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117 Cards in this Set
- Front
- Back
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Common infections of the skin
Folliculitis -what kind of infection is this? what does it involve? |
superficial infection involving only the upper portion of the follicle
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Common infections of the skin
Folliculitis -what is it caused by |
staph
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Common infections of the skin
what does it look like? |
isolated erythematous papules and pustules
rash is red and raised and usually shows small pustules (her notes says: erythematous papules singular or grouped in hair areas of the skin) |
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Common infections of the skin
Furuncle is also called a |
boil
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Common infections of the skin
Furuncle -what is it caused by? how is it different that Folliculitis |
caused by staph
it is a deeper infection of the hair folllicle |
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Common infections of the skin
Furuncle -what does it look like? |
tender erythematous nodule, larger, sore looking
-raised bump may or may not have a pustual head at its point |
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Common infections of the skin
Furnucle -what areas of the body does this occur in |
areas of heat and moisture
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Common infections of the skin
Cellulitis -what tissue does it involve? |
deep connective tissue
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Common infections of the skin
Cellulitis -what kind of infection is it, and what is it caused by |
generalized infection of the skin
strep or staph |
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Common infections of the skin
Cellulitis -how does it occur? |
because of the break in integrity of the skin (like an abrasion or laceration)
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Common infections of the skin
Cellulitis -common in what people who have what 3 things? |
PVD
PAD diabetes |
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Infections of the skin
Herpes Simplex Virus -what kind of infection is this |
viral
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Infections of the skin
Herpes Simplex Virus -a viral infection that is manifestated by |
vesicles on the oral muscosa (mouth or lipds) TYPE I
OR vescles in the genital muscoa (TYPE II) |
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Infections of the skin
Herpes Simplex Virus I -what is the example? -outbreak lasts how long |
cold sore
3-10 days |
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Infections of the skin
Herpes Simplex Virus I -patient is contagious for how many days |
the first 3-5 days
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Infections of the skin
Herpes Simplex Virus I -how is this spread |
respiratory droplet or direct contact with lesion or fluid
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Infections of the skin
Herpes Simplex Virus II -what is the example what is also seen with this |
genital herpes
lymphadenopathy in groind (noncurable) |
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Infections of the skin
Herpes Simplex Virus II -outbreaks last how long |
3-8 days
can last 2-3 weeks |
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Infections of the skin
Herpes Simplex Virus I and II tell me about the severity of this: (2) it increased when? |
severity increases with age
and when the patient is immunosuppressed |
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Infections of the skin
Herpes Simplex Virus I & II -after the first infection, what happens to the virus? |
it lays dormant in the nerve ganglion ( they have no symptoms)
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Infections of the skin
Herpes Simplex Virus I & II -after they get the 1st infection, how does it come back again |
stimulus causes reactiviation of virus which will follow the pathway of sensory nerves of the skin (where lessions appear)
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Infections of the skin
Herpes Simplex Virus I & II -what is the #1 trigger to activate the stimulus? |
stress
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Infections of the skin
Herpes Simplex Virus I & II -what are other physical/psychological triggers |
dry lips
sunburn fever menses fatigue |
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Infections of the skin
Herpes Simplex Virus I & II -how is it spread? |
direct contact
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Infections of the skin
Herpes Simplex Virus I & II -incubation period? |
2-10 days
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Herpes zoster (shingles)
-a viral infection manifesteted by vesicles on the skin and commonly seen in older adults/elderly it is a reactivation of what |
the varicella virus, which has been dormant for many years in the dorsal root ganglia
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Herpes zoster (shingles)
clinical manifestations |
it presents as confluent vesicular rash on the skin that usually follows one dermatome
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nursing care of skin infections
what is the most effecitve intervention what is the focus? |
skin care with proper cleansing
focus on skin care and prevention of spread of infection |
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nursing care of skin infections
what can you tell them to do for furnicles and cellulitis to increase comfort |
apply a warm compress twice a day
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nursing care of skin infections
what do you tell them to avoid |
constrictive clothing
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Acne
-what is it |
red, pustular eruption that affects the sebaceous glands of the skin
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Acne
-what do lesions results from |
an increase in sebum production which is stimulated by androgenic hormones and obstruction of the sebaceous canal outlet
