Chapter 50, 13

Question 1

What are the 3 layers of the skin?

Answer 1

• Largest organ in the body
  ○ Epidermis
  § Protection
  ○ Dermis
  § Provide strength, support, blood and nutrients to epidermis
  ○ Subcutaneous tissue
  § Helps anchor the dermis to the underlying structures
  § Provides insulation for temperature regulation
  § Provides cushion like protection for padding for the skin and underlying structures.

Question 2

What 3 things categorize skin infections?

Answer 2

• Skin and soft tissue infections categorized by
  ○ Depth of infection
  ○ Tissues involved
  Interventions necessary to resolve infection

Question 3

How are uncomplicated skin infections handled?

Answer 3

• Uncomplicated
  ○ Respond to antibiotic therapy alone
  ○ Surgical drainage with or without antibiotic therapy

Question 4

How are complicated skin infections handled?

Answer 4

• Complicated
  ○ Invasion of deeper tissues and require debridement
  ○ Necrotic tissue

Question 5

What is herpes simplex virus?

Answer 5

• Common lifelong infection
  ○ Body fluids, skin-skin, skin mucosa, mucosa-mucosa

Question 6

What are the two types of herpes?

Answer 6

• Types
  ○ Type 1, recurring oral lesion, Cold sore
  ○ Type 2, cause of genital herpes

Question 6

Where does herpes usually present?

Answer 6

• Locations
  ○ Skin, mucous membrane, CNS, genital tract
  ○ Primary and secondary infections
  § First time.
  § Second time when trigger reactivates it.

Question 7

What 2 types of complications can herpes cause?

Answer 7

• Complications
  ○ Psychological
  ○ Pregnancy

Question 8

What do antiviral medications usually end in?

Answer 8

• Antiviral medications
  ○ Often end in VIR
  ○ IV route used for patients with severe disease, complications, pneumonitis, encephalitis, hepatitis.

Question 9

Where are fungal infections usually found?

Answer 9

• Proliferate in warm moist environments
  ○ Groin, feet, axillae, skinfolds

Question 10

What is psoriasis and what are its two types?

Answer 10

• Immune disorders that cause chronic inflammation
  ○ Plaque psoriasis is the most common (80-90%)
  ○ Choreatic psoriasis

Question 11

What are the aggravating factors of Psoriasis?

Answer 11

• Aggravating factors
  ○ Infections, medications, stress, trauma, hormonal changes

Question 12

What are the 5 types of skin traumas?

Answer 12

Skin trauma
- Lacerations
○ Break in the skin from penetration of a sharp object or shearing force
- Abrasions
○ Result of friction and shear from external forces
§ Knee scrapes
- Excoriation
○ Superficial abrasion, self induced, incontinence
- Friction blisters
○ From force resulting in a rubbing motion
- Skin tears
○ Minor trauma, primarily in older adults

Question 13

What two labs do we want to look at with skin traumas?

Answer 13

WE WANT TO LOOK AT ALBUMIN AND PROTEIN

Question 14

What 6 things cause pressure injuries?

Answer 14

Pressure injuries
- Impaired or decreased mobility, impaired blood flow
- Increased age, comorbidities, cognitive impairment
- Steroids
- Incontinence
- Nutrition status
- Medical history
- Braden scale (the lower the result the higher the risk)

Question 15

What is the most common form of Cancer in the US?

Answer 15

• Melanoma and non-melanoma (ABCDE)
  § Asymmetrical
  § Border irregular
  § Colour
  § Diameter
  § Elevation
  ○ Main modifiable risk factor is exposure to UV radiation
  § Treatment: surgical, cryotherapy, radiotherapy, chemotherapy

Question 16

What are the 3 types of skin cancer and their severity? BSM

Answer 16

Skin cancer
- Top basal cell carcinoma
- Middle, squamous cell carcinoma
- Bottom, malignant melanoma

Question 17

What is the ABCDE acronym for skin cancers?

Answer 17

Melanoma and non-melanoma (ABCDE)
- Asymmetrical
- Border irregular
- Colour
- Diameter
- Elevation

Question 18

What are risk factors for cancer?

Answer 18

• Risk factors for cancer
  ○ Carcinogen, carcinogenesis
  ○ Modifiable vs nonmodifiable

Question 19

What are cancer characteristics?

Answer 19

• Cancer characteristics
  ○ No anchorage independence
  ○ No apoptosis
  ○ They metastasis

Question 20

What are the two types of cancers?

Answer 20

• Types
  ○ Solid, hematological

Question 21

What 7 things should you watch for as an indication of cancer?

Answer 21

○ Caution
§ Change in bowl or bladder habits
§ Sore that does not heal
§ Discharge
§ Indigestion or hard time swallowing
§ Change in wart or mole
§ Cough or hoarseness
§ fatigue

Question 22

What is the gold standard for diagnosing cancer?

Answer 22

• Biopsy’s

Question 23

What are the 3 modalities of cancer treatment?

Answer 23

• 3 broad treatment modalities
  ○ Surgical, radiation, medical

Question 24

What are risk factors of chemotherapy?

Answer 24

- Chemotherapy ○ Bone marrow suppression, fatigue, N/V, GI, fertility, alopecia, neuropathy, oral mucositis, hypersensitivity.

Question 25

What are side effects of radiation therapy?

Answer 25

- Radiation therapy ○ Erythema, fibrosis, fatigue, oral mucositis

Question 26

What way is the best to remove cancers?

Answer 26

- Surgery

Question 27

What do meds that affect the immune system end in?

Answer 27

ALL MEDS THAT END IN MAB AFFECT THE IMMUNE SYSTEM

Question 28

How long is the lifespan of hemoglobin and platelets?

Answer 28

○ Lifespan of hemoglobin is 108 days ○ Platelet lasts 7-10 days We care about neutrophil count

Question 29

What are the 3 primary ways we can stop cancer?

Answer 29

- Primary prevention ○ Risk factor modification, immunization, chemoprevention

Question 30

What are the 4 Secondary ways we can prevent cancer?

Answer 30

- Secondary prevention ○ Screening family history ○ Pap smear yearly ○ Colonoscopy at 45 ○ Prostate 50

Question 31

What are the 2 tertiary ways we can prevent cancer?

Answer 31

- Tertiary prevention ○ Reducing morbidity and mortality ○ Treatment and management of side effects

Question 32

What is primary intention in skin healing?

Answer 32

- Closing wounds with stitches or staples.

Question 33

What is secondary intention in skin healing?

Answer 33

- Wound heals naturally without closure

Question 34

What is tertiary wound healing?

Answer 34

- Delaying closure of the wound before closing

Question 35

What do we want to pay attention to before giving chemotherapy?

Answer 35

- Immature white blood cells (ANC/Neutrophils)

Question 36

What makes Extraversion special?

Answer 36

- The medications used are vesicants.