integumentary system!

what is the largest organ in the human body?

skin

what percent of total body weight in the integumentary system?

15%

what is the function of the integumentary system?

-microbial function

-formation of vitamin D

-temperature

-sensory

-excretion

describe the epidermis?

outer, protective layer

describe the dermis?

thick layer of connective tissue. allows skin to stretch and contract

describe the hypodermic?

subcutaneous layer

what are Mongolian spots?

dark purple spots. more common in asian and black neonates. are usually gone around ages 6-10

what does congenital nevus increased the risk of?

increase the risk of developing melanoma

what may cafe au lait be associated with?

neurofibromatosis type 1

where is nevus simplex or macular stain common?

eye lids, nape of neck

describe port wine stains?

vascular mass formations. grow with time

what are some inflammatory disorders of the skin?

-contact dermatitis

-atropic dermatitis

-eczema

-psoriasis

what is contact dermatitis?

localized inflammatory response to chemical or physical agents

what are common irritants of contact dermatitis?

-soaps and detergents

-chemicals

-poison ivy

-metals -> nickle

what are clinical manifestations of contact dermatitis?

-erythema

- itching or burning

-vesicles/bullae (fluid filled pimples)

-patches

what is atropic dermatitis also known as?

eczema

what types of factors does atropic dermatitis have?

genetic and environmental factors

what is the pathophysiology of atopic dermatitis?

-skin barrier dysfunction

-immune system dysregulation

causes of atopic dermatitis?

-family history

-stress

-impaired skin barrier

-nervous system imbalance

-immune dysfunction

-environmental pollution

-excessive hygiene

what are clinical manifestations of atopic dermatitis?

-dry, itchy skin

-usually found in the folds of skin

-episodes of remission and exacerbations

how may atopic dermatitis appear in infants and toddlers?

appear as a rash on the scalp, face or arms and legs

how does atopic dermatitis appear in children?

may begin inside creases of the elbows or knees, the neck, wrists, ankles, and/or crease between the buttocks/legs

how does atopic dermatitis show in adults?

on the inner creases of the elbow or knees, hand, and/or nape of the neck

what is the treatment for atopic dermatitis?

-skin hydration (less frequent bathing)

-emollients and moisturizers (fragrant free soaps)

-eliminating irritants

-medication therapy

describe bleach baths for atopic dermatitis?

may help reduce inflammation and itching

topical corticosteriods potency and class?

1 super high potency and 7 least potent

what is psoriasis?

chronic inflammatory skin disease; hyper proliferation (extra build up of skin cells)

what is the most common type of psoriasis?

chronic plaque psoriasis. in the scalp, extensor elbows, knees, gluteal cleft

what are the clinical manifestations of psoriasis?

-thick, silver plaques

-well defined borders

-pruritic

-itchy

-red raised lesions that is itchy

what makes psoriasis worse?

stress

what is gute?

drop like. dudden eruption of really small psoriasis plaques

what is pustular psoriasis?

acute on the spread of widespread ephemeral, scaling, pustules

what areas does psoriasis effect?

areas like the axilla or underneath the armpit, perennial, or genital regions

psoriasis

what is the curative treatment for psoriasis?

no curative treatment, goal is to manage symptoms

what are the topical ways to help manage psoriasis symptoms?

corticosteroids and calcitriol

what is calcitriol?

type of vitamin D that helps skin cell production

what is systemic psoriasis treatment?

methotrexate

what is methotrexate?

immunosupprescent for severe forms of psoriasis when other methods have failed. used with folic acid to prevent adverse effects. adverse effects are hepatoxicity and increased risk for infection

what is urticaria also known as?

hives

what can urticaria be triggered by?

medication, food, insect sting

what happens during urticaria?

mast cells are activated which release histamine which causes the swelling and itching

what can urticaria be accompanied by?

angioedema

what may urticaria appear with?

anaphylaxis

when is urticaria be considered with a medical emergency?

