integumentary
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| Angioma | A tumor-like mass formed by a group of dilated blood vessels. Crust - scab on an abrasion.
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| Carbuncle | Cluster of furuncles; infection of several hair follicles that spreads to surrounding tissue.
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| Dermatitis - | Superficial infection of the skin.
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| Eczema | Lesions surrounded by erythema; they rupture then dry and itch; associated with allergies.
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| Erythema | Redness or inflammation of the skin.
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| Excoriation | surface layer injury caused by scratching or abrasion.
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| Furuncle | boil. Benign tumor of the skin raised, hard and shiny
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| Keloid. | Papillomatous growth occurring in many forms – worst Verruca. Pigmented congenital skin blemish that is usually benign but may become cancerous - Nevi.
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| Necrosis | dead tissue.
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| Nodule | An elevated, firm, solid circumscribed lesion; deeper in dermis than a papule; 1 to 2 cm in diameter.
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| Macule | a flat area that is a change in the color of the skin (freckles).
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| Papule - | elevated, firm area less than 1 cm in diameter.
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| Pruritus – | itching.
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| Pustule | Elevated superficial lesion; similar to a vesicle but filled with purulent fluid.
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| Tinea pedis | athlete's foot.
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| Tumor | outgrowth of skin cells.
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| Layers of skin: | Epidermis, Dermis: Subcutaneous Layer
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| 1. Epidermis composed of three layers: | Stratum corneum,avascular,filled with keratin,makes the cells dry, tough and waterproof:Pigment layer, (Melanin):Stratum germinativum, New cells reproduced here replace cells of the stratum corneum
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| 2. Dermis | just below the epidermis layer: (a) Contains blood vessels, nerves, glands and hair follicles. (b) Cells are composed of connective tissue and elastic fibers. (c) Cells are bathed in interstitial fluid.
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| 3. Subcutaneous Layer | (a) adipose and loose connective tissue. (b)shape and contour to the body. (c) Primary functions include;Store water and fat,Insulation,Protection of the body organs,Provides a pathway for nerves and blood vessels
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| Malignant Melanoma | is a cancerous neoplasm in which pigment cells (melanocytes) invade the epidermis, dermis, sometimes the subcutaneous tissue.
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| The ABCD’s of Melanomas | A, Asymmetry (one half unlike the other). B, Border (irregularly scalloped or poorly circumscribed border). C, Color varied from one area to another; shades of tan and brown, black, and sometimes white, red or blue; change in shape, size, or color of mole
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| Vesicle: | circumscribed elevation of skin filled with serous fluid; smaller than 0.5 cm (chicken pox, herpes simplex, and herpes zoster).
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| Herpes simplex (Type I and II) | type I is characterized by a vesicle at the corner of the mouth, on the lips, or on the nose. type II is characterized as below the waist.
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| Chicken pox | is also characterized by vesicles on the body.
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| Wheal | is a round elevation of the skin, white in the center with a pale and red periphery.
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| Atheroma | a fatty plaque;
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| Bleb | a blister filled with fluid; Cyst - a sac or capsule containing fluid or semi-solid material; Excoriation
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| Exfoliated cells | dead cells shed from the skin, mucous membranes, or bone; Exudate - fluid, usually containing pus or bacteria;
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| Fissure | a groove, crack or slit;
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| Hyperplasia | extra growth of normal tissue;
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| Petechiae | thin hemorrhagic spots on the skin.
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| Photochemotherapy | used to treat psoriasis.
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| treat psoriasis | Topical steroids used are: Hydrocortisone, and Valisone.
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| There are four types of Malignant Melanomas: | (1) Superficial spreading melanomas, (2) Malignant lentigo melanomas, (3) Nodular melanomas, and (4) Acral lentiginous melanomas.
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| Pediculosis (lice infestation) | a parasitic disorder of the skin that is usually associated with poor living conditions and poor personal hygiene.
