Med Surge - Test 2 Integument Disease (Pink)

Front 1

Skin vitals:

-WD

C/W:

Back 1

-WD is the skin warm and dry?
Talking about surface, not texture.


-C/W: cool/cold/wet

Front 2

Pink pimples
-are also called

Back 2

neonatal acne

Front 3

Pink pimples are often caused by:

Back 3

exposure in the womb to maternal hormones.

Front 4

Pink pimples

-what is the treatment?

Back 4

No treatment is needed, just time.

They can last for weeks or even months on baby's skin.

Front 5

what are milia?

Back 5

little white bumps on the nose and face

Front 6

What are milia caused by?

Back 6

blocked oil glands

Front 7

Milia
-treatment?

Back 7

when the baby's oil glands enlarge and open up in a few days or weeks, the white bumps disappear

Front 8

Milia
-what happens if you squeeze them?

Back 8

scaring can result. they will open up and go away on their own

Front 9

Jaundice
-what is it?

Back 9

a yellow coloruation on your babys skin and eyes

Front 10

Jaundice
-what is it caused by?

Back 10

It is caused by an excess of bilirubin (a breakdown product of red blood cells).

Front 11

Jaundice
-high levels of bilirubin such as ___mg, can cause what 3 things?

Back 11

25

-deafness,
- cerebral palsy,
- or other forms of brain damage

Front 12

Jaundice
-best way to get rid of it?
2 ways

Back 12

fluids (breastfeeding and formula) and UV light

-treatment with a special light that helps rid the body of the bilirubin by altering it or making it easier for your baby's liver to get rid of it — may be used.

Front 13

What happens if the mom gives the baby water? the baby can experience water intoxication, which can lead to

Back 13

seizures

Front 14

Jaundice occurs when bilirubin builds up....

Back 14

faster than a newborn's liver can break it down and pass it from the body.


http://kidshealth.org/parent/pregnancy_center/newborn_care/jaundice.html#

Front 15

Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body. Reasons for this include:

Back 15

•Newborns make more bilirubin than adults do since they have more turnover of red blood cells.

•A newborn baby's still-developing liver may not yet be able to remove adequate bilirubin from the blood.


•Too large an amount of bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool

Front 16

If the bilirubin level becomes sufficiently high, what may be used on the baby's skin to lower the level?

Back 16

phototherapy
-- cover eyes

Front 17

Cafe-au-lait Spot
-what is it?


what is it caused by?

Back 17

A beige or brown flat, oval patch


increased pigment in the skin’s surface layer, sometimes called hyperpigmentation.

Front 18

“third nipple

Back 18

Cafe-au-lait Spot

Front 19

Cafe-au-lait Spot
-what are the color of the spots in children with light complexions?


-what about black/darken skin children?

Back 19

The spots are typically the color of coffee with milk in children with light complexions,


they are usually the color of black coffee in children with darker skin.

Front 20

Cafe-au-lait Spot

Treatment:

Back 20

laser therapy is an option (results vary)

Some may be removed permanently. Some may darken. Some may only be removed temporarily, Cafe-au-lait spots elsewhere on the body usually aren’t treated.

Up to 20% of the population has a cafe-au-lait spot.

Front 21

Cafe-au-lait Spot


when do they appear

Back 21

It can be present at birth or appear within a week or so afterwards

Front 22

Mongolian Spot
-what is it?

Back 22

Melanin (brown skin pigment) trapped in the midlayer of the skin.

-The patches appear as a bluish or grayish bruise on the lower back or buttocks

Front 23

Mongolian Spot

-when to worry?

Back 23

Mongolian spots are completely benign and present no medical threat whatsoever.

Front 24

Mongolian Spot

-treatment?

Back 24

 Most fade completely by age five.

Front 25

Geriatrics
-have an increased or decreased function of the skin layers

Back 25

decreased

Front 26

Geriatric patients :Epidermis

Decrease thickness of epidermal layer, resulting in:

Back 26

thinning (increase transparency and fragility)

Front 27

Geriatric patients :Epidermis

-decrease miotic activity, results in?

Back 27

delayed wound healing and more susceptibility to infections

miotic activity is the degree to which cell population proliferates

Front 28

Geriatric patients :Epidermis

-decrease number of melanocytes, results in:

Back 28

increase sensitivity to sun exposure, appears blotchy, higher risk fo shearing injuries and ulcer development

Front 29

Geriatric patients :Epidermis

-flattening of dermal and epidermal junction, results in:

Back 29

increase susceptibility to shearing forces, blisters, pressure related injuries

Front 30

Geriatric patients

what causes the face to drag and wrinkles appear?

