4B - SHERPATH - CHAP. 43 - care of the pt with a integumentary disorder - 10/7/22

melanocytes

- Another layer in the epidermis contains highly specialized cells called ___________ - these cells give rise to the pigment _______, a black or dark brown pigment occurring naturally in the hair, the skin, and iris and choroid of the eye

Sepsis meningitis lymphangitis

Complications from cellulitis include ______, __________, and ____________.

benzoyl peroxide

Treatments for Acne Vulgaris 1. _______ ________ - application : washes and soaps - effect : antimicrobial and reduces inflammation

retinoid

Treatments for Acne Vulgaris 1. ________ therapies (tretinoin, adapalene, tazarotene) - application : Primarily topical for entire affected area - effect : reduces inflammation - adverse effects a. Redness, burning, and sensitivity to sunlight b. Do not combine with OTC washes and medications

Isotretinoin

Treatments for Acne Vulgaris 1. ____________ - application : oral - effect : Reduces sebum production and abnormal keratinization of gland ducts - adverse effects : destructive effect on fetal development and depression - comments Assess for: • Changes in behavior • Hepatotoxicity • Pregnancy prior to starting medication

herpes simplex virus

VIRAL DISORDERS OF THE SKIN 1. ______ _______ _____ (HSV) - causes cold sores and genital herpes. - it's one of the most common skin infections - genital herpes affects an estimated 1 in 6 adults between the ages of 14 and 49 yrs - 2 types : type 1 and type 2 - may have severe consequences in pregnancy : miscarriage and premature delivery have been linked to ______ _______ _____ - has no cure

Pityriasis Rosea

VIRAL DISORDERS OF THE SKIN 1. __________ _____ s a skin rash that may affect people of any age but is noted most often in young adults. - It is not known what causes the rash, but it is thought to be linked to a viral infection. - it's not considered to be contagious - caused by a virus, but it isn't clear which virus - Some studies indicate it may be linked to certain strains of the herpesvirus, but not the type 1 herpesvirus - The rash generally disappears without treatment within 4 to 8 weeks - begins as a single lesion referred to as a herald patch, a scaly area up to 4 inches in diameter (10 cm) with a raised border and a pink center that resembles ringworm (a fungal infection) - usually requires no treatment, but preventive interventions can control secondary infections related to pruritus

asymmetric borders color diameter elevated evolving

When assessing growths or changes in a mole, ask the following questions, using the mnemonic device ABCDE: is the Mole A__________? are the B______ irregular? is the C____ uneven or irregular? has the D_______ of the growth changed recently? has the surface area become E_______ or is it E_______?

hair

____ is composed of modified dead epidermal tissue, mainly keratin. - It is distributed all over the body in varying amounts - the root of the ___ is enclosed in a follicle deep in the dermis - the shaft of the ____ protrudes from the skin

nails

_____ also are composed mainly of keratin, but the keratin is more compressed - the base of the ____, the root, is made up of living cells and is covered mostly by the cuticle - Part of the root, the lunula, is exposed and looks like a white crescent

wheals

______ : round elevation of the skin; white in the center with a pale red periphery - the increased histamine causes the capillaries to dilate, resulting in increasing permeability - respiratory involvement may occur

comedo

______ blackhead - it's dark because of the effect oxygen has on sebum, not because of the presence of dirt

fungal

______ infections, which are known as dermatophytoses, which are superficial infections of the skin - The most common types are tinea capitis, tinea corporis, tinea cruris, and tinea pedis.

macules

_______ : small, flat blemishes flush with the skin surface

papules

_______ : small, raised, solid skin lesions less than 1 cm in diameter

vesicle

_______ circumscribed elevation of skin filled with serous fluid; smaller than 0.5 cm

keratin

_______, a fibrous water-repellent protein found in skin, is tough and protects the skin from excessive fluid loss - It also helps the skin resist injury and prevents the entry of harmful substances.

