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Final med surge- study guide from notes

front 1

skin consists of which two layer ?

back 1

Epidermis & Dermis

front 2

Epidermis is the outer layer of the skin and has how many layers?

back 2

5 thin layers

front 3

Dermis is the inner layer of the skin and has how many layers?

back 3

2 layers

front 4

Melanocytes

back 4

Skin cells constantly regenerating melanocytes gives the skin its hair and color

front 5

the dermis contains what?

back 5

blood vessels and nerves

front 6

Secrete Sebum

back 6

oily/wax that protects skin

front 7

Skin helps to stimulate vitamin D production when exposed to ultraviolet (UV) light

T/F

back 7

True

(vitamin and calcium need to work together)

front 8

Keratin

back 8

makes skin waterproof

front 9

Sebaceous Glands

back 9

produce sebum

front 10

in some spot melanocytes increase in production and produce brown spots called what?

back 10

Senile Lentigines (age spots)

front 11

what is the most common complaints of skin disorders

back 11

Pruitis(itching) and pain

front 12

overexposure to Uv light can cause what?

back 12

malignant changes (cancerous skin changes)

front 13

skin biopsy

back 13

removal of a sample from a skin lesion to differentiate between a benign and malignant lesion

front 14

shave biopsy

back 14

shave top layer off a lesion

front 15

punch biopsy

back 15

remove core from the center of a lesion

front 16

incisional biopsy

back 16

remove/excise the entire lesion

front 17

wood light

back 17

detects fungal infection

front 18

Keloid

back 18

a thick ridge of scar that stands up from surrounding skin

front 19

Maclue

back 19

flat area with a change in skin color

front 20

papule

back 20

elevated, solid lesion

  • wart, elevated moles, limpoma, basal cell carcinoma

front 21

Vesicle

back 21

larger, raised fluid filled lesion

front 22

Bulla

back 22

a fluid filled vesicle or blister, larger than 1 cm

front 23

pustule

back 23

elevated, superficial lesions filled with purulent fluid

front 24

plaque

back 24

elevated,superfical, solid lesion

front 25

wheal

back 25

firm, edematous, irregularly shaped area

front 26

ABCDE'S

back 26

  • A-asymmetric
  • B-irregular border
  • c-color change
  • d- diameter change
  • e-evolving

front 27

mupirocin medication

back 27

used topically for staph and strep infections

front 28

contact dermatitis

back 28

delayed allergic response- allergen has contact with the skin and immune system

front 29

Atopic dermatitis

back 29

-eczema

-genetic component

-red and itchy skin

front 30

Stasis dermatitis

back 30

due to venous stasis

-occurs mostly on lower extremities

-begins with erythema and pruitis

front 31

Seborrheic dermatitis

back 31

inflammation of the scalp, eyebrows, eyelids, ear caneles, nasal libia folds and axillary

front 32

acne vulgaris

back 32

usually begins during puberty; not contagious

front 33

acne rosacea

back 33

  • usually begins between ages 30-50
  • S/S- erythema, papules/Telangiectases (dilation of capillaries causing small red/pruple clusters or "spider veins"

front 34

Cellulitus

back 34

infection of the dermis and subcutaneous tissues

front 35

Furuncle

back 35

inflammation of the hair follicles

front 36

Carbuncles

back 36

collection of boils that have multiple pus "heads"

front 37

Onychomycosis

back 37

fungal infection of fingernails and toenails

front 38

scables

back 38

acquired by contact with infested person or their clothing, bed linens, bedding

-contagious

front 39

basal cell carcinoma

back 39

typically appears as a small, scaly area and tends to become larger as the disease progresses

-most commonly found on face or trunk

front 40

squamous cell carcinoma

back 40

  • caused by sunlight
  • starts as small nodule and rapidly becomes ulcerated
  • most often appears on head and neck

front 41

actinic keratoses

back 41

  • common among older adults
  • pre-cancerous lesions
  • appear on fair-skinned people as small, scaly, red or grayish papules
  • can evolve into a squamous cell carcinoma that can grow rapidly and metastasize

front 42

malignant melanoma

back 42

least common form of skin cancer, but causes the most skin cancer deaths

front 43

epidermal burn (1st degree burn)

back 43

involves only the superficial epidermal layer and usually does not need treatment