Back 30

the dermis is composed of collagen and elastic fibers that give the skin flexibility and strength.

collagen production increases in areas of tissue injury and helps form scar tissue

-the elasticity of the skin depends on both the amount and quality of the elastic fibers, which are scattered among the collegen fibers

-older adults have a degeneration of elstic fibers, therefore they have decreased tone and elasticity (wrinkles)

WHAT SHOULD YOU USE TO TEST FOR SKIN TURGOR

forehead and chest

Front 31

Geriatric patients :Dermis

-decrease blood flow, results in?

Back 31

dry skin (xerosis)

Front 32

Geriatric patients :Dermis

degernation of elastic fibers, results in?

Back 32

wrinkles (decraese tone and elasticity)

Front 33

Geriatric patients :Dermis

-abnormal nerve endings (reduced number and function of nerve endings)

Back 33

alteration in sensory perception

Front 34

Geriatric patients :Dermis

decrease dermal thickness, results in?

Back 34

increase susceptibility to trauma

Front 35

Geriatric patients :SQ

-thinning of SQ layer results in 2 things

Back 35

increase susceptability to hypothermia and

decrease resistance to injury (pressure necrosis)

Front 36

Geriatric patients :SQ

-redistribution of adipose tissue results in

Back 36

"bags"
cellulite
double chin
abdominal apron

Front 37

Geriatric patients :SQ

Striae
-results from?

Back 37

tissue has been overstretched and actually ripped on the underlying structure

they do not go away

they lighten up

Front 38

Geriatric patients :SQ

Panus
-what is it?

Back 38

large accumulation of tissue / yeast

Front 39

Geriatric patients :SQ

Cellulite
-what is it?

Back 39

redistribution of adipose tissue and that tissue is holding onto fluid.

Looks like texture of an orange (what changes it from smooth to rough –expansion of fat cell and fluid that is pushed in there)

Front 40

Skin assessment
-color and color changes is affected by what 4 things?

Back 40

blood flow,
oxygenation,
body temperature,
pigment reduction

Front 41

Skin assessment
-check for moisture and edema

edema causes skin to look (3)

Back 41

taut(tightly stretched), shiny, and pale

Front 42

Skin assessment
-assess for skin lesions

primary vs secondary

Back 42

primary lesions are an inital reaction to a problem that alters one of the structural components of the skin

secondary- changes in the appearance of the primary lession (due to prgression of an underlying disease or in response to a systemic intervention

Front 43

Skin assessment
-assess skin integrity, how?

Back 43

look for skin tears in areas of constricting clothing, upper extremities where skin is pinched to ambulate, tapes, and dressings

Front 44

Skin assessment
-what are vascular markings?

Back 44

birthmarks, cherry anginomas, venosu stars) they are normal.

Front 45

Skin assessment
-what results in bleeding under the skin

Back 45

petechaie and ecchymoses

Front 46

Skin assessment
-color changes can be seen most easily in the areas of

Back 46

least pigmentation (oral mucousa, sclera, nail beds, palms, soles)

Front 47

Skin assessment - Alterations in skin color

-White is also called

-results from: 2

Back 47

pallor

-decreased hemoglobin levels
-decreased blood flow to the skin (vasoconstriction)

Front 48

Skin assessment - Alterations in skin color

-White (pallor)
significance is seen with what (4)?

Back 48

anemia
shock/blood loss
vascular compromise
edema

Front 49

Skin assessment - Alterations in skin color

yellow/organe
-also called
-results from:

-significance is seen with what (2)

Back 49

jaundice

increase total serum bilirubin level


increase hemolysis or RBCs
liver disorders

Front 50

Skin assessment - Alterations in skin color

yellow/orange can results from an increase serum crotene level

significance is seen with what (4)

Back 50

increase congestion of caroten containing foods (carrots)

-pregnancy

-thyroid deficiency

-diabetes

Front 51

Skin assessment - Alterations in skin color

Erythema is also called

Back 51

red

Front 52

Skin assessment - Alterations in skin color

-Erythema results from

Back 52

increase blood flow to skin (vasodilation)

Front 53

Skin assessment - Alterations in skin color

-Erythema
significance is seen with what? (5)

Back 53

-generalized inflammation
-localized inflammation (sunburm, cellulitis, trauma, rash)
-exposure to cold
-fever
-increase ETOH intake

Front 54

Skin assessment - Alterations in skin color

-Cyanosis is also what color?

