PNR 120 Exam 3 (Answered) Complete Solution

PNR 120 Exam 3 (Answered) Complete Solution Skin functions -protective covering -waterproof due to keratin -barrier to bacteria and other invading organism -protects underlying tissues from thermal, chemical, and mechanical injury -regulates body temp -converts ultraviolet rays to vitamin d -melanin protects tissue from UV light -nerve receptors transmit feelings of heat, cold, pain, touch, and pressure age related changes in skin and structure -decreased elastic fibers -loss of collagen fibers -skin becomes thinner and more transparent -reduced sebaceous gland activity -reduction in melanocyte activity -decrease in hair follicles -some areas of melanocytes increase (senile lentigines/ age spots) prevention of integumentary system hygiene, diet, age, environment -coumadin can make skin brittle dx of integumentary system -skin biopsy -c/s -microscopic test -special light inspection -diascopy -skin patch testing Braden Scale Pressure ulcers lower the number, higher the risk 4-23 less than 17 = risk for pressure ulcers risk factors for skin tears -dehydration -ecchymoses -friction, shearing, pressure from bed or chair -impaired sensory perception or mobility -medications like corticosteroids -renal disease, CHF, stroke -incorrect removal of adhesive dressings -rough handling when being moved Payne-Martin Classification System -Category I: a skin tear without tissue loss -Category II: a skin tear with partial tissue loss -Category III: a skin tear with complete tissue loss in which the epidermal flap is missing Skin Tear Protocol -Continuously cleanse the wound -Conform to the wound -Absorb exudates -Keep the wound bed moist and reduce pain and discomfort inflammatory infections examples Dermatitis, Acne, Psoriasis,Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis bacterial infection examples Cellulitis, Furuncles, Carbuncles viral infection examples Herpes Simplex, Herpes Zoster fungal infection examples tinea pedis (athletes foot) tinea cruris (jock itch) tineacapitis (ringworm) tinea barbae (barber's itch) moniliasis (thrush) onychomycosis (nail fungus) parasitic infection examples Pediculosis, Scabies dermatitis types and tx -contact dermatitis: local skin irritation. Redness welling and itching -atopic dermatitis: eczema -Stasis dermatitis: Due to venous stasis. Redness, itching, and hyperpigmentation -Seborrheic dermatitis: Inflammation of the scalp and other areas. Lesions are scaly white or yellowing plaques and itching tx: avoid contact irritant or allergen, good lubrication, preserve skin moisture, control inflammation and itching, corticosteroids acne etiology, patho,s/s - papules and pustules - acne vulgaris and acne rosacea dx and tx (VADAR) -Retinoic acid (tretinoin) -Azelaic acid (azelex) -dermabrasion -Veltin Gel -Antibiotics topically and orally Psoriasis Etiology, pathophysiology, signs, and symptoms• -Noncontagious, chronic, recurring skin disorder that typically appears as inflamed, edematous skin lesions covered with adherent silvery white scales Diagnosis and treatment -History and physical examination -Mild cases and steroid creams -Tar preparations -Antimetabolites Stevens-Johnson Syndrome An allergic reaction that can include rashes, and involve the inside of the mouth. May be due to drug sensitivity. allergic reaction -carbamazepine (tegretol) -phenytoin (dilantin) -sulfadoxine-pyrimethamine (fansidar) -sulfamethoxazole-trimethoprim (bactrim, Septra) Stevens-Johnson Syndrome dx and tx lesion, discontinue drug, fluids/nutrition, analgesics, sedatives Bacterial infections tx -warm compress -incision and drainage -systemic antibiotics Cellulitis infection of dermis and tissue Furuncles boils. skin abscess of hair follicle carbuncles Group of boils. multiple heads herpes zoster viral disease affecting the peripheral nerves, characterized by painful blisters that spread over the skin following the affected nerves, usually unilateral; also known as shingles. chickenpox in children dormant and can be reactivated by trauma, malignancy, or local radiation immunocompromised individuals are at a high risk herpes simplex virus is imbedded in a nerve ganglion that innervates the site of the lesion. Lesions of lips and/or nares. usually painful but doesn't cause systemic symptoms Simplex type 2-associated with genital herpes Simples 1- lesions primarily orofacial herpes simplex dx and tx