Maryville Nurs 623 Exam 1 Questions And Answers

Basics with skin conditions - ANS •Alopecia •Rash •Pruritus •Urticaria •Pigmentation change Skin lesion—New vs. Change HPI questions for skin problems - ANS 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 Urticaria - duration Pigmented changes Pigmentation/Changes of the skin Diff diagnosis - ANS Nevi- brown, beige or pink( 5mm) Melanoma Related to pregnancy- melasma (mask of pregnancy) Addison disease Side effect of medication- steroid therapy skin lesions - ANS 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 stasis 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 - ANS 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 - ANS scabies and lice Scabies - ANS 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 the 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 - ANS 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, to treat any infection that is present. Starve mites by sealing them in a bag for about 10 days. Lice treatment - ANS Permethrin 1% leave on for 10 mins then rinse. May repeat in 7 days if needed. Fungal skin infections - ANS · Candidiasis- bright, beefy red rash treat with topical antifungal, · Dermatophytosis - the tineas (ringworm) · Onychomycosis treated 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