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Acne
-debri collection promotes bacterial growth and then what results |
rupture of hte gland into the surround dermis with inflammation
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Acne is an androgenically stimulated, inflammatory disorder of the sebaceous glands resulting in comedones, papules, pustules, cysts and cannot occur without a hair follicle
which are non-inflammatory |
comedomes
-black and white heads |
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Acne which are inflammatory
-where are they usually found |
papules
pustules cysts face and trunk acne is an androgenically stimulated, inflammatory disorder of the sebaceous glands resulting in comedones, papules, pustules, cysts and cannot occur without a hair follicle |
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Acne
-non inflammatory comedomes what are open comedomes? |
blackheads- sebaceous gland whose outlet is plugged with dirt and debri
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Acne
-non inflammatory comedomes what are closed comedomes? |
whiteheads- sebaceous outlet that is plugged and bacteria was trapped inside
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Acne
-treatment for superficial lesions |
Topical: benzoyl peroxide (2-2.5%) and antibiotic solution
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Acne
-treatment for those with cystic inflammatory disease |
systemic: antibiotics (doxycycline and minocycline) and BCP which affects hormone system
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Acne
-treatment for severe acne |
accutane
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Acne
-Treatment- Accutane what does it do |
chemically adjusts whats happening hromonally to produce sebaceous oils
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Acne
-Treatment- Accutane category? what do woman have to do before they get it? |
x
pregnancy test (they must be on BCP and use a condom) it is teratogenic |
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Acne
-Treatment- Accutane what lab must the nurse monitor |
LFT
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Acne
-Treatment- Accutane what are 3 SE |
dry chapped skin
depression teratogenic (can cause birth defects) |
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What is a pilonidal cyst?
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lesion of sacral area that often has a sinus track extending into deeper tissue
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Pilonidal cyst
-what is the lesion filled with |
purulent matter
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Pilonidal cyst
-usually has a sinus track deep into the SQ tissue. as this cyst fills or becomes infected, it can become tender. it is very painful. what can be done to help this? |
incision and drainage can be performed by the cyst will refill
oral antibiotics the cure is surgical removal and the area heals by secondary intention |
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Pilonidal cyst
occurs in what population |
people who have pressure on their coccyx (truck drivers)
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Vacuum assisted closure
-what does it help do |
remove intersitital fluid and infectious material and can assist grandulation tissue
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Vacuum assisted closure
what does this require? |
a suction tube covered by a special sponge and sealed in place for 48 hrs.
negative low level pressure is continuously applied through the tube. |
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Vacuum assisted closure
do not use where monitor how often |
in areas of skin cancer
monitor every 2 hrs for bleeding |
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What affects the skin
-what is the best preventative measure of skin |
hydration
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What affects the skin
-nutrition intact skin and wound healing depend on what 2 things when is nutritional status inadequate? |
positive nitrogen balance and protein levels
when serum albumin is less than 2.5 mg/dl |
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Psoriasis
-what kind of disorder is this |
a scaling disorder associated with dermal inflammation
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Psoriasis
-it is abnormal growth of what |
epidermal cells in the outer skin layer
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Psoriasis
there is no cure true or false |
true
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Psoriasis
-it is accelerated shedding that results in |
scaly plaques
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Psoriasis
is this an autoimmune response? what can it progress too? |
yes, and overstimulation of the immune response
to affect the liver and lungs (liver inflammatio and pulmonary fibrosis) |
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Psoriasis
is an example of what vocab skin term |
lynchification
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Psoriasis Influencing factors
Genetic and enviornmental factors |
genetic factors exist but the enviornmental factors is what determines if the disease actually occurs
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Psoriasis Influencing factors
what is the treatment |
exposure to UV light
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Psoriasis Influencing factors
what is something that helps |
warmer climates
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Psoriasis Influencing factors
what can aggrevate the disease (3) |
hormone changes like puberty and menopause
stress obesity |
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Psoriasis Influencing factors
what 3 medications aggrevate this |
beta blockers, antimalarials, lithium
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Complications of Psoriasis
-3 |
predisposition to cancer
chronic skin problems psoriatic arthritis |
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Psoriasis vulgaris is the most common type of psoriasis and presents as plaques, scaling thick red papules, slivery white scales
common areas are: |
