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45 Cards in this Set
- Front
- Back
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What sunscreen blocks both UVA rays and UVB rays?
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Benzopenones.
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What is the general recommendation for everyone in regards to sunscreen?
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Everyone should use a sunscreen with a minimum SPF of 15 daily.
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Does the SPF of sunscreen stay the same?
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No. The SPF value of all sunscreens decreases with time after application and therefore should be reapplied every 2 to 3 hours in a sufficient amount. One ounce per total body application is recommended.
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What does sun exposure over time does to the skin?
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Years of exposure to the sun are cumulative and damaging.
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What is photosensitivity? Why does it occur?
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The chemicals in certain medications potentiate the effect of the sun, even with brief exposure. The nurse should be aware that many drugs are included in theses catagories. The chemicals in thse medications absorb light when exposed to natural sunlight and release energy that harms cells and tissues.
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What are the clinical manifestations of drug-induced photosensitivity?
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They are similar to those of exaggerated sunburn. These include swelling, erythema, vesicles, and papular, plaque-like lesions. Skin that is at risk for photosensitivity reactions can be protected by the use of sunscreen products.
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What would make a person suspicious of malignant skin neoplasm?
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The presence of a persistent skin lesion that does not heal is highly suspicious for malignancy and should be examined by a health care provider.
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When teaching a patient to examine his or her own skin once a month, what should the patient look for?
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The cornerstone of the skin self-examination is the ABCD rule.
- Examination of skin lesions for (A)symmetry, (B)order irregularity, (C)olor change/variation, and (D)iameter of 6mm or more is simple to teach patients and easy to remember. |
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Many providers have added an "E" to the ABCD rule. What does the "E" stands for?
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Meaning has the lesion
(E)volved or changed in some way. |
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What are the risk factors for skin malignancies?
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Having a fair skin type (blond or red hair and blue or green eyes), history of chronic sun exposure, family history of skin cancer, and exposure to tar and systemic arsenicals.
Environmental factors that increase the risk of skin malignancies include living near the equator, outdoor occupations, and frequent outdoor recreational activities. Behavioral factors such as professional indoor and outdoor tanning and immunosuppression by smoking are controllable risk factors for skin malignancies. |
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What are two of the most common forms of skin cancer?
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Nonmelanoma skin cancers, either basal cell carcinoma or squamous cell carcimona, are the most common form of skin cancer.
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What is the major difference between Melanoma and Nonmelanoma skin cancers?
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Nonmelanoma skin cancers do not develop from melanocytes, the skin cells that make melanin, as melanoma skin cancers do. Instead, they are a neoplasm of the epidermis.
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Where are the most common sites that nonmelanomas develop?
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Sun-exposed areas and include the face, head, neck, back of the hands, and arms.
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What is Actinic Keratosis?
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Also known as solar keratosis, actinic keratosis consists of hyperkeratotic papules and plaques occuring on sun-exposed areas. Actinic keratosis is a premalignant form of squamous cell carcinoma that affects nearly all of the older white population.
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What is a malignant melanoma?
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It is a tumor arising in melanocytes, which are the cells producing melanin.
***Melanoma has the ability to metastasize to any organ, including the brain and heart.*** |
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What are some unique risk factors that predisposes a person to malignant melanoma?
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Immunosupression, dysplastic nevi, and exposure to environmental hazards, including herbicides, also increases a person's risk.
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In providing collaborative care for a patient suspected of melanoma skin cancer, it is important to avoid what type of diagnostic testing?
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Shave-biopsies, shave-excisions, or elecctrocautery. All suspicious lesions should be biopsied using an excisional biopsy technique.
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What is the survival rate of melanoma?
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Melanoma is nearly 100% curable by excision if diagnosed at stage 0. The 5-year survival rate (75% to 95%) in stage I can vary depending on sentinel node biopsy results, which indicate if metastasis has occurred. If spread to regional lymph nodes has occurred (Stage III), the patient has a 45% chance of 5-year survival. If metastasis to other organs occur (Stage IV), treatment becomes mostly palliative.
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What are the indications for microdermabrasion?
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Smoother appearance of photodamaged and wrinkled skin.
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What is the procedure for microdermabrasion?
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Removal of the epidermis and top dermal layer by application of aluminum oxide or baking soda crystals; reepithelialization of abraded surface then occurs.
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What are the side effects of microdermabrasion?
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Light pink tone that resolves within 24 hr; photosensitivity.
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What should the nurse teach a patient that has had microdermabrasion?
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Generous application of emollients and sunscreen.
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What are the indications for a chemical peel?
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Improves appearance of aged and photodamaged skin, acne scarring, freckles, actinic and seborrheic keratoses.
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How is a chemical peel done?
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Solution applied (e.g., solid carbon dioxide, trichloracetic acid) in varying amonts to the skin, causing a controlled burn; loss of melanin occurs.
