PQRST stand for in regard to assessing a chief skin complaint? | P- Provocative and Palliative factors
Q- Quality and Quantity
R- Region
S- Severity
T- Time |
What does ABCDE stand for in regard to assessing growths or changes in a mole? | A- Asymmetric
B- Border
C- Color
D- Diameter
E- Elevated |
Describe a stage 1 pressure injury: | Is in a localized area of the skin; intact with nonblanchable redness. |
Describe a stage 2 pressure injury: | Partial thickness loss; appears as shallow wound that is shiny/dry, with a pink-red wound bed without slough or bruising. |
Which stage of pressure injury includes full-thickness tissue loss; subcutaneous tissue can be visible, but bone and muscle are not? | Stage 3 pressure injury |
Describe a stage 4 pressure injury: | Full-thickness tissue loss with exposed bone, tendon, cartilage or muscle; eschar and slough may be present |
If a pressure injury extend into to the muscle and supporting structures, the patient may be at risk for: | Developing osteomyelitis |
What is an unstageable pressure injury? | An injury with full-thickness tissue loss, a wound base covered with slough, and eschar; the depth and stage cannot be determined until base of the wound is exposed. |
What kind of eschar should not be removed? | Stable eschar on the heels |
What kind of pressure injury may appear as a purple or maroon area of discolored intact skin, or blood-filled blister? | Suspected deep tissue pressure injury |
What is the most common site in women to develop HSV-2? | The cervix |
Patients with herpes simplex should also be assessed for: | HIV |
For HSV-1 over the counter treatment is effective when used within how many days of an outbreak? | The first 1-2 days |
What is the healing time for HSV-1 without treatment? | 10-14 days |
How long are HSV-2 lesions present? | 7-14 days |
Acyclovir should be administered within the first 72 hours upon onset of: | Herpes zoster symptoms |
The herpes zoster virus causes inflammation of the: | Spinal ganglia |
A person lacking the varicella immunity or who is immunocompromised can acquire ______ from a person with shingles. | Chickenpox |
A pityriasis rosea rash disappears without treatment within: | 4 - 8 weeks |
Pityriasis rosea begins as a single lesion referred to as: | a herald patch |
How can the bacteria causing cellulitis be spread? | By direct contact with an open area on a person who has the infection. |
What are the common causes of of cellulitis in adults? | Streptococci and staphylococcus aureus |
Cellulitis is an infection of the: | Skin and underlying subcutaneous tissues |
How does the skin appear in a person with cellulitis? | Erythematous, edematous, tender, and warm |
Signs and symptoms of deep vein thrombosis and ______ are very similar. | Cellulitis |
The affected body part in cellulitis should be kept: | Immobilized and elevated; warm moist dressings should be applied to the infected area |
Why might cellulitis symptoms worsen before getting better with antibiotic therapy? | The bacteria die and release substances that damage tissue. |
Antibiotics for cellulitis are continued for a minimum of: | 10 days |
Lesions associated with impetigo contagiosa starts as macules, and develop into: | Pustulant vesicles which rupture and form a dried exudate |
What type of soap should be used in removing the crust from a patient with impetigo contagiosa? | Antiseptic; before applying antibiotic cream, lotion, or ointment |
Prevention of _______ is a primary goal related to impetigo contagiosa. | Glomerulonephritis
(inflammation of the glomerulus of the kidney) |
What is a carbuncle? | A cluster of furuncles |
An infection of the soft tissue under and around the nail is known as a: | Felon |
What kind of precautions should be used for a patient with folliculitis in the hospital? | Wound and secretion precautions; isolation |
Define suppuration: | The production of purulent material |
What can help to speed up the process of suppuration? | Warm soaks, 2-3 times a day |
List the viral disorders of the skin | Herpes simplex
Herpes zoster
Pityriasis rosea |
List the bacterial disorders of the skin: | Cellulitis
Impetigo contagiosa
Folliculitis (furuncles, carbuncles, felons) |
Tinea cruris is also known as: | Jock itch |
What is tinea corporis? | Ringworm of the body |
What is the most common fungal infection? | Tinea pedis (athlete's foot) |
