Med-Surge Integumentary Sx

Front 1

Collagen

Back 1

-Protein that gives strength and resilience
-Loss of collagen results in wrinkle

Front 2

Desquamation

Back 2

Loss of skin

Front 3

Dermatology

Back 3

Study of skin diseases

Front 4

Dermatologist

Back 4

physician who specializes in this field

Front 5

Purpura*

Back 5

Discolored skin d/t blood in the tissue outside the blood

Front 6

Dx Tests

Back 6

-Diagnostic tests can be used to determine the origin of the skin disorder

Front 7

Wood's Light

Back 7

use of UV rays to Dx pigment abnormalities, can also detect superficial fungal and bacterial infections

Front 8

Tzanck's smear

Back 8

examination of cells and fluids found in vesicles (ex. Herpes zoster and varicella), they are applied ti a glass slide and examined using a microscope

Front 9

Biopsy

Back 9

removal of skin-tissue specimen for microscopic exam to determine malignancy or to Dx a skin disorder

Front 10

Scabies scraping

Back 10

shave off the top of a suspected lesion, place on a glass slide covered with immersion oil and examine the slide under a microscope

Front 11

Pruritis (Itching)

Back 11

-Sx skin disease
-Can also be cause of d by systemic disorders, such as liver disease and dry skin
-Scratching is inevitable, and causes skin breaks which can result in scarring and infections

Front 12

Pruritis Tx

Back 12

-divert attention, hypnosis
-Administer medications: antianxiety (Ataraz, Vistaril), antihistamines (Benadryl, Tavist), topical corticosteroids

Front 13

Pruritis Prevention

Back 13

Cotton clothing, apply lotion to dry skin, skin testing, cool or lukewarm baths, soothing baths (colloidal oatmeal, starch)

Front 14

Therapeutic Bath

Back 14

*Cleanse body and soothe skin
*Promotes wound healing
*Relieves itching
Aids in the removal of eschar
Aids in prevention of infection
After the bath, you can apply medication to the body
Give this type of bath in a WP or bathtub, disinfect after each pt. Use
Oatmeal, cereals, starch, tars and baking soda can also be added to the bath
Don’t use soap (dries the skin), use medicated bath oil
**Tepid water (heat makes one itch)-no more than 100 degrees F
Pat the skin dry, rubbing increases pruritis
*Use lotion if the MD allows

Front 15

Skin and Tissue Grafts

Back 15

Skin grafts are used to cover areas of skin lost from burns, infections or wounds

Front 16

Graft

Back 16

-transplant of skin that is placed on viable tissue
-very painful
-may take months to heal, depending on success

Front 17

Free Graft

Back 17

skin completely removed from its original site and grafted on to the recipient site

Front 18

Pedicle Graft

Back 18

one end of the graft remains attached to the donor site so that new circulation is established
Nursing Considerations:

Front 19

Nursing Considerations

Back 19

-Explain procedure
-Can expect postop edema, ecchymosis
-Protect sites, grafts
-Provide emotional support

Front 20

Moist Dressings

Back 20

-Moist packs-reduce edema and weeping in acute dermatitis
-soften and remove exudate and crusts
Relieve pruritus and discomfort
-clean or sterile
-closed dressing-covered with plastic or a firm material
-open dressing-not covered, tissues need O2 to prevent necrosis
-requires frequent dressing changes or resoaking q2 hours

Front 21

Wound Debridement

Back 21

-Physician or Surgeon will remove loose skin, crusts, eschar or denuded (protective) tissue
-Sterile procedure often done when changing moist packs (change moist packs q2hours!!)

Front 22

Surgical Treatments

Back 22

Plastic or Reconstructive Surgery-improves disfigurement, may be performed for cosmetic effects, to repair congenital defects or repair trauma tissue

Front 23

Skin and Tissue Grafts

Back 23

Assess the skin:
-report any changes
-color
-turgor
Document: size, color, texture, location or distinct characteristics of the skin
Fluid and Electrolyte Balance
Encourage the client to drink and eat
Provide high Kcal, high protein meals
Observe and document I & O

Front 24

Urticaria (hives) S/S:

Back 24

edematous, raised pink areas called wheals
Wheals itch and burn
May disappear quickly or stay for days
Most commonly caused by an allergic reaction to meds, foods, spores or pollens

Front 25

Chronic urticaria

Back 25

asts longer than 6 weeks, cause is unknown in 80-90% of adults

Front 26

**Angioedema

Back 26

involves deeper dermal and Subq. Tissues. Affects the lips, eyelids, skin, GI tract, hands, feet, genitalia, tongue, and larynx

Front 27

**Angioedema Tx

Back 27

removal of cause, tepid baths, antipruritic lotions, antihistamines, epinephrine for severe cases