melanin

_______, another skin protein, forms a protective shield that guards the keratinocytes and nerve endings from ultraviolet light. - responsible for the skin's color - _______ levels are determined genetically. Although skin color is inherited, exposure to the sun and other factors can influence skin color

pruritus

________ : itching

pruritus

________ is the primary symptom in all types of dermatitis - Calamine lotion, a common over-the-counter medication, is used to reduce itching.

pustulant vesicles

_________ ________ : small, circumscribed elevations of the skin that contain pus

synthesis

_________ occurs with very limited periods of exposure

suppuration

___________ : production of purulent material

excoriation

___________ injury to the surface layer of skin caused by scratching or abrasion

*

nursing interventions - Nursing interventions for patients with pressure injuries include ongoing assessment and evaluation of improvement. - Assessment data include the size and the depth of the injury, the amount and color of any exudate, the presence of pain or odor, and the color of the exposed tissue - Healing is a long-term process; therefore, make sure the plan of care is consistent over time and evaluate it for effectiveness.

cyst

primary skin lesions - ____ : Elevated, circumscribed, encapsulated lesion; in dermis or subcutaneous layer; filled with liquid or semisolid material a. sebaceous cyst, cystic acne b. examples : sebaceous cyst

scar

primary skin lesions - ____ : Thin to thick fibrous tissue that replaces normal skin after injury or laceration to the dermis a. healed wound or surgical incision b. example : incisional scar

crust

primary skin lesions - _____ : Dried serum, blood, or purulent exudate; slightly elevated; size varies: brown, red, black, or tan a. scab on abrasion. eczema b. examples : scab

tumor

primary skin lesions - _____ : Elevated and solid lesion; may or may not be clearly demarcated; deeper in dermis; >2 cm in diameter a. Neoplasms, benign tumor, lipoma, hemangioma b. examples : hemangioma

wheal

primary skin lesions - _____ : Elevated, irregularly shaped area of cutaneous edema; solid, transient; variable diameter a. Insect bites, urticaria, allergic reaction b. examples : wheal

patch

primary skin lesions - _____ : Flat, nonpalpable, irregularly shaped macule; >1 cm in diamete a. Vitiligo, port-wine stains, mongolian spots, café-au-lait spots b. examples : vitiligo

scale

primary skin lesions - _____ : Heaped-up keratinized cells; flaky skin; irregular; thick or thin; dry or oily; variation in size a. Flaking of skin with seborrheic dermatitis after scarlet fever, or flaking of skin after a drug reaction; dry skin b. example : fine scaling

ulcer

primary skin lesions - _____ : Loss of epidermis and dermis; concave; varies in size a. pressure sores, stasis ulcers b. examples : stasis ulcer

bulla

primary skin lesions - _____ : Vesicle >1 cm in diameter a. Blister, pemphigus vulgaris b. examples : blister

papule

primary skin lesions - ______ : Elevated, firm, circumscribed area; <1 cm in diameter a. Warts (verrucae), elevated moles, lichen planus b. examples : lichen planus

nodule

primary skin lesions - ______ : Elevated, firm, circumscribed lesion; deeper in dermis than a papule; 1-2 cm in diameter a. Erythema nodosum, lipomas b. examples : hypertrophic nodule

plaque

primary skin lesions - ______ : Elevated, firm, rough lesion with flat-topped surface; >1 cm in diameter a. Psoriasis, seborrheic keratosis, actinic keratosis b. examples : plaque

macule

primary skin lesions - ______ : Flat, circumscribed area that is changed in color; <1 cm in diameter a. Freckles, flat moles (nevi), petechiae, measles, scarlet fever c. examples : measles

keloid

primary skin lesions - ______ : Irregularly shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing a. keloid formation after surgery b. example : keloid

vesicle

primary skin lesions - _______ : Elevated, circumscribed, superficial, not into dermis; filled with serous fluid; <1 cm in diameter a. Varicella (chickenpox), herpes zoster (shingles) b. examples : vesicles caused by varicella

