skin, hair, and nails
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- bruises, welts, or burns may indicate ?
- accidents or trauma or abuse
- What does a nurse do if a client reports any symptoms?
- explore it further with a symptom analysis. Think COLDSPA
- Why is it important to ask a client about any birthmarks, tattoos or moles the client may have?
- To establish a baseline for future variations can be detected.
- What does bleeding of any skin mark, especially a mole, indicate?
- cancer
- IF the client reports a change in their ability to feel pain, pressure, or light touch, or temp. changes the nurse should assess for?
- vascular or neurological problems such as peripheral neuropathy related to diabetes mellitus or arterial oclusive disease.
- Problems with not being able to feel sensations could put a client at risk for ?
- pressure ulcers
- Patchy hair loss is associated with ?
-
infections
stress
hair styles
some types of chemotherapy - generalized hair loss is seen in client with ?
- systemic illnesses such as hypothyroidism, and in clients receiving certain chemotherapy or radiation
- What is the most common cancer ?
- skin cancer.
- Name the three types of skin cancer.
-
basal cell carcinoma
squamous cell carcinoma
melanoma - What type of skin cancer accounts for the most deaths ?
- melanoma
- Intermittent exposure to sun or ultraviolet light is associated with which types of skin cancer?
-
melanoma
and
basal cell carcinoma - Squamous cell carcinoma is commonly found in what area of the body?
- body sites with very heavy sun exposure.
- Overall amount of exposure is associated with which type of skin cancer ?
- squamous cell carcinoma
- Who is the most suspectable to skin cancer?
- people with pale white, freckled skin and red hair.
- nail changes may be seen in clients with ?
- malnutrition or with local irritation
- Excessive body odor may indicate?
- an abnormality with the sweat glands or an endocrine problem such as hypothyroidism or hyperthyroidism.
- Does perspiration decreases with age?
- Yes because sweat gland activity decreases.
- Is a strong body odor a normal finding ?
- NO, it indicated an abnormality
- Sun exposure can cause ?
- premature aging, and increase risk of skin cancer, and damage to hair
- For female clients, pregnancy and menstruation can cause ?
- skin and hair conditions as a result from hormonal imbalances
- How often should a client perform a skin self examination?
- monthly
- pallor is seen in clients with ?
- arterial insufficiency, decreased blood supply, and anemia
- central cyanosis is seen in clients with ?
- cardiopulmonary problems
- peripheral cyanosis is a result of ?
- vasoconstriction
- How would a nurse differentiate between central and peripheral cyanosis ?
- look for central cyanosis in the oral mucosa
- In what areas is cyanosis seen in ?
- perioral, nail-beds, and conjunctival areas
- What color is associated with cyanosis ?
- BLUE
- Where can colors associated with jaundice can be seen ?
- sclera, oral mucosa, palms, and soles
- What is ancanthosis nigricans ?
- darkening and roughening of skin in localized areas; particularly the posterior neck
- White patches of skin are known as ?
- vitiligo
- Are freckles a normal or abnormal finding ?
- NORMAL
- Vitiligo, seborrheic keratosis, striae, moles, cutaneous tags,cutaneous horns, cherry angiomas and scars are what type of finding? Normal or Abnormal?
- They are all normal skin variations normal findings
- How would the skin feel if a client is in shock or as a result of hypotension?
- clammy
- Stage 1 ulcer
- unbroken skin that appears red; no blanching when pressed
- Stage 2 ulcer
- skin is broken; the lesion resembles a vesicle, erosion, or blister
- Stage 3 ulcer
- resembles a cater, involves the epidermis, dermis , and subcutaneous tissues. DOES not extend to underlying fascia
- Stage 4 ulcers
- involves the epidermis, dermis, subcutaneous tissue, bone, and other support tissue. resembles a massive crater
- A client appears with a less than 1 cm flat, non palpable skin color change the nurse should document the presents of a ?
- MACULE
- greater than 1 cm, flat, non palpable skin color change, may have irregular border.
- PATCH
- Elevated nevi, warts, lichen planus are all examples of ?
- Papule
- Freckles, flat moles, petechiae, rubella, vitiligo, port wine stains, ecchymosis are examples of ?
- a patch or macule
-
< 0.5 cm
elevated, palpable, solid mass
circumscribed border - PAPULE
-
> 0.5 cm.
elevated, palpable, solid mass
circumscribed border
may be coalesced papules with flat tops - PLAQUE
- Psoriasis, actinic keratosis are examples of ?
- PLAQUES
- A carcinoma and larger lipoma are examples of ?
- TUMORS
- Using a Wood light, fungus would be present if the light fluorescence is what color?
- Blue
- What would Beau's lines indicate ?
- acute illness
- What is the only layer of skin that under goes cell division and contains melanin?
- innermost layer of the epidermis
- Facial hair on women is known as ?
