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ch 27 skin problems I
ch 27 skin problems I
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10/19/2013

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Term
xerosis
Definition
dry skin
Term
lciheniication
Definition
thickening
Term
what should you remind a pt about bathing
Definition
use moisturizing soaps, antimicrobial and scented soaps can make dry skn worst
Term
what can lubricating creams and lotions do for the skin
Definition
seal in moisture and prevent flaking
Term
what do some skin lotions that are hydrophlic do
Definition
water seeking so they draw moisture in
Term
what is puritis caused from
Definition
stimulation of certain itch specific nerves at the dermal- epidermal junction
Term
itch scratch cycle
Definition
when a pt trys to relive itching by scratching which causes this patern
Term
what are some systemic diseases that can cause itching
Definition
liver disease
venous disorders
Term
how does liver disease cause itching
Definition
buildup of bilirubin which stimulates the itch receptors
Term
uticaria
Definition
hives
Term
what are the 3 pahses of wound healing
Definition
inflammatory
proliferation, maturation
Term
approximated healing
Definition
wound without tissue loss that is closed by sutures the edges are lined up in corect position
Term
how does approximated wound healing heal
Definition
by first intention because closing the wound eliminates the dead space and shortens the 3 phases
Term
deeper tissue injuries with tissue loss are healed by second intention why
Definition
because it results in a cavity like defect requiring gradual filling in of the dead spce and prolongs the repair process
Term
expalin wounds that may be intentionally left open to repair themselves/ and what is this known as
Definition
after debris and exudate have been removed and inflammatory has subsides it is closed by first intention.know as third intention
Term
third intention
Definition
when wound healing is left open, debrided then stiched up- results in scars
Term
partial thickness wounds
Definition
superficial involving damage to the epidermis and upper layers of the dermis
Term
how do partial thickness wound heal
Definition
re-epithelialization - the produciton of new skin cells by undamaged cells in the basal layer of the dermis
Term
resuracing
Definition
regorwth across an open area that is only one cell layer thick at first then thickens
Term
in a health pt how long can resurface healing take
Definition
5 to7 days
Term
full thickness wounds
Definition
wounds extend into the lower layers of the dermis and underneath to the sub q
Term
how does a full thickness wound heal
Definition
granulation- new blood vessles have to form at the base of the wound and fibroblastic cells move in to fill in the space
Term
what do fibroblastic cells do to the full thickness wound
Definition
pulls the wound edges together to decrease the wound size
Term
tissue compression from pressure restrict blood flow and causes
Definition
reduce tissue perfusion and o2 and cell death
Term
what are the 2 steps of a pressure ulcer program
Definition
early identification and implementing interventions
Term
pressure mapping/ what is it and what does red and blue mean
Definition
measures pressure rom a person sitting or lying the map is colored on the computer screen to show temp differnces- red meansgreater heat production and increased pressure and blue means lower pressure
Term
what are three things to remember when positioning to prevent ulcers
Definition
DO NOT keep the hob elevate 30 degrees to prevent shearing
if on side do not position on trochanter
do not place rubber donut under sacral area
Term
how many fluids should be consumed daily with a patient with pressure ulcers
Definition
2 and 3 l
Term
what is one thing to remember for skin care and preventing pressure ulcers
Definition
use moistureizers on dry skin daily and apply when the skin is damp
Term
can you massage bony prominances
Definition
no--pressure ulcer alert!!
Term
2 things to remember about skin cleaning and pressure ulcers
Definition
mild heavy soap for incontenance and do NOT USE TALCS DIRECTLY ON PERINEUM
Term
what are 4 things to id high risk pressure ulcer pts
Definition
mental status
mobility
nutrition
incontinence
Term
how does the pt with a neg nitrogen balance heal
Definition
slowly
Term
serum albumin and prealbumin are used to monitor nutritional status for pressure ulcers what is the best indicator and why
Definition
prealbumin because it is more sensitive because it has a shorte life
Term
when is nutrition considered inadequate
Definition
albumin isless then 3.5 and prealbumin is less then 19.5
Term
what are some factors that can affect serum prtein levles
Definition
hydration
metaobilc stress
infection
Term
what does a positive nitrogen balance require an intake of
Definition
30 to 35 calories per kilogram of body weight daily
Term
capillary closing pressure
Definition
amount of pressure needed to occlude skin capillary blood flow
Term
dynamic systems vs static devices
Definition
dynamic- alternate inflation and deflation of a device thru electricity
static- devices made of gel water foam or air in a constant state of inflation to prevent pt pressure overload
Term
who is poitioning delagated to most often
Definition
uap
Term
what is the 30 degree rule for positioning
Definition
this plan states that a pt is positioned and propped so that whatever art of the body is elevated is tilted back to a 30 degree angle to the mattress rather then resting directly on prominent bony area
Term