pustule

primary skin lesions - _______ : Elevated, superficial lesion; similar to a vesicle but filled with purulent fluid a. impetigo, acne b. examples : acne

fissure

primary skin lesions - _______ : Linear crack or break from the epidermis to the dermis; may be moist or dry a. athlete's foot, cracked at the corner of the mouth b. example : fissures

atrophy

primary skin lesions - _______ : Thinning of skin surface and loss of skin markings; skin translucent and paper-like a. striae, aged skin b. example : aged skin

erosion

primary skin lesions - _______ : loss of part of the epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla a. varicella, various after rupture b. example : erosion

excoriation

primary skin lesions - ___________ : Loss of the epidermis; linear hollowed-out crusted area a. abrasion or scratch, scabies b. examples : scabies

telangiectasia

primary skin lesions - ______________ : Fine, irregular red lines produced by capillary dilation a. telangiectasia in rosacea b. example : rosacea

lichenification

primary skin lesions - _______________ : Rough, thickened epidermis secondary to persistent rubbing, itching, or skin irritation; often involves flexor surface of extremity a. Chronic dermatitis b. example : Stasis dermatitis in an early stage

skin

1. By covering the body, the ____ protects the internal organs. - It works to maintain homeostasis by monitoring and adapting to changes in temperature and environmental conditions. - the ____ is subjected continuously to temperature variances, humidity, environmental changes, risk for exposure to pathogens, trauma, ecchymosis, and daily wear and tear - the ____ carries out numerous functions to protect and maintain the body - provides a barrier to many microorganisms in the environment. - aids in elimination of waste products, prevents dehydration, and serves as a reservoir for food and water - helps the body maintain a constant temperature under varying internal and external conditions a. It allows blood vessels near the surface to constrict when the environment is cold to preserve heat and allows them to dilate when it is hot to release excess body heat - consists of 2 primary layers : the outermost layer, called the epidermis and the innermost layer, called the dermis or corium a. beneath these layers of skin lies the subcutaneous layer, or superficial fascia

acyclovir

1. For HSV-1 outbreaks, over-the-counter topical treatments often are effective if used within the first 1 to 2 days of the outbreak. - Antiviral drugs such as _________—administered orally, topically, or intravenously—can shorten the out-break and lessen its severity - adverse reactions to _________ are usually mild and include headache, occasional nausea and vomiting, and diarrhea

dermatitis

1. Superficial infection of the skin is known as __________. - It can be caused by numerous agents, such as drugs, plants, chemicals, metals, and food - The nurse first observes erythema and edema, followed by the eruption of vesicles that rupture and encrust. - pruritus is always present, which promotes further skin excoriation

herpes zoster

1. ______ _____, commonly known was shingles, and chicken pox (varicella) are caused by the same virus : varicella-zoster virus (sometimes called human herpesvirus type 3). - A person with shingles has a history of chickenpox infection - The virus causes an inflammation of the spinal ganglia and produces skin lesions of small vesicles along the peripheral nerve fibers of the spinal ganglia - the pain associated with ______ ______ is severe; most pts describe it as burning and knifelike a. extreme tenderness and pruritus occur in the affected area b. the pt needs frequent analgesic therapy during the acute episode - usually not permanently disabling to a healthy adult. - The greatest risk is for a patient with a lowered resistance to infection, such as one receiving chemotherapy or large doses of prednisone - in a pt with a compromised immune system, the disease can be fatal

suspected deep tissue

1. _________ ____ ______ pressure injury - During this stage, the wound appears as a localized purple or maroon area of discolored intact skin or a blood-filled blister. - This is caused by underlying soft tissue damage from pressure or shear. - Characteristics of the area range from painful, firm, mushy, boggy, or warm to cool compared with adjacent tissue - in patients with dark skin tones, deep tissue injury is sometimes difficult to detect but often starts with a thin blister over a dark wound bed. - The wound sometimes becomes covered with thin eschar - even with prompt treatment, some wounds evolve rapidly, exposing additional layers of tissue

