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RNSG 1341

Integumentary Disorders (Chapters 4, 12, 15, 16)

A vascular superficial layer that is the outer, protective layer Epidermis
Manufactures Vitamin D (which is manufactured by the sun) Epidermis
Second layer of the skin Dermis
Gives skin structure, texture, substance, flexibility and strength - Collegen - Reticulum - Elastin
Responsible for collagen synthesis and wound healing Fibroblasts
Responsible for fluid and microbial removal Lymphatic glands
Responsible for nutrients and thermoregulation Blood vessels
Contains mast cells for inflammatory responses as well as macrophages (engulfing/repairing cells) Dermis
Layer of skin the attaches skin to underlying tissue and organ Hypodermis (Subcutaneous layer)
Sweat Glands contains - Eccrine - Apocrine
Eccrine Regulates Body temperature
Apocrine - Produces body odor
Skin dryness Xerosis
Actinic lentigo Brown spot of aging
What is released in response to injury? - Prostaglandins - Histamine
Systemic response to infection include Elevated temp, chills, fever, malaise, fatigue, lymph node swelling, leukocytosis (WBC > 10,000), poor appetite, positive wound/blood cultures
Labs to monitor inflammation WBC, Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)
Vitamins that aid in tissue healing A, B, C and K
Primary (1st) intention healing Shortened phase Closed/uncomplicated/clean wound Initial (inflammatory) phase Scar contraction/maturation phase 7 days and continues several months Thin scar
Secondary intention healing Granulation/contraction Deeper tissue injury or wound Irregular wound margins Greater inflammatory response with more debris/cells/exudate Healing takes place from inside out More granulation tissue/larger wound Takes longer to heal
Tertiary (3rd) intention healing Delayed suturing of wound Contaminated wound left open Primary wound infected, reopened surgically High risk for infection Large, deeper scar
Phases of wound healing Physiological process Inflammatory phase Proliferative phase Remodeling phase
Serous fluid Thin, clear of slightly yellow
Serosanguinous fluid Mixture of both clear and bloody exudate; pink
Sanguineous fluid Both serum and red blood cells, thicker reddish appearance
Purulent WBCs, tissue debris and bacteria Thick, different color--brown, green, yellow drainage May have odor--abnormal
Proliferative/Maturation phase = repair phase Granulation tissue and epithelial cells form Scar formation usually occurs
Partial thickness wounds (Stage II) Damage to epidermis and upper latter of dermis Heals by re-epithelialization within 5 to 7 days Skin injury immediately followed by local inflammation
Full thickness wounds (Stage III or IV) Damage to lower layers of dermis and subcutaneous tissue Removal of tissue results in defect, fills with granulation Bone, tendon and muscle exposed
Created by: pdimple