scalp, elbows, trunk, knees, scarum ears, breasts , buttocks
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Treatment of psoriasis is based on the extent of the disease
topical steroids -corticosteroids do what |
suppress cell devision by absorption
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Treatment of psoriasis is based on the extend of the disease
Tar - does what |
decraeses cellular division and reduces inflammation
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Treatment of psoriasis is based on the extend of the disease
Calicpotrene (Dovonex) |
a synthetic form of vitamin D for cell regulation
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Treatment of psoriasis is based on the extend of the disease
Systemic treatment is used when the patient's disease is resistane to topical therapy. Cytotoxins: methotrexate -2 SE |
LFT
teratogenic |
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Treatment of psoriasis is based on the extend of the disease
System treatment is used when the patient's disease is resistane to topical therapy. Immunosuppresives: Imuran |
suppresses the growth of the cells
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Treatment of psoriasis is based on the extent of the disease
why is UV light the treatment |
because it stimultates vitamine d for cell regulation
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Treatment of psoriasis is based on the extend of the disease
UV light treatment -risks of treatment (5) |
infection
skin thinning cancer early aging (premature aging) actinic keratosis |
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when the specific cause of inflammatory rashes is not always known, the diagnosis is
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eczema
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eczema is a form of
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dermatitis (inflammation of the skin)
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eczema
contact dermatitis is what |
infection of the skin because you came in contact with something
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eczema
is a mild inflammatory response, that is located where? |
superficial
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eczema
is caused by what? |
a number of health conditions, allergies, genetic factors, physical and mental stressors, and irritants
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Pediculosis is an infection by
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human lice
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Pediculosis
-named for body part : capitis, corporis, pubis |
capitis = head
corporis = body |
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Pediculosis
-Corporis where are eggs located? this results in exposure ---then itching which is the result of biting of the scalp, and what should one look for? |
in the seams of clothing which causes itching
matting/white flecks and a foul odor |
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Pediculosis
-Human lice can lead to a 2nd infection secondary to what |
scratching that takes place
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Scabies is an infection by a:
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mite (carried by pets)
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Scabies is common among what population
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poor hygiene (who cant use bathing facilities or access to clothes washing facilities)
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Scabies
-intense intching when? -what should you look for? |
at night
whtie skin ridges made from burrowing of the mites into the skin |
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What is pediculosis capitis
what should you check for |
head lice
white flecks attached to a hair shaft near scalp |
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Treatment of pediculosis capitis and scabies is a chemical called
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Kwell -Lidane or tpical malathion
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Nails
clubbing occurs with |
hypoxia and impaired gas exchange (COPD)
hypoxia because supporting structures did not receive enough oxygen, the nail caved in because of the weight of the nail that has been pushed down and its growning downward because the underlying tissue structure was not strong enough to support it b/c it couldnt grow |
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Nails
pitting occurs with |
psoriasis
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Nails
-depressions / Beau's Grooves |
prolonged malnutrition
severe illness febrile state |
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Nail
what is the normal angle between the nail plate and the proximal nail fold |
160 degrees
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Nail assessment
-minor associations with the aging process include what 3 things |
gradual thickening of the nail plate
presence of longitudinal ridges yellowish gray discoloration |
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Nails tell you about what state
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protein state
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Nails
fragile and brittle nails is linked with what |
dehydration and decraesed protein
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Cellulitis
How is it cared for: |
skin care with proper cleansing, warm compress, antibacterial soap. Mark borders to know how fast advancing b/c of risk of tissue hypoxia
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Cellulitis
-Rx treatment (what medications) |
penicillins and cephalosporins 14 days, burrows solution
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Herpes simplex I and II
-Know the difference between the two: |
HSV1 are cold sores and last 3-10 days and HSV2 is genital herpes that last a life time and the outbreaks last 3-8 days
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Herpes simplex I and II
Causative agents: 3 ways it is spread: |
caused by a virus spread by direct contact btw an actively infected person and a susceptible host.
