NSG 219, Exam 3, Integumentary | 100 expert curated questions and answers 2025 | A+ Graded | Guaranteed Pass

describe proper skin assessment

talk and assess at same time. is there any damage? lesions? bruising? scars? younger people will have thicker skin than older people. touch skin if allowed. is it hot or cold? hows their skin tugor? is it moist? look at their feet

functions of the skin

protection, homeostasis (water balance), temperature regulation, vitamin synthesis, psychosocial- scars or burns may affect how pt feels

describe gerontologic considerations for skin

skin thinning cause decreased elasticity of the skin causing wrinkles. hair color fades due to less release of melanin. diabetes, smoking, ETOH use, malnutrition and anemia affects how your skin ages. hormonal and vitamin insufficiency's cause dry skin, hair thinning and alopecia

sun damage to skin is _____________

cumulative

excess sun damage can lead to

skin cancer, make sure if you are outside you are using protection like clothes and sunscreen.

a photoaged person is more susceptible to skin cancer because..

UV exposure decreases the ability to repair cellular damage

describe finding that would indicate a normal skin assessment

the skin is evenly pigmented with no petechiae, purpura or lesions. it is warm with a good turgor. the nails are pink and oval shaped as well as adhere to nail bed with 160-degree angle. hair is shiny and full, amount and distribution are appropriate for age and gender, there is no flaking of scalp, forehead or pinna

what could a pt nails tell you about them

if they are blue, they may have poor O2 perfusion. also, could indicate heart problems. if they are biting them down, they may have anxiety

subjective data about skin

what the pt is telling you. do they have a history of health problems? is there any previous trauma? any surgeries or diseases affecting skin? have they been on any medications for a while or starting new ones? what allergies do they have? history of UV exposure?

objective data about skin

what do you see when you first look at the pt? what do you hear, smell, see? is there swelling or indentions

Antibacterial drugs

treat bacterial infections

antibiotic drugs

treat bacteria infections

antifungal drugs

treat fungal infections

antiviral drugs

used to treat viral infections

define dermatitis

inflammation of the skin due to an exposure from an allergen (internal or external)

clinical manifestations of dermatitis

itching, lesions without distinct borders

dermatitis can be classified as

nonspecific eczematous, contact or atopic

dermatitis risk factors

external skin exposure to allergens, internal exposures to allergens and irritants, stress, genetic, specific cause not always known, poison ivy

medications for contact dermatitis

antihistamines, steroids, most compresses, calamine lotion for itching, avoid scratching to create open wounds and increase r/f infection

what in a hospital may cause a pt contact dermatitis

antiseptics used in surgery (betadine, iodine), adhesives like electrode gels, tegaderm and tape, transdermal drug delivery such as nicotine and fentanyl patch

complications of contact dermatitis in hospitalized pt's

bacterial and fungal infections, cellulitis, open sores or lesions, permanent change in texture or scarring, permanent skin discoloration

what is diphenhydramine

Benadryl

what will antihistamines do to a pt

dry them out, watch for s/s of dehydration, use IV fluids along with to help prevent dehydration. also cause low UOP and urinary retention

what is antihistamine used for

relief of redness, pruritus' and edema

when a pt comes in with an allergic reaction

give IV Benadryl and steroids to decrease inflammation

client education for antihistamines

photosensitivity, avoid operating heavy machinery and driving as medication may cause drowsiness

define herpes zoster (varicella zoster)

shingles. caused by reactivation of the virus that causes chicken pox. CP runs its course and lies dormant in nerve tissue near brain or spinal cord for years

rash on one side of body indicate

shingles (herpes zoster), place these pt's away from others

catching chicken pox during pregnancy can also mean an increased risk of

complications affecting you, including pneumonia

a nurse notices that a pt has come in with shingles spread to one side of the face, radiating to the eye. what test may be expected

ct scan of soft tissue to ensure it has not spread to brain

nursing interventions for a pt with herpes zoster

antiviral drugs (acyclovir, valacyclovir, famciclovir) most effect 72 hours following eruption, vaccine for those over 50, compresses and calamine lotions may help, teach pt on postherpetic neuralgia topical lidocaine

herpes zoster risk for recurrence

people over 50 due to decreased immune system, women more prone, immunosuppression such as pt on meds or conditions like HIV, autoimmune pt and those with chronic conditions

these meds can help be effective against herpes zoster

acyclovir, valacyclovir, famciclovir

herpes zoster triggers

emotional stress, immunosuppressants, acute/chronic illnesses (diabetes), exposure to the virus

define herpes simplex 1 and 2

HSV1- causes cold sores around lips and moth. can spread via kissing, sharing utensils even with no visible sore. HSV2- mainly causes genital herpes, which can spread through sexual contact

is there a cure for herpes simplex

no, but antiviral medications like acyclovir, famciclovir and valacyclovir can help reduce symptoms and frequency of outbreaks.

