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Integument review
NPTE
| Question | Answer |
|---|---|
| Layers of superficial burn | epidermis only |
| Appearance of superficial burn | red, dry tender |
| Healing of superficial burn | 2-3 days, no scars |
| superficial partial thickness layers | epidermis into papillary layer of dermis |
| superficial partial thickness appearance | blisters intact, red |
| superficial partial thickness healing | 7-21 days w/ minimal scarring |
| Deep partial thickness layers | epidermis, dermis (including hair, sweat glands) |
| Deep partial thickness appearance | Marked edema, mixed red w/ waxy white, broken blisters, |
| Deep partial thickness healing | spontaneous, 3-5 wks excessive scarring |
| Full thickness layers | epidermis, dermis, subcutaneous, possible into muscle |
| full thickness appearance | white, gray, black, escar, leathery |
| full thickness healing | heals w/ graft |
| subdermal layers | all into muscle and bone |
| subdermal appearance | charred |
| subdermal healing | grafting, tissue defects |
| hand position to prevent deformities after burn | wrist ext, MCP flex, PIP and DIP ext, thumb abd |
| hip position to prevent deformities after burn | neutral roation w/ slight abd |
| redness w/ lesions, itchy, weeping crusted skin | dermatitis |
| inflamation, pus filled vessicles, itching | Impetigo |
| pus, hot, red edematous, fever common | cellulitis |
| contraindications of shingles | US, heat |
| erythematous plaques covered w/ silvery scale | psoriasis |
| red rash w/ raised scaly plaques | lupus |
| skin is taut, firm, edematous, firmly bound | scleroderma |
| scleroderma precaution | sensitive to pressure, acute HTN can occur |
| round, irregular, dry, flat on sun exposed skin | actinic keratosis (pre-cancerous) |
| raised lesion on trunk usu in elders | seborrheic keratosis |
| ivory raised w/ indented center in fair skinned | basal cell (malignant, rarely mets) |
| poorly defined borders, red, flat, sun exposed skin | squamous cell (can met) |
| asymmetric irregular border, color variation | malignant (from melanocytes) |
| red or purple/blue, usu. LE | kaposi's sarcoma |
| Transparent film indications | autolytic debridement, secondary dressing, Stage I and II, |
| transparent film considerations | avoid w/ infection, non-absorptive |
| hydrocolloids indications | mild exudate, maintains moist, supports autolytic |
| hydrocolloids considerations | odor w/ yellow exudate is normal when dressing is removed avoid in infections or with heavy exudate |
| hydrogel indications | necrosis, burns, rehydrates, autolytic |
| hydrogel considerations | comes in many types and absorptive capacity varies, don't use sheet w/ infection dressing must be changed every 8-48 hours |
| Foams indications | min-mod exudate |
| Foams considerations | do not use w/ dry escar or wounds w/ no exudate |
| Alginates indications | mod to large amount of exudate infected and non-infected |
| Alginates considerations | car dry wound bed |
| Gauze dressing indications | mechanical debridement, infected wounds, several types |
| Autolytic type and contraindications | (Natural) infection, immunosuppressed, dry gangrene, dry ischemic |
| Enzymatic type and contraindications | (enzyme to necrotic tissue) ischemia, dry gangrene, clean granulated wounds |
| Mechanical type and contraindications | (nonselective) clean granulated |
| Sharp type and contraindications | (selective w/o anesthesia) clean, advanced cellulitis w/ sepsis, infection threatens life, pt on anticoagulants |
| Surgical type and contraindications | (non-selective, wide excision) cardio-pulm disease, DM, severe spasticity, pt cant tolerate, short life expectancy, QOL won't be improved. |
Created by:
carter28
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