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Dematology Review
Dermatology Review
| Question | Answer |
|---|---|
| What are common integumentary findings in African Americans? | Keloid formation, traction alopecia, pseudofolliculitis, folliculitis barbarae, and perineal follicularis |
| What skin findings require prompt evaluation and intervention with fluids, oxygen admin, and skin repair? | Findings indicating dehydration, cyanosis, or impaired skin integrity (acute lacerations). |
| If a patient has a specific concern about his skin, when do you look at it? | Inspect the area/lesion first, then ask other questions. |
| What are the ABCDEF's of melanoma detection? | Asymmetry, Border irregularity, Color, Diameter of more than 6mm, Evolution over time, Friend |
| The presence of what on the skin increases risk for melanoma? | Any dysplastic nevi, or more than 50 normal moles. |
| What is phototoxicity? | A reaction caused by a medication's molecules absorbing energy from a particular UV wavelength and then damaging surrounding tissues. |
| What is photosensitivity? | medications, sunscreens, perfumes, cosmetics and topical skin creams cause a reaction on the skin that usually presents with a rash after sun exposure. |
| What is photoallergy? | Manifests with blisters and redness on exposed skin, occurs only after repeated exposure to an offending substance, and persists for some time after removal of the offending substance, UV exposure, or both. |
| What 5 features do normal moles possess? | 1. Solid, tan, brown, black, or skin-colored. 2. Smaller than 6mm 3. Well-defined edges 4. Round or oval shape. Flat or dome-like surface 5. Emergence before 30 years of age. |
| Severe pruritis interfering with sleep is usually from what? | Scabies |
| Localized pruritis is usually caused by what? | infestation, insect bite, allergic reaction, toxic exposure. |
| Generalized pruritis is usually caused by what? | Medication and food allergies |
| Impetigo results from what type of infection? | Either Staph or Strep |
| Fissure? | linear break in skin surface, not related to trauma. |
| Excoriation? | lesion resulting from scratching or excessive rubbing of skin |
| Lichenification? | Accentuation of normal skin lines resembling tree bark. Commonly caused by excessive scratching. |
| Polymorphous lesions? | several different shapes. Ex: Urticaria, tinea corporis |
| Punctuate lesions? | Small, marked with points or dots Ex: Petechiae, Rocky Mountain spotted fever. |
| Serpinigous Lesions? | Curving, snake-like. Example: Scabies |
| Iris Lesions? | Bull's Eye. Ex: Lyme Disease |
| Annular Lesions? | Ring-like, circular. Ex: Tinea Corporis |
| Verrucaform Lesions? | Circumscribed, papular with rough surface. Ex: Warts |
| Filiform Lesions? | Papilla-like for finger-like projections (similar to tongue papillae). Ex: warts |
| Nummular/Discoid Lesions? | Coin-Shaped. Ex: Nummular psoriasis |
| Umbilicated Lesions? | Central Depression. Ex: Herpes Zoster |
| Zosteriform Lesions? | Distributed along dermatome. Ex: Herpes Zoster |
| Satellite Lesions? | Single lesions in close proximity to larger lesion. "orbiting" Ex: Cutaneous Candidiasis |
| Confluent Lesions? | With enlargement or multiplication, begin to coalesce for form larger lesion. Ex: Urticaria |
| Describe Stage III pressure ulcers. | Full thickness tissue loss. SubQ fat may be visible but bone, tendon, or muscle is not not exposed |
| Describe Stage II pressure ulcers. | Partial thickness loss of dermis. Presents as shallow open ulcer with a red pink wound bed. NO SLOUGH! |
| Describe Stage I pressure ulcers. | INTACT SKIN! With nonblanchable redness of a localized area. Usually over bony prominence. Area may be painful, firm, soft, warmer or cooler as compared to adjacent tissue. |
| Describe Unstageable pressure ulcer | Full thickness tissue loss in which the base of the ulcer is covered by slough(yellow, tan, gray, green, or brown), eschar (tan, brown, or black) or both. True depth cannot be determined. |
| Neuropathic ulcers are commonly caused by what? | Diabetes |
| When do you use the Wagner's Classification of ulcers? | To determine grade of neuropathic ulcer. (caused by diabetes) |
| What 5 skin conditions in newborns are indications of greater risk for morbidity and mortality? | 1. Progressive Jaundice 2. Pallor 3. Cracked or peeling skin 4. Cafe au lait spots >3cm, and more than 6 in number. 5. Stiff or immobile skin |
| What is carotenemia caused by? Symptoms? | Caused by Excessive ingestion of yellow or orange veggies, or chronic renal disease. Symptoms: yellowish palms, soles and face (NOT SCLERAE) in infants and children. |
| How do you verify Jaundice? | Apply light pressure to skin to cause blanching. JAUNDICE DOES NOT BLANCHE!!! yellowish skin from OTHER causes will turn white. |
