Hollistic Health, content for midterm 2

types of skin cancer

basal cell, squamous cell, malignant melanoma

basal cell

most common (90%), caused by long term sunlight exposure, easily treated, starts at lowest level of epidermis and grows very slowly (rarely metastasizes)

squamous cell

second most common type, easily treated when detected early, epidermis appears crusted and scaly- can metastasize, appears as persistent thick and rough patches that may bleed, can look like warts or open sores with raised border and crusted surface

malignant melanoma

from pre existing mole that changes or new irregular spot, from pigment producing melanocytes, most lethal, metastasize to lymph and internal organs, cured if diagnosed and removed early

health teaching: skin cancer

check skin once a month, use ABCDE rule, have someone search areas you cant see, wear high spf sunscreen and protective clothing

epidermal wound healing

superficial wounds, new skin cant regenerate if injury destroys large area of stratum basale- that requires skin graft

deep wound healing

when wound extends to dermis and subcutaneous layer, 4 phases- Inflammatory, Migratory, Proliferative, Maturation

Inflammatory phase

blood clot unites wound edges, epithelial cells migrate across wound, vasodilation, phagocytes and fibroblasts

Migratory phase

repair the wound- epithelial cells bridge wound, fibroblasts make scar tissue, damaged blood vessels regrow, tissue in wounds called granulation tissue

proliferative phase

migratory phase intensifies

maturation phase

scab sloughs off epidermis- returns to normal size, collagen organised, fibroblasts disappear, blood vessls return to normal

examining wound: slough

examining wound: infected (purulent)

examining wound bed: granulation vs hypergranulation

re-epithelialisation and percentage

what is fibrosis

scar formation

hypertrophic scar

elevated above epidermal surface, within boundries of original wound

keloid scar

extends beyond boundries into surrounding tissues

initial components of cardiac assessment

wash hands, privacy, introduce, ask them to introduce and check id bracelet, ask reason for seeking care and demographics

risk factors for hypertension - demographics that impact cardiac disease

smoking, dislipidemia, diabetes mellitus, older age (over 60), sex (men and post menopausal women), family history, poor diet, obesity, excess alcohol consumption (modifiable or non modifiable)

subjective data for cardiac assessment

pt cardiac history- (HTN, CAD/MI, diabetes, hyperlipidemia, congenital heart disease, obesity,) family cardiac history, allergies, medications (vitamins, herbals, prescribed, otcs)

lifestyle and teaching in cardiac

Diet: salt, caffeine, fat (dietary approachs to stop hypertension, Alcohol: abstain or less than 2 drinks per day, Drugs: cocaine, Smoking: reduce or quit, Last Physical exam, Immunisations: flu can cause MI, covid can cause myocarditis and heart complications, Excersize: 30-60 mins moderate excersize, healthy body weight and BMI, Reduce Stress

chest pain OPQRSTUA

o- when did it start? constant or come and go? p- what makes it better or worse? is it triggered by an activity? q- how would you describe it? r- is it localised or does it radiate? s- rate it on a scale of 1-10. does it affect ADLs? t- is there a time of day when it is worse or better? u- what do you think it is? have u had this pain before? a- what other symptoms do you have?

locations off cardiac related chest pain image

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chest pain associated symptoms

pain, shortness of breath, cough, heavy sweating, fatigue or weakness, light headedness, nausea or vomiting, swelling, urinating during the night FINISH

types of shortness of breath chart insert

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developmental considerations when pregnant

HR increase by 10-15 bpm, changes in BP (varies w position), apical pulse is higher and more lateral), splitting of S1 and it is louder, S3 has extra blood volume, systolic murmur in 90% of cases, ECG slows slight left axis deviation, mammary souffle (continous murmur because of extra blood being supplied to breast)

developmental considerations for older adults

increased AP diameter of chest (barrel chest), gradual increase of systolic bp, risk of orthostatic hypotension, decreased ability of heart to augment co with excersize, S4 common if heart disease, decreased tolerance for tacharrhythmias, premature ectopic beats more common, systolic murmur common, arrhythmia and heart failure are more common

cultural and social considerations

increased CVD in men and women in Canada, influence of social factors: high bp, smoking, serum cholestrol, access to healthy foods, obesity, diabetes

hypertension canada guidelines important

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salt intake per day

less than 2 grams

excersize FINISH

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cardiovascular disease in women

symptoms can be attributed to something else, often ignored, women minimise the significance of symptoms, heart disease is leading cause of death in women older than 55, ovaries decrease production of estrogen- increased low density lipoprotein, b and body fat above the waist, decreased high density lipoprotein, metabolism of sugar affected, HRT helps improve post menopausal symptoms

finish cardiac

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