an area that blanches with pressure then returns to noraml whenpressure is removed indicates
Definition
color changes related to vessle dialation rater then tissue damage
Term
expalin the 5 stages of pressure ulcers
Definition
1-skin is intact
2-skin is not intact, partial skin thickness loss
3- skin loss is full thickness
4-skin loss is full thickness with muscle tendons or bone showing
5- unstagebale
Term
how can you measure the length of a wound and the depth
Definition
disposable paper tape/ the cotton tipped applicator
Term
cellulitis
Definition
inflammation of the skin cells beyond area of injury
Term
in early stages of wound healing how is the eschar
Definition
dry and leathery but firmly attached
Term
what is the problems with eschar
Definition
its nonliving and a good breeding area for bacteria
Term
besides bacteria in eschar what else is a problem
Definition
they release an enzyme that soften necrotic tissue
Term
undermining
Definition
seperation of the skin layers at the wound margins
Term
serosanguineaous exudate
Definition
blood tinged amber colored
Term
creamy yellowish pus what can it mean
Definition
staph
Term
creamy blue pus that stains dresing and has a fruity odor what can this mean
Definition
pseudomonas
Term
beige pus with fishy odor can mean
Definition
proteus
Term
brownish pus with fecal odor can mean
Definition
bacteriods
Term
can the prescence of pruulent exudate alone prove local or systmeic infection
Definition
no
Term
who is able to remove lose bits of tissue form wounda
Definition
certified wound specialist
pt
advance practice nurse
Term
what is a wound usually cleaned with
Definition
daline
Term
mecahnical debridement
Definition
entrapment and detachment of dead tissue
Term
topical chemical debridement
Definition
enzyme preps applied to loosen necrotis tissue
Term
natural chemical debridement
Definition
using naturall occuing enzymes that self digest dead tissues
Term
hydrophobic
Definition
nonansorbent waterproof
Term
wet to damp debridment
Definition
necrotic tissue is debrided mechanically with less trauma to healing tissue
Term
continuous wet gauze debridment
Definition
wound surface is bathed with a wetting agent
Term
how can dialy whirpool baths help with wounds
Definition
loosens debris and washes away exudate and particles
Term
electrical stimulation for wounds
Definition
low voltage to increase blood vessle growth this is applied directly to a wound thru a sterile dressing
Term
vaccuum assisted wound closure
Definition
enhances the formation of granulaiton tissues
Term
when shouldnt you use vaccum devices with wounds
Definition
when the pt is on an anticouagualnt
Term
hyperbaric o2
Definition
treatment with o2 under high pressure
Term
topical growth facotrs
Definition
active to stimulate wound healing
Term
what is the risk for the longer a wound remains open
Definition
sepsis
Term
pedicle flap
Definition
fluu thickness flap of skin that is raised and rotated to cover the defect
Term
after surgery with a pedicle flap what is done postop
Definition
immolization with pressure dressings for 3 to 5 days any movement that may cause it to seperate is prhibited
Term
a pale flap with delayed capilarry refill time may mean
Definition
inadequate arterial perfussion
Term
what does a dusky appearnace of a pedicle flap mean
Definition
inadequate venous or lymph drainage
Term
fol,liculitis
Definition
superficial infection with only the upper portion of the follicle usually caused by staph
Term
furnucles
Definition
boils usually staph
Term
cellulitis
Definition
generalized infection from strep or staph
Term
what happens if mrsa infects a wound or gains acces to the blood
Definition
sepsi and death
Term
whAT DOES FOLLICULTIS LOOK LIKE
Definition
ISOLATED RED PUSTULES SINGLE OR IN GROUPS
Term
WHAT DOES A FURNUCLE LOOK LIKE
Definition
SMALL TENDER RED NODULES THAT BECOME PUS FILLED
Term
TYPE ONE HERPES
Definition
CAUSE IS THE CLASSIC COLD SORE INCREASE WITH AGE AND IS WORSE WHEN PT IS IMUNOSUPPRESSIVE
Term
HOW IS THE HERPES VIRUS SPREAD
Definition
DIRECT CONTACT AUTOINOCULATION
Term
AUTOINOCULATION
Definition
TRANSFER OF VIRAL TYPE FROM ONE PART OF BODY TO ANOTHER
Term
HOW LONG DO OUTBREAKS OF ORAL HEPERS LAST
Definition
3 TO 5 DAYS
Term
HERPETIC WHITLOW
Definition
FORM OF HERPES OCCURS ON THE FINGERS OF MEDICAL PERSONAL THAT HAVE COME INTO CONTACT WITH VIRAL SECREATIONS
Term
herpes zoster
Definition
shingles from reactivation of dormant chickenpox usually in a segmented pattern
Term
posttherpitic neualgia
Definition
from shingles is sever pain that persists after the lesions are gone
Term
when does herpes zoster occur
Definition
immnosuppressed
Term
who is herpes zoster contagious to
Definition
anyone who has not had chickenpox and is usally most transferable when the lesions are pus filled
Term
what is a vaccine for herpes zoster
Definition
zostavax
Term
dermatophyte infections
Definition
also knon as fungal infections
Term
candida albicans
Definition
yeast infections where it is warm and moist enviroment
Term
when is zostavx used
Definition
vaccine for adults older then 50 who do not currently have shingles it is given one time im or iv
Term
tzanck smear
Definition
viral culture wher ethe base of the lesion is examined under microscope
Term
when a pt is admitted with staph and is resistant to antibiotics what is done
Definition
isolation percautions
Term
what are the most comon antibiotics used for systemic infections
Definition
penicillians and cephlaspoins
Term
what is used for fungal growth
Definition
ketoconazole (nizoral)
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