Term
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Definition
•Chronic skin disorder of middle-aged and older
•Blushing to dark red erythema
•Telangiectatic vessels
•Inflammatory pustules and papules
•Butterfly rash on cheeks and bridge of nose plus forehead and chin |
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Term
| Rosacea describe the butterfly rash |
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Definition
| cheeks and bridge of nose plus forehead and chin |
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Term
| Two different diseases causes red rashes on the face, do you know the difference? |
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Definition
•Lupus on cheeks and bridge of nose
•Rosacea on cheeks and bridge of nose plus forehead and chin |
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Term
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Definition
-3-day or German measles
-Diffuse, punctate, macular rash begins on trunk and spreads to arms/legs, mild fever, postauricular suboccipital and cervical lymph node adenopathy common with cold like symptoms
-Transmission to pregnant women-cataracts, microcephaly, mental retardation, deafness, PDA |
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Term
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Definition
•dysplastic nevi have capacity to ***transform to malignant melanoma***
-larger, flat, raised plaque with pebbly surface or a target-like lesion with a darker raised center and irregular border;
-***occur on both sun-exposed and covered areas*** |
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Term
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Definition
•Cancers arising from melanocytes
-rapidly progressing, metastatic form of cancer;
-5 year survival has improved to 90% |
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Term
Malignant Melanoma
Description of lesion |
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Definition
•Asymmetry
•Border irregularity
•Color variegation
•Diameter > 0.6 cm
•Evolving change over time |
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Term
Malignant Melanoma
Prognosis |
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Definition
| depends on tumor thickness, anatomic site, type of lesion and levels of invasion |
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Term
Malignant Melanoma
6 Risk factors |
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Definition
-Family history of melanoma
-Blond or red hair
-Presence of marked freckling on upper back
-History of three or more blistering sunburns before 20
-History of 3 or more years of an outdoor job as a teenager
-Presence of actinic keratosis
-Persons with 3 of these risks have a 20-fold increase |
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Term
Stages of Pressure ulcers
Friction |
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Definition
| to damages dermis/epidermis interface, *tissue damage* |
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Term
Stages of Pressure ulcers
Shear |
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Definition
| - to *bends blood vessels*, obstructs blood flow, ischemia to skin, *tissue damage*. |
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Term
Stages of Pressure ulcers
External pressure |
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Definition
| - to obstruct blood flow, ischemia to skin, *tissue damage* |
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Term
Stages of Pressure ulcers
Stage 1 & signs |
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Definition
•characterized by a defined area of persistent redness in lightly pigmented skin or an area of persistent redness with blue or purple hues in darker pigmented skin. Ex; sit with legs crossed and the red mark on leg. Darker skin feel for temperature of skin.
Signs
•Nonblanchable erythema of intact skin, the heralding lesion of skin ulceration. In individuals with darker skin, discoloration of the skin, warmth, edema, induration,or hardness may also be indicators. Hard to stop from this stage. Meaure and document |
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Term
Stages of Pressure ulcers
Stage 2 & signs |
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Definition
•represent a partial thickness loss of skin involving epidermis or dermis or both. Appears as abrasion, blister or shallow crater
Signs
•Minimal depth.
•No real crater.
•Does NOT include slough, eschar, tunnels or undermining. |
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Term
Stages of Pressure ulcers
Stage 3 & signs |
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Definition
•represents a full-thickness skin loss involving damage and necrosis of subcutaneous tissue –deep crater
Signs-
•Often wounds of older patients are more shallow as age causes thinning of the tissue layers and loss of subcutaneous fat tissue. |
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Term
Stages of Pressure ulcers
Stage 4 & signs |
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Definition
•involve full-thickness skin loss and necrosis with extensive destruction of damage to underlying tissues.