Back 54

blue

Front 55

Skin assessment - Alterations in skin color

-Cyanosis results from?

Back 55

increase in deoxygenated blood

Front 56

Skin assessment - Alterations in skin color

Cyanosis
-signficance is seen with what? 1

Back 56

cardiopulmonary diseases

Atherosclerosis
Cardiomyopathy
Congestive heart failure.
Coronary artery disease (CAD)
High blood pressure/hypertension
Hypercholesterolemia/hyperlipidemia

Peripheral artery disease (PAD).

Stroke

Front 57

Skin assessment - Alterations in skin color

-Blue
Bleeding from vessels into tissue, which results in 2

Back 57

petechia 1-3mm

ecchymosis greater than 3 mm

Front 58

Skin assessment - Alterations in skin color

Brown results from

Back 58

increase in melanocyte production

Front 59

Skin assessment - Alterations in skin color

Brown
-significance is seen with: 4

Back 59

chronic inflammation,
pregnancy,
addisons disease,
sunlgiht

Addison's disease is a disorder that occurs when the adrenal glands do not produce enough of their hormones.

Front 60

Skin assessment - Alterations in skin color

Reddish Blue results from


-significance is seen with?

Back 60

increase amount of hemoglobin

decrease peripheral circulation





inadequate tissue perfusion

Front 61

Skin assessment in dark skin
-pallor, inspect where?

Back 61

mucous membranes for ash gray

Front 62

Skin assessment in dark skin
-cyanosis, inspect where?

Back 62

lips and tongue are gray and the palms, soles of feet, conjuncivae, nails

Front 63

Skin assessment in dark skin
-jaundice?

Back 63

oral mucosa, hard palate,

Front 64

Process of wound healing, primary-secondary-third intention

wounds can be easily closed and dead space eliminated

Back 64

first intention

Front 65

Process of wound healing, primary-secondary-third intention

shorter phase of tissue repair
inflammation resolves quickly

Back 65

first intention

Front 66

Process of wound healing, primary-secondary-third intention

-connective tissue repair is minimal, resulting in thin scar

Back 66

first intention

Front 67

Process of wound healing, primary-secondary-third intention

-a wound without tissue loss, such as a clean laceration or surgical incision

Back 67

first intention

Front 68

Process of wound healing, primary-secondary-third intention

deep tissue injuries or wounds with tissue loss, such as chronic pressure ulcer or venous stasis ulcer result in a cavity like defect that requires gradual filling in of the dead space with connective tissue

Back 68

secondary intention

Front 69

Process of wound healing, primary-secondary-third intention

this healing prolongs the repair process

Back 69

secondary intention

Front 70

Process of wound healing, primary-secondary-third intention

wounds with a high risk for infection, such as surgical incisions that enter a nonsterile body cavity or traumatic wounds that occur under unclean conditions

Back 70

third intention

Front 71

Process of wound healing, primary-secondary-third intention

wounds that my be left open intentionally for several days

Back 71

third intention (delayed primary)

Front 72

Process of wound healing, primary-secondary-third intention

can be closed with sutures or staples and wound is approximated

Back 72

first intention

Front 73

Process of wound healing, primary-secondary-third intention

-after debri (dead cells) and exudate have been removed and inflammation has subsided, the wound is closed by

Back 73

first intention.
this type of healing involves delayed primary closure (third intention)

Front 74

Process of wound healing, primary-secondary-third intention

suturing of a wound will decrease dead space and decrease healing time

Back 74

first intention

-must be closed within 24 hrs
-immediately sutured

Front 75

Process of wound healing, primary-secondary-third intention

wound is open and healing will occur by filling with granulation tissue, connective tissue, and increased healing time

Back 75

second intention

Front 76

Process of wound healing, primary-secondary-third intention

-deeper tissue injuries/wounds with tissue loss (chronic pressure ulcer)

Back 76

second intention

Front 77

Process of wound healing, primary-secondary-third intention

patient initally has an open wound and will be taken back to surgery to get it closed

Back 77

delayed primary (3rd intention)

Front 78

Process of wound healing, primary-secondary-third intention

wounds with a high risk for infection (surgical incisions) that enter a nonsterile body cavity

Back 78

delayed primary (3rd intention)

Front 79

Process of wound healing, primary-secondary-third intention

traumatic wounds that occur under unclean conditions and maybe left open for days until the dead cells and inflammation subsite

Back 79

delayed primary, 3rd intention

Front 80

Process of wound healing, primary-secondary-third intention

an aseptically made wound with minimal tissue destruction and minimal tissue reaction begins to heal as the edges are approximated by close sutures or staples

Back 80

healing by first intention

Front 81

Process of wound healing, primary-secondary-third intention

no open areas or dead spaces are left to serve as potential sites to infection

Back 81

healing by first intention

Front 82

Process of wound healing, primary-secondary-third intention

an infected or chronic wound or one with tissue damage so extensive that edges cannot be smoothly approximated is usually left open and allowed to heal from the inside out.

