What are three types of ultraviolet light? | UVA, UVB, UVC |
Test used to diagnose fungal infections of the skin and nails. Skin scrapings and a nail clipping are used for cultures. Painless procedure. | KOH potassium hydroxide examination and culture |
Examination using black light in a dark room to reveal superficial skin infections and changes in pigmentation. It is noninvasive and painless. | Wood's light examination |
Test to identify substances patients are allergic to. Common irritants are applied to the skin and covered with special patches or tape. The areas are read after 48, 72, and 96 hours (sometimes one week). Skin reactions may include redness, swelling, and blisters. The test is painless. | Patch testing |
Removal of tissue for microscopic examination. May require just a dressing, may require sutures. | biopsy |
Biopsy post procedural care | Inspect for bleeding. Apply direct pressure if needed. Return for suture removal if needed. |
This procedure will have a lesion washed and opened to obtain a fluid sample to test for viral infections, and may cause mild discomfort. results are immediate. | Tzanck test |
The top of a lesion is taken off to test for the presence of mites, eggs, or their feces, and may be briefly uncomfortable. | Scabies scraping |
What must a patient avoid taking 48 hours before a biopsy to prevent excessive bleeding? | NSAIDs or aspirin |
A type of biopsy where the specimen is no deeper than the dermis. | Shave biopsy |
A type of biopsy where a circular tool cuts around the lesion which is lifted and severed | Punch biopsy |
A wedge of tissue is removed from a lesion | incisional biopsy |
Removal of an entire lesion, deep specimen. Sutures will be required to close the site. | excisional biopsy |
acyclovir, famciclovir, valacyclovir, foscarnet are oral _____, used to treat _________ | antivirals Herpes(simplex I, II, zoster) |
doxycycline, minocycline, tetracycline, and erythromycin are oral ______ used to treat ______. They can cause a sensitivity to _______. | antibiotics acne UV light |
terbinafine(Lamisil), griseofulvin (Fulvicin P/G), and ketoconazol (Nizoral) are oral ________ when topical medications do not get a response. They are commonly used for _____ infections | antifungals nail |
Give ketoconazole with _____ or _____ to minimize GI effects. | food milk |
_______ is an oral antifungal that decreases the effect of warfarin | griseofulvin |
When applying topical _______, avoid occlusive dressings, keep away from mouth and eyes. temporary skin irritation is common. | antimicrobials |
raised, solid lesion defined edges less than 1cm (mole, wart) | PAPULE |
raised, defined cavity filled with pus (acne, impetigo) | PUSTULE |
macule greater than 1cm (vitiligo) | PATCH |
Combined papules that form a raised area greater than 1cm in diameter (psoriasis) | PLAQUE |
Distinct flat area with color different from surrounding tissue (freckle, petechiae, hypopigmentation) | MACULE |
Superficial, irregular swelling caused by fluid accumulation (allergic response, insect bite) | WHEAL |
Firm/soft lesion that extends deep into dermis (lipoma, hemangioma) | TUMOR |
Thin-walled, fluid-filled chamber >1cm (Blister) | BULLA |
Thick, dried exudate remaining after vesicles rupture (impetigo, weeping eczematous dermatitis) | CRUST |
Dry or greasy skin flakes (psoriasis, seborrheic dermatitis, eczema) | SCALE |
Distinct, linear crack extending into dermis (Chellosis, tinea pedis) | FISSURE |
Shallow, superficial depression (impetigo, herpes zoster/simplex lesions after rupture) | EROSION |
Depression deeper than erosion, may bleed (Pressure injury, chancre) | ULCER |
Abrasion caused by scratching (Scratching with insect bites, scabies, dermatitis) | EXCORIATION |
Flat or raised, color darker than surrounding skin | NEVUS (Mole) |
The use of light and photosensitive drugs to promote shedding of the epidermis | Phototherapy |
Pigmented spots on sun exposed areas (liver spots) | LENTIGINES |
Large, purplish bruises from minor trauma that resolve slowly | SENILE PURPURA |
Waxy, raised lesions that are flesh colored to dark brown or black and variously sized | SEBORRHIC KERATOSIS |
Small, soft, raised lesions that are flesh colored or pigmented (skin tags) | ACROCHORDONS |