describe antivirals for genital herpes

they will decrease severity, promote healing and decrease the frequency of recurrent outbreaks. does not cure infection and dosage and or treatment length may vary

Define impetigo

a contagious bacterial skin infection caused by staphylococcus aureus or streptococcus pyogenes that forms pustules and honey, crusted sores. highly contagious, do not send child to school!! can spread through direct contact with sores or sharing items such as towels, clothing or bedding.

how to prevent impetigo

practice good hygiene, keep wounds clean and avoid contact with infected people

treatment for impetigo

antibiotic ointment or oral antibiotics to speed healing and reduce contagiousness. mupirocin for localized cases and amoxicillin, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline for extensive cases

define acne vulgaris

common skin condition that occurs when dead skin cells and oil from skin (sebum) clog follicles

s/s of acne vulgaris

blackheads, whiteheads, papules, pustules, nodules, cystic lesions

nursing implications for acne vulgaris

can be treated with topical antibiotics and RETINOIDS (vit a derivatives) to increase skin turnover. Accutane (isotretinoin) is most used tx uses massive quantities of vit a benzol peroxide salicylic acid

define scabies

highly contagious skin condition caused by tiny mites called sacroptes scarbieis which burrow into skin and leg eggs causes intense and itchy rash and small, pimple like bumps or blisters.

how is scabies spread

prolonged skin to skin contact with an infected person making it common in close living environments like households, dorms or nursing comes. can also spread through sharing items like bedding towels or clothing but this is less common

clinical manifestations of scabies

presents as excoriated, erythematous papules, pustules and crusted lesions. curved or linear ridges in skin are characteristics. check in webs of fingers

hospital personnel should _________ precautions on pt with scabies

contact

treatment for scabies

scabicide (topical permethrin or oral/topical ivermectin), treating close family members and contacts even if they don't have symptoms

define pediculosis

infestation with lice,

clinical manifestations of pediculosis

itching and excoriation from scratching. white nits seen as hair shaft. sesame seed sized

treatment for pediculosis

topical sprays, creams and shampoo containing permethrin cream or malathion lotion. use a fine toothed comb to remove nits. oral agents such as ivermectin may be used. clothes and linens washed in HOT water

define permethrin

insecticide and a medication used to treat scabies and lice

Define Tinea (dermatophytosis)

a group of fungal infections that affect different parts of the body

tinea pedis

fungal infection of the foot; athlete's foot. causing itching, scaling and sometimes cracks or blisters

tinea corporis

ringworm of the body with a circular, red, scaly rash

tinea barbae

Also known as barber's itch; a superficial fungal infection that commonly affects the skin. It is primarily limited to the bearded areas of the face and neck or around the scalp.

tinea crusis

ringworm of the groin (jock itch)

tinea capitis

ringworm of the scalp

Tinea unguium (onychomycosis)

fungal infection of the nail

how do you treat tinea

antifungals, topical "-azole" antifungals (clotrimazole, miconazole, terbinafine). oral antifungal (terbinafine, itraconazole) for severe or persistent cases especially with scalp and nail

describe prevention of tinea

avoid walking barefoot in public areas like pools or locker rooms, dont share personal items like towels, shoes or clothing, keep skin dry and wear breathable clothes especially in warm climates

antifungals may be contraindicated with meds such as

digoxin and warfarin

tinea corporis manifest as

circular, itchy rash with clearer skin in the middle

tinea corporis can spread

human to human contact, animal to human contact, object to human contact, soil to human contact

Define psoriasis

a chronic autoimmune skin condition that causes skin cells to multiple faster than usual, LEADING TO THE BUILDUP OF THICK, SCALY PATCHES due to over production of keratin

psoriasis assessment findings

scaly patches, removal of scales stimulates bleeding, pruritic skin lesions primarily on scalp, elbows, and knees, sacrum, lateral areas of extremities, pitting or crumbling nails, RED RAISED SKIN WITH SILVERY PATCHES

psoriasis risk factors

infections such as candida, severe strep throat, and upper respiratory infections, skin trauma or recent surgery, genetics, stress, seasons, hormones, medications (lithium, betablocker, antimalaria)

define psoriasis vulgaris

reddened thickened skin with silvery white scales. bilateral distribution with no cure and tx being aimed at decreases severity of symptoms and decreasing cell turnover with vitamin a

describe psoriasis medications

corticosteroids like triamcinolone and betamethasone to reduce inflammation, cytotoxic meds like methotrexate to reduce cell turnover of epidermal cells; used in severe cases, biologic agents that suppress stimulation of keratinocytes by suppressing immune function

treatments to manage symptoms and reduce flare ups of psoriasis

topical treatment like corticosteroids, vitamin d analogs, salicylic acid and retinoids. light therapy to decrease cell turnover. systemic meds (methotrexate and cyclosporine) to target immune response. lifestyle changes like stress management, avoid triggers, eat healthy diet

a nurse should teach a pt with psoriasis to

learn how to manage stress, consume a healthy diet, and avoid ETOH

define seborrheic dermatitis

common, chromic skin condition that causes red, inflamed, scaly patches with an oily or greasy appearance. typically affects more oil producing areas such as scalp, face, upper chest and back.