Back 82

healing by secondary intention

Front 83

Process of wound healing, primary-secondary-third intention

-edges are approximated

Back 83

healing by primary intention

Front 84

Process of wound healing, primary-secondary-third intention

-the nurse periodically cleans and assesses the wound for healthy tissue production. scar tissue is extensive, and healing is prolonged

Back 84

healing by secondary intention

Front 85

Process of wound healing, primary-secondary-third intention

a potentially infected srugical wound maybe left open for several days. if no clinical signs of infection occur, hte wound is then closed surgically

Back 85

delayed primary (healing by third intention)

Front 86

Wound healing
-impaired wound healing would be seen with what? (4)

Back 86

1. reduced circulation

2. inhibition of leukocytic response. decrease resistance to infection

3. low tissue oxygenation

4. impaired synthesis of cells and collagen

anybody that has a problem with oxygen (PVD, PAD< lower extemitiy stuff, diabetes)

Front 87

Wound terms

The edges of a wound are together and lined up to be anatomically positioned and correct.

Back 87

approximated

-held in place until healing is complete

Front 88

Wound terms

The surgical removal of foreign material and dead or damaged tissue.

Back 88

Debridgement

Front 89

Wound terms

A bursting open of a follicle or wound

Back 89

dehiscence

Front 90

Wound terms

Fleshy projections
formed on the surface
of a gaping wound
that is healing by
2nd intention

Back 90

Granulation:

Front 91

Wound terms

removal of damaged tissue resulting in a defect that must be filled with scar tissue

Back 91

(granulation)

new pink tissue growing forward to close the wound

Front 92

Wound terms

used to describe discharge from a wound

Back 92

exudate

Front 93

Exudate
-serosanguneous:

Back 93

blood tinged amber fluid (Consisters of serum and RBC. Normal for 1st 48 hours after injury.)

can smell salty

Front 94

Exudate
-serosanguneous:

what does it smell like

Back 94

salty

Front 95

Exudate
-serosanguneous:

sudden increase in this fluid preceds what?

Back 95

wound dehiscence in wounds closed by 1st intention

Front 96

Exudate
-purulent

Back 96

cloudy thick color substance

it means it is NOT clear fluid

Front 97

Exudate
-purulent

what does it smell like



what color is it

Back 97

foul odor









can be any color

Front 98

Ecchymosis –

Back 98

bruising (subQ bleeding or hemorrhaging)

Front 99

Petechiae - are what?

what are they seen with?

Back 99

are micro hemorrhages

meningococcal infection,
idiopathic thrombocytopenia purpura,

Leukemia,
severe infection,
forceful vomiting or coughing

Front 100

Demarcation:

Back 100

very distinct lines/patterning to something

Front 101

Purpura are what

Back 101

large, purple bruaises that are sometimes raised

Front 102

Petechiae are small.......



do they blanch?

Back 102

red or purple dots that look liek a rash





(they will not blanch because it is clotted)

Front 103

Words of the skin

Pruritis:
Xerosis:
Erythemia:
Urticaria:
Lichenification:
Taut:

Back 103

Pruritis*: Itching
Xerosis: Dryness
Erythemia: Redness
Urticaria: Hives
Lichenification:Thickening of skin
Taut: slightly stretched

Front 104

Assessment of dark skinned patients

cyanosis
-where would you look for gray color?

Back 104

gray = lips and tongue

Front 105

Assessment of dark skinned patients

cyanosis
-where would you look for a blue tinge?

Back 105

nail beds, palms, and soles

Front 106

Assessment of dark skinned patients

-conjunctiva is where you would find what color

Back 106

pallor

Front 107

Assessment of dark skinned patients

Jaundice
-where would you check for this yellow tinge (2 places)

Back 107

oral mucuous membranes, especially the hard palate

examine the sclera nearest to the iris rather than the corners of the eyes