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What are the side effects of a chemical peel?
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Moderate swelling and crusting for 1 wk; redness persisting 6-8 wk; pink tone possible for several mo; photosensitivity.
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What should the nurse teach the patient about a chemical peel?
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Use sunscreen, avoid sun for 6 mo to prevent hyperpigmentation.
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What is a face-lift?
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a face-lift (rhytidectomy) is the lifting and repositioning of the lower two thirds of the face and neck to improve appearance.
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After a face-lift, what should the patient expect to reduce swelling?
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Application of ice packs is usually used for 24 - 48 hours to reduce swelling and decrease the possibility of hematoma formation. Complications could occur if the person smokes or is involved in vigorous excercise. Antibiotics is used at the discretion of the surgeon. Infection is not a common problem.
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What is laser surgery usually used for?
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To reduce fine wrinkles around the lips or eyes and remove facial lesions.
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What are common side effects of laser surgery?
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Swelling, redness, and bruising are common after treatment. The treated areas usually are kept moist with ointment or occlusive dressings (surgical bandages) for the first few days. * The treated skin must be protected from the sun.
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What are two types of skin grafts?
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Free grafts and skin flaps.
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How are free grafts futher classified?
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According to the method of providing a blood supply to the grafted skin.
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What is one method of free graft?
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One method is to transfer the graft (epidermis and part or all of the dermis) to the recipient site from the donor site.
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What is an autograft?
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A graft that comes from a different area on the patient's own body.
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What is an isograft?
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A graft given by an idenical twin.
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What is the method of free grafting known as reconstructive microsurgery?
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With the use of an operating microscope, circulation is immediately restablished in the free flap by anastomosis of the blood vessels from the skin flap to the vessels in the recipient site.
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How is a skin flap procedure done?
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Skin flaps involve moving a section of skin and subcutaneous tissue from one part of the body to another without terminating the vascular attachment. The vascular attachment is called a pedicle. Skin flaps are used to cover wounds with a poor vascular bed, when padding is needed, and to cover wounds over cartilage and bone. There may be a need for intermediate flap placement if the recipient site is far removed from the donor site. For instance, a skin flap from the thigh to the head would require an intermediate graft. The flap is advanced to the recipient site when circulation is well established at the intermediate site.
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The nurse advises a patient with photosensitivity to use a sunscreen that contains
a. cinnamates b. avobenzone c. benzophenones d. para-aminobenzoic acid (PABA) |
Answer: c. benzophenones
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In teaching a patient who is using topical corticosteroids to treat an acute dermatitis, the nurse should tell the patient that
a. the cream form is the most efficient system delivery. b. topical corticosteroids usually do not cause systemic side effects. c. creams and ointments should be applied with a glove in small amounts to prevent futher infection. d. abruptly discontinuing the use of topical corticosteroids may caus ea reappearance of the dermatitis. |
Answer: b. topical corticosteroids usually do not cause systemic side effects.
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In teaching a patient with malignant melanoma about this disorder, the nurse recognizes that the prognosis of the patient is most dependent on
a. the thickness of the lesion. b. the degree of color change in the lesion. c. how much the lesion has spread superficially. d. the amount of ulceration present in the lesion. |
Answer: a. the thickness of the lesion.
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The nurse identifies that a patient with a diagnosis of which of hte following disorders is most at risk for spreading the disease?
a. Tinea pedis. b. Impetigo on the face. c. Candidiasis of the nails. d. Psoriasis on the palms and soles. |
Answer: b. Impetigo on the face.
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What is pediculosis corporis?
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Pediculosis corporis is caused by the louse Pediculus humanus humanus. Unlike the head louse, the body louse deposits eggs on clothing.
Examination of the skin shows only evidence of the itch caused by the infestation, numerous excoriations. Examination of clothing, particularly around the beltline and collars, will frequently show the louse. There may be an associated secondary infection. |
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Important patient teaching after a chemical peel includes
a. avoidance of sun exposure. b. application of firm bandages. c. limitation of vigorous excercise. d. use of ice to relieve discomfort. |
Answer: a. avoidance of sun exposure.
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What are some indications for having a face-lift?
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1. Redundant soft tissue resulting from disease (e.g., acne scarring).
2. Asymmetric redundancy of soft tissues. 3. Redundant soft tissue resulting from trauma. 4. Preauricular lesions. 5. Redundant soft tissues resulting from solar elastosis (saging of the skin as a result of sun damage), changes in body weight, and the effects of gravity. 6. Restoration of body image. |
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What is the most important postoperative consideration following a face-lift?
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Prevention of hematoma formation is the most important postoperative consideration. Application of ice packs is usually used the first 24 to 48 hours to reduce swelling and decrease the possibility of hematoma formation.
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