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22 Cards in this Set
- Front
- Back
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folliculitis vs furuncles vs carbuncles
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- inflammation of hair follicle
- furuncle- deep in hair follicle(s) spreading to dermis - carbuncle - even deeper in subcut tiisue |
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HSV
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primary vs non-primary
- if you first get type 1, that is your primary episode - if you then acquire type 2, that is your initial non-primary episode - initial primary episode is worst |
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hsv factors
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sunlight, stress, dec immunity
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Genital herpes transmission
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- will usually get burning or tingling feeling 24h before vesicles erupt
- however, incubation is 3-7 days, so you were contagious those days unbeknownst to you |
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HSV pregnancy
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- with active lesions, must have c-section
- associated with preterm pregnancies |
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fungal infections
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- avoid heat and humidity
- keep skin and feet dry - avoid sharing towels and combs |
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pediculosis. clinical manifestations
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- lice - capitus, corporus, pubis
- not associated with uncleanliness - intense pruritis, scratching causes secondary infections - head lice found behind ears and back of head, silvery eggs - body lice live in clothing - pubis - pruritis at night. reddish brown dust in underwear is excretions |
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pediclousis nursing
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- shampoo with lindane
- fine tooth comb dipped in vinegar to remove nits (eggs) - all family members must be treated - clothing bedding washed in hot water (130f) - use lindane as instructed - causes CNS symptoms |
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scabies. clinical manifesations
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- mites
- associated iwht bad hygiene - burrows usually inbewteen fingers and on wrists - 4 weeks until symptoms appear - pruritis at night due to warmth stimulating them |
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nursing scabies
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- warm soapy shower to remove debris from crusts
- DRY, COOL SKIN - apply lindane or other scabicide to skin from neck down (doesn't affect face) - medication left on for 12-24 hours - use as directed. impt to dry and cool skin before treatment, otherwise inc absption of med (cns effects) - ichitiness may persist for weeks due to hypersensitivty |
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stevens - johnson syndrome. clinical manifestations
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- adverse reaction to certain medications - NSAIDS and sulfonamides, antiseizure meds too
- starts off as conjuctival burinng, itching, tender skin, fever, malaise, sore throat, HA, myalgia - then skin turns erythematous - epidermis shed, dermis exposed - weeping skin like inburns |
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medical management stevens-johnson syndrome
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- fluids and electrolytes
- Ab for sepsis - IVIG for rapid healing - topical Ab, anesthetics, biologic dressings - oral and eye care |
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nursing diagnoses stevens johnson
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impaired tissue integrity
- avoid friction when moving pt - topical agents and Ab, hydroptherapy - oral hygine deficient fluid volume risk for imbalanced body tmep - prone to chilling - cootton blankets, heat lamps/shields - limit wound care exposure acute pain anxiety |
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severity of burns
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superficial partial thickness
- epidermis, possibly some dermis - reddened that blanches with pressure deep partial-thickness (2nd) - epid and upper dermis, possibly deeper dermis - sensitive to cold air - weeping surface full-thickness - all of dermis gone, possibly musle, bone - pain free - broken skin, fat exposed - requires grafting for recovery |
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estimate total BSA burned
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role of 9's - each body of area receives 9% of BSA
- head - ant/post chest - ant/post abdomen - arm - ant/post leg * groin 1% |
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electrical burns
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- since point of entry is small, hemorrhage may be deep into viscera
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pathophysiology of burns
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- effects are localized until it reaches 20% TBSA --> systemic effects
F&E - shift from intrav to interstitial, shock, edema Cardiovascu - burn shock causes dec CO - immedly fluid resscictate Pulm - inhalation injurty Renal - dec funcn due to burn shock and myobglobin and hemoglobin buildup occluding renal tubules GI - paralytic ileus --> abdom distention, vomiting [NG gastric decompression] - Curling's ulcer (gastric bleeding) - altered mucosal barrier prone to infection in GI - abdominl compartment syndrome |
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phases of burn care
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emergent/resuscitative
- from injury until fluid resc complete Acute/intermediate - from diuresis to wound closure Rehabilitation - wound closure to optimal physical and psychosoc dvlmpt |
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emergent/rescustiative care
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- extinguish flames, cool burns with water, irrigate chemical wounds
- ABC, oxygen and large-bore IV - remove clothing, cover wound |
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when should a burn patient receive gastric decompression
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- above 20% TBSA burned, GI effects of Curling ulcers and paralytic ileus
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fluid replacement for emergent care
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- formula
2-4mL/kg/%TBSA for first 24 hours - 1/2 of it given first 8h - next 1/2 given next 16h - a GUIDELINE, not absolute |
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biobrane dressing
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- nylon dressing for deep partial thickness - prevents weeping
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