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47 Cards in this Set
- Front
- Back
Role of Integument |
-protection -insulation -sensory perception -fluid balance -temperature control -absorbs UV -Vitamin D synthesis |
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Primary Lesion |
-first lesion to appear on the skin -visually recognizable structure: macule, papule, plaque, nodule, tumor, wheal, vesicle, pustule |
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Secondary Lesion |
-occurs when primary lesion undergoes changes: scale, crust, thickening, erosion, ulcer, scar, excoriation, fissure, atrophy -may result from various factors such as scratching, rubbing, medication, natural disease progression, or processes of healing |
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Pruritis |
-itching -one of the most common manifestations of dermatologic disease -can lead to damage if the skin's protective barrier is injured |
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Uritcaria |
-hives -vascular reaction of the skin marked by the appearance of smooth, slightly elevated patches -can be redder or paler than surrounding skin and are often accompanied by itching |
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Rash |
-general term for an eruption on the skin -accompanied by itching -typically occur as a response to some primary agent: sun exposure, allergens, irritants, or medications |
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Blisters |
-fluid-containing elevated lesions of the skin with clear watery or bloody contents -occur as a manifestation of a wide variety of diseases |
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Xeroderma |
-mild form of ichthyosis or excessive dry skin -characterized by dry, rough, discolored skin with the formation of scaly desquamation |
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Changes with Age
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-decreased pain perception
-decreased vascularity -weakened inflammatory response -impaired thermoregulation -thinning of stratum corneum -decreased protection against UV -decreased vitamin D production -loss of collagen |
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Cyanosis |
skin turns blue |
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Erythema |
skin turns red |
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Jaundice |
skin turns yellow |
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Carotenemia |
skin turns orange |
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Mongolian spots |
-skin can be bluish gray, deep brown, or black -often appear on the base of the spine, buttocks, back and sometimes shoulders, ankles, or wrists -usually fade with age |
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Causes of Pressure Ulcers |
-pressure -friction -shearing forces -maceration -decreased skin resilience -malnutrition -decreased circulation |
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Risk Factors of Pressure Ulcers |
-decreased sensation -impaired mobility or activity level -incontinence -diaphoresis -altered level of consciousness -impaired nutrition -contractures -obesity |
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Clinical Manifestations of Ulcers |
-over bony prominences -circular shaped like inverted volcano OR shaped like the object causing pressure |
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PUSH Tool for Ulcers |
can be described, measured, and categorized by surface area, exudates, and type of wound tissue |
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Braden Scale for Ulcers |
-used to assess a patient's risk for developing ulcers -factors include sensory perception, moisture, activity, mobility, nutrition, and friction and shear -categories include completely limited, very limited, slightly limited, and no impairment |
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Norton Scale for Ulcers |
-used to assess a patient's risk for developing uclers -factors include physical condition, mental condition, activity, mobility, and incontinence -graded on a 1-4 scale, 1 being the lowest, or worst, score |
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Role of Physical Therapy for Ulcers |
delivery of therapeutic modalities, positioning, management of tissue load, and good mobility |
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Risk Assessment Tools |
-Braden Scale -Norton Scale |
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Prevention of Ulcers |
-clients should be evaluated at least every 3 months -acute care clients should be reassessed daily or at least weekly -high-risk client will need frequent position changes, at least every 2 hours in bed and at least every hour while sitting |
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Positioning for Ulcers |
-Rule of 30s: sidelying 30-45 degrees oblique angle and do not elevate head of bed above 30 degrees -equipment for transfers to reduce shear -pressure redistribution devices, but covers can cause heat and friction -NO doughnut cushions |
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Burns |
-direct contact with thermal, chemical, electrical, or radiation source -heat source transferred to body tissues |
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Risk Factors of Burns |
-high risk: under 3 and older than 70 years old -lack of adult supervision -impaired judgment/orientation -impaired mobility -rural location -occupation -lack of smoke detector -cigarettes/fireworks |
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Rule of Nines for Burns |