angioedema and SOB

what is a treatment for urticaria?

epinephrine

hives

what are infectious disorders of the skin?

bacterial, viral, parasitic, and fungal

what is folliculitis?

infected hair follicle. painful and itchy

what can folliculitis be caused by?

tight fitting clothing, shaving or waxing, hot tubs

what to do for the treatment of folliculitis?

antimicrobial cleanser (benzoyl peroxide). for more severe use oral antibiotics

folliculitis

what is cellulitis?

infection of the skin. dermis and subcutaneous layers

what are the clinical manifestations of cellulitis?

swelling, erythema, tenderness, and warmth. can go all the way around the limb

what are risk factors of cellulitis?

decreased immune system, any cuts or abrasions

what to use for severe cases of cellulitis for treatment?

systemic antibiotics

what is an abscess caused by?

staphylococcus aureus or methicillin resistant staphylococcus aureus (MRSA)

what does an abscess look like?

painful, red nodule

what is the treatment for abscess?

antibiotics, may require surgical damage

what is impetigo?

superficial bacterial infection of the skin

is impetigo contagious?

YES

who is impetigo most common in?

children age 2 to 5

what are the clinical manifestations of impetigo?

-honey crusted lesions

-crusts

-painful

-usually involves face and extremities

what is the treatment for impetigo?

Mupirocin is first line of treatment. 3 times a day for 5 days. antimicrobial ointment

when can kids return back to school with impetigo?

after 24 hours after mupirocin treatment. if lesions haven't crusted over keep them covered

what is necrotizing soft tissue infections?

infection in the soft tissue that leads to the destruction of the muscle and fat

what are the clinical manifestations of necrotizing soft tissue infections?

-severe pain

-erythema without sharp margins

-crepitus

-fever

-tachycardia

what is crepitus?

gas build up and when you push on it it feels and sounds like Rice Krispies

what is the treatment for necrotizing soft tissue?

-aggressive surgical debridement

-systemic antibiotics

-can be fatal

-can lead to amputation

how is HSV transmitted?

via oral secretions

clinical manifestations of HSV?

painful, vesicular lesions

HSV1?

mouth and lips

HSV2?

genitals

when is HSV more likely to be spread?

when the lesions are active

when is antiviral therapy more effective?

when started within 72 hours of the lesion appearing

what are the two variations of varicella zoster virus?

chickenpox and shingles

when do symptoms develop in chickenpox?

15 days after exposure

how does chicken pox develop?

macules to papules to vesicles

clinical manifestation of chicken pox?

itchy

clinical manifestation of shingles?

painful, unilateral vesicular eruption

how does shingles happen?

activation of latent VZV. people who have had inactive chicken pox

what is the treatment for shingles?

antiviral treatment -acyclovir

what is scabies?

mite infestation of the skin

how is scabies transmitted?

via direct contact

what are the clinical manifestations of scabies?

severe pruritic (itching), worse at night. burrows in the skin

what is pediculosis?

lice infestation

pediculosis capitis?

head lice

pediculosis corporis?

body lice

pediculosis pubis?

pubic lice

pediculosis ciliaris?

eyelash lice

what are the clinical manifestation of pediculosis?

itchy scalp, nits.

what is the treatment for pediculosis?

permethrin., wash sheets and clothing on high heat

directions for permethrin for head lice?

-apply on clean, towel dried hair

-leave on for 10 minutes

-comb remaining nits out

-apply 9 days later is nits are still observed

directions for permethrin for scabies?

-apply to the entire body from the neck down

-leave on for 8 hours

what are fungal infections also known as?

tinea infections. can affect many parts of the body

what in tinea corporis?

ringworm

topical anti fungal agents?

clotrimazole and ketoconazole

systemic anti fungal agents?

fluconazole and terbinafine

what are nursing considerations for anti fungal agents for oral?

have a risk of hepatotoxicity. take for six to 12 weeks

what are examples of integumentary trauma?

burns and pressure injury