cholesterol D

1. ___________ compounds in the skin are converted to vitamin _ when bare skin is exposed to the sun's ultra-violet rays - Vitamin _ is necessary for healthy bone development - the sun is important for vitamin _ synthesis, prolonged exposure to the sun's rays, which include ultraviolet radiation, should be avoided due to the increased risk of developing skin cancer

integumentary

1. _____________ disorders may be acute or chronic - Recovery may be lengthy with little visible outward improvement. - A person's body image and self-esteem may be affected. Society's reaction to a skin condition has a significant effect on the patient - personal appearance is a primary concern to many individuals and others may think the condition is infectious and may isolate the pt socially - An _____________ disorder can have a negative effect on a patient's self-concept because of the value society places on a person's physical characteristics. - Assess the patient's coping abilities by using open-ended questions to encourage him or her to talk and ventilate feelings

*

1. assessment - herpes zoster - should include obtaining a thorough health history and performing a careful inspection to gather relevant data - Subjective data include (1) sharp, burning pain, usually on one side; (2) severe pruritus of the lesions; (3) general malaise; and (4) a history of chickenpox (varicella). - Objective data include (1) evidence of skin excoriation related to scratching, (2) patches of vesicles on erythematous skin following a peripheral nerve pathway, and (3) demonstration of tenderness to touch in the involved area

erythema pain tenderness

1. clinical manifestations of cellulitis - is an infection of the skin and underlying subcutaneous tissues - The affected areas become erythematous, edematous, tender, and warm to the touch. - Often a fever accompanies the other symptoms. The first signs and symptoms generally are ________, ____, and __________ over an area of skin a. These signs and symptoms are caused by the bacteria and by the body's attempts to halt the infection - Over time, the area of erythema spreads and small red spots may appear. - Erysipelas is one form of streptococcal cellulitis in which the skin is bright red and noticeably edematous, and the edges of the infected area are raised. 2. prognosis - Cure is possible with 7 to 10 days of treatment. Cellulitis may be more severe in people with chronic diseases and those who are susceptible to infection, such as those with immunosuppression.

acylclovir analgesics steroids

1. herpes zoster - medical management - Oral and intravenous _________, when administered early—ideally within 72 hours of onset of the development of symptoms—re-duces the pain and duration of the virus - __________ are given for the pain - ________ may be given to decrease inflammation and edema

*

1. objective data - for HSV-1 include an edematous, ery-thematous area on the face a. The most common location is the lips, but it may spread to the eyes. b. In HSV-2, the labia, vulva, or penis appears edematous and erythematous.

4

1. stage _ pressure injury : involves full-thickness tissue loss with exposed bone, tendon, cartilage, or muscle. - Sometimes slough or eschar is present on some parts of the wound bed. - the injury often includes undermining or tunneling - as with stage 3 pressure injuries stage _ pressure injuries vary in depth depending on their location - because these injuries extend into muscle and supporting structures, the patient is at risk for osteomyelitis.

3

1. stage _ pressure injury : involves full-thickness tissue loss, in which subcutaneous fat is sometimes visible, but bone, tendon, and muscle are not exposed - if slough is present, it does not obscure the depth of tissue loss - possible features are undermining and tunneling - the depth of a stage _ pressure injury varies depending on it anatomic location - on the bridge of the nose, the ear, the occiput, and the malleolus - all of which lack subcutaneous tissue - these injuries are shallow - extremely deep stage _ pressure injuries develop in areas with significant layers of deep adipose tissue

2

1. stage _ pressure injury : involves partial-thickness loss of dermis. - . It appears as a shallow open injury, usually shiny or dry, with a red-pink wound bed without slough or bruising - (Bruising raises the suspicion of deep tissue injury.) - Some stage _ injuries manifest as intact or open (ruptured) serum-filled blisters - don't use the term stage _ to describe skin tears, tape burns, perineal dermatitis, maceration, or excoriation