Signs-
•Full-thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures. Undermining and sinus tracts may also be associated with Stage IV pressure ulcers. |
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Term
BURNS
Superficial partial thickness
(first-degree) |
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Definition
SUNBURN
-outer layers of epidermis=heals on own. Little blister start of 2nd degree |
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Term
BURNS
Partial thickness (second-degree) |
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Definition
CURLING IRON
-epidermis and dermis=past superficial layers of skin
-Structures that originate in the subcutaneous layer such as hair follicles and sweat glands remain intact. Pain sensors remain intact.=hurts a lot! |
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Term
BURNS
Full thickness burns (third-degree) |
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Definition
-Extends into subcutaneous tissue=destroyed all levels (epidermis, dermis & Subcutaneous layers, will need a skin graft) Pain receptors are destroyed, but will have pain in areas of 1st and 2nd degree burns.
•May damage muscle, bone, blood vessels |
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Term
BURNS
Full thickness burn affects what skin layers? |
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Definition
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Term
BURNS
First Priority Airway Assessment & Management |
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Definition
•Stop the burning process
-Airway always 1st
•Ensure patent airway
•Carbon monoxide-provide high FIO2
•Upper airway damage
•Circumferential burns of thorax
•Then move onto fluid resuscitation, pain, and wound management |
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Term
BURNS
First priority to take care of a major burn? |
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Definition
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Term
BURNS
Nursing Care -Physical Assessment
Determine Severity of the Burn |
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Definition
•Based on depth, extent, and location
•Age, pre-existing health status, presence of other injuries, and mechanism of injury |
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Term
BURNS
Pathophysiology - Plasma Loss and Other Vascular Responses |
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Definition
•Increased capillary permeability
–Decreased colloid osmotic pressure
–Plasma loss leads to ***hypovolemia*** =biggest problem Too much blood volume in the body. Give tones of fluids to restore volume. “Tank” not Full, no pressors.
•Rate of fluid loss from intravascular spaces depends on:
–Age
–Burn size and depth
–Intravascular pressures(measure BP, central venous pressure)
–Time elapsed since the burn |
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Term
Complications of Burns
How does a major burn impact other organ systems? |
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Definition
-Hemodynamic Instability=hypovalemic
-Respiratory system dysfunction
-***Hypermetabolic*** response
-Renal insufficiency
-Gastric ulceration=stress or curlig ulcer. TEST: curling ulcer is caused by stress
-Sepsis=septic shock /Distributive shock
-Systemic infection |
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Term
T/F?
Hypermetabolic response is a complicatons of burns? |
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Definition
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Term
| Premalignant skin lesion in elderly |
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Definition
•Actinic (solar) damage
–Seborrheic keratosis
–Keratoses: premalignant lesions Ex; Jerry’s spot on side of head
–Lentigines: liver spots
•Most common premalignant skin lesion to develop on sun-exposed areas;
•< 1cm, dry, brown scaly with reddish tinge, usually multiple |
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Term
Papulosquamous Dermatoses
Psoriasis
Characteristics of psoriasis. What lesions are present? |
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Definition
| •Autoimmune, Red, thickened plaques with scaling and papules. |
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Term
Papulosquamous Dermatoses
Psoriasis
Pathophysiology |
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Definition
On left side
Activated T cells
Growth factors
keratinocytes & blood vessels grow
create papule
On right side
Activated T cells
attract neutrophils & monocytes
enter the papules
create inflammation |
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Term
| Drug-Induced Skin Eruptions |
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Definition
-Erythema multiforme
-Occurs after herpes simplex; self-limiting |
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Term
Can drugs cause dangerous skin eruptions? Yes Describe? Name condition
Stevens-Johnson syndrome=fatal disease |
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Definition
-Stevens-Johnson syndrome=fatal disease
-Skin detaches from body surface; <10% of body affected
-Lesions are similar-round erythematous papule resembling insect bite; “target or iris” |
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Term
| Toxic epidermal necrolysis |
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Definition
->30% of epidermis detaches=more of body surface affected.
-30%–35% mortality rate
Sulfonamides, nonsteroidal anti-inflammatory drugs and anticonvulsants such as DILANTIN (phenytoin) |
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