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39 Cards in this Set

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-What are some things that can cause ingrown toe nails?
-improperly timrred nails
-hyperhidrosis
-poorly fitting footwear
-trauma
-subungual neoplasms
-obesity
-excessive external pressure
What are some tx options for ingrown toe nails?
-warm water soaks
-cotton-wick insertion in the lateral groove corner
-debridement of the lateral nail groove
-silver nitrate cautery to the hypertrophied lateral nail tissue
-complete or parital nail evalsion
-wedge resection of the distal nail edge
-partial nail avulsion with phenol matricectomy sodium hydroxide matricectomy
-laser matricectomy
-electrosrugical matricectomy
-surgical excision of nail plate, nail bed, and matrix
Do do a digital block of the toe, what do you use?
1 percent lido without epi using a 10ml syringe to pull up medication and 30 guage needle to deliver lido
What can u use around the base of the toe for a dry operative field?
sterile rubber band
Look at the steps to how to do it on ppt...
because I am not typing it all out
What do you want to document after toe nail procedure?
-procedure, location, medications used and amount and any complications
When should the toe be evaluated for infection?
if increasing pain, swelling, redness, or drainage
To do a digital nerve block, the needle is inserted where?
-down to the bone, midway between the palmar and dorsal surfaces of the digit, 1-2 cm distal to the web space
In a digital derve block, the anesthetic is administered with the needle ______ to the digit, then angled slightly toward where?
-perpendicular
-angled slightly toward the palmar and dorsal surfaces as additional solution is injected
-What are some things that can cause ingrown toe nails?
-improperly timrred nails
-hyperhidrosis
-poorly fitting footwear
-trauma
-subungual neoplasms
-obesity
-excessive external pressure
How much anesthetic is usually needed on each side of a digital nerve block?
less than 1.5 mL
What are some tx options for ingrown toe nails?
-warm water soaks
-cotton-wick insertion in the lateral groove corner
-debridement of the lateral nail groove
-silver nitrate cautery to the hypertrophied lateral nail tissue
-complete or parital nail evalsion
-wedge resection of the distal nail edge
-partial nail avulsion with phenol matricectomy sodium hydroxide matricectomy
-laser matricectomy
-electrosrugical matricectomy
-surgical excision of nail plate, nail bed, and matrix
Do do a digital block of the toe, what do you use?
1 percent lido without epi using a 10ml syringe to pull up medication and 30 guage needle to deliver lido
What can u use around the base of the toe for a dry operative field?
sterile rubber band
Look at the steps to how to do it on ppt...
because I am not typing it all out
What do you want to document after toe nail procedure?
-procedure, location, medications used and amount and any complications
When should the toe be evaluated for infection?
if increasing pain, swelling, redness, or drainage
To do a digital nerve block, the needle is inserted where?
-down to the bone, midway between the palmar and dorsal surfaces of the digit, 1-2 cm distal to the web space
In a digital derve block, the anesthetic is administered with the needle ______ to the digit, then angled slightly toward where?
-perpendicular
-angled slightly toward the palmar and dorsal surfaces as additional solution is injected
How much anesthetic is usually needed on each side of a digital nerve block?
less than 1.5 mL
What size needle is used in subungual hematoma drainage?
18-21 guage
When should a pt return for follow up to a subungual hematoma drainage?
2-3 weeks if no complications occur
What is one of the most common infections of the hand?
paronychia
What is a paronychia?
superficial infection or abscess of the paronychial tissue of the hands or less commonly the feet
What are some tx options for acute paronychia?
-warm water soaks
-oral antibiotic therapy
-surgical drainage
in cases of chronic paronychia, it is important that the pt avoid what?
possible irritants
What are some tx options for chronic paronychia?
-topical antifungals
-topical steroids
-surgical intervention
An acute paronychia most often results from what?
nail bitting, finger sucking, aggressive manicuring, a hang nail or penetrading trauma, with or without retaining foreign body
What is the most common infecting organism for paroncyhia?
S. aureus
then streptococci and pseudomaonas
Children are prone to acute paronchias how?
through direct inoculation of fingers with flora from the mouth secondary to finger sucking and nail biting
What is the cause of chronic paronchia?
mutlifactorial
Who are at risk for developing chronic paonychias?
-those who are repeatedly exposed to water containing irritant or alkali, and those who are repeatedly exposed to mist environments
Name some high risk people for development of paronychias.
-bartenders
-housekeepers
-homemakers
-dish washers
-swimmers
-diabetics
-immunosuppressed person
If warm water soaks fail to tx paronychias, what can be done next?
warm water soaks along with PO anti staph meds and splint protection of the affected part are indicated
In children who suck their fingers and pts who bite their nails, what should they be treated against?
anaerobes with antibiotic therapy
Read how to do a paronychia surgical tx on the power point
because I am lazy and don't want to type it all out
If the nail fold contains puss in paronychia, you should incise it with a what number blade?

and with the blade directed _______ from the nail bed to avoid what?
11 or 15

-away from nail bed to avoid injury and subsequent growth abnormality
The dressing from a paronychia removal should be removed when?
in 48 hrs followed by warm water soaks QID for 15 minutes
When should a pt return after a paronychia removal?
2-3 weeks if there is no complications