Maryville Nurs 623 Exam 1 Study Guide Questions with

Maryville Nurs 623 Exam 1 Study Guide Questions with Correct Answers 100% Verified Basics with skin conditions - Correct Answers •Alopecia •Rash •Pruritus •Uticaria •Pigmentation change Skin lesion—New vs. Change HPI questions for skin problems - Correct Answers Duration of symptoms Precipitating factors •Medications •Food •Occupation •Outdoors •Hobbies/Sport participation •Exposure to insects •Jewelry/metals/chemicals •Family history

Is it:

Local or systemic Pruritus- all day or worse at night Uticaria - duration Pigmented changes Pigmentation/Changes of the skin Diff diagnosis - Correct Answers Nevi- brown, beige or pink(< 5mm) Melanoma Related to pregnancy- melasma (mask of pregnancy) Addison disease 1 / 4

Side effect of medication- steroid therapy skin lesions - Correct Answers Macule - flat, nonpalpable (freckle, petechia) Papule - PALPABLE, solid elevation of skin (elevated nevus) Nodule - elevated solid mass, deeper and firmer than papule (wart) Tumor - solid mass deep in subcutaneous tissue (epithelioma) Wheal - irregularly shaped, elevated area (hive, mosquito bite Vesicle - elevation of skin with serous (clear) fluid Pustule - similar to vesicle but filled with pus (acne) Ulcer - deep loss of skin (venous statis ulcer) Atophy - thinning of skin Bullae-Clear fluid-filled blisters > 10 mm in diameter. These may be caused by burns, bites, irritant or allergic contact dermatitis, and drug reactions.primary versus secondary skin lesions - Correct Answers Primary skin lesions are those which develop as a direct result of the disease process.Secondary lesions are those which evolve from primary lesions or develop as a consequence of the patient's activities.Parasitic Skin Infections - Correct Answers scabies and lice 2 / 4

Scabies - Correct Answers Highly contagious infestation that occurs mainly in children, young adults, health care workers, and institutionalized persons of all ages.

Subjective: Complaints of intense itching that is usually more severe at night.

Objective:Earliest physical sign is small 1 to 2 mm red papules located in areas of body most attractive to mites. Itching, excoriation, , crusting, and scaling may be present making it hard to see scabies.

Diagnostics:Ink burrow test

Scabies treatment - Correct Answers Permethrin 5% cream (Remember you have 5 fingers)- leave on for 8-14 hours then shower- daily for 7 days.Oral antihistamines for itching, topical steroids for itching.The entire household must be treated. Everything should be washed with hot water/detergent, treat any infection that is present.Starve mites by sealing them in a bag for about 10 days.Lice treatment - Correct Answers Permethrin 1% leave on for 10 mins then rinse. May repeat in 7 days if needed.Fungal skin infections - Correct Answers · Candidiasis- bright, beefy red rash treat with topical antifungal, · Dermatophytoses - the tineas (ringworm) · Onychomycosis treat with Terbinafine for 6-12 weeks (only 73-79% effective, educate patient.· Fungal infections survive on keratin, so considered superficial.· Pathogens: Epidermophyton, trichophyton, microsporum. 3 / 4

· Those at risk are DM and immunocompromised.

· Diagnostics: KOH

Tinea corporis (Ringworm of body) - Correct Answers Hx of erythematous round and elevated pruritic lesion that grows in size & starts to clear in the center Miconazole 2% cream BID x4 weeks, Clotrimazole 1%, Terbafine 1% Tinea capitus (ringworm of head) - Correct Answers Children common. Painless bald spot, may have kerion that looks like honeycomb, inflammation. Boggy mass containing broken hairs and oozing purulent material from follicular orifices Systemic antifungals - Griseofulvin BID for 2-4 months or 2 weeks after negative cultures. Teratogenic

• use 2nd method of contraception.

OR terbinafine cream Tinea versicolor (skin, AKA pityriasis versicolor) - Correct Answers Round or oval lesions of hypo or hyperpigmentation macule, located mainly on back chest, arms, sometimes neck/face. Sometimes very fine scales seen. Agent P oribiculare causes round, pityrosporum ovale causes oval Clotrimazole 1% cream and solution BID up to 4 weeks Bacterial infections of the skin - Correct Answers · Impetigo · highly contagious Cellulitis · Keflex (1st gen cephalosporine) 10-14 days, or dicloxacillin, · PCN allergy use Erythromycin.· non purulent assume staph aureus Purulent cellulitis · I&D first line

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