Front 28

Vitiligo

Back 28

-Occurs when areas of skin lack in pigmentation
-Results in patches of pale or white looking skin
-Cause unknown

Front 29

Vitiligo Tx

Back 29

methoxsalen after exposure to sunlight can temporarily darken the affected area

Front 30

Surgical Tx

Back 30

grafting and melanocyte transplantation
-Melanin-gives skin color
-Albinos cannot make melanin

Front 31

Eczema (atopic dermatitis) Sx

Back 31

small vesicles appear along with red and pruritic skin, when the vesicles burst and ooze, crusts form
-Viral, bacterial or fungal skin infection may develop

Front 32

Eczema (atopic dermatitis)

Back 32

-Cause unknown but heredity, allergy, and emotional stress can contribute
-Most commonly found in the folds of the elbow, back of the knees, on the face, neck, wrists, hands and feet

Front 33

Eczema (atopic dermatitis) Tx

Back 33

-prevent dry skin, cracking and itching
-Apply moisturizing creams, corticosteroid ointments, or wet dressings
Use lanolin free lotions

Front 34

Eczema (atopic dermatitis) Meds

Back 34

Topical corticosteriods-exert localized anti-inflammatory activity, reduce swelling, redness, itching, antihistamines-may relieve itching!
-Potency depends on drug concentration and the vehicle (lotion, cream, etc.)

Front 35

Adverse Reactions

Back 35

Burning, itching, irritation, redness, dryness of the skin, secondary infections

Front 36

Psoriasis

Back 36

-Chronic, noncontagious disorder that affects young adults and middle aged adults
-Cause is unknown but hereditary, environmental, metabolic or immune factors contribute to breakouts
-Stress and anxiety precede exacerbations of the disorder

Front 37

Psoriasis S/S

Back 37

: red papules covered with silvery, yellow-white scales that the client sheds
Patches appear on the elbows, knees, scalp and lower back, the nails may loosen at the fingertips (onycholysis)

Front 38

Psoriasis Tx

Back 38

-reduce scaling and itching
-Therapeutic baths, wet dressings, or lubricating ointments
Psoriasis

Front 39

Psoriasis Meds

Back 39

-Topical antipsoriatics-help remove the plaques associated with this disorder
-Ex: calcipotriene (Dovonex)
-Anthralin (Anthra-Derm)
-Antihistamines
-Methotrexate & oral retinoids are useful in treating severe, extensive psoriasis

Front 40

Psoriasis

Back 40

-Chronic, noncontagious disorder that affects young adults and middle aged adults
-Cause is unknown but hereditary, environmental, metabolic or immune factors contribute to breakouts
-Stress and anxiety precede exacerbations of the disorder

Front 41

Adverse Reactions

Back 41

-Burning, itching and skin irritation
-Anthralin may cause temporary discoloration of the hair and fingernails

Front 42

Psoriasis S/S

Back 42

: red papules covered with silvery, yellow-white scales that the client sheds
Patches appear on the elbows, knees, scalp and lower back, the nails may loosen at the fingertips (onycholysis)

Front 43

Psoriasis Tx

Back 43

-reduce scaling and itching
-Therapeutic baths, wet dressings, or lubricating ointments
Psoriasis

Front 44

Psoriasis Meds

Back 44

-Topical antipsoriatics-help remove the plaques associated with this disorder
-Ex: calcipotriene (Dovonex)
-Anthralin (Anthra-Derm)
-Antihistamines
-Methotrexate & oral retinoids are useful in treating severe, extensive psoriasis

Front 45

Adverse Reactions

Back 45

-Burning, itching and skin irritation
-Anthralin may cause temporary discoloration of the hair and fingernails

Front 46

Psoriasis

Back 46

-Chronic, noncontagious disorder that affects young adults and middle aged adults
-Cause is unknown but hereditary, environmental, metabolic or immune factors contribute to breakouts
-Stress and anxiety precede exacerbations of the disorder

Front 47

Psoriasis S/S

Back 47

: red papules covered with silvery, yellow-white scales that the client sheds
Patches appear on the elbows, knees, scalp and lower back, the nails may loosen at the fingertips (onycholysis)

Front 48

Psoriasis Tx

Back 48

-reduce scaling and itching
-Therapeutic baths, wet dressings, or lubricating ointments
Psoriasis

Front 49

Psoriasis Meds

Back 49

-Topical antipsoriatics-help remove the plaques associated with this disorder
-Ex: calcipotriene (Dovonex)
-Anthralin (Anthra-Derm)
-Antihistamines
-Methotrexate & oral retinoids are useful in treating severe, extensive psoriasis

Front 50

Adverse Reactions

Back 50

-Burning, itching and skin irritation
-Anthralin may cause temporary discoloration of the hair and fingernails