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73 Cards in this Set
- Front
- Back
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Characteristic of Herpes zoster lesions
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Clustered skin vesicles Classic presentation is grouped vesicles on erythematous base along a dermatome. B/c they follow nerve pathways the lesions do not cross the body's midline
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Melanomas are
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pigmented malignant lesions that originate in the melanin-producing cells of the epidermis. Highly metastatic
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Basal cell carcinomas metastasis
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Rare, although underlying tissue destruction can progress to include vital structures.
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Squamous cell carcinomas are malignant neoplasms of the what? Characterized by?
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Epidermis, local invasion and potential for metastasis
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what characteristic of malignant melanoma would be documented in clients record after assessment
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Irregularly shaped pigmented papule or plaque with a red, white or blue color.
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Basal cell appears how?
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pearly papule with a central crater and a rolled, waxy border.
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Squamous cell carcinoma appears how?
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firm nodular leasion that is topped with a crust or a central area of ulceration.
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Actinic keratosis is…
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a premalignant lesion
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Actinic keratosis appears as?
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Small macule or papule with a dry, rough, adherent yellow or brown scale.
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Appearance of frostbite in hand
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White or blue skin color and skin that is hard, cold and insensitive to touch. As thwaning occurs, so does flushing of the skin, the development of blisters or blebs or tissue edema
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In someone who develops frostbite, how long does it take for gangrene to develop if it does?
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9-15 days
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Stage 2 pressure ulcer is described as
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Partial-thickness skin loss of epidermis or dermis. Superficial, and may look like an abrasion, blister, or shallow crater.
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Stage 1 pressure ulcer is described as
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Reddened area but skin still intact
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In stage 3 pressure ulcer it is seen as?
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A deep, crater like apperance
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In stage 4 the pressure ulcer develops what?
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Tunneling
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Nurse would note upon inspection if scabies disorder is present
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Multiple straight or wavy threadlike lines noted beneath the skin
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Process of Scabies
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The skin lesions are caused by the female, which burrows beneath the skin and lays its eggs. The eggs hatch in few days and baby mites make their way to the skin surface where they mate and complete life cycle.
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Precautions institued during care of client with scabies
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Wear gown and gloves, transmited by skin on skin contact
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Burn injury with suspected inhalation injury, will receive what kind of oxygen delivery?
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100% O2 via tight fitting non rebreather face mask until carboxyhemoglobin level falls below 15%. Oropharynx inspected for evidence of erythema, blisters and ulerations. Need for endotracheal intubation also assessed.
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Post Burns to face/chest, has hoarse cough, sputum with black flecks, eyelashes/eyebrows singed and eyelids swollen: Indicates?
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Inhalation injury, the burn has prob caused laryngeal edema which has occluded the airway. Hx of flame burn to face, hoarseness, cough, carbonaceous sputum, facial edema color change.
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Anticipated outcome of escharotomy procedure
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Return of distal pulses
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Escharotomies are performed to…
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Alleviate the compartment syndrome that can occur when edema forms under nondistensible eschar in a circumferential burn. Will not affect the formation of edema or granulation tissue. Bleeding considered complication.
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Leg position appropriate for circumferential burns
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Elevation above the level of heart. May compromise circulation. Elevating reduces dependent edema formation.
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In adult the hourly urine volume should be
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30-50ml
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Instructions for discharged client with grafting of burn injuries
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Wear warm clothing, wash with mild soap rinsing throroughly and patting skin dry with clean towel, avoid sunburns and sunlight, avoid products containing perfume alcohol or lanolin because they irritate newly healed skin
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Person at greatest risk for integumentary disorder and second greatest
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outdoor construction worker b/c of sun, unusual cold, or other conditions that damage skin. Older adult b/c of immobility and lack of nutrition.
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Under Wood's light what areas are associated with certain skin infections.
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Areas of blue-green or red fluorescence
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Care instructions for client with dry skin and pruritus
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Humidifier during winter, drink 3000ml unless contra, avoid alochol and caffeine. Avoid rubbying alcohol, astringents or other drying agents to skin, One bath, warm water mild soap, followed by app of emoillient to prevent evap of water
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Cellulitis is described as
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A skin infection into the deep dermis and sub q fat.
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Cellulitis is usually caused by
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Streptococcus pyogenes
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Cellulitis appears usually as
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Red erythema, without sharp boarders and spreads widely through tissue spaces. Skin is erythematous,edematous, tender and sometimes nodular.
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Erysipelas is
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an acute, superficial, rapidly spreading inflammation of the dermis and lymphatics
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What should nurse anticipate being prescribed for client with acute cellulitis?