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| Pediculosis Capitis | caused by the head louse (found attached with hair shaft);
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| Pediculosis Corporis | caused by the body louse (found around the neck, waist, and thighs or the seams of the clothes);
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| Pediculosis Pubis | caused by the pubic louse (attached to the pubic hair, look like a crab).
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| Nits or lice can be seen on the body. | Pinpoint raised red macules, pinpoint hemorrhages, severe pruritus and excoriation confirm the diagnosis.
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| Topical application of a pediculicide | lindane (Kwell) or pyrethrins (RID) is used in the area of contamination to treat pediculosis.
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| Scabies | female itch mite. The mite penetrates the skin and makes a burrow to lay eggs. Overcrowded living conditions, poverty, changing sexual behaviors, and world travel have increased the incidence of scabies.
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| Scabies | causes wavy, brown, threadlike lines on the body.
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| Scabies Drug therapy | basically the same as for pediculosis, Crotamiton (Eurax) and a 4% to 8% solution of sulfur in petrolatum.
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| Dermatitis Venenata | results from contact with certain plants, such as poison ivy and poison oak. Pruritus is the primary symptom in all dermatitis. Severe erythema and any type of lesion may be found on the contacted site.
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| Exfoliative dermatitis | may be caused by the infestation of certain heavy metals (e.g., arsenic mercury, gold, iodine, aspirin, codeine, and detergent, etc.).
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| Dermatitis Medicamentosa | occurs when a person is given a medication to which he is hypersensitive.
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| Contact Dermatitis | contact with agents in a person is hypersensitive. Common causes of contact dermatitis are: detergents, soap, industrial chemicals, plants such as poison ivy, poison oak. To avoid contact dermatitis causing agents, use gloves, protective gears, etc. In se
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| Paronychia | a disorder of the nails. The nails get soft or brittle, and the shape can change as they grow into the soft tissue (ingrown nails).
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| Impetigo | caused by Staphylococcus aureus, streptococcus, or a mixed bacterial invasion of the skin. The result is a highly contagious inflammatory disorders.
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| Impetigo | common in children. The lesions start as macules that develop into pustulant vesicles. Affected areas are the face, hands, arms, and legs. Honey colored dried exudate form from the pustulant lesions ranges in size from pinpoint to the size of a nickel.
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| Suppuration | Production of purulent material.
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| Eczema (Atopic Dermatitis) | primarily a disease of infants and associated with the allergies from: chocolate, eggs, wheat, and orange juice. Risk factors for skin cancer: Fatigue, emotional stress, diet.
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| Forms of skin disorders: | (1) Viral infections, (2) Bacterial infections, (3) Fungal infections. NOTE: Cultures from the lesion
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| Biopsy of the lesion | the most important diagnosis of cancerous tumor cells of the skin.
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| psoriasis | No specific diagnostic tests exist. Photochemotherapy is used to treat.
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| (1) Sudoriferous (sweat) glands: | (a) Tube-like structures located in the dermis and subcutaneous layers. (b) Excretion of sweat helps cool the body surface and. (c) Rid the body of waste products such as uric acid, ammonia and other products.
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| (2) Ceruminous glands: | (a) Secrete a waxlike substance called cerumen. (b) Located in the external ear canal.
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| (3) Sebaceous (oil) glands: | (a) Secrete sebum through the hair follicles. (b) Function is to lubricate the skin and hair. (c) Sebum also inhibits bacterial growth.
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| (4) Hair: | composed of modified dead epidermal tissue (keratin).
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| (5) Nails: | composed of tightly packed keratin.
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| In Paronychia, | an infection of the nail develops and spreads around the nail, thus giving it the nickname “runaround.” Application of wet dressings or topical antibiotics may be used. Sometimes a surgical incision and drainage of the infected area are performed.
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| Functions of the skin | barrier, temperature regulation, excretes waste, prevent dehydration, vitamin D synthesis.
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| Superficial fascia or a vascular layer of skin | epidermis.
