Medical Surgical – Dermatological – Flashcards
Unlock all answers in this set
Unlock answersquestion
ulceration
answer
indication of potential malignancy in other moles
question
hyperchloremia
answer
is associated with use of mafenide acetate solution (sulfamylon solution) whis increases bicarbonate diuresis
question
1% sivler sulfadiazine cream (silvadene)
answer
leukopenia
question
melanomas
answer
the most serious type of skin cancer
question
squamous cell carcinomas
answer
arise from the epidermis and can metastasize but is not the most lethal type of skin cancer
question
shift weight in the wheelchair every 15 minutes
answer
to reduce the risk of pressure ulcer formation
question
burned appearance of frostbitten tissue
answer
is a result of red blood cell aggregation with microvascular occlusion
question
critical data to collect before a client undergo a biopsy of a 6mm bluish-red lesion
answer
the description of the lesion suggest a malignant melanoma. The examination shoul include not only a thorough skin examination, but also palpation of the regional lymph nodes that drain the area near the lesion
question
to promote healing for a client with a large wound healing by secondary intention,
answer
the nurse recommends a diet high in protein and vitamin c - diets high in protein and vitamin c are recommended because these nutrients promote wound healing. a wound with little or no tissue loss (a surgical wound) heals by primary intention. wounds involving loss of tissue (severe lacerations or pressure ulcers) are left open until filled with scar tissue. This healing by secondary intention takes longer
question
papules
answer
is a small, solid, elevated lesion with distinct borders. It is usually smaller than 10mm in diameter. papules are common lesions of acne. and warts can also be papules.
question
the nurse limits hydrotherapy sessions to no more than 30 mins
answer
to minimize sodium loss - water used in the hydrotherapy tubs is hypothonic. prolonged periods if immersion increase the client's risk of sodium loss
question
a client I admitted for treatment of malignant melanoma of the upper leg. Initially, the nurse plans to prepare the client for
answer
surgical excision - the therapeutic approach to malignant melanoma depends on the level of invasion and the depth of the lesion. Surgical excision is the treatment of choice for small, superficial lesions. Deeper lesions require wide local excision, after which skin grafting may be needed.
question
when targeting a group of clients for helath teaching, the nurse should be aware that which group is at greatest risk for developing malignant melanoma?
answer
clients who are fair-haired, fair-skinned, and os celtic descent
question
a client with a large healing deep partial-thickness burn of the forearm and wrist is being discharged from the burn treatment clinic. which of the following should the nurse remind the client to avoid for a year?
answer
exposure to the sun - once the wound is healed, frequent and liberal application of lotion is recommended to keep the newly formed and healing skin supple to help promote healing and minimize scarring
question
a 15 yrs old girl was admitted with burns of her face and hands. which statement indicates to the nurse that the client has adapted to her changed body image?
answer
can I go with my family to the visitor's lounge?
question
a client is being discharged after surgical excision of a malignant melanoma. which statement indicates to the nurse an understanding of the danger of ultraviolet?
answer
"i'll reapply my sunscreen every 2 hours when I'm out in the sun."
question
a client arrives at the emergency room department with a snakebite of the lower left leg. what should the nurse do?
answer
Immobolize the limb below the level of the heart
question
a client is hospitalized with extensive full thickness burns of both legs. In response to the clients questions, the nurse explains that during the acute phase of burn injury, biological dressing are used primarily to ...
answer
promote healing - biological dressings are temporary f=grafts used during the acute phase to increase the rate of epithelialization, act as a barrier to protect the wound from contamination, and reduce fluid and protein loss.
question
when collecting data from a bedridden client admitted from home, the nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse documents the presence of a pressure ulcer, noting that it is stage
answer
II - with a stage II ulcer, there is partial-thickness skin loss involving the epidermis and the dermis. the ulcer is visible and superficial and may appear as an abrasion, blister, or shallow crater. Edema persists, and the ulcer may become infected. The client may report pain, and there may ba small amount of drainage.
question
a nurse on a surgical unit is acaring for four clients with healing wounds. which of the four clients' wounds should the nurse anticipate will heal by primary inention.
answer
gastroplasty incision - wound closure occurs by primary intention (surgical closure), secondary intention (left open to close by the reparative process), and tertiary closure (left open and surgically closed at a later date). with primary intention, a clean wound is closed mechanically, leaving well approximated edges and minimal scarring. a surgical incision is an example of a wound that heals by primary intention.