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Warm compresses to affected area
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Diagnosing of Herpes Zoster is done by
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Culture of the lesion
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Hallmark sign characteristic of pemphigus is
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Nikolsky's sign
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Nikolysky's sign is
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when the epidermis can be rubbed off by sligh friction or injury.
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Homans sign is a sign of
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Thrombosis in the leg, is discomfort in the calf on dorsiflexion of the foot.
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Chvostek's sign is seen in what and is described as
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Tetany, a spasm of the facial muscles elicited by tapping the facial nerve in the region of the parotid gland.
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Trousseau's sign is a sign for what in which
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Tetany, carpal spasm can be elicited by compressing the upper arm and causing ischemia to the nerves distally.
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Cause of Acne
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Unknown
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Exacerbations of Acne caused by?
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Hormonal changes in menstrual cycle, heat, oily skin. Not chocolate, nuts, fatty foods not related.
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Instruction to include for a patient coming in a week later for skin test
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DC prescribed antihistamine and systemic corticosteroids 2 days before test
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Instructions for patch testing
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Keep site dry at all times, discourage sweating activiteis, don't reapply patch if off, Remove loose patch for reapp later, Initial reading 2 days after and final 2-5 days later.
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Characteristic of Lyme Disease Stage 2
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Neurological defects and cardiac conduction defects, including bell's palsy and paraylsis (not usually permanent)
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Characteristic of Lyme Disease Stage 1
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Skin Rash
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Characteristic of Lyme Disease Stage 3
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Joint enlargments and arthralgias
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Client bitten by tick wants tested for LD can he have it?
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Must wait 4-6 weeks to test for
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Karposi's sarcoma lesions in AIDS described as
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red, dark blue or purple macules on lower legs that change into plaques. Large plaques ulcerate or open and drain. Spread by metastasis thru upper body then face and oral mucosa, can also spread to lymphatic system, lungs, GI tract.
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Late diseas of Karposi sarcoma results in
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swelling and pain in lower extrem, penis, scrotum or face
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Diagnosis of karposi sarcoma is made by
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Punch biopsy of cutaneous lesions and biiopsy of pulmonary and GI lesions.
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Puts at greater risk for karposi sarcoma
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Decreased Immune system.
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What does nurse wear when bathing client with Cutaneous kposi's sarcoma
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Gown Gloves
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Paronchia is viewed on clients skin as
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Infection around nail, red shiny skin often associated with painful swelling.
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Paronchia freq result form
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trauma,picking at nail, or disorders such as dermatitis
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Often paronchia becomes secondarily infeted with what? Leading to
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bacteria or fungus leading to nail involvement
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Instructions for impetigo
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Throuough handwashing, separting laundry, and separate washing of client's dishes are required b/c is contagious as long as lesions present.
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What is prescribed for frostbite of toes
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Rapid and continual rewarming of toes in warm water bath until flushing of the skin occurs
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How long should frostbite toes be warmed?
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15-20 minutes
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Isotetinoin (Accutane) is prescribed for
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severe cystic acne
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Accutane side effects include
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elevated triglycerides, skin dryness, eye discomfrot such as dryness and burning, and cheilitis (lip inflammation)
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What supplements are stoped when using Accutane
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Vit A
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Following raditaion what could cause chest and neck areas to be red that are painful
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Superficial injury to tissue from the radiation.
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Can enhance penetration of topical corticosteroid therapy to client with psoriasis by
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applying warm moist heat and occlusive outter wrap. If large area involved may be limited to12 hours per day b/c of systemic se's
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SE related to Amoxicillin
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Vaginal Discharge
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Causitive factors of exacerbation of Psoriasis
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Emotioanl distress, trauma, systemic illness, seasonal changes, hormonal changes
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Heterograft is
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Skin from another species
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Carbon monoxide levels of 5-10% result in
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Impaired visual acuity
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Carbon monoxide levels of 11-20% result in
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flushing and headahce
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Carbon monoxide levels of 21-30% result in
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Nausea and impaired dexterity
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Carbon Monoxide levels of 31-40% result in
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Vomiting, dizziness and syncope
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Carbon Monoxide levels of 41-50% result in
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tachypnea and tachycardia
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Carbon Monoxide Levels greater than 50%
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Coma and Death
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By which route should meds be given if possible in a client with severe burns
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IV b/c oral medications are not absorbed well b/c GI tract slows with burn shock or paralytic ileus. Parenteral routes are avoided b/c absorption may be poor or erratic due to fluid shifts
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