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| Layer underneath dermis | subcutaneous.
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| Also known as the corium | Dermis.
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| Layer of the skin contains blood vessels | Dermis.
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| Causative agent is usually staphylococcus aureus, streptococci or mixed bacterial invasion of the skin | Impetigo (honey colored crust).
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| Bacterial invasion of the skin manifest with macules that develop into pustualant vesicles | Impetigo
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| Fungal infections found on scalp | Tinea capitis.
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| Fungal infection usually occurs in groin | Tinea cruris.
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| Circular with loss of hair usually found on the body – fungal infection, | Tinea corporis.
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| Caused by direct contact with detergent, soaps, chemicals, or plants | Contact dermatitis. Inflammatory papulo-postulant skin
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| Infestation of lice on the hair of the head | pedieulosis.
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| Inflammation that begins deep in the hair follicle and spreads to surrounding skin | boil, furuncle.
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| Lesion described as hives or irregularly shaped and elevated | wheal
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| Infestation transmitted through prolonged contact with linens or clothes | scabies. Parasitic disease is diagnosed with a microscopic exam of the skin
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| Kwell (lindane) or pyrethrins (RID) | used to kill lice.
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| Nursing intervention should be | the application of the medication to rid the pt of the lice.
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| Basal Cell Carcinoma | occurs thru the contact with certain chemicals, overexposure to the sun, and radiation treatment.
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| Basal Cell Carcinomas arise in the basal cell layer of | the epidermis.
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| Basal Cell Carcinomas arise in the basal cell layer | Often found on the face and upper trunk, usually scaly in appearance, and metastasis is rare.
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| Fair people are more susceptible, because they have less melanin on the skin surface. | Basal Cell Carcinomas
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| Squamous Cell Carcinoma | occurs on the sun-exposed areas of head, neck, and lower lip, and arises in the epidermis layer.
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| This cancerous neoplasm is a firm, nodular lesion topped with a crust or a central area of ulceration. | Squamous Cell Carcinoma
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| Squamous Cell Carcinoma | can metastasize quickly comparing to Basal Cell Carcinoma via the lymphatic system.
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| Herpes simplex virus as well as chickenpox is characterized by these lesions | Vesicles. The same virus Herpesvirus hominis causes herpes 1, 2.
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| This virus nicknamed as “cold sore” is usually passed with direct contact to face | Herpes Simplex 1. Herpes
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| Simplex type 2 | also called genital herpes occurs through sexual contact.
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| Herpes zoster (shingles) is caused by | same virus that causes chickenpox (varicella) (Herpes varicellae).
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| Herpes 1, 2 and herpes zoster (shingles) is treated by | Zovirax (Acyclovir) as an antivirus agent.
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| The lesions are located along the nerve fibers of spinal ganglia. | Herpes 1, 2 and herpes zoster (shingles)
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| There is no cure for | the Herpesvirus.
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| herpes Type 1 heals | within 10 to 14 days.
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| herpes Type 2 heals | within 7 to 14 days.
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| Herpes zoster | painful course lasts from 7 to 28 days)
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| Herpes zoster | fatal for the patients who have lowered resistance to infection, or those on chemotherapy.
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| Avoid hot beverages | stomatitis.
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| The nurse should suggest to the physician | nutritional supplement as soon as a 5% weight loss is noted.
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| Pain Management: | Begin pain intervention as soon as the patient states that he or she is in pain. B. Reduce the patient's anxiety level by telling them that you believe they are in pain and you will assist them in their pain relief
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| Assessment of pain | restlessness, moaning, grimacing, diaphoresis,BP and pulse increase in response to pain after about 12 hrs.
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| Methods for pain control (1) Physical techniques: | (a) Physical stimulus (TENS), (b) Acupuncture, (c) Heat and cold, (d) Exercise, (e) Comfort measures.