6 Aging changes of the skin | 1 Thinning skin layers and degeneration of elastin resulting in wrinkles
2 decreased size and number of sweat glands
3 decreased sebum production
4 dryness and pruritus (itching) increased
5 decreased melanin production, increased paleness
6 development of skin lesions |
What conditions may be treated with phototherapy? | Psoriasis, vitiligo, chronic eczema |
raised cavity filled with fluid less than 1cm (Herpes simplex/zoster) | VESICLE |
Raised solid lesion >1cm, may be hard or soft, may extend deeper into dermis than papule (Fibroma, xanthoma) | NODULE |
Fluid-filled cavity in dermis or subcutaneous tissue (Sebaceous cyst) | CYST |
What are contraindications to phototherapy because the conditions are aggravated by the treatment? | History of herpes simplex infection
skin cancer
cataracts
lupus erythematosus |
After phototherapy the patient may have _____ and _____ | pruritus and dry skin |
Signs of phototoxicity are _____,_____ and _____, and should be assessed | redness, vesicles, pain |
This is used with UVA phototherapy to treat vitiligo, psoriasis, and cutaneous T-cell lymphoma | PSORALIN/ 8 methoxypsoralen |
Phototherapy patient education. What should the patient do 8 hr before and after treatment? | wear sunscreen
wear protective clothing
wear dark glasses
*decreases exposure to other sources of ultraviolet light |
The type of phototherapy specifically used to treat psoriasis and atopic dermatitis | GOECKERMAN REGIMEN |
The Goeckerman regimen uses ____ _____ bath and topical _____ product before exposure to _______ light. | tar emulsion
tar
ultraviolet |
Topical drug capable of dissolving keratin, slowing bacterial growth and used to treat dandruff, acne, and psoriasis is a _____ drug. | Keratolytic |
What are 4 keratolytics? | benzoyl peroxide
salicylic acid
sulfur
coal tar |
What are the side effects for keratolytic drugs? | dryness, irritation, scaling, edema, photosensitivity |
Nursing interventions for keratolytics? | Avoid excessive sun exposure
Assess effects |
What are 3 topical antibacterial agents used to treat skin disorders? | bacitracin
polysporin(bacitracin and polymixin B)
silver sulfadiazine (Silvadine) |
The topical antibacterial agents ______ and _____ treat skin infections and partial-thickness (first degree burns) | bacitracin and polysporin |
The antibacterial agent __________ treats wound infection with serious burns | Silver Sulfadiazine (Silvadene) |
When treating a skin infection with bacitracin or polysporin, what potential side effects may occur? | Contact dermatitis
Allergy (rare)
itching
burning
anaphylaxis |
What are nursing interventions for the use of bacitracin and polysporin? | Ask about allergies
apply as prescribed
report itching, burning, rash, redness |
Possible side effects of silver sulfadiazine include | rash
pruritus
burning
pain
nephritis, anorexia (rare)
blood dyscrasias
hepatitis
nephrosis
hypoglycemia |
nursing interventions for the use of silver sulfadiazine | apply using gloves to clean burn surface
use a 4x4 gauze or tongue blade, do not double dip
cover burn completely and continuously
Monitor:
renal and GI distress
headache
joint pain
hepatic function
vital signs
CBC
serum glucose |
name 5 topical antifungals | nystatin
clotrimazole (mycostatin, Mycelex)
oxiconazole (Oxistat)
naftifine (Naftin)
terbinafine (Lamisil) |
Side effects of topical antifungals? | Irritation
erythema
burning
rash
abdominal cramps and cystitis for vaginal preparations |
What are nursing interventions for topical antifungals? | apply as ordered
do not use occlusive dressings unless ordered |
Name 3 topical anti-inflammatory agents | hydrocortisone (Cortizone)
triamcinolone (Aristocort)
fluocinolone (Bio-Syn) |
Side effects of ________agents include itching, erythemia, irritation, severe allergic reactions (rare), systemic drug absorption | anti-inflammatory |
What are nursing interventions for anti-inflammatory agents? | do not use occlusive dressing without order
apply sparingly, rub in thoroughly |
azelaic acid (Azelex), clindamycin (Cleocin), erythomycin (Eryderm), and benzoyl peroxide are topical ________agents | antimicrobial |
Pruritus, burning, stinging, tingling, and mild to moderate inflammatory acne vulgaris are side effects for topical ______ | antimicrobials |