- Hirsutism
- scar
-
cicatrix
new=red or purple
old=white and glistening - ecchymosis
-
bruise
secondary to blood extravasation
associated with trauma, bleeding tendencies - an elevated ecchymosis
- hematoma
- cherry angioma
-
papular and round
red or purple
trunk and extremities
blanch w. pressure
normal age related -
telangiectasis AKA
venous star -
spiderlike or linear
bluish or red
does not blanch
noted on legs anterior chest
associated w. venous pressure states - spider angioma
-
red, arteriole lesion
central body and radiating branches
face, neck, arms, trunk
blanch w. pressure
associated with liver disease, pregnancy, vitamin B deficiency - paronychia
- local infection of the distal finger
- erthema
- warm, red area
- what is a cause of acne ?
- inflammation of the sebaceous glands.
-
Acne
Closed coledones are? - non-inflammatory lesion aka white heads=
-
Acne
Open comedones - non-inflammatory lesion= black heads.
-
What is the treatment for acne ?
6 treatments -
removal of lesions
benzoyl peroxide
use of peeling and irritating agents= retinoci acid
antibiotics
phototherapy= supress new lesions
accutane=severe acne - Where is acne most common?
-
face
neck
upper back - While taking accutane for acne, what lab test should be monitored?
-
Liver function
Pregnancy
Triglycerides
cholesterol - Names of lesions associated with acne?
-
pustule
papule
nodules - Another name for scabies?
- Sarcoptes scabiei
- Scabies etiology and pathophysiology
-
penetration of stratum corneum
depositing of eggs
allergic reaction is form eggs, feces, mite parts.
transmission=direct contact or shared personal items - Where is the stratum corneum located?
- outer layer of epidermis
- Clinical manifestation of scabies?
-
severe itching= (mostly at night) NOT on the face.
presence of burrows= interdigital space, flexor of the wrist, anterior axilla,
redness
swelling
vesiculation - treatment of scabies?
-
10% rotamiton, y-benzene, hexachloride, benzyle benozate 12-25%
reaccurence possible
treatment of sexual partner
antibiotics if dermitis and secondary infection is present. - Pediculosis is also known as
-
head lice
body lice
pubic lice - What type of parasites is a Pediculosis ? What do they do?
-
obligate= suck blood
leave excrement and eggs on skin
live in seams of clothing if= body lice
live in hair = nits
pubic lice= sexually transmitted - clinical manifestation of pediculosis?
-
minute, red, non-inflammatory point flush with skin.
progression to papular wheal like lesions
pruritus secondary to excoriation
firmly attached to head and hair shaft in body and head lice. - treatment used in clients with pediculosis.
-
y-bensene hexachloride or pryethrins to treat various body parts.
apply as directed
contact screening with bed partners, playmates, headgear - RSVP in reference to contact lens problems that must be managed by an eye care professional.
-
R= redness
S= sensitivity
V= vision prolblems
P= Pain - Removal of hard lens by the nurse.
- use a small suction cup designed for that purpose.
- Aphakia
-
crystalline lens is absent because of congenial defect, trauma, or surgery= cataract extraction.
eye loses approximately 30% of its refractive powers. - Emmetropia
- Normal vision
- What vision disorders can be corrected with surgery?
-
myopia
hyperopia
astigmatism
presbyopia
aphakia - can emmetropia be corrected with surgery?
- NO it is normal vision.
- Legal blindness is measured as ?
- best corrected vision in the better eye is measured as 20/200 or less.
- 20/200 indicates?
- legal blindness
- What does EOMI stan for
- extra ocular muscles intact
- myopia and the cause of myopia
-
can see near objects clearly= nearsightedness
cause= when the image is focused in front of the retina due to the eye being too long. - Hyperopia and the cause
-
can see distant objects clearly =farsightedness
cause= an image is focused behind the retina. the eye is too short - astigmatism and the cause
-
unevenness in the corneal or lenticular curvature causing horizontal and vertical lines to be focused at two different points on the retina.
See with myopia or hyperopia - Prebyopia
- a form of hyperopia that occurs as a normal aging process, usually age 40. Lens becomes less elastic, it loses refractive power.
- Crystalline lens
-
located behind the iris.
function= bend light rays so they fall on the retine - Macula
- high concentration of rod and cones
- fovia centralis
- visual acutity
- Optic disc
- where blood supple to the eye enters the eye.
- functional blindness
- some light perception but no usable vision.
- Glacoma
- too much aqueous humor produced by the ciliary body. causes pressure to be put of the retina =IOP
- What disorders would cause a client to seek eye exams more often than the normal average?
-
diabetes
CV disease - Conditions that can reduce a persons ability to wear contacts
- loss of tear function= decreased by antihistimines, decongestants, diuretic, BCP and hormones during pregnancy.
- Partially sighted individuals
- visual accuity of 20/200 in the better eye, greater than 20 degrees of visual field, but the visual acuiy is 20/50 or worse in the better the better eye
- Cataract surgery = pre-op
-
provide information
suggest dark glasses
apply dilating drops= dark iris need more meds. - cataract surgery = post op
-
notify that depth perception will not return until patches are removed
vision may take 1-2 weeks to improve
mild analgesics
report intense pain, purulent drainage, increased redness, or decreased vision.