Nursing Care of Patients With Skin Disorders

Understanding Medical Surgical Nursing, 4th Edition
Nursing Care of Patients with Skin Disorders
Pathophysiology
Pressure Against Skin
Tissue Anoxia
Etiology
Pressure
Friction
Shear
Immobility
Impaired
Circulation
Impaired Sensory Perception
Elderly
Very Thin or Obese
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
Turn/Reposition at Least every 2

Keep Heels Off Bed
Pad/Protect Bony Prominences
Use Pressure-Reducing Mattress
Use Lift Sheet to Move
Provide Nutrition and Hydration
hr
Sensory
Perception
Moisture
Activity
Mobility
Nutrition
Friction and Shear
Pain
Open
Color
Ulcerated Area
Tip
Black: Necroses
Yellow: Infection
Red: Healing
Physical Examination
Culture and Sensitivity
Blood Supply Studies
Wound Biopsy
Remove
Debride
All Pressure
Mechanical
Enzymatic
Autolytic
Surgical
Cleanse
4 15 PSI
Types
Hydrogel
Polyurethane
Film
Hydrocolloid
Wafer
Biological
Alginate
Gauze
Moist
Environment
Caution with
Tape
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
Impaired Skin Integrity

Risk for Infection
Pain
Pathophysiology
Inflammation of the Skin
Etiology
Allergens
Irritants
Heredity
Stress
Contact
Irritant
Allergic
Atopic
Seborrheic
Rash, Itching
Lesions
Scales
Crusts
Fissures
Macules
Papules
Pustules
Infection
Sepsis
History
Culture
and Physical
and Sensitivity
Antihistamines
Analgesics
Antipruritics
Steroids
Colloidal Oatmeal
Wet Dressings
Baths
Impaired Skin Integrity

Disturbed Body Image
Deficient Knowledge
Pathophysiology
Inflammatory Disorder
Proliferation of Epidermal Cells
Scaling
Stress
Strep Pharyngitis
Hormone Changes
Cold Weather
Skin Trauma
Some Drugs
Papules, Plaques
Silvery Scales
Itching
Infection, Fever, Chills

Arthritis
Nail Changes
Lymphadenopathy
Physical Assessment
Rule Out Infection
Tub Baths
Corticosteroids
Salicylic Acid
Keratolytics
Vitamin D Creams
Retinoids
Coal Tar, Anthralin

UV Light
Chemotherapy
Occlusive
Dressings
Fish Oil
Supplements
Pathophysiology
Viral Infection
HSV1 Above Waist
HSV2 Below Waist
Primary Infection
Direct Contact
Respiratory Droplet
Fluid Exposure
Lies Dormant
Recurs with Stress
Prodromal
Phase
Burning, Tingling
Vesicles
and Pustules
Burning, Itching, Pain
Contagious
Until Scabs Form
History
Culture
and Physical
Antiviral
Agents (Acyclovir/Zovirax)
Topical
Oral
Antibiotics for
Avoid Triggers
Secondary Infection
of Recurrence
Pathophysiology
Acute
Inflammation/Infecti
on
Painful Vesicules
Follows Nerve
Distribution
Usually One-sided
Reactivation
of Varicella Zoster Virus

(Chickenpox Virus)
Occurs with Reduced Immune
Function
Elderly
AIDS
Immunosuppressed
Avoidance of Infected Persons

Varicella Vaccine (Varivax)
Zostavax
Vesicles,
Irritation
Itching
Fever
Malaise
Pain
Plaques
Postherpetic Neuralgia
Persistent Dermatomal Pain
Hyperesthesia
Opthalmic Herpes Zoster
Sepsis
History
Culture
and Physical
Acyclovir
IV, Oral, Topical
Analgesics
Anticonvulsants/Antidepressants
Antihistamines
Corticosteroids
Antibiotics for Secondary Bacterial
Infection
Pathophysiology/Etiology
Direct Contact with Fungus
Overgrowth with Antibiotic Therapy
Grows in Warm Moist Environment
Tinea Pedis
Tinea Capitas
Tinea Corporis
Tinia Cruris
Candidiasis
Keep Skin Clean and Dry

Topical Antifungals
Oral Antifungals
Corticosteroids
Teach to Avoid Spread
Pathophysiology
Inflammation of Skin/Connective Tissue
Infection
Staphylococcus/MRSA
Streptococcus
Etiology
Open Wound/Trauma
May be Unknown
Warmth
Redness
Edema
Pain, Tenderness
Fever
Lymphadenopathy
Culture and Sensitivity

Blood Cultures
Antibiotics
Topical
Systemic
Debridement
Increased Sebum
Production
Obstruction of
Pilosebaceous
Ducts
Signs and
Symptoms
Comedones
Open
Closed
Therapeutic
Interventions
Benzoyl Peroxide
Vitamin A Acid
Antibiotics
Estrogen Therapy
Risk for Spread

Acute Pain
of Infection
Infestation by Lice
Transmission by Direct Contact
Pediculosis
Pediculosis
Pediculosis
Capitis
Corporis
Pubis
Itching
Papular Rash
Presence of Lice,
Nits, and Excreta
History and Physical

Test for STD if Pediculosis
Pubis
Pediculosides
Permethrin, Pyrethrin, Lindane
Mechanical Removal
Antipruritics
Topical Corticosteroids
Self Medication
Removal of Nits
Cleaning of Clothing and Objects
Inspection of Family and Friends
Pathophysiology
Sarcoptes Scabiei Mites
Burrow into Skin
Etiology
Contact with Infected Clothing or
Animals
Itching
Rash
Burrows
Shaving of Lesion
Microscopic Evaluation
Topical
Scabicides
Permethrin
Crotamiton
Antipruritics
Self Medication
Treat Family Members
Wash Clothing and Linens
Itching May Continue 2 Weeks
Following Treatment
Autoimmune Disorder
Bullae on Skin and Mucous Membranes
Triggers
Sun
Some Drugs or Foods
Bullae
Mucous Membranes
Spread to Skin
Rupture
Raw Wounds
Pain
Burning
Itching
Positive
Biopsy
Nikolskys Sign
Corticosteroids
Cytotoxic Agents
Antibiotics
Analgesics
Antipruritics
Fluid Replacement
High Protein, High Calorie
Diet
Monitor Fluid Balance

Monitor Diet
Administer Wet Dressings or Baths
Control Pain
Maintain Oral Hygiene
Provide Psychosocial Support
Cancer
Arising From
Basal Cell Layer

Basal Cell Carcinoma
Epidermis
Squamous Cell Carcinoma
Menalocytes
Malignant Melanoma
Ultraviolet Rays
Fair Skin
Genetic Tendency
X-Ray Therapy
Chemicals
Immunosuppressive
Therapy
Limit
Exposure to UV Rays
Use Sunscreen
Wear Protective Clothing
Report
Changes in Moles
Examination
Biopsy
Surgical Excision
Chemotherapy
Radiation Therapy
Rhinoplasty
Blepharoplasty
Rhytidoplasty
Otoplasty

Nursing Care of Patients With Skin Disorders

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Understanding Medical Surgical Nursing, 4th Edition