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49 Cards in this Set

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old people loose the sub Q fat in the skin, they will get cold faster, the skin will slip b/c of this (shear) . Arteriolscerlorisis can result in ...
poor circulation in the skin caused by this disease so won't have as good heat or cold regulation as young people. bodies can't respond as well to heat changes so they feel cold when others don't. lose subQ fat w/h also makes them cold too
skin is our barrier, largest organ we have. protects from dehydration, also protects from thermal regulation. a spinal cord injury will affect the sweat glands, the vasculartur in that area, are they going to have a problem with temp regulation?
therefore loosing sense of feeling in the skin can cause someone to get a burn and can't sense it. Cutaneous sensation is what this is called. a lose of Cutaneous sensation.
what vitamin does skin need to manufactured so you don't loose calcium?
vitamin D so get out in the sunshine some. also we loose water and electrolytes thru excretion.
diagnostic skin testing
what is Wood's light for?
ringworm.Dont worry about Tzanck smear. Biopsy diagnostic testing, what are we looking for? cancer dumb ass
when someone comes into the hospital w/ a skin problem you should use a camera w/ a grid and a string that pulls out to show exactly how far away the camera is and grid is. why
this method w/ the grid size known and distance known you know how big the wound is or long the rash or lesion. Time and date stamp it and legal signature. this is est. a baseline. and then keep taking serial photographs to see if your treatments are working. getting better or getting worse, obj. data here.
what do we look for when skin guy comes into the clinic? if they are dry, lips cracked, what would dry and brittle hair mean?
vitamin or malnutrtion. a nutrition problem. Cells are phospholipids, lipids, that means fat. eat the right kind of fats. her friend started having kidney pain. the kidneys were slipping when she ran, thats from low fat no pads to hold them in place.
other than looking at hair, what else do we look at. the scalp. look for rash or plack. we look for spider veins, any evidence of vascular anomily, why
b/c we might see that on the skin. red dots, spider lines. hydration, turgor. oily skin doesn't wrinkle, it has zits but it doesn't wrinkle. dry skin doesn't have zits. oily skin doesn't wrinkle.
the pt says I have a rash. we are going to ask them how long have you had it. are you allergic, to est. a timeline say what were you doing? been out the states recently. what do we chart when est. a baseline for a skin thing.
the size of it.
open or not lesion
location location location
when a old pt has blue bruised looking skin, do you chart it as bruised skin?
no. say mult. black n blue areas (NOT BRUISES) along the thrunk or forearems. flat or raised. there is a diff b/t a hematoma (pocket of blood) and a bruise (flat bruise). don't diagnose it, just describe it.
is the wound dry or moist
does it have discharge
if its open, does it have odor
if it does have discharge, what about that?
what color is the discharge?
there is a diff b/t serous, sangiouus, or white green yellow. serous is clear i think.
wound size and it's edges.
is it an irregular edge or a smooth edge. describe it. is is round or irregular. is it open then is the edges of that wound ...
edges are flat or rounded. big deal here.
pop quiz...what does cutanious sensation mean
feeling in the skin. a quadplegic loses this in his legs
kidney failure will make your skin smell like
there are 2 layers to the skin the papillary layer and reticular layer. what does the papillary layer do
papillary layer holds everything in
the reticular layer produces collagen and elastic bundles
a wound that is white and rounded like raised edges, its not healing, its stopped healing what do you want it to look like?
flat and pink wound is still healing. the healing processes are still going on. white and rounded means healing has stopped. and that wound won't close.
you want the wound bed to be red and beefy and look like a peice of raw meat in there! then you know its ...
vascularized, and its healing. granulation is all taking place. if wound bed is slimy and black or white or any discoloration other than raw meat, its probably not getting any epithelialization or granulazation to that wound.
if hair distribution on a male or female doesn't follow the sex, what does that indicaate?
maybe some indicrin function that is in alteratnion.
nails. what is paronychia?
An acute or chronic infection of the marginal structures about the nail.
illness trama etc show up on the nails. CLUBING is what teacher wants us to look at. COPD deal. but what else?
clubbing means infection or paronychia
any kind of hypoxia will cause clubbing. any changes in the nails. Beaus lines can be vertical or horizontial. what causes Beaus lines
trauma. can be fixed.
acrulic nails will cause unhealthy nail beds
nail and hair. remember dry or brittle hair, malnutrition, curling irons, endocrine disorder. what would hair loss indicate
male pattern baldness
a disease
endrocrine disorder
behavior like bitting their own long hair. a psych probelm b/c it causes hair balls in stomach.
head lice. can't jump. gets transfered by sharing stuff like borrowing hats or combs or jackets or sweat shirts. wo lockers at school stops this. why do people get head lice?
they come in contact w/ them. not b/c they are dirty. social stigma head lice is gross and we shouldn't. how do you treat it? w/ a shampoo like quill or rid. and comb out the eggs. lindain is used in shampoos for lice but its very toxic! old people can die from this stuff.
a cheap way to get rid of lice is too. . . kerosine and a bag over your head or vasoline over the head and suffocate them. put clothes in a hot dryer for 10 minutes. 30 gallon plastic bags and put everything in those bags for 30 days. so...
wash everything you need, run it thru a dryer then tie it all up in a 30 gallon bag and let it go thru its life cycle.
what is padiculis humanis capitis
human head bugs on the human head. padunculitis humanis capitis. padunculitus humanis ingunealus is bugs in your groin
lesions on the test will ask me to describ a kind of lesion. these include:
macule = flat, color change, like a freckle or a flat mole.