1

1. stage _ pressure injury : localized area of skin, typically over a bony prominence, that is intact with non-blanchable redness - Skin with darker tones may not have visible blanching, but its color is likely to differ from the surrounding area. - The wound characteristics vary: areas may be painful, firm, soft, warm, or cool compared with adjacent tissue. - This stage is typically difficult to detect in patients with dark skin tones.

dermis corium

1. the ______, or _____, often is called the true skin - it's well supplied with blood vessels and nerves and contains glands and hair follicles - varies in thickness throughout the body but tends to be thickest on the palms and soles - composed of connective tissue with cells scattered among collagen and elastic fibers. - receives strength from the collagen and flexibility from the elastic connective fibers. - The cells throughout this layer are bathed in tissue fluid, called interstitial fluid. - The skin wrinkles with the normal aging process, as the ______ loses some of its elastic connective fibers, and the subcutaneous tissue directly beneath it loses some of its adipose tissue.

epidermis

1. the _________ the outermost layer of the skin, is composed of stratified squamous epithelium - The cells of the _________ are packed tightly and have no distinct blood supply - the _________ is divided into layers, or strata: an outer, dead, cornified portion and a deep, living, cellular portion - the inner layer is called the stratum germinativum; it's the only layer of the ________ able to undergo cell division and reproduce a. It receives its blood supply and nutrition from the underlying dermis through a process called diffusion - By the time they reach the outermost epidermal layer, called the stratum corneum, they are flat, and the cell structure is filled with a protein called keratin a. keratin makes the cells dry, tough, and somewhat waterproof

skin

1. wound care - the ____ serves as the body's first defense - Impairments in the integument provide a portal for infection - Management of wounds and the prevention of their development are essential for health maintenance. - During wound care, the type and size of the wound primarily will determine the dressing and treatment plans

melanoma basal cell squamous cell

An important objective in skin assessment is to identify possible malignancies. The three most common are ________, _____ ____ carcinoma, and ________ ____ carcinoma.

unstageable

An unstageable pressure injury involves full-thickness tissue loss, a wound base covered by slough (yellow, tan, gray, green, or brown), and eschar in the wound bed that usually is tan, brown, or black - The true depth and stage of the injury cannot be determined until the base of the wound has been exposed - Stable eschar on the heels provides a natural biological cover. Do not remove it

felon

BACTERIAL DISORDERS OF THE SKIN 1. _____ : infection of the soft tissue under and around an area such as the fingernail. - the involved finger becomes erythematous, edematous, and tender to touch

impetigo contagiosa

BACTERIAL DISORDERS OF THE SKIN 1. ________ __________ : caused by S. aureus, streptococci, or a mixed bacterial invasion of the skin - it's highly contagious inflammatory disorder, seen at all ages but particularly common in children - these lesions start as macules, develop into pustulant vesicles - The exposed areas of the body most often affected are the face, hands, arms, and legs - The pustulant lesions are distributed randomly over the involved area. - the disease may be spread by touching personal articles, linens, and clothing of the infected person 2. subjective data : include symptoms of (1) pruritus, (2) pain, (3) malaise, (4) spread of the disease to other parts of the body, and (5) the presence of other diseases. 3. objective data : include all or some of the following: (1) erythema; (2) pruritic areas; (3) honey-colored crust over dried lesions; (4) smooth, red skin under the crust; (5) low-grade fever; (6) leukocytosis; (7) positive culture for Streptococcus or S. aureus; and (8) purulent exudate

furuncle

BACTERIAL DISORDERS OF THE SKIN 1. _________ (boil) : inflammation that begins deep in the hair follicles and spreads to the surrounding skin - Irritation is a common predisposing factor. - Common locations are the posterior area of the neck, the forearm, buttocks, and the axillae

carbuncle

BACTERIAL DISORDERS OF THE SKIN 1. _________ : cluster of furuncles - it's an infection of several hair follicles that spreads to surrounding tissue - Obesity, poor nutrition, untreated diabetes mellitus, and poor hygiene contribute to the formation of __________. - can have 4 or 6 cores with spontaneous rupture of the core a. the pain stops immediately on rupture

