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medsurg54
care of patient with skin disorder
| Question | Answer |
|---|---|
| What causes pressure sores? | prolonged pressure against the skin |
| What pressure level closes capillaries in healthy people? | 25 to 32 mm Hg |
| How long does it take for a pressure sore to begin to develop? | 20-40 minutes |
| What forces can lead to the formation of pressure sores? | mechanical |
| What patient populations are at a greater risk to developing pressure sores? | immobile patients, those with decreased circulation, and those with impaired sensory perception or neurologic function |
| How can you prevent pressure sores? | position patients every 2 hours and avoid direct pressure on bony prominences, use tool such as Braden or Norton Scale on admission and daily, oral nutrition supplements, apply foam or pressure-reducing mattress |
| What are the signs and symptoms of a pressure sore? | reddened area, usually over a bony prominence, that does not blanch with pressure; it can progress to an open, ulcerated area |
| What is the most common complication of a pressure sore? | wound infection |
| What are the therapeutic measures that can be done to treat a pressure sore? | basic treatment includes debridement, cleansing, and dressing of the wound to provide a moist and healing environment |
| What are the different stages of pressure wounds and what are the findings at each stage? | Deep tissue injury, Stage I, Stage II, Stage III, Stage IV, Unstageable |
| What is dermatitis? | inflammation of the skin and is characterized by itching, redness, and skin lesions, with varying borders and distribution patterns |
| Name three types of dermatitis. | contact, atopic, and seborheic |
| How can you prevent dermatitis? | prevent irritation to the skin by avoiding irritants, allergens, excessive heat and dryness, and by controlling perspiration |
| What are the complications of dermatitis? | lesion or rash worsens with continued irritation, exposue to offending agents, or scratching; infections |
| How do you treat dermatitis? | control itching, alleviate discomfort and pain, decrease inflammation, control or prevent crust formation and oozing, prevent infection, prevent further damage to skin, and heal lesions as much as possible |
| What is psoriasis? | chronic inflammatory skin disorder in which the epidermal cells proliferate abnormally fast |
| How can you prevent psoriasis? | general preventive measures include avoidance of upper respiratory infections, avoid or deal with stress, avoid skin trauma(including sunburns), avoid medications that may precipitate a flare-up |
| What are the complications of psoriasis? | secondary infections, psoriatic arthritis with nail changes and destructive arthritis of large joints, the spine, and interphalangeal joints |
| How do you treat psoriasis? | decrease the rapid epidermal proliferation, inflammation, and itching and scaling |
| What is herpes simplex? | common viral infection that tends to recur repeatedly |
| Name two types of herpes simplex. | HSV-1: occurs above the waist and causes a fever, blister, or sore; HSV-2: occurs below the waist and causes genital herpes |
| How can you prevent infection with herpes simplex virus? | avoid contact with a known infected lesion during the blistering phase; avoid sharing contaminated items |
| What are the signs and symptoms of herpes simplex? | some experience prodromal phase of burning or itching at the site a few hours before eruption; area becomes erythematous and swollen; vesicles and pustules erupt in 1-2 days; redness with no blistering, lesions can burn, itch and be painful |
| What are the complications of herpes simplex? | newborn may be infected, eyes can become severely infected, secondary bacterial infection, and rarely, herpes encephalitits can occur(deadly if not treated promptly) |
| What is the treatment for herpes simplex? | acyclovir: primary lesion-to suppress the multiplication of vesicles; oral antivirals: severe or frequent attacks or immunosuppressed patients; lotions, creams and ointments: to accelerate drying, and healing lesions; antibiotics: secondary infections |
| What is herpes zoster? | shingles; acute inflammatory and infectious disorder |
| What are the signs and symptoms of herpes zoster and a reactivation of herpes zoster? | produces a painful vesicular eruption on bright red edematous plaques along the distribution of nerves from one or more posterior ganglia; reactivation of varicella virus (chicken-pox) |
| How can you prevent infection with herpes zoster? | avoid people with herpes zoster during contagious phase; varicella vaccine in children and adults who have not had chicken-pox |
| How can you prevent a reactivation of herpes zoster? | Zostavax for age >60 who have had chicken-pox |
| What are the complications of herpes zoster? | post-herpetic neuralgia, persistant dermatological pain, and hyperesthesia (sensitivity to pain); ophthalmic herpes zoster can affect VIII CN and affect eyesight; hearing loss, tinnitus, facial paralysis, and vertigo; skin necrosis, and systemic infection |
| What is the treatment for herpes zoster? | aimed at controlling the outbreak, reducing pain and discomfort, and preventing complications; antiviral acyclovir, analgesics, anticonvulsants, antidepressants, corticosteroids, antihistamines, antibiotics, cool compresses or baths |
| What are fungal infections? | dermatomycosis-occurs when impairment of skin integrity in a warm, moist environment, direct contact with infected humans, animals or objects |
| Name six fungal infections. | tenia pedis; tinea capitis; tinea corporis; tinea cruris; tinea unguium; candidiasis/thrush |
| What is cellulitis? | inflammation of the skin and subcutaneous tissue |
