Medsurg 1 > Midterm > Flashcards

Midterm Flashcards

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1
Q

Subcutaneous

A

Innermost layer of skin (fat), lying over muscle and bone

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2
Q

Dermis

A

-Layer above subcutaneous
-contains no skin cells
-contains protective mast cells and macrophages

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3
Q

Epidermis

A

-Outermost layer of skin
-first line of defense

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4
Q

ABCDE of skin cancer

A

-Asymmetry of shape
-Border irregularity
-Color variation
-Diameter greater than 1/4 inch
-Evolving size/shape/color

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5
Q

Potential condition of white or paleness skin

A

-edema
-blood loss
-albinism
-vitiligo

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6
Q

Potential condition of yellow/orange skin

A

-liver disorders
-chronic kidney disease

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7
Q

Potential condition of red or hyperpigmentation in dark skin

A

-inflammation
-fever
-alcohol intake

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8
Q

Underlying cause of white or pale skin

A

-decreased blood flow to skin
-decreased hemoglobin level

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9
Q

Underlying cause of yellow/orange skin

A

-Increased total serum bilirubin level (jaundice)
-increased serum carotene level

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10
Q

Underlying cause of red or hyperpigmentation of dark skin

A

Increased blood flow (vasodilation)

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11
Q

Underlying cause of blue skin

A

-increase in deoxygenated blood (cyanosis)
-bleeding from vessels into tissue

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12
Q

Underlying cause of reddish blue skin

A

-increased overall amount of hemoglobin
-decreased peripheral circulation

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13
Q

Potential conditions of white nail color

A

-shock
-anemia
-myocardial infarction

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14
Q

Potential conditions of yellow/brown nail colors

A

-jaundice
-psoriasis
-diabetes
-cardiac failure

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15
Q

Potential conditions of red nail color

A

-bacterial endocarditis
-trauma

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16
Q

Potential conditions of blue nail color

A

-respiratory failure
-methemoglobinuria

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17
Q

Normal nail shape

A

Angle of 160 degrees

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18
Q

Early clubbing nail shape & significance

A

180 degrees (hypoxia, lung cancer)

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19
Q

Late clubbing and significance

A

Exceeds 180 degrees (hypoxia, emphysema, COPD)

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20
Q

Early koilonychias

A

Flattening of nail (iron deficiency,poorly controlled diabetes)

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21
Q

Late koilonychias

A

Concave curvature (psoriasis, irritants)

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22
Q

Beaus lines (grooves)

A

Horizontal depressions in nail plates

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23
Q

Pitting in nails

A

Small, multiple pits (psoriasis)

