Question Answer
how does the skin regulate temperature SUB Q – cushion and retains heat; stores energy in fat form(lipids) Blood vessels- constrict to keep heat in, dilate to release heat Sudoriferous (sweat) glands- moisture evaporates, cools body
how does the skin synthesize vitamin D vitamin D is necessary for healthy bone development. xholesterol compounds in the skin are converted to vitamin D when exposed to the suns ultraviolet rays
how does the skin eliminate waste products uremic frost: crystalized urea in sweat, caused by kidney failure and uremia ( urea in the blood)
what causes body odor caused by bacteria breaking down waste in sweat
how do goosebumps occur Arrector pili muscle around hair follicle contracts to fear or cold, caused hair to stand upright and skin to dimple
how are fingerprints formed papillary layer of dermis projects epidermis causing ridges
what causes skin color and its variations skin color depends on how much light is reflected when it strikes melanin, the underlying skin pigment
what melanocytes produce produce melanin, a dark brown or black pigment = skin color
How do you assess for cyanosis in a dark skinned pt by assessing color of lips and mucous membranes
what causes wrinkles due to the loss of elasticity, subcutaneous tissue and tissue fluid
how can skin care products prevent wrinkles skin care products can temporarily increase fluid and elasticity but cannot prevent aging
stage I pressure ulcer intact with non-blanchable redness
stage II pressure ulcer involves partial-thickness loss of dermis, no sloughing or bruising
stage III pressure ulcer involves full-thickness tissue loss, if sloughing present, does not obscure ulcer, subcutaneous fat may be exposed, bone, tendon, and muscle are NOT exposed.
stage IV pressure ulcer involves full-thickness tissue loss WITH exposed bone, tendon, or muscle, slough or eschar occasionally present
unstageable involves full-thickness tissue loss covered by slough or eschar
what are the three degrees of burns superficial burn (first degree) partial thickness burn (second degree) full thickness burn (third degree)
what are the classification of a superficial (first degree) burn erythema, blanches with pressure, painful (use cold to relieve pain), no grafts, heals in 3-7 days
what are the classifications of a partial thickness (second degree) burn blisters, edema, painful, sensitive to cold, shiny, weepy, superficial heals 14-21 days, deep heals 21-28 days (possible skin grafts and scarring)
what are the classifications of a full thickness (third degree) burn deep red, black, white, brown, dry, edema, little to no pain, healing weeks to months, eschar-black, leathery crust, skin grafts, scarring, contractures
what is the rule of nines divides the body into multiples of nine to assess the total body surface area burned in adults. (not accurate in children)
what is the rule of nines chart front of head is 4.5% / back of head 4.5%front of arm 4.5%/back of arm 4.5% front of torso 18%/back of torso 18%groin 1%front of leg 9%/back of leg 9%
what is eschar black leathery crust that forms over burned tissue, non-elastic, impairs circulation
How do you remove eschar? -hydrotherapy softens so is done first -debridement(removal of damaged tissue) prevents infection and promotes healing
what is the function of skin grafts promotes healing and prevents infection
what are the three types of grafts autograft= self (graft is taken from uninjured area) Homograft/allograft= human (from another person who is not an identical twin heterograft/xenograft= different species like pig or cow. temporary graft
what do you do for donor site care inspect the donor site for signs of infection such as erythema and malodor.
skin graft care pain management (assess and treat), assess graft and donor site, little or no movement (prevents dislodgement), keep moist with lotion for 6-12 months, do not remove unless ordered, report changes in the graft to HCP. protect grafted skin from direct sunl
why should you apply lotion to a skin graft grafted skin does not perspire so it prevents cracking and dryness
what must you wear for grafts on the lower extremities a strong elastic stocking for 4 to 6 months
nutritional needs for burn pt -high calorie, nutrient dense -protein -vitamins A, B, C, Ca, Zinc, Magnesium, FE-frequent small feedings
what are some high calorie nutrient dense supplements ensure, carnation instant breakfast (CIB)
what should you do in case of a thermal fire stop, drop, and roll; use a blanket (thermal is steam or liquids)
what should you do in case of a chemical fire remove clothing, flush with plenty of water (Chemical is systemic toxicity-absorption)
what should you do in case of an electrical fire turn off power (electrical is internal damage, risk fro cardiac arrest. has entry and exit points)
what are the three phases of burn management emergent phase, acute phase, rehabilitation phase
what happens during the emergent phase -establish airway-prevent further contamination -provide warmth -assess if current on tetanus immunization
when is the emergent phase first 72 hours after time of injury (most deaths in emergent phase occur from hypovolemic shock or respiratory failure)note time may be wrong
what are the goals for emergent phase -respiratory integrity -prevent hypovolemic shock -preserve vital organ functioning -administer tetanus (if more than 5 yrs since immunization)
emergent phase care -IV fluid therapy (Lactated Ringer's), greatest fluid lost within first 12 hrs-foley catheter to monitor output, 30 to 50 ML/HR-nasogastric (NG) tube R/T Curling's Ulcer -medications given IV -Tetanus immunization if indicated
what is Curling's Ulcer (stress ulcer) is an acute gastric erosion resulting as a complication from severe burns when reduced plasma volume leads to ischemia (inadequate blood supply to an organ or part of the body, especially heart muscles) and cell necrosis (sloughing) of the
when is the acute phase -72 hrs after the injury-fluids shift back to intravascular space; assess fro signs and symptoms of fluid overload
