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care of patient with integumentary & musculoskeletal disorders


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Tyresha Warren


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pruritus
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the symptoms of itching, tingling, or burning

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care of patient with integumentary & musculoskeletal disorders - Marcador

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care of patient with integumentary & musculoskeletal disorders - Detalles

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Pruritus
The symptoms of itching, tingling, or burning
Vesicle
Circumscribed elevation of the skin filled with serious fluid; smaller than 0.5 cm at the corner of the mouth, on the lips, or on the nose
Exudate
Fluid, cells, or other substances that have been slowly exuded, or discharged, from cells or blood vessels through small pores or breaks in cell membranes
Excoriation
Injury to the surface layer of the skin caused by scratching or abrasion
Macules
Small flat blemishes flush with the skin surface
Pustulant vesicles
Small, circumscribed elevations of the skin that contain pus
Suppuration
Production of purulent material
Papules
Small, raised, solid skin lesions less than 1 cm in diameter
Urticaria
The presence of wheals or hives in an allergic reaction, commonly used by drugs, food, insect bites, inhalants, emotional stress, or exposure to heat or cold
Wheals
Round elevation of the skin; white in the center with a pale red periphery
Pediculosis
Lice infestation
Keloid
An overgrowth of collagenous scar tissue at the site of the skin wound
Verruca
Is a benign, viral, warty like skin lesion with a rough, papillomatous (nipple like) growth pattern
Nevi
(singular, nevus) or moles, are pigmented, congenital skin blemishes that are usually benign but may become cancerous
Alopecia
The loss of hair
Contractures
Shortening or tension of muscles that affects extension
Curling's ulcer
A duodenal ulcer that develops 8 to 14 days after severe burns on the surface of the body; the first sign is usually vomiting of bright red blood
Rule of nine
Determines the TBSA burned; divides the body into multiples of nine
Eschar
Black, leathery, crust (i.e. a slough) that the body forms over burned tissue; eschar can harbor microorganisms and cause infection
Debridement
Removal of damaged tissue and cellular debris from a wound or burn to prevent infection and to promote healing
Autograft
Surgical transplantation of any tissue from one part of the body to another location in some patients
Homograft (allograft)
The transfer of two tissues between tow genetically dissimilar individuals of the same species, such as the skin transplant from another person who is not an identical twin ( often a cadaver)
Heterograft (xenograft)
Tissue is from another species, such as a pig or cow used as a temporary graft
Arthrocentesis
Is the puncture of a pt joint with a needle and the withdrawal of synovial fluid for diagnostic purposes
Ankylosis
The accompanying fixation of the joint
Tophi
Calculi containing sodium rate deposits that develop in periarticular fibrous tissue, typically in its with gout
Sequestrum
A fragment of necrotic bone that is partially or entirely detached from the surrounding or adjacent healthy bone
Fibromyalgia
Is a chronic syndrome or unknown origin that causes pain in the muscle, bones or joints
Arthrodesis
Surgical fusion of a joint; it can be performed when severe joint destruction has occurred
Arthroplasty
Total joint replacement; repair or refashioning of one or both sides, parts, or specific tissue within a joint ; often is required on the elbow, knee, or shoulder joint to restore or increase mobility
Bipolar hip replacement (hemiarthroplasty)
Prosthetic implant used to replace the femoral head and the neck in hip fractures when the vascular supply to the femoral head is or may become compromised
Colles fracture
Fractures of the distal portion of the radius within 1 inch of the wrist joint; commonly occurs when a person attempts to break a fall by putting the hands down
Open reduction with internal fixation (ORIF)
A surgical procedure allowing fracture alignment under direct visualization while using various internal fixation devices applied to the bone
Crepitus
Sound that resembles the crackling noise heard when rubbing hair between the fingers or throwing salt on an open fire. it is associated with gas gangrene, the rubbing of bone fragments, or the crackles of a consolidated area of lung in pneumonia
Compartment syndrome
Is a pathologic condition caused by the progressive development of arterial vessels compression and reduced blood supply to one of the body's compartments, typically in an extremity