cellulitis

BACTERIAL DISORDERS OF THE SKIN 1. __________ : a potentially serious infection, involves the underlying tissues of the skin - Although it is not contagious, the bacteria that cause __________ can be spread by direct contact with an open area on a person who has an infection - The most common causes in adults are group A streptococci and Staphylococcus aureus; Haemophilus influenzae type B is more common in children. - the risk is increased by venous insufficiency or stasis; diabetes mellitus; lymphedema; surgery; malnutrition; substance abuse; the presence of another infection; compromised immune function resulting from HIV; treatment with steroids or cancer chemotherapy; or autoimmune diseases, such as lupus erythematosus - develops as an edematous, erythematous area of skin that feels hot and tender a. occurs when bacteria enter the body through a break in the skin, such as a cut, scratch, or insect bite that is not cleansed with soap and water. b. The infection usually affects skin on the lower extremities or face, although cellulitis can occur on any part of the skin c. the infection is usually superficial, but __________ may spread and become life threatening as the infection invades the deeper tissues, lymph nodes, and bloodstream

folliculitis

BACTERIAL DISORDERS OF THE SKIN 1. ____________ : is an infection of a hair follicle, generally by S. aureus bacteria. - The infection may involve one or several follicles. It often occurs after men or women shave. A stye resulting from an infected eyelash is an example of ____________.

tinea pedis

FUNGAL INFECTIONS OF THE SKIN 1. _____ _____ : is the most common of all fungal infections - Commonly known as athlete's foot, it occurs between the toes of people whose feet perspire heavily. - The fungus also can be spread from contaminated public bathroom facilities and swimming pools - produces more skin maceration than the others. - Commonly seen are fissures and vesicles around and below the toes, with occasional discoloration of the infected area. - fissures between the toes and soft skin are accompanied by vesicular lesions and thick toenails.

tinea cruris

FUNGAL INFECTIONS OF THE SKIN 1. _____ ______ : is known as jock itch - it's found in the groin area - has brownish red lesions that migrate out from the groin area. - Pruritus and skin excoriation from scratching are found. - the groin area reveals brown to red lesions that radiate outward, with skin excoriation from intense scratching.

tinea capitis

FUNGAL INFECTIONS OF THE SKIN 1. _____ _______ : is known commonly as ringworm of the scalp - usually an erythematous, round lesion with pustules around the edges. Temporary alopecia occurs at the site, and infected hairs turn blue-green under a Wood's lamp (an ultraviolet light). - Collection of objective data for _____ _______ includes an inspection and location of a round, scaled lesion that has pustules around the edges of the scalp. The involved area is erythematous and has no hair.

tinea corporis

FUNGAL INFECTIONS OF THE SKIN 1. _____ ________ : is inwon as the ringworm of the body - it occurs on parts of the body with little or no hair - produces flat lesions that are clear in the center with erythematous borders. Scaliness also occurs, and pruritus is severe - the lesions are flat with clear centers and erythematous borders on nonhairy body parts.

acne vulgaris

INFLAMMATORY DISORDERS OF THE SKIN 1. ____ ________ : is an inflammatory papulopustular skin eruption that involves the sebaceous glands; it occurs primarily in adolescents. - The exact cause is unknown. Factors that may contribute to the condition include stress, hormone fluctuations, medications, diet, oil production, dead skin cells, clogged pores, and bacteria - develops when the oil glands become occluded. - At puberty, androgens are secreted, increasing the size of the oil glands and causing the sebum to combine more readily with epithelial cells and bacteria. - Sebum then may occlude a hair follicle, forming a comedo