-pink/red tender appearance

front 44

superficial partial thickness (2nd degree burn)

back 44

epidermis and parts of the dermis are affected

-red to white with blisters

-mild to moderate edema

front 45

deep-partial thickness (3rd degree burn)

back 45

includes tissue damage to the epidermis extending deep into the dermis

-red to white with moderate edema

-no blisters

-occurs from flames, grease, tar, chemical burns

front 46

full thickness (3rd degree burns)

back 46

tissue damage to the epidermis, deep into dermis and can extend into subcutaneous tissue- nerve damage

-red to tan, black,brown, white

serve edema and hard eschar

front 47

deep full thicknesss (4th degree burn)

back 47

involves all layers including underlying tissues such as fat, muscle, tendons, bone

-nerve endings get destroyed

front 48

emergent phase

back 48

first 24-48 hours but can last up to 72 hours

it begins with fluid loss and edema formation

front 49

respiratory support (phases of burns)

back 49

assess for respiratory distress and monitor signs of respiratory distress

  • upper airway- swelling can occur and obstruct the airwya
  • lower airway-damage from inhaling smoke and soot

front 50

Fluid resuscitation (emergent phase )

back 50

parkland formla for fluid restrictions

-4ml lactated ringers (LR) x % burn weight in kg

front 51

Auto graft

back 51

(preferred) the patients own skin

front 52

hemograft

back 52

the skin of another person- allograft

front 53

heterograft

back 53

pig

front 54

biosynthetic/synthetic

back 54

artificial graft

front 55

portal hypertension

back 55

ascites, varices, ercephalopathy, often irreversible-transplant may be needed.

front 56

Liver biopsy

back 56

identifies extent of liver damage, inflammation, fibrosis, or cirrhosis when diagnosis is unclear

front 57

Diverticulum

back 57

a singular smalll outpouching of the colon wall

front 58

Diverticulosis

back 58

when multiple diverticula are present without evidence of inflammation with increased pressure within the colon or stool trapped in a diverticulum, a tear can occur.

front 59

diverticulitis

back 59

  • inflammation and infection can develop from diverticulum
  • with aging, the incidence of diverticular disease increases as a result of chronic constipation

front 60

Crohns Disease

back 60

an autoimmune inflammatory bowel disease that can involve any part of the GI tract

front 61

Crohns disease S/S

back 61

Crampy abdominal pain, chronic intermittent diarrhea (with or without blood), weight loss, and fatigue

-inflammatory symptoms can affect the outside GI tract (eyes, liver, bile ducts, skin, and joints)

front 62

crohns disease diet

back 62

foods that increase symptoms, such as dairy products, fatty foods, and fresh fruits and vegetables should be limited

front 63

Ulcerative colitis

back 63

similar to crohns disease however, only occurs in the large intestine and rectum

front 64

Ulcerative colitis diet

back 64

high fiber foods, caffeine, spicy foods, and milk products are avoided. diarrhea may increase the need for fluids TO prevent dehydration

front 65

irritable bowel syndromeq

back 65

not a disease but rather a functional problem

front 66

HEP A

back 66

Fecal-oral route: fecal contact; fecal contaminated flood, water or raw shellfish

front 67

HEP B

back 67

blood or bodily fluids such as saliva, semen, menstrual or vaginal fluid; equipment contaminate by infected blood

front 68

HEP C

back 68

blood or bodily fluids that contain blood; IV drug use is the most common birth from HCV-infected mother

front 69

pancreatitis

back 69

inflammation of the pancreas, may be either acute or chronic.

front 70

Acute pancreatitis

back 70

inflammation of the pancreas appears to be caused by a process called auto digestion