Volkmann's contracture
Is a permanent contracture( with clawhand, flexion of wrist and fingers, and atrophy of the forearm
Paresthesia
Numbness or tingling
Blanching test
Meaning to whiten or pale, is a test of the rate of capillary refills, which is a signal of circulation; aka capillary nail refill test
Scoliosis
Curvature of the spine
Kyphosis
A rounding of the thoracic spine ( hump-backed appearance)
Lordosis
An increase in the curve at the lumbar space region that throws the shoulders back, resulting in a sway-backed gait
What is the function of melanin
Another skin protein, it forms a protective shield that guards the keratinocytes and nerve ending from ultraviolet light
What are the epidermis cells of the skin
Stratum germinativum, stratum corneum, melanocytes
What is the definition of a keloid
An overgrowth of collagenous scar tissue at the site of a skin wound; the collagen tissues become raised, hard and shiny; the keloid can be red, pink or flesh color
What does sebum do
Lubricates the skin and hair that covers the body; also inhibits bacterial growth
What should you teach a pt with type two herpes
It may still be transmitted by viral shedding even during periods of remission; frank discussion concerning safe sexual practices, including condoms, are indicated
What is the antibiotic for Herpes Zoster
Acyclovir, orally & IV; ideally within 72 hr of development of symptom; reduces pain and duration of the virus
If a staff member gets the symptoms of shingles, what should you do?
Any staff who has symptoms consistent with herpes zoster should be removed from active duty; health care staff who have not received 2 doses of varicella vaccine may be contagious for 8-12 days and should be moved to another duty location away from patients
What should you do if a pt has impetigo?
Highly contagious; interventions are aimed at the disrupting the course of the disease and preventing the spread of infection; penicillin is one of most common antibiotics; the lesions are soaked with antiseptic solution, and the dried exudates is removed with a special instrument
When you see a spiral fracture on an x-ray its usually associated with what type of force?
Break or coil around the bone, sometimes called a torsion fracture and results from a twisting force
Trauma severe enough to fracture the pelvis can also be injury to what
Vital abdominal organs, such as the bladder, vagina, uterus, liver, spleen, intestines may also be damaged;
If a pt has shingles what should you do when giving meds
Contact precaution and airborne precautions
In PQRST what does the "S" stand for
Severity of the signs and symptoms
What is accutane used for and what should you tell the pt
It reduces the sebum production and abnormal keratinization of gland ducts; women of child bearing age should receive counseling about the need for reliable methods of contraception with medication; adverse reaction is destructive effect on fetal development, depression
What is phantom pain
A pain felt in the area of the missing extremity as if it were still present. Phantom pain occurs because the nerve tracts that register pain in the amputated area continue to send the message to the brain; this is normal
When do you give Fosamax
First thing in the morning, with 6-8 oz of plain water, 30 minutes before other meds, beverages or food
What is systemic lupus
Is an autoimmune disorder characterized by inflammation of almost any body part. It is a chronic, multisystem inflammatory disorder that occurs when the body produces antibodies against its own cells.
Risk factors for fat embolism
Long bone and pelvic fractures, crush injuries, and hip replacement surgery; it can occur within 48 hours of the injuries
What is the function of the skin
Aids excretion of waste products; has nerve ending tht provide sensory info r/t pain, heat&cold, touch, pressure, vibration; insulates body and protect from trauma through subq layer of fat; prevent dehydration; protect from pathogenic organisms & foreign substances; natural barrier against infections; regulate temp; synthesizes vitamin D
What is a butterfly rash
It occurs over the nose and cheek and along the eyelid area in 10-50% of pt with acute cutaneous lupus erythematosus
Define macule
Is a flat, circumscribed area that is changed in color; <1 cm in diameter. Example: freckles, flat moles (nevi), petechiae, measles, scarlet fever
Define papule
Is an elevated, firm, circumscribed area; <1 cm in diameter. Examples: warts (verrucae), elevated moles, lichen planus.
Define wheal
Is an elevated, irregularly shaped area of cutaneous edema; solid, transient; variable diameter. Example: insect bites, urticaria, allergic reaction
Define pustule
Elevate, superficial lesion; similar to a vesicle but filled with purulent fluid; example: impetigo, acne