eczema

INFLAMMATORY DISORDERS OF THE SKIN 1. ______ : ATOPIC DERMATITIS - chronic inflammatory disorder of the integument. - It usually is diagnosed in children, but exacerbations often continue into adulthood - There are associations with allergies to chocolate, wheat, eggs, and orange juice. - The allergen causes histamine to be released, and an antigen-antibody reaction occurs. 2. subjective data : include complaints of pruritus and scratching. - Children are generally fussy and irritable, and anorexia is common. The skin is sensitive to touch. A family history of allergies and asthma supports the findings in many cases. 3. objective data : vesicles and papules found on the scalp, forehead, cheeks, neck, and surfaces of the extremities. - The involved area is erythematous and dry. Tiny cracks in the epithelium allow fluid to escape and further promote dryness. The primary signs result from the scratching in response to pruritus. Scales accompanied by dryness in the involved area are a dis-tinguishing characteristic of eczema.

contact dermatitis

INFLAMMATORY DISORDERS OF THE SKIN 1. _______ __________ : caused by direct contact with agents in the environment to which the individual is hypersensitive. - the epidermis becomes inflamed and damaged by repeated contact with the physical and chemical irritants - Common causes of dermatitis are detergents, soaps, industrial chemicals, and plants such as poison ivy

urticaria

INFLAMMATORY DISORDERS OF THE SKIN 1. _________ : presence of wheals or hives in an allergic reaction, commonly caused by drugs, food, insect bites, inhalants, emotional stress, or exposure to heat or cold - _________, or hives, is caused by the release of histamine in an antigen-anti-body reaction 2. subjective data include pt complaints of pruritus, edema, a burning pain, and sometimes dyspnea 3. collection of objective data identifies transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers - intense scratching may be seen, and in some cases, respiration may be compromised 4. Administering an antihistamine—and sometimes epinephrine—provides relief from _________. Identification of the cause of the _________ is important to prevent recurrence.

angioedema

INFLAMMATORY DISORDERS OF THE SKIN 1. __________ : form of urticaria and is caused by the same offenders - it occurs in the subcutaneous tissue, whereas urticaria is a lesion of the skin and mucous membranes. - characterized by local edema of an entire area, such as an eyelid, hands, feet, tongue, larynx, gastrointestinal (GI) tract, genitalia, or lips. - only a single edematous area usually appears at 1 time 2. subjective data : symptoms of burning, pruritus, acute pain (if in the GI tract), or respiratory dis-tress (if in the larynx) 3. objective data : reveals edema (swelling); overlying skin appears normal. 4. Treatment to relieve __________ may include antihistamine drugs such as diphenhydramine.

dermatitis venenata

INFLAMMATORY DISORDERS OF THE SKIN 1. __________ ________ results from contact with certain plants, commonly poison ivy and poison oak - The signs and symptoms include mild to severe erythema with pruritus. - Initial exposure causes the body to form sensitizing antigens, resulting in an immunologic change in certain lymphocytes - instruct the patient to wash the affected part immediately after contact with the offending allergen. after the lesions appear, only cool, open, wet dressings should be used

Dermatitis Medicamentosa

INFLAMMATORY DISORDERS OF THE SKIN 1. __________ _____________ : occurs when people are given a medication to which they are hypersensitive. - An individual may present with a skin reaction to a medication that was taken in the past without incident. Any drug can cause a reaction, but the common agents are penicillin, codeine, and cephalosporins - identifying the drug and discontinuing its use are paramount

exfoliative dermatitis

INFLAMMATORY DISORDERS OF THE SKIN 1. ___________ __________ : can be caused by the ingestion of certain heavy metals, such as arsenic or mercury, or by antibiotics, aspirin, codeine, gold, or iodine - The skin sloughs off, and the area becomes edematous and erythematous - If severe pruritus with fever occurs, the patient may require hospitalization. - Treatment is individualized. If the cause can be determined, the source should be removed or treated appropriately.

papillae

Located in the upper portion of the dermis are small finger-like projections called ________ that project into the lower epidermal layer - Without the dermal ________, the epidermal layer would be unable to survive.