| What is the cause of cellulitis? | resulting from infection usually with Staphylococcus or Streptococcus bacteria; MRSA becomin a common cause, may be a result from skin trauma or secondary bacterial infection of an open wound |
| How can you prevent cellulitis? | good hygiene and prevention of cross-contamination; if open wound present-prevent infection and promote healing |
| What are the signs and symptoms of a cellulitis? | initially is localized area of inflammation that may become more generalized if not treated properly; warmth, redness, localized edema, pain, tenderness, fever, and lymphadenopathy; infection can worsen to become systemic |
| How do you treat a cellulitis? | topical and systemic antibiotics according to culture and sensitivity tests; debridement; systemic antibiotics if fever and lymphadenopathy are present; elevate extremity |
| What is acne vulgaris? | common skin disorder of the sebaceous glands and their hair follicles |
| What is the cause of acne vulgaris? | hormonal changes during puberty or menstruation |
| How can you prevent acne or lessen its severity? | avoid "picking" pimples; avoid excessive washing, irritants, and abrasives |
| What are the signs and symptoms of acne vulgaris? | comedones/whiteheads; open comedones/blackheads; inflammation can lead to papules, pustules, nodules, cysts, or abscesses |
| How do you treat acne vulgaris? | benzoyl peroxide, antibacterial agent, prevents pore plugging; antibiotics kill bacteria in follicles; vitamin A acid loosens pore plugs and prevents new comedones |
| What is a pediculosis? | infestation by lice |
| Name three types of pediculosis. | capitus; corporis; and pubis |
| How do you prevent infection by lice? | avoid contact with infected person or object |
| What are the signs and symptoms of infestation with lice? | no itching or intense itching especially at back of head; nits noticed in hair; papular rash |
| What are the complications of pediculosis? | secondary bacterial infection; hyperpigmentation; rickettsial or other systemic disease from vectors |
| How do you treat pediculosis? | OTC pediculicides containing pyrethrins or permethrin most commonly recommended; mechanical removal; Lindane if others not effective; Complications treated with antipruritics, topical corticosteroids, and systemic antibiotics; Physostigmine for eye hair |
| What are special patient education considerations? | follow package instructions; bathe with soap and water, disinfect combs and brushes in hot medicated soapy water; remove nits with fine-toothed comb; cotton-tipped aplicator for eye hair; launder in hot water and detergent |
| What is scabies? | contagious skin disease caused by the mite Sarcoptes scabei |
| What are the signs and symptoms of scabies? | short, wavy, brownish black lines from parasites burrowing into the superficial layer of the skin |
| How do you prevent infestation with scabies? | be treated at same time of infected person if living with them, wash bed linen, clothes and towels |
| What are the complications of scabies? | hypersensitivity reactions to the mite can result in crusted lesions, vesicles, pustules, excoriations, and bacterial superinfections |
| How do you treat scabies? | topical scabicides(permethrin, crotamiton) for disinfection; left on overnight, washed off in am, refer to package instructions; 1-2 applications effective; antipruritics for itching |
| What are special patient education considerations? | warm soapy bath or shower removes scales and skin debris; meds as ordered; treat people living with you at same time; clean clothing and linen; itching may continue up to 2 weeks after treatment |
| What is pemphigus? | acute or chronic serious skin disease characterized by the appearance of bullae of various sizes on otherwise normal skin and mucous membranes; autoimmune disorder |
| What are the signs and symptoms of pemphigus? | sudden appearance of succesive crops of bullae on skin and mucous membranes; bullae are fragile and flaccid-enlarge, rupture, and form painful, raw, eroded, partial-thickness wounds that bleed, ooze, and form crusts; pain, burning, itching, foul smell |
| What is Nickolsky’s sign? | occurs when there is sloughing or blistering of normal skin when minimal pressure is applied |
| What are the complications of pemphigus? | secondary bacterial infection; high associated morbidity and mortality rates |
| How do you treat pemphigus? | Corticosteroids and immunosupressants to control disease and start remission; medicated mouthwash; antibiotics, antifungals, analgesics, antipruritics; high-protein and high-calorie diet with fluid replacement therapy |
| Name six benign skin lesions. | cyst; seborrheic keratosis; keloid; pigmented nevus; wart; hemangioma(angioma) |
| What is a malignant skin lesion? | skin cancer |
| Name three types of malignant skin lesions. | Lentigo maligna melanoma; Superficial spreading melanoma; Nodular melanoma |
| What is the cause of malignant skin lesions? | overexposure to UV rays; white, blue-eyed; genetic tendencies; x-ray therapy; exposure to certain chemical agents; burn scars; chronic osteomyelitis, and immunosuppressive therapy |
| How can you prevent a malignant skin lesion? | limit of avoid direct exposure to light; SPF 15 or more, protective clothing against sun |
| How do you treat malignant skin lesions? | surgical excision; regional node dissection; grafting for closure or repair; chemotherapy for metastasis; radiatio therapy as adjunct tx; cryosurgery; electrodesiccation |
| Name four plastic surgery procedures and why are they used? | rhinoplasty-correct congenital or acquired septal defects; blepharoplasy-remove bags under eyes, wrinkles and bulges; rhytidoplasty(face)-removal of excessive wrinkling or sagging skin; Otoplasty(ear) correct congenital defects, deformation |
Created by:
laotracuata
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