Define keloid
Is an irregular shaped, elevated, progressively enlarging scar; grows beyond the boundaries of the wound; caused by excessive collagen formation during healing. Example: keloid formation after surgery.
Define excoriation
Is loss of epidermis; linear hollowed-out crusted area. Example: abrasion or scratch, scabies.
Define fissure
Linear crack or break from the epidermis; may be moist or dry; examples: athletes foot, cracks at the corner of the mouth
Define ulcer
Is loss of epidermis and dermis; concave; varies in size. Example: pressure sores, stasis ulcer.
Define atrophy
Atrophy is thinning of skin surface and loss of skin markings; skin translucent and paper-like. Examples: striae; aged skin
What is the major function of the skin
The body's protector, first line of defense against infection and injury protecting the internal organs
What should be the goal for a pt that has lupus
Relief of symptoms, remission of the disease, early alleviation of exacerbations, and prevention of untoward complications
A pt is getting an MRI ( magnetic resonance imaging) what do they need to remove
All metals, such as jewelry, clothing w/ metal fasteners, glasses, hair clips, and pt w/ metal prostheses such as heart valves, orthopedic screws, or cardiac pacemakers may not be allowed to undergo MRI, depending on the type of metal used
What metal are safe during an MRI
Titanium is typically safe
Define melanocytes
The cells give rise to the pigment melanin, a black or dark brown pigment occurring naturally in the hair, the skin, and the iris and choroid of the eye
Stage 1 pressure injury is
A localized area of the skin, typically over a bony prominence, that is intact with nonblanchable redness
Stage 2 pressure injury is
Involves partial thickness loss of epidermis, it appears as a shallow open injury, usually shiny or dry with a red-pink wound bed w/out slough or brusing
Stage 3 pressure injury is
Involves full thickness tissue loss, subcutaneous fat is sometimes visible, but bone, tendon, and muscle are not exposed
Stage 4 pressure injury is
Involves full thickness tissue loss with exposed bone, tendon, cartilage or muscle
Unstageable pressure injury is
Involves full thickness tissue loss, a wound base covered by slough ( yellow, tan, gray, green, brown) and eschar in the wound bed that is usually tan, brown or black
Herpes type 1(HSV-1)
Causes cold sores, often referred to as fever blisters, usually associated with febrile conditions; the infection is generally self limiting, it usually clears up by itself requiring no treatment
HSV-1 is characterized by what
A vesicle commonly know as a cold sore, usually erythematous and edematous ( red and swollen), it produces a burning pain when the vesicle ruptures; usually occurs after an acute illness or infection
A person who has previously had what virus will also get shingles
Chickenpox; the varicella virus lies dormant until the persons resistance to the infection becomes lowered
Risk factors for shingles include
Suppressed immunity, aging, infection and stress
What does the shingle virus cause
An inflammation of the spinal ganglia and produces skin lesions of small vesicles along the peripheral nerve fibers of the spinal ganglia
Define cellulitus
Occurs when bacteria enters the body through a break in the skin, such as a cut, scratch, or insect bite that is not cleansed with soap and water; infection is usually superficial, but may spread & become life threading as the infection invades deeper tissues, lymph nodes and blood stream
Define impetigo
A highly contagious inflammatory disorder, more common in younger children but can affect any age; lesions start as macules & develop into pustulant vesicles and then rupture and from dried exudate
Nursing interventions for impetigo
Are aimed at disrupting the course of the disease and preventing the spread of infection
How do you stop the disease from progressing with impetigo
Antibiotics are used to arrest the disease process, systemic parenteral penicillin is one of the most commonly used antibiotics
How are the lesions removed from impetigo
Soaked with an antiseptic solution, and the dried exudate is removed with a special instrument
What is lice (pediculosis)
A parasitic disorder of the skin
How is pediculosis transmitted
It can occur anywhere, lice are transmitted by close contact with infected individuals or their personal items such as hats, clothing and grooming items
What do lice do once they find a host
Seek blood, they can only live 1-2 days without blood source; they leave their eggs (nits) on the skin surface attached to hair shaft
Clinical manifestation of lice
Nits or lice can be seen on the body, pinpointing, raised red macule, pinpoint hemorrhages, and severe pruritus confirm the diagnosis