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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.

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