what are the goals for the acute phase -treat burn= reverse isolation or protective isolation, and wound care -prevent complications
what are complications that can occur during the acute phase -infection- most common cause of death after 72 hrs -heart failure -renal failure-contractures (condition of shortening and hardening of muscles, tendons, or other tissue. -paralytic Ileus-Curling's Ulcer (duodenal ulcer occuring 8-14 days after
Goals and Care in Rehab -Maintaining independence (no pillow, use trochanter roll, prevent foot drop)-productive life/how t adapt to injury (mobility, prevent contractures, social skills, body image)
what are the four types of burns thermal chemical electrical radiation
what are the different types of inhalation injuries -smoke-carbon monoxide poisoning-direct thermal heat (as a result of inhalation of steam or explosive gases) (establishing airway is the primary concern)
smoke injuries singed nasal hairs (assess for respiratory complications)signs and symptoms of inhalation injury: nasal hairs flaring, stridor, wheezing, hoarseness, sooty sputum
Carbon Monoxide (CO2) poisoning -colorless, odorless, tasteless gas-CO2 binds to hemoglobin, taking place of oxygen -hypoxia (despite presenting with pink skin) do not rely on pulse oximeters
direct thermal heat upper and lower airway complications:-erythema-edema-blisters-ulcerations(intubation often necessary)
they types of skin cancer basal, squamous, melanoma
basal skin cancer -basal cell layer of epidermis-scaly papule, with central crater and waxy, pearly border. -with early detection and complete removal the outcome is favorable-Secondary cancer is rare
risk factors for basal cancer frequent contact with certain chemicals,over exposure to the sun, radiation treatment
squamous skin cancer -epidermal layer of skin-its firm, nodular crusty lesion -early detection and treatment -10% of pts with squamous cell will have secondary cancer
risk factors for squamous skin cancer -sun-exposed areas -cancer occurs on sites of chronic irritation or injury
melanoma skin cancer -epidermis, dermis, and sometimes subcutaneous tissue -elevated asymmetrical dark lesions w/irregular borders -most deadly skin cancer -secondary cancer occurs easily, is rapid nodular type
risk factors for melanoma skin cancer -UV exposure (sunlight)-fair skin-tanning beds-family history -prior melanoma -unusual-multiple moles
what is Silvadene (sulfadiazine) used for used with other treatments to help prevent and treat wound infections in pts with serious burns
allergic reaction to silvadene hives, difficulty breathing, swelling of face, lips, tongue, or throat.
how do you apply Silvadene clean area to be treated, cream should be applied in a layer about one 16th of an inch thick
what is Zovirax used for to treat herpes virus infection, including shingles and genital herpes, also chickenpox. it cannot cure herpes, but may prevent sores or blisters.
what class is Zovirax Antiviral
how do you apply Zovirax apply only enough cream to cover the cold sore tingly area.
what should you do if you notice Nevi (Moles) report any changes in:-color -size-texture*also report any bleeding or pruritus
what are the infectious organisms viralbacterialfungalparasitic
what is Herpes Simplex I -Viral infection -transmitted by direct contact-vesicle serous fluid -usually at corner of mouth, lips, or nose -painful -vesicle serous fluid -usually at corner of mouth,
what is Herpes Simplex II -transmitted usually by direct sexual contact -viral infection -cervix most common site in women, and the penis is most common site in men -flu like symptoms 3-4 days before outbreak
what is the treatment for Herpes Simplex -No cure -prevent spread; infection control and handwashing-warm compress-analgesicsantiviral medications; Acyclovir (Zovirax)
what is Herpes Zoster (shingles) -caused by same virus as chickenpox (varicella-zoster)-Viral infection -Lies dormant (inactive)-vesicles (blisters) appear along nerve pathway -risk factors: suppressed immunity, aging, infection, stress
symptoms of Herpes Zoster (shingles) -Pain; burning, knife-like -tenderness -pruritus -malaise (general feeling of discomfort)-can be fatal
treatment of Herpes Zoster (shingles) -steroids (corticosteroids)-Acyclovir (Zovirax); therapeutic response=reduction in pain-Medicated baths -diet high in Vitamin C; promotes healing
what are chickenpox -same lesions as Herpes Zosters except can be all over the body -return to school when lesions are crusted over -Viral infection
what are Verruca (warts) -Nipple-like growth -Viral infection -rough edges -singly or in groups -thought to be contagious
what is Impetigo -Bacterial infection -staph or strep -Honey-colored, crusted lesions, dried exudate with smooth red skin -pruritis
what are some other bacterial infections -Furuncles (boil) -Folliculitis= infection of hair follicle -Carbuncles= cluster of boils -Cellulitis= infection of the cells -Felon= infection around fingernail-Paronychia= Ingrown nails
what are the interventions for bacterial infections -warm soaks; speeds process of suppuration (drainage) -I&D (incision and drainage) -pain (assess and treat) -prevent spread -antibiotics -emollients (moisturizer)= helps with itching, burning, painful skin lesions
fungal infections -Tinea Capitis (ring worm)- head -Tinea Corporis (ring worm)- body-Tinea Cruris (jock itch)- groin -Tinea Pedis (athlete's foot)- feet-Candidiasis- Candidiasis Albicans (yeast infection); appearance= whits patches, medication= Nystatin prevents fungus from growing
what are intervention for fungal infections -keep involved area clean and dry -loose fitting clothes -warm compresses-medications; over-the-counter Anti-fungals= Micatin (miconazole nitrate), Lotrimin all topical treatments.-intense itching with fungal infections= increased risk for infecti
Parasitic infestations Pediculosis (Lice); Capitis (head)
How does the skin protect the body sensory receptors within the skin recieve information about the environment. messages about the heat, cold, pressure, and touch are received and relayed to the central nervous system for interpretation.
Med Surg integ.

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