Question | Answer |
Identify at least four factors that contribute to skin damage | Chemical, moisture, infection, mechanical, radiation, friction, infectious, allergic response, viral, vascular , burn, inflammatory, intrinsic disease |
List the types of skin infections and management | fungal, bacterial, viral,arthropod |
classification system for skin tears | #I can be approximated (A)linear (like incision) (B) flap <1mm dermis exposed #2(A) scant tissue loss >75% dermis covered by flap(B) moderate to large tissue loss>25% dermis exposed #3 complete tissue loss-no flap |
management of radiation dermatitis | gently cleanse, moisturize, symptom management (compressed for itching)prevent trauma, manage radiation dermatits with dressings if needed |
The term incontinence associated dermatitis has replaced what terms | diaper or perineal dermatitis |
Identify chemical factors that cause skin injury | Fecal incontinence, alcohol, betadine, GI contents, drainage from percutaneous tubes |
Describe the symptoms and common location for candidiasis | Itching, white cheesy exudate, skin folds, satellite lesions |
What is the difference between cellulitis and erysipelas | Erysipelas has prodromal sx, sharply defined erythema, very painful, edema, streaking r/t of following the lymphatic tract-Cellulitis:erythema with diffuse border, tenderness, warmth and edema |
Name two common viral infections of the skin | Herpes simplex and varicella zoster |
allergic contact dermatitis | Located precisely at the point of contact, sharp margination, erythematous no satellite lesions |
grades of radiation dermatitis | #1 Erythema, dry desquamation, #2 patchy moist desquamation in skin folds, brisk erythema, moderate edema #3 moist desquamation other than skin folds #4 ulceration, necrosis, full thickness, spontaneous bleeding |
What is the name of the classification system for skin tears | Payne-Martin classification system |
Treatment for category II and III skin tears is transparent film dressing. True or false | False |
What is a common cause of chemical dermatitis | loose stool, C. Diff |
Identify three categories of skin protectants | Barrier moisture ointment, moisture barrier paste, skin sealant |
what is the is the key indicator of candidiasis | pruritis |
What is the term for inflammation of the skin folds | Intertrigo |
What two conditions can be confused with candidiasis | contact dermatitis, folliculitis |
How can you distinguish pressure ulcers from genital herpes | Location- pressure ulcers over bony prominence herpes on fleshy skin areas |
when does the greatest radiation skin effects occur | after treatment ends |
Define dry desquamation | Skin is intact but erythematous, flaky or scaly |
True or false: radiation recall can occur after the administration of doxorubicin | True |
A lesion that is elevated, firm, and <1cm in diameter is known as : | papule |
A vesicle >1cm in diameter is known as : | bulla |
Name mechanical causes of skin damage | Friction, shearing forces, pressure, skin stripping |
Macule | flat, circumscribed, <1cm, different color than skin (nevus) |
Papule | elevated, firm, circumscribed, <1cm (wart) |
Patch | flat, nonpalpable, iregular shaped macule >1cm (port wine stain) |
Plaque | elevated, firm, rough, flat top, >1cm (Psoriasis) |
Wheal | elevated, irregular shape, cutaneous edema, solid, transient, variable diameter (bug bite) |
Nodule | elevated, firm, circumscribed, deeper in dermis that papule 1-2cm (lipoma) |
Vesicle | elevated, cirmscribed, superficial, fillied with serous fluid, <1cm (herpes zoster, chicken pox) |
Bulla | vesicle >1cm (blister) |
Pustule | elevated, superficial, similar to vesicle but filled with prurulent fluid (acne) |
Cyst | elevated, circumscribed, encapsulated in dermis or sub. q layer, filled with fluid or semisold |
Scale | heaped up keratinized cells, flaky skin, irregular, thick or thin, dry or oily, varies in size |
Lichenification | rough, thickened epidermis due to persistent rubbing, itching, or skin irritation |
Excoriation | loss of epidermis, linear hollowed-out, crusted area (abrasion or scratch) |
Fissure | linear crack or break of epidermis, may be dry or moist |
Erosion | loss of part of epidermis, depressed, moist, glistening, follows rupture of vesicle or bulla |
Ulcer | loss of epidermis and dermis, concave, size varies |
protocol for prevention and treatment of moisture or chemical skin damage | gentle cleaning, moisturization, skin protectant |
two fungal infections | candidiasis and dermatophyte (tinea) |
describe candidiasis | satellite lesions, pruritis (key indicator) cheesy exudate, erythema with pustules, papules or plaques |
candida intertrigo | intensely red, confluent, macerated, rash extends just beyond the limits of the skin folds. satellite lesions. Burow soln, antifungal cream or powder |
folluliculitis | pustules pierced in the center by hair, can be fungal, bacterial or mechanical (staph a. is usual cause) tx: soap and water, improve hygiene |
tinea | fungal infection-name and symptoms r/t site of infection (capitus:head, Pedis:foot, Corporis:body, Cruris:groin) active border, scaly, red, slightly elevated. Topical antifungal. |
Bacterial infections | cellulitis, erythrasma, erysipelas, empetigo |
erythrasma | bacterial inf. (cornybacterium) in skin folds.chronic, mildly pruritic, reddish brown pigmentation, well defined borders, little scaling, NO satellite lesions. vigorous washing, clotrimatozole topical or erythromicin tid |
bacteria that cause skin infections | staph a. beta hymolytic strep, staph epidermis |
impetigo | highly contagious, staph. a. superficial vesiculopustular. r/t poor hygiene, malnutrition |
nonbullous impetigo | start with asymptomatic small vesicles that rupture soon, moist red base that crusts over (honey colored crust) |