-quick and easy division of the body into anatomic sections each of which represents 9% or a multiple of 9% -head: 9% -anterior/posterior thorax: each 18% -each arm: 9% -each leg: 18% -genitals: 1% |
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Lund-Browder method for Burns
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modifies the percentages for body segments and provides a more accurate estimate of burn size according to age
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First-degree Burn |
only affects the epidermis |
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Second-degree Burn |
affects the dermis and epidermis |
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Third-degree/Fourth-degree Burn |
affects subcutaneous tissue, dermis, and epidermis |
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Role of Physical Therapy for Burns |
-promote wound healing -reduce edema and promote venous return -prevent/minimize deformities/scarring -increase ROM, strength, and function -increase independence in ADLs -encourage emotional and psychological well-being |
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What should a PT/PTA monitor in a burn patient? |
-vitals -medical complications -lab values -prealbumin -glucose -hypothermia -exposed body surfaces |
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Actinic Keratosis |
-precancerous -results from chronic skin exposure -well-defined, crusty or sandpaper-like patch or bump -disappear only to appear later -looks like squamous cell carcinoma -known risk of malignant degeneration and metastatic potential |
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Bowen's Disease |
-precancerous -can occur anywhere on the skin or mucous membranes -persistent, brown/red scaly plaque with well-defined margins -person usually has a history of arsenic exposure |
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Basal Cell Carcinoma |
-malignant -slow-growing surface epithelial skin tumor originating from undifferentiated basal cells contained in epidermis -rarely metastasizes -pearly or ivory appearance, rolled edges, slightly elevated, small blood vessels on surface -sun exposure is a significant risk factor |
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Squamous Cell Carcinoma |
-malignant -tumor of epidermal keratinocytes -in situ: confined to epidermis, but may extend into dermis -invasive: arises from precancerous lesion -poorly defined margins -unexposed skin is more likely to metastasize -sun exposure is a significant risk factor |
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Malignant Melanoma |
-tumor originating from melanocytes -4 types: superficial spreading, nodular, lentigo maligna, and acral lentiginous -appears on head & neck in men/legs in women -70% arise from pre-existing mole -curable if caught early, but can be fatal -lesions have unique characteristics |
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ABCD Skin Exam |
-Asymmetry: uneven edges, lopsided -Border: irregularity, poorly defined edges -Color: black, brown, red, white, pink, blue -Diameter: larger than a pencil eraser |
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Psoriasis |
-chronic, inherited, recurrent inflammatory but noninfectious dermatosis -well-defined erythematous plaques covered with a silvery scale -cause is unknown, but appears to be hereditary -aggravated by cold weather and stress -accompanied by itching and pain |
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Herpes Zoster |
-reactivation of the chickenpox virus -brought on by an immunocompromised state -pain and tingling along the affected nerve dermatome accompanied by fever chills, malaise, and GI distress -after 1-3 days, red papules develop into blisters -papules erupt then dry out 5 days later -healing takes place over 2-4 weeks |
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Cutaneous Lupus Erythematosus |
-chronic inflammatory disorder of the connective tissues -characteristic rash is red -exact cause remains unknown -appears in several forms: cutaneous LE and systemic LE -raised, red, smooth plaques on skin normally exposed to sunlight (face, scalp, neck, etc) |
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Skin Turgor |
-skin's ability to change shape and return to normal form (elasticity) -can reflect dehydration |
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Cellulitis |
-rapidly spreading acute inflammation with infection of the skin and subcutaneous tissue that spreads widely throughout tissue spaces -patches of skin that are red, hot, and painful -affects older adults and people with lowered resistance from diabetes, malnutrition, steroid therapy, and the presence of wounds, ulcers, and/or edema |
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Impetigo |
-superficial skin infection commonly caused by staphyl/streptococci -common in infants, children between 2-5, and older people -small macules rapidly develop into vesicles that become pustular -vesicle breaks and a thick yellow crust forms from the exudate, causing pain, erythema, adenitis, cellulitis, and itching |
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Atopic Dermatitis |
-chronic inflammatory skin disease -most common type of eczema -exact cause is unknown -infancy: red, oozing, crusting rash -adolescence: dry, thick, brown/gray skin -accompanied by xerosis and pruritis -no cure exists, but often resolves spontaneously |
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Contact Dermatitis |
-acute or chronic skin inflammation caused by exposure to a chemical, mechanical, physical, or biologic agent -can occur at any age -intense pruritis, erythema, and edema that may progress to vesiculation, oozing, crusting, and scaling |