Integumentary 3

juniperk's version from 2018-03-05 02:46


Question Answer
What are the clinical manifestations of herpes zoster?1 Vesicular rash on skin, clusteres of vesicles, 2 fatigue, 3 malaise, 4 fever, 5 headache, 6 discomfort/pain from rash
Herpes Zoster- Therapeutic mgmtComfort measures, oatmeal baths, rest, monitor lesions for secondary infections
Herpes Zoster- Nursing mgmtimportance of taking antiviral agents. The patient is educated about how to apply wet dressings or medication to the lesions and to follow proper hand hygiene techniques to avoid spreading the virus.
Scabies- pharm mgmtThe patient is instructed to take a warm, soapy bath or shower to remove the scaling debris from the crusts and then to pat the skin dry thoroughly and allow it to cool. A prescription scabicide, 5% permethrin is applied thinly to the entire skin from the neck down, sparing only the face and scalp. The medication is left on for 12 to 24 hours, after which the patient is instructed to wash thoroughly. One application may be curative, but it is advisable to repeat the treatment in 1 week
Will the puritis stop after treatment of scabies? What should you do if it does not stop?After treatment is completed, the patient may apply an ointment, such as a topical corticosteroid, to skin lesions because the scabicide may irritate the skin. The patient’s hypersensitivity does not cease on destruction of the mites. Pruritus may continue for several weeks as a manifestation of hypersensitivity, particularly in people who are atopic (allergic). This is not a sign that the treatment has failed. The patient is instructed not to apply more scabicide, because it will cause more irritation and increased itching, and not to take frequent hot showers, because they can dry the skin and produce pruritus. Oral antihistamines such as diphenhydramine or hydroxyzine can help control the pruritus.
What 6 labs should you monitor in a patient with ulcers?hematocrit, hemoglobin, electrolytes, albumin, transferrin, and creatinine.
What are the characteristics of stage 1 ulcer?Nonblanching. 2. Erythema 3. Warmth 4 tender 5. Completely reversible 6. Skin intact
What are the characteristics of stage 2 ulcer?1. Partial thickness loss of dermis 2. intact or open/ruptured serum-filled blister 3. Drainage 4. Swelling 5. Edema 6. Redness
Stage 2 tx?Cream/dressing Heel protectors
What are the characteristics of stage 3 ulcer?1. Full-thickness tissue loss 2. Subcutaneous fat may be visible 3. Slough 4. Crater formation 5. Eschar
What are the characteristics of stage 4 ulcer?1. Ulcer presents with full-thickness tissue loss with exposed bone, tendon, or muscle. 2 Often includes undermining and tunneling 3. Osteomyelitis or septic 4. Granulation tissue may be present
Which labs should a nurse monitor in a pt with an ulcer?WBC and Albumin level
What do the ulcers look like in a lower extremity arterial wound?Deep ulcer with smooth, well defined wound edges- Very Painful! relieved by lowering legs
What is the therapeutic mgmt for lower extremity arterial wounds?Clean/dry No heat, don't cross legs, No vasoconstrict drugs
What do the ulcers look like in a lower extremity venous stasis wound?Wound edges are irregular, superficial or shallow craters.
What is the therapeutic mgmt for lower extremity venous stasis wounds?Encourage walking, elevate legs
What is first-intention healing?Wound edges approximated with sutures or staples. Wounds made aseptically with a minimum of tissue destruction that are properly closed heal with little tissue reaction by first intention
What is Second-intention healing?. When the postoperative wound is to be allowed to heal by secondary intention, it is usually packed with saline-moistened sterile dressings and covered with a dry sterile dressing. Healing from the inside out.
What is Third-intention healing?Delayed closure. If the wound is infected, it is left open and then closed once the debris & exudate removed and inflammation has subsided. Wound vac.

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