skin chapter 56 review based off goodnotes

A comprehensive set of flashcards covering skin anatomy, function, assessment, common lesions and aging changes, diagnostic tests, wound care, and dermatologic therapies based on the provided notes.

What is the outermost layer of the skin?

The epidermis.

What pigment do epidermal cells produce that helps determine skin color?

Melanin.

What stimulates melanin production in the skin?

Strong ultraviolet light such as sunlight.

What is the dermis and what does it contain?

The dermis is strong connective tissue that contains nerve endings, sweat glands, and hair roots.

What tissue lies beneath the dermis?

Subcutaneous tissue.

Around the hair follicles, which glands secrete sebum?

Sebaceous glands.

What do sweat glands secrete?

Water (sweat) containing salts, ammonia, amino acids, ascorbic acid, uric acid, and urea.

List the functions of the skin.

Protection, body temperature regulation, secretion, sensation, and synthesis of vitamin D.

How does the skin protect underlying tissue besides physical shielding?

Langerhans cells initiate an immune response when foreign substances invade the epidermis.

How is body temperature regulated by the skin?

Vasodilation to dissipate heat, vasoconstriction to retain heat, and sweating to cool the body.

What secretions are produced by the skin?

Sweat and sebum.

What happens when sensory receptors in the skin are stimulated?

Nerves convey messages to the brain for interpretation.

What are common reasons a patient might seek health care for skin issues?

Pruritus (itching) and skin color changes.

What is another name for a mole?

Nevi.

What is capillary refill time considered normal?

3 to 5 seconds.

What data are collected by palpating the skin?

Temperature, moisture, texture, thickness, edema, mobility, and turgor.

Which vitamin is essential for healthy skin and what are its food sources?

Vitamin A; sources include liver, avocado, pumpkin, sweet potato, carrots, spinach, broccoli, cantaloupe, and apricots.

What hair and scalp features are assessed during an exam?

Hair: color, oiliness, texture, distribution. Scalp: scaliness and lesions.

What nail features are evaluated during an exam?

Shape, color of the nail bed, contour, blanching with pressure, capillary refill, and angle at the nail base.

What is the Nevi assessment description mentioned?

Nevi are moles; palpated for tenderness and measured in centimeters.

Define macule.

Distinct flat area with color different from surrounding tissue.

Define patch as described in the notes.

Macule less than 1 cm.

Define papule.

Any raised, solid lesion with clearly defined margins less than 1 cm.

Define vesicle.

Raised, fluid-filled cavity less than 1 cm in diameter.

Define pustule.

Raised, well defined cavity that contains pus.

Define plaque.

Combined papules that form a raised area greater than 1 cm in diameter.

Define nodule.

Raised solid lesion greater than 1 cm in diameter that may be hard or soft and may extend deeper into the dermis than a papule.

Define wheal.

Superficial, irregular swelling caused by fluid accumulation.

Define tumor.

Firm or soft lesion that extends deeper into the dermis.

Define bulla.

Thin-walled, fluid-filled chamber greater than 1 cm in diameter.

Define crust.

Thick dried exudate remaining after vesicle ruptures.

Define scale.

Dry or greasy skin flakes.

Define fissure.

Distinct linear crack extending into the dermis.

Define erosion.

Shallow superficial depression.

Define ulcer.

Depression deeper than erosion and may bleed.

Define excoriation.

Abrasion caused by scratching.

Define nevus.

Another name for mole; flat or raised with color darker than surrounding tissue.

Define cyst.

Fluid-filled cavity in the dermis or subcutaneous tissue.

What aging changes occur in the skin? (list key points)

Thinning of skin layers and degeneration of elastin fibers (wrinkling); decrease in size and number of sweat glands; decrease in production of sebum by sebaceous glands; dryness and pruritus; decrease in melanin production (palor); development of liver spots (lentigines); senile purpura; senile angiomas; seborrheic keratoses; acrochordons (skin tags).

What are lentigines and what are they also called?

Pigmented spots called liver spots (lentigines).

Name some senile skin changes.

Senile purpura (large bruises from minor trauma), senile angiomas (bright red papules), seborrheic keratoses (waxy raised lesions), acrochordon/skin tags.

What diagnostic tests are used to diagnose fungal infections of the skin, hair, or nails?

Potassium hydroxide (KOH) examination.