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24
Q

Acute paronychia

A

Inflammation of skin around nails

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25
Chronic paronychia
Inflammation around nails that lasts for months
26
Preventing pressure injuries steps:
1. Determine risk level 2. Reduce pressure 3. Improve pressure tolerance
27
Stage 1 pressure injury
-Non-blanchable redness -skin intact
28
Stage 2 pressure injury
-Partial-thickness skin loss -exposed dermis.
29
Stage 3 pressure injury
-Full-thickness skin loss -exposed fat tissue
30
Stage 4 pressure injury
Full-thickness tissue loss with exposure of muscle, tendon, or bone
31
Unstageable pressure injury
-wound bed is obscured by slough (yellow or green debris) or eschar (black or brown crust). -Requires debridement to determine the stage.
32
Cellulitis
Inflammation of the skin and subcutaneous tissue extending beyond area of injury
33
Eschar
Necrotic tissue
34
Granulation tissue
Pale pink to beefy red
35
Undermining wound characteristic
Separation of skin layers at the wound margins
36
Serosanguineous exudate
mixture of serous and sanguineous fluid, appearing as a clear or pink-tinged liquid. It is common in the early stages of wound healing
37
Serous exudate
Clear, thin, and watery fluid that is typically seen in early wound healing
38
Sanguineous exudate
Red or pink fluid that contains blood cells
39
Purulent exudate
Thick, yellow, green, or white fluid that contains pus, bacteria, and dead white blood cells. It indicates an infection
40
Autolytic (natural) debridement
Use of body’s own fluids to maintain a moist environment
41
Biologic debridement
Use of sterile maggots to consume necrotic tissue
42
Enzymatic (chemical) debridement
Use of topical agent to loosen necrotic tissue
43
Hydro surgical debridement
Use of water jet to forcefully apply saline to wound
44
Mechanical debridement
Use of mechanical forces such as irrigation, wet to dry dressing changes
45
Surgical (sharp) debridement
Removal with sharp instrument
46
Alginate dressing
Absorbent fabrics derived from natural fibers or seaweed. Forms a gel when in contact with injury (Stage 3 & 4 with moderate exudate)
47
Antimicrobial dressing
Impregnated with antimicrobial agents (injuries with infection)
48
Collagen dressings
Gels, pads, pastes, powders, solutions. Used with secondary dressings (stage 3 or 4)
49
Foam dressing
Foamed solutions that have open cells that hold fluid (stage 2 and greater with moderate or heavy exudate)
50
Gauze (moist) dressing
Dry, sponges and wraps made of cotton or polyester (PI’s that can’t be dressed and need moist environment)
51
Hydrocolloid dressing
Wafers, powders, pastes (non infected stage 2)
52
Hydrogel dressing
Designed to maintain a most environment (non infected stage 2,3,4)
53
Superabsorbent dressing
Highly absorptive layers (heavily exuding injuries)
54
Transparent films
Impermeable to liquid. See through. (Non infected stage 2, secondary dressing)
55
Plaque psoriasis
-most common -raised, red patches -found on scalp, knees, elbows and lower back -may be itchy, painful, or bleed
56
Guttate psoriasis
-small, dot-like lesions -usually starts after strep infection
57
Inverse psoriasis
-very red lesions in folds of body -smooth and shiny -most people have another type in addition
58
Pustular psoriasis
-white pustules surrounded by red skin -not infectious or contagious -occurs on hands and feet
59
Erythrodermic psoriasis
-severe, widespread -severe itching and pain -skin may come off in sheets -rare
60
Nail psoriasis
-nail pits -white, brown, or yellow nail discoloration -crumbling nails
61
Parkland formula
4mL X body weight(kg) X TBSA
62
Rule of 9s TBSA: entire head and neck
9%
63
Rule of 9s TBSA: entire right arm
9%
64
Rule of 9s TBSA: entire left arm
9%
65
Rule of 9s TBSA: entire trunk
36%
66
Rule of 9s TBSA: groin
1%
67
Rule of 9s TBSA: entire right leg
18%
68
Rule of 9s TBSA: entire left leg
18%
69
Stevens-Johnson syndrome
Skin detachment less than 10% of BSA
70
SJS/TEN
More than 10% but less that 30% detachment
71
Toxic epidermal necrolysis (TEN)
Detachment of more than 30% BSA
72
What is pediculosis?
Lice
73
Normal Fasting blood glucose levels
74-100 mg/dL
74
Fasting blood glucose levels in pre diabetes
100-125 mg/dL
75
Fasting blood glucose in diabetes
Greater than 126 mg/dL
76
Rapid acting (Lispro) insulin onset
15-30 minutes
77
Rapid acting (Lispro) insulin peak
30 mins - 2.5 hours
78
Rapid acting (Lispro) insulin duration
3-6 hours
79
Short acting (regular) insulin onset
30-60 min
80
Short acting (regular) insulin peak
1-5 hours
81
Short acting (regular) insulin duration
6-10 hours
82
Intermediate (NPH) insulin onset
1-2 hours
83
Intermediate (NPH) insulin peak
6-14 hours
84
Intermediate (NPH) insulin duration
16-24 hours
85
Long acting (glargine) insulin onset
70 mins
86
Long acting (glargine) insulin peak
None
87
Long acting (glargine) insulin duration
18-24 hours
88
Phases of normal wound healing
1. Inflammatory 2. Proliferative 3. Maturation
89
Inflammatory phase of healing
-begins at time of injury -lasts 3-5 days -WBCs migrate to wound -symptoms are edema, pain, redness, warmth
90
Proliferative phase of healing
-lasts 2-4 weeks -epithelial cells grow over granulation tissue
91
Maturation phase of healing
-begins as early as 3 weeks after injury -last for a year or longer -collagen is reorganized -scar tissue becomes thinner and paler in color
92
Urticaria
-Hives -remove triggering substance
93
Granulation
Replacement of damaged tissue with scar tissue
94
Metformin (biguanide)
-decreases liver glucose production -improves insulin sensitivity
95
What do GLP-1 agonists do
Mimic natural gut hormones that regulate glucose with insulin (Ends in “-tide”)
96
What do SGLT2 inhibitors do?
-prevent kidney reabsorption of filtered glucose (glucose excreted in urine) -ends in “-flozin”
97
What do DPP-4 inhibitors (gliptins) do?
Enhance incretin hormone action (Ends with “-liptin”)
98
Major type 2 diabetic drug classes (MSGS)
Metformin SGLT2 inhibitors GLP-1 agonists Secretagogues (insulin stimulators)
Medsurg 1
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