NSG 3180 Med Surg Unit 3 - Alterations in Tissue
Integrity
Skin
Skin assessment considerations
Aging
• Thinning skin, uneven pigmentation, wrinkling, skin folds
• Decreased elasticity, dryness, diminished hair, increased fragility
• Increased potential for injury, reduced healing
Skin appearance
• Erythema (redness), rash, jaundice, cyanosis, pruritus (itching)
Nail disorders
Systemic issue or disorder of skin/nails
• Beau lines = severe illness
• Rigid nails = trauma
• Paronychia = inflammation of skin around nails
• Pitted surface = psoriasis
• Spoon shaped = iron deficiency anemia
• Clubbing = pulmonary disease, hypoxia, chronic acidosis
Types of infections:
Viral
Bacterial
Fungal
Pruritus
NOT a disorder
Release of histamine
Can be aggravated by heat
Inflamed cells and nerve endings
Can result from dry skin or triggered by systemic
illness
S/S: excoriation, redness, raised area, could include a
rash
Causes: medications, stress, dryness, high
temperatures, exposure to irritants, early sign of other illnesses
1
, Tx: antihistamine, antipruritic
• Topical: antipruritics (oatmeal), capsaicin, lidocaine
• Systemic: antihistamines, corticosteroids Geriatric
considerations:
• Itching due to thinning of skin, loss of elasticity, easy bruising and
skin tears, may cause infection Nursing considerations:
• May be first indication of systemic disease
• Avoid situations that cause vasodilation
• Decrease sweating activities
• Wear cotton clothes
Urticaria
Hives
Type 1- hypersensitivity reaction of skin to
allergen
Release of histamine and other chemicals
Causes vasodilation and internal edema
S/S: sudden appearance of wheals, edematous
papules, pruritus
Causes: exposure to irritants, temperature extremes, stress, alcohol,
infection
Tx: antihistamines (could be topical, oral), corticosteroids for swelling, avoid
NSAIDs
Nursing considerations:
Remove causative agent, loose clothes
Herpes Simplex Virus 1
S/S: Painful vesicles on mouth/lips
Symptoms can be delayed 20 days following exposure
Exacerbated by infection, stress, fever, hormones, and sun exposure
Above the waist
Eat bland foods, avoid carbonation, avoid acids/citrus
Use alcohol free mouthwash
Causes: infection/fever, stress, hormones, sun exposure,
immunosuppression
Tx: topical antivirals (acyclovir), treat pain, NSAIDs, topical oral creams
2
Integrity
Skin
Skin assessment considerations
Aging
• Thinning skin, uneven pigmentation, wrinkling, skin folds
• Decreased elasticity, dryness, diminished hair, increased fragility
• Increased potential for injury, reduced healing
Skin appearance
• Erythema (redness), rash, jaundice, cyanosis, pruritus (itching)
Nail disorders
Systemic issue or disorder of skin/nails
• Beau lines = severe illness
• Rigid nails = trauma
• Paronychia = inflammation of skin around nails
• Pitted surface = psoriasis
• Spoon shaped = iron deficiency anemia
• Clubbing = pulmonary disease, hypoxia, chronic acidosis
Types of infections:
Viral
Bacterial
Fungal
Pruritus
NOT a disorder
Release of histamine
Can be aggravated by heat
Inflamed cells and nerve endings
Can result from dry skin or triggered by systemic
illness
S/S: excoriation, redness, raised area, could include a
rash
Causes: medications, stress, dryness, high
temperatures, exposure to irritants, early sign of other illnesses
1
, Tx: antihistamine, antipruritic
• Topical: antipruritics (oatmeal), capsaicin, lidocaine
• Systemic: antihistamines, corticosteroids Geriatric
considerations:
• Itching due to thinning of skin, loss of elasticity, easy bruising and
skin tears, may cause infection Nursing considerations:
• May be first indication of systemic disease
• Avoid situations that cause vasodilation
• Decrease sweating activities
• Wear cotton clothes
Urticaria
Hives
Type 1- hypersensitivity reaction of skin to
allergen
Release of histamine and other chemicals
Causes vasodilation and internal edema
S/S: sudden appearance of wheals, edematous
papules, pruritus
Causes: exposure to irritants, temperature extremes, stress, alcohol,
infection
Tx: antihistamines (could be topical, oral), corticosteroids for swelling, avoid
NSAIDs
Nursing considerations:
Remove causative agent, loose clothes
Herpes Simplex Virus 1
S/S: Painful vesicles on mouth/lips
Symptoms can be delayed 20 days following exposure
Exacerbated by infection, stress, fever, hormones, and sun exposure
Above the waist
Eat bland foods, avoid carbonation, avoid acids/citrus
Use alcohol free mouthwash
Causes: infection/fever, stress, hormones, sun exposure,
immunosuppression
Tx: topical antivirals (acyclovir), treat pain, NSAIDs, topical oral creams
2
