MARYVILLE NURS 623 EXAM 1 WITH VERIFIED QUESTIONS AND ANSWERS GRADED A+

MARYVILLE NURS 623 EXAM 1 WITH VERIFIED QUESTIONS AND ANSWERS GRADED A+ Basics with skin conditions - MARYVILLE NURS 623 EXAM •Alopecia •Rash •Pruritus •Uticaria •Pigmentation change Skin lesion—New vs. Change HPI questions for skin problems - MARYVILLE NURS 623 EXAM Duration of symptoms Precipitating factors •Medications •Food •Occupation •Outdoors •Hobbies/Sport participation •Exposure to insects •Jewelry/metals/chemicals •Family history Is it: Local or systemic Pruritus- all day or worse at night Uticaria - duration Pigmented changes Pigmentation/Changes of the skin Diff diagnosis - MARYVILLE NURS 623 EXAM Nevi- brown, beige or pink ( 5mm) Melanoma Related to pregnancy- melasma (mask of pregnancy) Addison disease Side effect of medication- steroid therapy Skin lesions - MARYVILLE NURS 623 EXAM Macule - flat, nonpalpable (freckle, petechiae) Papule - PALPABLE, solid elevation of skin (elevated nevus) Nodule - elevated solid mass, deeper and firmer than papule (wart) Tumor - solid mass deep in subcutaneous tissue (epithelioma) Wheal - irregularly shaped, elevated area (hive, mosquito bite Vesicle - elevation of skin with serous (clear) fluid Pustule - similar to vesicle but filled with pus (acne) Ulcer - deep loss of skin (venous statis ulcer) Atrophy - thinning of skin Bullae-Clear fluid-filled blisters 10 mm in diameter. These may be caused by burns, bites, irritant or allergic contact dermatitis, and drug reactions. Primary versus secondary skin lesions - MARYVILLE NURS 623 EXAM Primary skin lesions are those which develop as a direct result of the disease process. Secondary lesions are those which evolve from primary lesions or develop as a consequence of the patient's activities. Parasitic Skin Infections - MARYVILLE NURS 623 EXAM scabies and lice Scabies - MARYVILLE NURS 623 EXAM Highly contagious infestation that occurs mainly in children, young adults, health care workers, and institutionalized persons of all ages. Subjective: Complaints of intense itching that is usually more severe at night. Objective: Earliest physical sign is small 1 to 2 mm red papules located in areas of body most attractive to mites. Itching, excoriation, crusting, and scaling may be present making it hard to see scabies. Diagnostics: Ink burrow test Scabies treatment - MARYVILLE NURS 623 EXAM Permethrin 5% cream (Remember you have 5 fingers) - leave on for 8-14 hours then shower- daily for 7 days. Oral antihistamines for itching, topical steroids for itching. The entire household must be treated. Everything should be washed with hot water/detergent, treat any infection that is present. Starve mites by sealing them in a bag for about 10 days. Lice treatment - MARYVILLE NURS 623 EXAM Permethrin 1% leave on for 10 mins then rinse. May repeat in 7 days if needed. Fungal skin infections - MARYVILLE NURS 623 EXAM · Candidiasis- bright, beefy red rash treat with topical antifungal, · Dermatophytoses - the tineas (ringworm) · Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective, educate patient. · Fungal infections survive on keratin, so considered superficial. · Pathogens: Epidermophyton, trichophyton, microsporum. · Those at risk are DM and immunocompromised. · Diagnostics: KOH Tinea corporis (Ringworm of body) - MARYVILLE NURS 623 EXAM Hx of erythematous round and elevated pruritic lesion that grows in size & starts to clear in the center Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1% Tinea capitus (ringworm of head) - MARYVILLE NURS 623 EXAM Children common. Painless bald spot, may have kerion that looks like honeycomb, inflammation. Boggy mass containing broken hairs and oozing purulent material from follicular orifices Systemic antifungals - Griseofulvin BID for 2-4 months or 2 weeks after negative cultures. Teratogenic - use 2nd method of contraception. OR terbinafine cream Tinea versicolor (skin, AKA pityriasis versicolor) - MARYVILLE NURS 623 EXAM Round or oval lesions of hypo or hyperpigmentation macule, located mainly on back chest, arms, sometimes neck/face. Sometimes very fine scales seen. Agent P orbicular causes round, pityrosporum ovale causes oval Clotrimazole 1% cream and solution BID up to 4 weeks Bacterial infections of the skin - MARYVILLE NURS 623 EXAM · Impetigo · Highly contagious Cellulitis · Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin, · PCN allergy use Erythromycin. · Non purulent assume staph aureus Purulent cellulitis · I&D first line · NO 1st gen cephalosporine · Consider MRSA- Bactrim, Cleocin, Doxycycline