| What are 3 abnormal skin findings in pregnancy? | 1. Pyogenic granuloma (red papulee or nodule on lips- bleeds easily) 2. Erythema nodusm (tender, red, painful nodules on legs) 3. PUPPP- pruritic urticarial papules and plaques of pregnancy (intensely itchy red papules and plaques within stretch-marks) |
| In female patients, ovarian dysfunction may be characterized by??? | Hair on beard area, abdomen, upper back, shoulders, sternum, and inner upper thighs |
| What part of your hand do you use to palpate for skin temperature? | Dorsal Surface |
| What part of your hand do you use to palpate for skin moisture and texture? | Palmar surface of fingers and hands |
| What areas are the best places to look for pallor or cyanosis? Why??? | tongue, lips, nail beds, and buccal mucosa. Because they are less pigmented areas. |
| The healing process is divided into what 3 phases? | 1. Inflammatory 2. Proliferative 3. Remodeling |
| Why does skin tear easily in the older population? | Aging causes the junction between the dermis and epidermis to flatten, increasing the tendency of the skin to tear. |
| How do the lesions progress in Varicella? | Begins with macular lesions, progresses to papular, then vesicular, and ultimately superficial ulcers. |
| What infectious skin disorders also have fever and chills? | Measles, Rubella, Varicella |
| Scabs or dry crust that result from trauma or infection | Eschar |
| Redness of the skin due to congesion of capillaries. | Erythema |
| Protrusion of the viscera; removal of the viscera | Evisceration |
| Scarlike growth of collagen that results in a rounded, hard, shiny, white benign tumor. | Keloid |
| the closure or state of being closed, of a passage | Occulsion |
| To shed or cast off dead tissue | Slough |
| When does the inflammatory phase begin during wound healing? | Occurs immediately after an injury and lasts 2-5 days. |
| What has to be necessary for neutrophils to destroy the bacteria? | Oxygen |
| Which vitamins play a major role in wound healing? | Vitamins A, C, iron, copper, zinc |
| hemoglobin levels have to be what to indicate poor wound healing --> a delay in the healing process? | below 10 g/dL |
| Which types of medicatins delay wound healing? | anti-inflammatories, steriods, nonsteriod meds used to treat arthritis or respiratory conditions. |
| which vitamin can be given to reverse the process associated with steriod use (steriods delay wound healing)? | vitamin A |
| What is unique about venous ulcers r/t how a Pt gets a venous ulcer? | they are NOT due to a lack a venous return but rather a diminished ability of nutrients to diffuse through the interstial space from capillaries. |
| What are the etiologies of venous ulcers? | Calf pump failure, pregnancy, obesity, tumor, or deep vein thrombosis. |
| What two conditions can lead to venous ulcers as a result of calf muscle disuse? | Peripheral neuropathy and musculoskeletal disorders |
| Pt's who have atherosclerosis and DM are more likely to get which type of ulcer? A) venous ulcers B)arterial ulcers C) pressure ulcers | B)Arterial ulcers |
| What type of therapy is used to treat venous ulcers? | Compression therapy |
| Compressino therapy is containdicated with clients experiencing which conditions? | Phlebitis, diminished sensation, and arterial insufficiency. |
| Clients with a hx of smoking and who sustain mechanical trauma to the extremity are prone to which type of ulcers? | Arterial ulcers |
| How are pt's treated for arterial ulcers? | drug therapy with vasodilators, anticoagulants, or thrombolytic agents. |
| when is surgical treatment for an arterial ulcer necessary? | if drug therapy is insufficient |
| Describe the wound site assessment. | Identify location of wound, observe wound bed and appearance; check wound for size, shape, depth, and margins. Observe exudates or drainage, evaluate presence of pain. |
| What is the proper way to clean a wound around the incision line? | Clean from least contaminated to most contaminated which means: clean incision line first then move away from incision line. Clean from top to bottom, using the swab only once. |
| What type of dressing is used when applying a wet-moist dressing? | A sterile 4 x 8 ABD pad |
| what foods should a Pt eat if staples are removed? | Eat foods high in protein, carbs, vitamins, and minerals to promote wound healing. |
| What should a Pt do to prevent separation of wound edges when coughing or moving? | Splint wound |
| How much wt can a Pt lift who just had their staples removed? | 10 lbs or less. |
| What is the first thing a nurse should do before obtaining a wound culture? | Rinse wound thoroughly w/ sterile saline. |
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Created by:
lgultom1
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