provocative palliative quality quantity region severity time

PQRST - helpful mnemonic for assessing the chief complaints - P__________ and P_________ factors (factors that cause the condition) - Q______ and Q_______ (characteristics and size of the skin problem) - R_____ of the body - S_______ of the signs and symptoms - T___ (length of time the patient has had the disorder)

pressure injury

The NPIAP has determined that the term ________ ______ more accurately describes injuries to intact and ulcerated skin, especially because previously stage 1 was referred to as a pressure injury and the remaining stages were referred to as ulcers - ________ ______ are responsible for many hospitalizations and health care - related expenses, in addition to pain and suffering of pts - immediate action is required to ensure that the wound receives proper care and doesn't increase in size and develop additional complications

ecchymosis

bruising

arrestor pili piloerection

surrounding the hair follicle is a band of muscle tissue called ________ ____ - A sensation of cold or fear causes these muscles to contract, making the hair stand upright and dimpling the skin surrounding it. - the effect is called ____________, "gooseflesh," or "goosebumps"

skin integument

the ____, or ___________, is a major organ and the outer covering of the body, making it essential to life. - Together with its appendages—hair, nails, and special glands—it makes up the integumentary system.

stratum germinativum

the _______ ____________ provides a constant new supply of cells for the upper layer and enables the skin to repair itself after injury - As these cells push their way to the surface, their internal structures are destroyed, and the cells die

sebaceous sebum

the _________ (oil) glands secrete _____ (1) (an oily secretion) through the hair follicles distributed on the body. - Their function is to lubricate the skin and hair that covers the body - _____ (1) also inhibits bacterial growth

ceruminous cerumen

the __________ glands are modified sudoriferous glands. - They secrete a waxlike substance called _______ (1) and are located in the external ear canal - _______ (1) is thought to protect the canal from foreign body invasion. - however, too much _______ (1), causing impaction in the ear canal, can cause difficulty with hearing and can make the ear canal a breeding ground for infection.

sudoriferous

the ____________ (sweat) glands are coiled, tubelike structures located in the dermal and subcutaneous layers - The tubes open into pores on the skin surface. - These glands excrete sweat, which cools the body's surface - Sweat is composed of water, salts, urea, uric acid, ammonia, sugar, lactic acid, and ascorbic acid.

subcutaneous superficial fascia

the ____________ layer, sometimes called the __________ ______, is the layer of tissue directly beneath the dermis. - the ___________ layer connects the skin to the muscle surface. a. This layer is composed of adipose tissue and loose connective tissue - it serves several important functions, including (1) storing water and fat, (2) insulating the body, (3) protecting the organs beneath it, and (4) providing a pathway for nerves and blood vessels. - The distribution of subcutaneous tissue throughout the body provides shape and contour. - woman's body usually contains more subcutaneous tissue than a man's; thus, her body is softer and appears more rounded.

nail body

the remainder of the nail is called the ____ ____ - it appears pink because of the blood vessels lying immediately beneath it

1

type _ (HSV-1) : is the most common - It causes cold sores, often referred to as fever blisters, and usually is associated with febrile conditions - The infection is generally self-limiting, that is, it usually clears up by itself, requiring no treatment. - associated with oral lesions, but it may manifest anywhere on the body, including the perineal and genital regions - characterized by a vesicle at the corner of the mouth, on the lips, or on the nose. - healing time is 10 to 14 dats without treatment

2

type _ (HSV-2) : causes lesions in the genital area known as genital herpes - is also a member of the herpesvirus family, as HSV-1 - primary mode of transmission for type _ is through sexual contact - Lesions appear 2 days to 2 weeks after exposure - lesions are usually present for 2 to 3 weeks and are most painful during the first week - Complications may be severe if the disease spreads to other body areas. - most commonly found in the genital region - may present in facial or other areas of the body. - produces various types of vesicles that rupture and encrust, causing ulcerations a. The cervix is the most common site in women, and the penis is the most common area in men - lesions are usually present for 7 to 14 days a. after outbreaks, the virus goes dormant