1. Understanding Medical Surgical Nursing, 4th Edition Nursing Care of Patients with Skin Disorders

2. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Pressure Against Skin  Tissue Anoxia  Etiology  Pressure  Friction  Shear

3. Understanding Medical Surgical Nursing, 4th Edition  Immobility  Impaired Circulation  Impaired Sensory Perception  Elderly  Very Thin or Obese

4. Understanding Medical Surgical Nursing, 4th Edition  Assess Daily  Cleanse and Dry Daily and PRN  Lubricate Daily  Clean Incontinence Promptly  Use Moisture Barrier PRN  Do Not Massage Reddened Areas  Shift every Weight every 15 min

5. Understanding Medical Surgical Nursing, 4th Edition  Turn/Reposition at Least every 2 hr  Keep Heels Off Bed  Pad/Protect Bony Prominences  Use Pressure-Reducing Mattress  Use Lift Sheet to Move  Provide Nutrition and Hydration

6. Understanding Medical Surgical Nursing, 4th Edition  Sensory Perception Moisture  Activity  Mobility  Nutrition  Friction and Shear

7. Understanding Medical Surgical Nursing, 4th Edition  Pain  Open Ulcerated Area  Color Tip  Black: Necroses  Yellow: Infection  Red: Healing

8. Understanding Medical Surgical Nursing, 4th Edition  Physical Examination  Culture and Sensitivity  Blood Supply Studies  Wound Biopsy

9. Understanding Medical Surgical Nursing, 4th Edition  Remove All Pressure  Debride  Mechanical  Enzymatic  Autolytic  Surgical  Cleanse  4 – 15 PSI

10. Understanding Medical Surgical Nursing, 4th Edition  Types  Hydrogel  Polyurethane Film  Hydrocolloid Wafer  Biological  Alginate  Gauze  Moist Environment  Caution with Tape

11. Understanding Medical Surgical Nursing, 4th Edition  Deep Tissue Injury  I – Skin Intact, Red, Does Not Blanch  II – Partial Thickness Skin Loss  III – Full Thickness Skin Loss, May Have Eschar  IV – Damage to Muscle, Bone, or Support Structures  Unstageable

12. Understanding Medical Surgical Nursing, 4th Edition  Impaired Skin Integrity  Risk for Infection  Pain

13. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Inflammation of the Skin  Etiology  Allergens  Irritants  Heredity  Stress

14. Understanding Medical Surgical Nursing, 4th Edition  Contact  Irritant  Allergic  Atopic  Seborrheic

15. Understanding Medical Surgical Nursing, 4th Edition  Rash, Itching  Lesions  Scales  Crusts  Fissures  Macules  Papules  Pustules

16. Understanding Medical Surgical Nursing, 4th Edition  Infection  Sepsis

17. Understanding Medical Surgical Nursing, 4th Edition  History and Physical  Culture and Sensitivity

18. Understanding Medical Surgical Nursing, 4th Edition  Antihistamines  Analgesics  Antipruritics  Steroids  Colloidal Oatmeal Baths  Wet Dressings

19. Understanding Medical Surgical Nursing, 4th Edition  Impaired Skin Integrity  Disturbed Body Image  Deficient Knowledge

20. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Inflammatory Disorder  Proliferation of Epidermal Cells  Scaling

21. Understanding Medical Surgical Nursing, 4th Edition  Stress  Strep Pharyngitis  Hormone Changes  Cold Weather  Skin Trauma  Some Drugs

22. Understanding Medical Surgical Nursing, 4th Edition  Papules, Plaques  Silvery Scales  Itching

23. Understanding Medical Surgical Nursing, 4th Edition  Infection, Fever, Chills  Arthritis  Nail Changes  Lymphadenopathy

24. Understanding Medical Surgical Nursing, 4th Edition  Physical Assessment  Rule Out Infection

25. Understanding Medical Surgical Nursing, 4th Edition  Tub Baths  Corticosteroids  Salicylic Acid  Keratolytics  Vitamin D Creams  Retinoids  Coal Tar, Anthralin  UV Light  Chemotherapy  Occlusive Dressings  Fish Oil Supplements

26. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Viral Infection ▪ HSV1 – Above Waist ▪ HSV2 – Below Waist

27. Understanding Medical Surgical Nursing, 4th Edition  Primary Infection ▪ Direct Contact ▪ Respiratory Droplet ▪ Fluid Exposure  Lies Dormant  Recurs with Stress

28. Understanding Medical Surgical Nursing, 4th Edition  Prodromal Phase  Burning, Tingling  Vesicles and Pustules  Burning, Itching, Pain  Contagious Until Scabs Form

29. Understanding Medical Surgical Nursing, 4th Edition  History and Physical  Culture

30. Understanding Medical Surgical Nursing, 4th Edition  Antiviral Agents (Acyclovir/Zovirax)  Topical  Oral  Antibiotics for Secondary Infection  Avoid Triggers of Recurrence

31. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Acute Inflammation/Infection  Painful Vesicules  Follows Nerve Distribution  Usually One-sided

32. Understanding Medical Surgical Nursing, 4th Edition  Reactivation of Varicella Zoster Virus (Chickenpox Virus)  Occurs with Reduced Immune Function  Elderly  AIDS  Immunosuppressed

33. Understanding Medical Surgical Nursing, 4th Edition  Avoidance of Infected Persons  Varicella Vaccine (Varivax)  Zostavax