Sexual contact, direct contact and respiratory droplets |
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Herpes simplex I and II
Appearance upon assessment: |
grouped vesicles are present on an erythematous base, vesicles evolve to pustules, which rupture, weep, and crust. Older lesions ay appear as punched out shallow erosions with well defined bolders. Lesions are associated with itching, stinging or pain.
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Herpes simplex I and II
Treatments: |
warm compress and avoid constrictive clothing, med administration of anti virals (acyclovier and valacyclovier (valterx). Use propholacticly every day to prevent outbreaks)
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Herpes Zoster
What causes it: |
reactivation of the dormant vearicella zoster virus in patients who have previously had chickenpox.
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Herpes Zoster
How is it cared for: |
topical steroids,
antihistamines, antivirals antipyretics. Focus on skin care and prevention of spread |
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Herpes Zoster
Rx treatment: what is used for prevention? |
antivirals and a vaccine for pt at risk
zostavax used for prevention |
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Fungal infections
What causes it: |
infecting organism comes in contact with impaired skin in a susceptible host. Spread by direct contact with infected humans or animals.
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Fungal infections
How is it cared for: |
keep skin folds clean and dry, wash hands don’t share personal items, change bedlinens
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Fungal infections
-Rx treatment: |
topical antifungal agents are used. Imidazole creal is applied to the infected skin at least twice a day until the lesions have cleared
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Candidial infections
What causes it: what are risk factors 4 |
yeast infections. Organism is present almost everywhere and easily grows in a warm moist environment.
Risk factors are long term antibiotic therapy -- diabetes mellitus ---- and obesity. Occurs more often in hot humid climates |
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Candidial infections
-How is it cared for: |
keep all skin folds dry,
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Candidial infections
Rx treatment: |
topical antifungal agents are used.
Imidazole cream is applied to the infected skin at least twice a day until the lesions have cleared |
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Contact dermatitis
What causes it: |
exposure to a object that the pt is allergic to. i.e. poison ivy, poison oak
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Contact dermatitis
How is it cared for: |
avoidance therapy is used to reverse the reaction and clear the rash.
Cool moist compresses and luke warm baths with bath additives have a soothing effect, decrease inflammation and help debride crusts and scales. |
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Contact dermatitis
Rx treatment is 2 drugs: |
steroid therapy to suppress inflammation.
Antihistamines provide relief of itching |
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Nails
Normal nails have an angle of what? if the angle exceeds 180, it is associated with what |
160 degrees between the nail plate and the proximal nail fold is the normal nail shape.
if it exceeds 180 degrees is associated with hypoxia and COPD. |
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Nails
early clubbing: what does the nail base feel like when palpated? |
straightening of angle between the nail plate and the proximal nail fold to 180 degrees.
Nail base spongy when palpated. |
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Nail
early clubbing: indication of what? |
indication of hypoxia or lung cancer (supporting structures did not receive enough o2, the nail caved in because the wt of the nail has pushed down and its growing downward because the underlying tissue structure was not strong enough to support it cuz it couldn’t grow properly due to hypoxia
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Nails
Late clubbing: what does their nail look and feel like? |
angle between the nail plate and the proximal nail fold exceeds 180 degrees.
nail base visible edematous and spongy when palpated. enlargement of the soft tissue of the fingertips gives a drumstick appearance when viewed from above. |
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Nail
Late clubbing -what conditions is it seen with? |
seen with prolonged hypoxia, emphysema, COPD, advanced lung cancer
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