What test is used to diagnose viral skin infections?

Tzanck test.

What test detects scabies?

Scabies scraping.

What is Woods light examination used for?

Assess pigmentation changes and superficial skin infections; may reveal traces of saliva or semen in vulvar exam after sexual assault.

What is patch testing used for?

To identify allergens; irritants applied to skin, covered, and later examined for allergic reaction.

Describe shave, punch, incisional, and excisional biopsies.

Shave biopsy: not deeper than the dermis; Punch biopsy: circular tool around lesion; Incisional biopsy: wedge of tissue removed; Excisional biopsy: entire lesion removed.

What are the four main types of dressings and their purposes?

Dry dressings protect wounds and absorb drainage; Wet dressings decrease inflammation, soften crust, and promote tissue granulation; Absorptive dressings promote removal of excess exudate (useful with necrotic tissue); Occlusive dressings protect wounds and maintain moisture to promote healing.

What is a wound VAC (negative pressure wound therapy) and its purpose?

A system that applies negative pressure to promote healing of wounds, including traumatic wounds, dehisced surgical wounds, skin grafts, pressure injuries, and chronic ulcers.

Outline the basic steps to apply a wound VAC.

1) Clean the wound with normal saline; 2) Apply skin preparation around the wound; 3) Fill the wound with a sponge; 4) Apply a transparent dressing over the sponge and around the tubing to create an airtight seal; 5) Connect tubing to suction at prescribed negative pressure; 6) Attach a suction canister to collect drainage; 7) If pain is distressing, notify wound care and administer analgesic about 1 hour before the procedure.

What is phototherapy and what conditions is it used to treat?

Use of light with photosensitive drugs to promote shedding of the epidermis; used for psoriasis, vitiligo, and chronic eczema.

What are contraindications for phototherapy?

Herpes simplex infection, a history of skin cancer, cataracts, and lupus erythematosus.

What is phototherapy with psoralen (PUVA) used for and what precautions are advised?

Used to treat vitiligo, psoriasis, and cutaneous T-cell lymphoma; patients should wear sunscreen, protective clothing, and dark glasses for 8 hours before and after treatment to reduce UV exposure.

What is the Goeckerman regimen?

A type of phototherapy for psoriasis and atopic dermatitis: tar emulsion bath followed by topical tar and UV exposure.

What are keratolytics and give examples?

Agents that dissolve keratin and slow bacterial growth; examples include benzoyl peroxide, salicylic acid, sulfur, coal tar.

What are common side effects of keratolytics?

Excessive dryness, irritation, scaling, edema, photosensitivity.

Name some oral antibiotics used for acne and a key nursing consideration.

Doxycycline, minocycline, tetracycline, erythromycin; nursing: assess allergies and instruct to wear sunscreen due to UV sensitivity.

What is Silvadene used for and what are potential side effects?

Bactericidal used to prevent and treat wound infection in serious burns; side effects include rash, pruritus, burning, and pain.

What is Polysporin and what is it used for?

Topical antibacterial; used to destroy microorganisms and treat skin infections and some first-degree burns; side effects include contact dermatitis, itching, burning, and rare anaphylaxis.

Name some topical antifungals listed and their general use.

Nystatin, mycostatin, mycelex, oxistat, naftin, lamisil; used to treat fungal infections; side effects include irritation, erythema, burning, rash, abdominal cramps.

What are common adverse effects of oral antifungals?

Hepatotoxicity, headache, diarrhea, GI distress.

What are the main topical anti-inflammatory agents listed?

Hydrocortisone, triamcinolone, fluocinolone; used to reduce inflammation in various skin disorders.

What is isotretinoin (Accutane) used for and its major cautions?

A vitamin A derivative used to treat severe acne by reducing sebum production and shrinking sebaceous glands; major fetal deformities are a key risk; common side effects include stinging, erythema, scaling; monitoring includes pregnancy testing and contraception.

What pregnancy-related precautions are required with isotretinoin therapy?

Two negative serum pregnancy tests before starting therapy; two reliable forms of contraception must be used simultaneously starting one month before therapy and continuing after therapy.

What nursing interventions are important when providing isotretinoin treatment?

Do not apply to eyes, mouth, or nasal angles; limit sun exposure when dryness is heavy; monitor for GI symptoms; ensure pregnancy testing and contraception compliance; educate about potential fetal risks.