papule = elevated, solid, like a wart or scabies,solid.
plaque = like psoriasis or Actinic Keratosis
wheal = hives, transient. here today, gone tomorrow
nodule raised, lipoma, old dog tumor fatty tumor. firm tumor like.
vesicle = elevated, thin wall lesions filled w/ serous clear fluid. poision ivy or a burn or blister. < 1 cm dia.
bulla same as a vesicle but > than 1 cm. clear fluid like
pustule. a blister on your foot is a bulla if its less than 1cm its a vesicle.
macule = color change
paplule = like a wart elevated,
coposi sarcoma, solid
plaque = flat wart, dry flaky
wheals = itchy raised, irregular shape, several of different dia. mosquito bite is a wheal.
bulla & vesicles = think smallpox lesions
what are pustules filled with?
pustules are vesicle filled NOT w/ clear liquid but w/ pus. like pus u le
like acne. infection. pus filled. other acne is cysts. elevated and encapsulated w/ semi solid or liquid that is NOT purlulent. Cyst don't have pus.
what does Michial Jackson say he has vitiligo, whats that?
vitiligo...leeching of highly pigmented skin. an autoimmune disorder.
why do blacks have to take extra vitamin D when stationed in Greenland
their skin doesn't get enough sunlight to get the vitamin D they usually get in Africa. Lite skin folk don't have to take as much as black do.
what is melanoma? a skin cancer. what has made melanomas increase last 20 years?
tanning booths. melenoma age groups we are concerned with are? young people or anyone w/ a beautiful tan look for any changes to moles. Truckers and farmers too. long term exposure.
what do we look for at a mole. symmetry.
A = asymmentry = not the same
B = borders = irregular
C = color(more than one color)
D = diameter. > pencil eraser it needs to be checked out. if its evolving, changing...
it might be > than an erasor and consistant in color = a big mole. but look at it. Big deal here is change in the mole. symmetry.
what is atheletes foot, etc. you use foot powder for?
ring worm, a fungi. likes dark enviroments. Tinea pedis = in the foot. Tenea corporis = on the face. Tenea capitus = on scalp
what is psorisis?
autoimmune disease. can be painful. always say when charting a wound wheither or not it is painfull or itches. psorisis has a family history. gets scally and patchy and then falls off and is red and sore underneath. treat wound bed with cortisone or salt water or oatmeal baths.
the diff b/t a pustule and a vessicle is ...
same thing except the pustule is full of puss
vesicle is full of serosangrous fluid. we don't want that pus to get into the circulation system and becoming systemic.
what is impetigo?
contagious staph infection. very resistant to antibiotic. spread by direct contact. treat w/ topical antibiotics. prescription strength bactoban and don't want it to spread by washing the area w/ soap and water
so vesicles and bullas.
vesicles < 1 cm
bullus > 1 cm
ex are herpes zoster=shingles
chicken pox=herpes zoster
but shingles is herpes zoster
chicken pox never goes away, it hides behind the ganglion like herpes simplex does.
so you get shingles. it shows up on one side. what is the pattern of lesions look like? more like a belt. why?
it follows the nerve b/c its in the nerve and so it follows the nerve in a line
small pox is acute, contagious and a systemic viral disease. Its a variola viris. whats variola virus?
think variola?think smallpox
oldest and largest of viral diseases. like small pox
up to 1968,we all got smallpox vacinations.
what is puritis?
itching. why do old people itch? dry skin. And why do people itch? inflamatory process. what else. people w/ chronic renal failure will itch. why? toxins building up in the body. total shutdown of renal causes them to smell like pee. Cirrosis
the liver de toxifies and the kidneys excrete it. so trouble w/ any organ we will itch! why would we give someone an antihistimine for itching?
degrease inflamation by decreasing production of histomines and its the histomines that make us itch from an allergic reaction.
what is the Braden scale?
gold standard to protect ourselves and the patient in court. relates to 6 areas related to function.
where's the hardest place to heal?
behind the ears. so make sure the plastic tubing isn't caught in the crack behind the ear.
describe a stage one
erethemia = turns red / deep
doesn't blanch. goes deep. don't rub this deep red area. you can shear it easily
stage 2. a blister on your heal is a stage 2 wound.
getting to subQ but not quit there. the skin is broken in stage 2 wound. so its red and broken skin, a PRESSURE ULCER
wounds should NOT be dry we want them moist why?
so epitheleal area can heal with
can a wound go from a stage 2 to a stage 1?
no. once area is diagnosed as a stage 2, it will always be a stage 2 area.
keep these wounds dry
keep these pt nourished
skin breakdown is a neglect issue. ex. m/s pt wouldn't let anyone move her. or a bone cancer in pain, what do we do w/ their pressure ulcer. what do you do?
priority in hospice isn't skin but their comfort. comfort is the issue.
other exception to pressure ulcer issue is a pt that is alert and oriented and capable to make own health care issues and are still refusing care what???
a psy / social problem? yeah? Depression? get an antidepressent on board but quote the pt word for word in the chart including explitives to CYI. ut other than these, WE as providers cause these wound
stage 3 wound is now in the subQ area. this is almost to the bone, full thickness necrosis down to facia. yellow slimy. what else?
painfull. bone is some of the most painfull pains.
stage 4 ulcers usually in area
trocanter ulcers
coccox ulcers
sacreal ulcers. fter the bone is hit, what next?
bone infection. this is hard to treat b/c they aren't vasculized! periostium has lots of nerves. so painfull.