Alterations in the Integumentary System: Skin Cancer, Pressure Ulcers, Burns – Flashcards
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List four strategies to prevent skin cancer development
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- shade - sunscreen - examine skin - avoid sunburns
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Which type of burn will most likely result in scarring?
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2nd degree full thickness
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Partial thickness
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epidermis and various degrees of dermis
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Full thickness
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Entire epidermis and dermis/subcutaneous tissue
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A 26 yr old spent more than 7 hours at the beach and now has painful blisters on both shoulders. The epidermis and portions of the dermis are affected. What type of burn is this?
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2nd degree partial thickness
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An electrician is injured at work and has burns that progress through the subcutaneous tissue to the muscle on both arms and truck. What type of burn is this?
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3rd degree
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Patients with burns are at risk for developing infections
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True
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Burn patients never experience fluid imbalances
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False
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List 4 mechanisms by which pressure ulcers develop
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- pressure - shearing - friction - moisture
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4 strategies to prevent the development of pressure ulcers
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- identify patients at risk - changing positions - keep clean and dry - frequent assessments
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A patient has a 2 cm x 6 cm red non-blanchable area to the sacrum.
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Stage I
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A patient with a 3 cm x 4 cm wound to the medial right knee with a moderate amount of drainage and visible subcutaneous tissue.
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Stage III
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temp of 100.9 F, yellow/green tinged drainage with a foul odor.
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Infection
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Full thickness tissue loss which is completely obscured by slough/eschar
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non-stageable pressure ulcer
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Stage IV Pressure Ulcer
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Full thickness tissue loss with exposed bone, tendon or muscle
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Full thickness tissue loss with visible subcutaneous tissue only
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Stage III pressure ulcer
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Non-blanchable, Red, intact skin
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Stage I pressure ulcer
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Purple or maroon localized area of discolored intact skin
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Deep tissue injury
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Outer layer of epidermis only; erythema, painful; no blisters and skin maintains function. Heals in 3-10 days
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1st degree burn
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Painful, moist, red, blistered; involves various degrees of the dermis. Blisters serve a bandages, heals in 1-2 weeks.
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2nd degree burn partial thickness
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Entire dermis involved, painful, blisters; may resemble tissue paper; likely to scar. Blisters are flat, heal in 1 month
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2nd degree burn full thickness
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May progress through muscle to bone; skin grafts are required. Healing takes several months
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3rd degree burn
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Malignant melanoma
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- progress rapidly - associated with metastasis - fair skinned individuals at risk - associated w/ family history - 3rd
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Early Identification of Malignant melanoma
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- Asymmetry - Border irregularity - Color variation - Diameter > 6mm - Evolving/rapid enlargement
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Characteristics of Malignant Melanoma
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- black/brown in color - arises from preexisting nevi - slightly raised - irregular borders - perimeter may be red, inflamed, and tender - may ulcerate and bleed
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Basal Cell Carcinoma
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- most common/ 70-80% - 1st - does not metastasize - head and neck - neoplasm of non-keratinizing cells of the basal layer of the epidermis - common in white skin
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Characteristics of Basal Cell Carcinoma
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- may begin as flesh colored or pink - may ulcerate and have a shiny, waxy border - grow as a red, scaly area - darkly pigmented in dark skin
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Squamous Cell Carcinoma
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- more common in men - 2nd - sun exposed areas (nose, forehead, ear, and back of hand)
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Characteristics of Squamous Cell Carcinoma
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- Red, scaly - May have depressed center - Slightly elevated, irregular border - may have crusty appearance as progresses
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Systemic complications of burns
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- hemodynamic instability - fluid and electrolyte imbalances - respiratory dysfunction - hypermetabolic response - organ disfunction - infection - pain/emotional trauma
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Pressure ulcer
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a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear
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Contribution factors to pressure ulcers
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- impaired sensory perception - poor circulation - impaired nutrition - immobility - moisture
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Complications of pressure ulcers
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- necrosis - infection - tunneling - undermining
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Stage II
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- partial thickness loss of dermis - shallow open ulcer - red pink wound bed, without slough
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Unstageable
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Full thickness tissue loss in which actual depth of the ulcer is completely obscured by slough.
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