Hair infected by tinea capitis turns what color under a Wood's lamp? | Blue-green |
List the fungal disorders of the skin: | Tinea capitis
Tinea corporis
Tinea cruris
Tinea pedis |
What is a major fungal pathogen? | Microsporum audouinii |
What are papules? | Small, raised, solid skin lesions less than 1cm in diameter |
What will the skin look like in contact dermatitis? | Papules and vesicles appearing on dorsal surfaces |
What causes contact dermatitis? | Contact with agents in the environment to which the individual is hypersensitive |
What causes dermatitis venenata? | Contact with certain plants; poison ivy, poison oak |
What causes exfoliative dermatitis? | The ingestion of certain heavy metals, or by antibiotics, aspirin, codeine, gold or iodine. |
How does the skin appear in exfoliative dermatitis? | Skin sloughs off; area is erythematous and edematous |
Dermatitis medicamentosa occurs when: | People are given a medication to which they are hypersensitive |
What is the common symptom in all types of dermatitis? | Pruritis |
What is urticaria? | The presence of wheals or hives in an allergic reaction |
Urticaria, or hives, are caused by: | The release of histamine |
How do urticaria and agioedema differ? | Angioedema occurs in the subcutaneous tissue; urticaria is a lesion of the skin and mucus membranes |
Eczema is associated with allergies to: | Chocolate
Wheat
Eggs
Orange juice |
What causes a comedo (black head) to be dark? | The effects of oxygen on sebum; not dirt |
In psoriasis, the time for the entire skin to be replaced by soughing can decrease to: | 7 days |
What is pediculosis? | Lice infestation |
How long can lice live without a blood source? | 1-2 days |
How many eggs may the female lay per day in head louse? | 10 eggs per day |
What does the pubic louse look like? | A crab with sharp pincers |
After the lice are killed, they must be picked off using a: | Nit comb |
What causes scabies? | The human itch mite |
How does the skin appear in an individual with scabies? | Wavy, brown, threadlike lines;
in the hands, arms, body folds and genitalia |
Which diagnostic test may yield a mite in a person with scabies? | Skin scraping |
Spider angioma, or telangiesctasia is associated with which disease? | Liver disease |
Vessels that dilate and form a tumor-like mass is known as an: | Angioma |
A melanoma can metastasize to which organs? | Any organ; brain and heart |
What is the most deadly form of skin cancer? | Melanoma |
What are the 4 types of malignant melanomas? | 1. Superficial spreading (most common!)
2. Lentigo malignant
3. Nodular
4. Acral lentiginous |
Where is lentigo malignant melanoma usually found? | On the heads and necks of older adults |
Prognosis of malignant melanoma depends on: | The thickness of the tumor |
What is the survival rate of people with malignant melanoma lesions of 3mm or thicker? | Less than 50% |
Describe the nails in a person with paronychia | Soft, brittle, and the shape can change as they grow into soft tissue |
The infection of paronychia is treat with: | Topical antibiotics and wet dressings; drainage may be needed |
Nonthermal burns result from: | Electricity
Chemicals
Radiation |
A burn's effect depends on which two factors? | 1. The extent of the body's surface burned
2. The depth of the burn |
What is the major concern in a stage 1 burn (emergent phase)? | Hypovolemic shock for up to 48 hours |
What is the major concern in a stage 2 burn (acute, intermediate, diuretic phase)? | Circulatory overload |
When does the acute phase of a burn begin? | 48-72 hours after burn injury; when kidneys excrete large volumes of urine |
What is the goal of stage 3, or the long-term rehabilitation phase of a burn patient? | To return the patient to as normal state as possible;
freedom from wound infection |
In a burn injury, when does the greatest fluid loss occur? | Within the first 12 hours |
After a burn, the proteins, plasma, and electrolytes shift from the vascular compartment to the __________. | Interstitial compartment |
How is the rule of nines divided throughout the body? | Head: 9%
Arms: 9% each
Legs- posterior: 9%
Legs- anterior: 9%
Chest: 18%
Back: 18%
Perineum: 1% |
Nursing assessment of a burn includes: | 1. Depth of burn
2. Causative agent
3. Temperature and duration
4. Skin thickness |