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| Methods for pain control Psychological Techniques: | (a)Distraction and diversion,(b)Talking,(c)Relief of anxiety,(d)Hypnosis,(e)Deep control breathing,(f)Group,(g)massage,(h)relaxation,(i)biofeedback,and(j)imagery
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| Methods for pain control Medication: | (a)Nonopioids,(b)Opioids,(c)Adjuvant analgesics,(Opioids include morphine, hydromorphine, fentanyl, and methadone.)
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| Methods for pain control Medication: | Nonopioid analgesics for cancer pain are: acetaminophen, aspirin; and nonsteroidal anti-inflammatory drugs are:ibuprofen, indomethacin, and naproxen.
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| Genital herpes | Characterized by recurrent episodes of acute, painful, erythematous, vesicular eruptions (blisters) on or in the genitalia or rectum
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| HSV-Type I causes | infrequent recurrences of lesions (Vesicles) around the lips.
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| Local anesthetic (Lidocaine) or systemic analgesics | may be prescribed for pain.
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| Medications that inhibit herpetic viral replication | Acyclovir (Zovirax):
Famciclovir (Famvir).
Valacyclovir (Valtrex).
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| Nursing interventions/assessment for skin cancer: | a. Chief complaint and history of present illness: Visual Inspection of the Skin:
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| Assess general appearance of the skin: | texture,dryness and skin turgor. Observe the color(a)hemoglobin (pallor),(b)Oxygen saturation (cyanosis),(c)bilirubin,urea,or other chemicals(jaundice),(d)melanin.(7) Temperature.(8)mucus membranes (color, moistness, swelling, lesions.) (9) nails
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| Sudden onset of urticaria (hives) accompanied by intense itching | may indicate a severe drug reaction. quickly assess the patient and contact the physician.
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| Dark skin predisposed to certain skin conditions | pseudofolliculitis, keloids, and Mongolian spots.
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| four types of Malignant Melanomas | (1) Superficial spreading melanomas, (2) Malignant lentigo melanomas, (3) Nodular melanomas, and (4) Acral lentiginous melanomas
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| Psoriasis | noninfectious skin disorder; it is a hereditary, chronic, proliferative disease involving the epidermis and can occur at any age.
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| Psoriasis | The lesions appear as raised, erythematous, circumscribed, silvery, scaling plaques.
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| Psoriasis | The severe scaling is a result of the rapid cell division (from 7 to 28 days).
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| the main function of the integumentary system | protection, temp regualation, vit-D synthesis
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| sudoriferous glands | releases perspiration through the skin
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| poses threat to a person's self-concept | any injury
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| what is important to establish in order to meet a person's psychological needs | therapeutic relationship
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| what are most skin conditions | non-contagious, rarely fatal, mostly chronic
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| this is required with any open, draining lesions | sterile and isolation technique
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| what does constant moisture due to skin | softens the skin, contributes to skin maceration
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| common diagnosis for skin problem | skin integrity, risk for infection, knowledge deficit, ineffective coping
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| what is a primary nursing intervention for skin diseases | p/t of mode of transmission
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| why are wet dressings and baths done | to sooth, vasoconstrict, debride, decrease pruritus
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| important to know before starting heat and cold therapy | responses to temp-variations, integrity of body part, ability to sense temp, ensure proper operation of equipment
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| best way to prevent malignant skin diseases | education
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| how are burns classified | depth and TBSA involved
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| three phases of burns | hypovolemic/emergent, acute/diuretic, longterm/rehabilitation
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| 3 phases of burn care | overlap with different goals and nursing intervention in each
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| primary intervention for the burn patient in the emergent phase | patent airway
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| treatment method for a burn patient | depends on age, surface area involved, location, depth and other diseases present
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| primary cause of death in burn victims within the first 72hrs | hypovolemic shock
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| primary cause of death in burn victims within the acute phase | infection
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| if the burn injury occured in a closed or confined area, what should be suspected | inhalation injury
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| treatment for burns | temporary skin substitution derived from human fibroblast cells.
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