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50 Cards in this Set
- Front
- Back
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Functions of the skin?
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-protection
-sensation -fluid balance -regulate temperature -vitamin production (Vitamin D) -Immune response function |
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Major changes in the aged population and their skin?
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-dryness
-wrinkling -uneven pigmentation -thinning of skin-fragile -decrease muscle tone -vulnerable to injury & disease |
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Photoaging
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-damage from excessive sun exposure
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What is a common skin lesions that is part of aging?
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-cherry angiomas
-seborrheic keratoses -wrinkles -zerosis -zanthelasma |
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Normal color variations on a aged person...describe (3)
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-solar lentigo -liver spots
-melasma - dark discolorations of the skin -lentigines - freckles |
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seborrheic keratoses?
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-normal part of aging
-crusty brown "stuck-on" patches |
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Zanthelasma
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-normal with older patients
-yellowish waxy deposits on upper and lower eyelids. |
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What is the difference in Primary and secondary lesions?
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-primary lesions are the "initial lesion". The main lesion not caused by meds...just your body.
-secondary-is from an external cause |
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During your inspection of a lesion what things would you document and look at?
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-primary vs secondary
-location and size -redness, heat, pain, swelling -**compare with other side of body -not color/shape of lesion -anatomic distribution -not configuration -palpate-texture, shape, softness, fluid filled -measure with metric ruler |
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Therapeutic management of skin care for patients with skin conditions?
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-bathing-mild, lipid-free soap, rinse completely, blot dry
-prevent secondary infections |
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What is a acutely inflamed lesion and what type of treatment would you choose?
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-hot, red, swollen and oozing
-wet dressing -soothing lotions |
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What is a chronic condition (lesion) and what treatment would you choose to treat it?
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-it is skin that is dry and scaly
-water soluble emulsions -creams -ointments -paste |
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What are 3 major classifications of dressings for skin condtions?
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-wet
-moisture-retentive -occlusive |
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What effects would a wet dressing have on a skin lesion?
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-reduce inflammation
-clean exudates, crusts, and scales -maintain drainage of infected areas -promote healing |
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What effects do moisture-retentive dressings have?
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-perform same function as wet compresses but more efficient
-in place 12-24 hrs |
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What effects do occlusive dressings have?
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-cover topical medication applied to an abnormal skin lesion; keeps are airtight
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How does a therapeutic bath help with management?
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-for large body surfaces
-helps sedate and stop the itching -removes crusts, scales and old medications -Aveeno, sodium bicarb |
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What are concens/problems with topical treatment
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-can induce allergic reactions-dermatitis
-inflammation of the skin -DC immediately |
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How do lotions help the skin
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-replenish lost skin oils
-relieve pruritis |
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What is paste and when is it used mostly?
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-mixture of powders and ointments
-used for inflammatory blistering conditions |
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Pruritis; what is it and how can you break the cycle
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-release of histamine
-avoid soap & hot water -bath oils -warm bath with mild soap followed by emolliet -cold compress -cool agent (menthol) - |
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Medications used for pruritis
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-topical corticosteroids
-antihistamine |
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Stevens'Johnson Syndrome what is it and which meds can cause it?
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-disorder of the skin and mucous membranes
-allergic reaction to antibiotics (sulfonamides) antiseizure meds NSAIDs |
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S/S of steven johnson syndrome
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-cinjunctival buring or itching
-flu like symptoms -rapid onset of erythma -severe cases mucosal involvement |
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Who are at risk for steven johnson syndrome
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-increased age on increased amount of meds
-immunosuppressed people -2-3 cases per 1 million -increased risk if on sulfonamides |
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Goals of tx with stevens johnson syndrome
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-fluid/electrolyte
-sepsis -opthalmic complications -DC all nonessential meds -burn center -surgical debridement -tissue samples cultured -IV fluids |
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What medications are used for treament of stevens johnson syndrome
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-corticosteroids
-IV immunoglobulins -topical plastic semipermeable dressing to reduce pain -meticulous eye care |
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folliculitis
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-superficial infection involving only the upper portion of the follicle
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Furuncie
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-boil
-deeper infection in the follicle |
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Cellullitis
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-generalized infection with either staphylococcus or streptococcus involving deeper connective tissue
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Impetigo
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-superficial infection of skin (folliculitis)
-caused by staph, strep or multiple bacterias -VERY contagious, spread by direct touch -excessive use of antibacterial soap |
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Clinical signs of Impetigo
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-begins small, red macules (flat)
-quickly becomes discrete, thin-walled vesicles that rupture -covered w/ honey-yellow crust |
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Medical management of Impetigo?
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-antibiotic
-small areas topical antibiotics -wash or soak lesions with soap to remove crust -apply lotion -wear gloves |
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Viral skin infections
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-Herpes Zoster (shingles)
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Herpes Zoster, what is it?
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-infection caused by varicella virus
-painful vesicular eruption along pathway of nerve -red rash, fluid filled blisters -itch painful |
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Medical management of Herpes zoster?
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-antiviral, acyclovir, effective if given w/i 24 hrs of outbreak
-analgesics -corticosteroids |
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What is Psoriasis
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-noninfectious inflammatory dermatoses
-hereditary, body creates too much keratin -common in ages 15-35 |
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pathophysiology of psoriasis
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-epidermal cells produce 6-9x faster than normal
-cells in basal layer of skin divide too quickly |
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Clinical signs of psoriasis
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-lesions are red, raised patches of skin covered w/ silvery scales
-scaly patches -usually bilateral symmetry -nails can be involved -risk for RA |
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Treatments for psoriasis
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-decrease stress
-gentle removal of scales -baths w/ oils -emollient creams w/ alpha-hydroxy acids |
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Pharmacologic therapy for psoriasis
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-topical
-intralesiona agents -systemic agents-corticosteroids biologic agents cytotoxic agents immunosuppressants -photochemotherapy -UV light -Tar preparations |
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Meds used for antrax
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-cipro
-doxycycline |
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Pediculosis...lice types
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-pediculosis capitis (head)
-pediculosis corporis (body) -pediculosis pubis (gentalia) |
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Scabies
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contagious, caused by mites
-common between fingers/palms -confirmed by microscope |
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Basal cell carcinoma (BCC)
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-common
-begins small waxy nodule w/ pearly borders, rolled edges -central ulceration, sometimes crustin, shiny, flat, gray or yellowish plaques |
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Squamous cell carcinoma (SCC)
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-malignant cancer
-rough, thickened, scaly tumor -asymptomatic but may bleed -borders more inflammatory than BCC -almost looks like a wart |
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Malignant melanoma
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-1/5 die
-resembles a mole but with irregular borders -variety of colors (red/black) -peak ages 20-45 - |
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ABC's of skin cancer
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A-asymmetry
B-border irregularity C-color not uniform D-diameter-sudden increase in size |
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Treatment of skin cancer
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-removal of lesion
-mohs's surger-layer by layer -5FU topical ointment-chemo -radiation -chemo -protection of sun |
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Prevention of skin cancer
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-sunscreen >15 SPF prior to going out
-reapply every 1 hour -ASA 30 minutes prior to going into sun |