-commonly associated with heavy alcohol consumption or cholelithiasis (gallstones)

front 71

chronic pancreatitis

back 71

a progressive fibre-inflammatory disease in which functioning pancreatic tissue is replaced with fibrotic tissue because of inflammation

-appears in LUQ pain that worsens after eating, nausea, and vomiting, weight loss, strerrohaa and intolerance to fatty foods.

front 72

Appendicitis

back 72

inflammation of the appendix, the small, fingerlike appendage attached to the cecum of the large intestine

front 73

S/S of appendicitis

back 73

abdominal pain, anorexia, nausea, vomiting, diarrhea, fever, and increased WBC'S. within hours of onset, the pain usually becomes localized to the right lower quadrant at the mcburneys point , mid-way between the umbilicus and the right iliac crest

front 74

Peritonitis

back 74

an inflammation of the perioneum that occurs from a variety of causes.

front 75

common causes of peritonitis

back 75

a ruptured appendix, peptic ulcer, gangrenous gallbladder, perforated colon, pancreatitis, peritoneal dialysis, diverticulitis, incarcerated hernia, or gangrenous small bowel

front 76

peritonitis S/S

back 76

decreased peristalsis results in bloating, full feeling, anorexia, nausea, and vomiting, and no bowel movement or flatus

front 77

S/S of diverticulitis

back 77

most people have no symptoms. steady or crampy pain in the left lower quadrant of the abdomen is the most common symptom. nausea, vomiting, and bowel habit changes with constipation can occur; other symptoms may include bleeding, fever, and fatigue

front 78

cholecystitis

back 78

an inflammation of the gallbladder

front 79

cholelithiasis aka cholecystolithiasis

back 79

the formation of gallstones in the gallbladder

front 80

choledocholithiasis

back 80

refers to gallstones within the common bile duct.

front 81

the nephron is the basic unit of the kidney

T/F

back 81

true

front 82

creatine normal

back 82

0.5-1.2

front 83

specific grvaity

back 83

1.005-1.03

-the lower, excessive fluid intake

-the higher, dehydration- heart failure or shock

front 84

ribrofavin

back 84

bright yellow urine

front 85

IV contrast or dye, which labs should you get done

back 85

BUN and creatine so you dont hurt the kidney

front 86

oliguria

back 86

decreased urine output

front 87

anuria

back 87

absence of urine

front 88

polyuria

back 88

increased urine output

front 89

nacturia

back 89

excess urination at night

front 90

pyuria

back 90

puss in urine

front 91

always collect cultures before antibiotics T/F

back 91

True

front 92

which lab is going to tell you how the kidneys are functionign

back 92

creatine

front 93

BUN.

back 93

10-30

front 94

ALT NORMAL

back 94

7-56

front 95

AST NORMAL

back 95

10-40

front 96

creatine

back 96

90-120

front 97

Pylogram

back 97

imaging of renal pelvis, calyces, ureter.

-labs needed bun and creatine

front 98

Renal Angiography

back 98

visualizes renal blood vessels

-checking the distal pulses in the legs every 30-60 minutes with vital signs

-do not bend the leg or raise head of bed (more than 45 degrees)

front 99

Cystoscopy

back 99

scope that goes up through the bladder

-local or sedation for the patient

front 100

Is contrast that's instilled dangerous or safe?

back 100

dangerous can shut the kidneys down

front 101

stress incontience

back 101

involuntary urine loss from increasing abdominal pressure

front 102

urge inconteience

back 102

involuntary urine loss with abrupt/ strong desire to void

front 103

disability- associated incontience

back 103

inability to get to toilet due to health/ environment barrier

front 104

overflow incontience

back 104

involuntary loss of urine , associated with bladder over distention

front 105

total incocnitence

back 105

loss of urine

front 106

azotemia

back 106

to much nitrogen and creatine / waste products in the blood

front 107

cysitis

-aka honeymoon cystitis

back 107

inflammation of the bladder wall

front 108

Pylelonephritis

back 108

kidney infection

-hgiher risk for sepsis

front 109

lithotripsy

back 109

no data