34. Understanding Medical Surgical Nursing, 4th Edition  Vesicles, Plaques  Irritation  Itching  Fever  Malaise  Pain

35. Understanding Medical Surgical Nursing, 4th Edition  Postherpetic Neuralgia  Persistent Dermatomal Pain  Hyperesthesia  Opthalmic Herpes Zoster  Sepsis

36. Understanding Medical Surgical Nursing, 4th Edition  History and Physical  Culture

37. Understanding Medical Surgical Nursing, 4th Edition  Acyclovir  IV, Oral, Topical  Analgesics  Anticonvulsants/Antidepressants  Antihistamines  Corticosteroids  Antibiotics for Secondary Bacterial Infection

38. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology/Etiology  Direct Contact with Fungus  Overgrowth with Antibiotic Therapy  Grows in Warm Moist Environment

39. Understanding Medical Surgical Nursing, 4th Edition  Tinea Pedis  Tinea Capitas  Tinea Corporis  Tinia Cruris  Candidiasis

40. Understanding Medical Surgical Nursing, 4th Edition  Keep Skin Clean and Dry  Topical Antifungals  Oral Antifungals  Corticosteroids  Teach to Avoid Spread

41. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Inflammation of Skin/Connective Tissue  Infection ▪ Staphylococcus/MRSA ▪ Streptococcus  Etiology  Open Wound/Trauma  May be Unknown

42. Understanding Medical Surgical Nursing, 4th Edition  Warmth  Redness  Edema  Pain, Tenderness  Fever  Lymphadenopathy

43. Understanding Medical Surgical Nursing, 4th Edition  Culture and Sensitivity  Blood Cultures

44. Understanding Medical Surgical Nursing, 4th Edition  Antibiotics  Topical  Systemic  Debridement

45. Understanding Medical Surgical Nursing, 4th Edition  Increased Sebum Production  Obstruction of Pilosebaceous Ducts

46. Understanding Medical Surgical Nursing, 4th Edition  Signs and Symptoms  Comedones ▪ Open ▪ Closed  Therapeutic Interventions  Benzoyl Peroxide  Vitamin A Acid  Antibiotics  Estrogen Therapy

47. Understanding Medical Surgical Nursing, 4th Edition  Risk for Spread of Infection  Acute Pain

48. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology/Etiology  Infestation by Lice  Transmission by Direct Contact

49. Understanding Medical Surgical Nursing, 4th Edition  Pediculosis Capitis  Pediculosis Corporis  Pediculosis Pubis

50. Understanding Medical Surgical Nursing, 4th Edition  Itching  Papular Rash  Presence of Lice, Nits, and Excreta

51. Understanding Medical Surgical Nursing, 4th Edition  History and Physical  Test for STD if Pediculosis Pubis

52. Understanding Medical Surgical Nursing, 4th Edition  Pediculosides  Permethrin, Pyrethrin, Lindane  Mechanical Removal  Antipruritics  Topical Corticosteroids

53. Understanding Medical Surgical Nursing, 4th Edition  Self Medication  Removal of Nits  Cleaning of Clothing and Objects  Inspection of Family and Friends

54. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology  Sarcoptes Scabiei Mites ▪ Burrow into Skin  Etiology  Contact with Infected Clothing or Animals

55. Understanding Medical Surgical Nursing, 4th Edition  Itching  Rash  Burrows

56. Understanding Medical Surgical Nursing, 4th Edition  Shaving of Lesion  Microscopic Evaluation

57. Understanding Medical Surgical Nursing, 4th Edition  Topical Scabicides  Permethrin  Crotamiton  Antipruritics

58. Understanding Medical Surgical Nursing, 4th Edition  Self Medication  Treat Family Members  Wash Clothing and Linens  Itching May Continue 2 Weeks Following Treatment

59. Understanding Medical Surgical Nursing, 4th Edition  Pathophysiology/Etiology  Autoimmune Disorder  Bullae on Skin and Mucous Membranes  Triggers  Sun  Some Drugs or Foods

60. Understanding Medical Surgical Nursing, 4th Edition  Bullae  Mucous Membranes  Spread to Skin ▪ Rupture ▪ Raw Wounds  Pain  Burning  Itching

61. Understanding Medical Surgical Nursing, 4th Edition  Positive Nikolsky’s Sign  Biopsy

62. Understanding Medical Surgical Nursing, 4th Edition  Corticosteroids  Cytotoxic Agents  Antibiotics  Analgesics  Antipruritics  Fluid Replacement  High Protein, High Calorie Diet

63. Understanding Medical Surgical Nursing, 4th Edition  Monitor Fluid Balance  Monitor Diet  Administer Wet Dressings or Baths  Control Pain  Maintain Oral Hygiene  Provide Psychosocial Support

64. Understanding Medical Surgical Nursing, 4th Edition  Cancer Arising From  Basal Cell Layer ▪ Basal Cell Carcinoma  Epidermis ▪ Squamous Cell Carcinoma  Menalocytes ▪ Malignant Melanoma

65. Understanding Medical Surgical Nursing, 4th Edition  Ultraviolet Rays  Fair Skin  Genetic Tendency  X-Ray Therapy  Chemicals  Immunosuppressive Therapy

66. Understanding Medical Surgical Nursing, 4th Edition  Limit Exposure to UV Rays  Use Sunscreen  Wear Protective Clothing  Report Changes in Moles

67. Understanding Medical Surgical Nursing, 4th Edition  Examination  Biopsy

68. Understanding Medical Surgical Nursing, 4th Edition  Surgical Excision  Chemotherapy  Radiation Therapy

69. Understanding Medical Surgical Nursing, 4th Edition  Rhinoplasty  Blepharoplasty  Rhytidoplasty  Otoplasty