dandruff is a type of

seborrheic dermatitis

seborrheic dermatitis in infants is known as

craddle cap

contributing factors to seborrheic dermatitis are

overgrowth of yeast, genetics, weather such as cold and dry, stress and fatigue, hormonal or immune factors such as pt with HIV/AIDS, Parkinson's or depression

treatment for seborrheic dermatitis

medicated shampoo, topical antifungal to control yeast growth, corticosteroid creams, topical calcineurin inhibitors and regular cleansing

a nurse should teach a pt with seborrheic dermatitis to

avoid harsh soaps/skincare to not irritate skin, moisturize regularly, manage stress and choose suitable hair care

define lyme disease

a vector borne disease caused by borrelia burgdoferi

clinical manifestations of lyme disease

bullseye rash at the site of tick bite, usually within 3-30 days of being bitten. rashes, fever and fatigue (flu-like)

late clinical manifestations of lyme disease

numbness in hands or legs, arthritis and short-term memory loss,

pt education for Lyme disease

avoid tick infested areas in warm months, wear protective clothing and use tick repellent, perform tick checks after outdoor activities and focus on hidden areas such as underarms, scalp and behind knees

treatment for Lyme disease

topical antibiotics such as doxycycline, amoxicillin and tetracycline

define chiggers

microscopic bugs that attach themselves to your clothing and move onto your skin for feeding. while feeding, the hatchling will deliver fluid into your skin, killing your skin cells

clinical manifestations of chiggers

itchy, red bumps often in clusters, appearing where skin in thin or tight-fitting clothing meets skin like ankles, waistline and under socks

treatment and relief for chiggers

wash area with soap and water immediately to remove chiggers, apply anti-itch cream or calamine lotion and consider antihistamine to relieve itching, avoid scratching to prevent infection

describe how to prevent triggers

wear long clothing and use insect repellent in chigger prone areas, shower after being outdoors to remove chiggers

define actinic keratosis

premalignant lesions of the cells of epidermis. common in adults with prolonged sun exposure or tanning bed. if left untreated may progress to squamous cell carcinoma.

describe actinic keratosis and where they are found

rough, scaly patches on the skin. commonly found in sun exposed areas like face, ears, scalp (especially in those with hair loss), neck, shoulders, forearms and back of hands

risk factors of actinic keratosis include

frequent sun exposure without protections, fair skin, light hair, light eyes, older wage, history of sunburns and tanning bed use

treatment of actinic keratosis

cryotherapy, topical meds, chemical peels, laser therapy, photodynamic therapy, early detection and removal

define basal cell carcinoma

arise from basal layer of epidermis, MOST COMMON SKIN CANCER, genetic predisposition, chronic irritation and UV exposure

define squamous cell carcinoma

cancer of epidermis, locally invasive, often seen in older Caucasian men, caused by skin damage from repeated injury or irritation, chronic open wounds at risk for malignant transformation (diabetic ulcers)

____________________ is the most common cause of lip cancer

squamous cell carcinoma

define melanoma

pigmented cancer arising in the melanin producing epidermal cells. often begins as benign growth or mole. highly metastatic. survival depends on early diagnosis and treatment (surgery)

risk factors of melanoma include

genetic predisposition, excessive UV exposure or occupational exposure to chemical carcinogens, Prescence of moles

Nevi is also known as

mole

describe the melanoma ABCDE guide

a- asymmetry, does one half not match the other. b- border, uneven border. c- color, variety of colors like brown, tan and black. d- diameter, grows larger in size than a pencil eraser (1/4 inch). e- evolution, change in shape, color, elevation, another trait or new symptom

health promotion and maintenance of skin cancer

avoid/reduce exposure to sunlight or tanning beds, evaluate all skin lesions using ABCDE guide for melanoma, consult with PCP to examine any lesions with unusual features, annual appt. w/ dermatologist to monitor moles and other lesions

the primary risk factor leading to skin cancer and melanoma is

enviromental exposure to UV radiation leading to damage in DNA causing genetic defects

a nurse understands that a person who has light color hair, eyes, freckles easily is at advanced risk for

the development of skin cancer