Adult Health Test 1 Integumentary part 3

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Questions and Answers

What is the most common cause of contact dermatitis?

Exposure to food allergens

Extreme temperatures

Insect bites

Changes in soap or detergent (correct)

Which symptom is commonly associated with dermatitis venenata?

Excoriation of the skin

Severe edema in the larynx

Respiratory arrest

Pruritus with erythema (correct)

What is the first action to take after exposure to plants causing dermatitis venenata?

Wash the affected area with cool water and soap (correct)

Apply hot compresses to the area

Apply corticosteroids immediately

Wait for symptoms to develop

What mechanism underlies the allergic reaction in urticaria?

Histamine release from an antigen-antibody reaction Signup and view all the answers

Which statement about dermatitis medicamentosa is true?

Respiratory arrest can result from severe reactions. Signup and view all the answers

What is the recommended nursing intervention for contact dermatitis?

Keep fingernails trimmed short Signup and view all the answers

Which of the following medications is commonly used for treating symptoms of urticaria?

Antihistamines Signup and view all the answers

Which condition is characterized by localized edema in subcutaneous tissue?

Angioedema Signup and view all the answers

What is the primary method of transmission for lice?

Close contact with infected individuals or their belongings Signup and view all the answers

How long can adult lice survive without a blood source?

1-2 days Signup and view all the answers

In what areas of the body are scabies common?

Arms, body folds, and genitalia Signup and view all the answers

Which of the following is NOT a treatment option for lice?

Antibiotics Signup and view all the answers

What distinct sign indicates a scabies infestation?

Light brown wavy lines on the skin Signup and view all the answers

Which medication can be used as an alternative for lice treatment in children under two years old?

Petroleum jelly Signup and view all the answers

How many eggs can head lice lay in a single day?

10 eggs Signup and view all the answers

Which type of lice is primarily transmitted through sexual contact?

Pubic lice Signup and view all the answers

What is a common symptom of eczema?

Dry, scaly patches Signup and view all the answers

What is an effective management strategy for acne vulgaris?

Maintain proper skin hygiene Signup and view all the answers

Which condition is characterized by red patches covered with silver scales?

Psoriasis Signup and view all the answers

Which of the following symptoms is NOT associated with systemic lupus erythematosus?

Weight gain Signup and view all the answers

What triggers can contribute to systemic lupus erythematosus?

Genetic, hormonal, and environmental factors Signup and view all the answers

Which treatment is commonly prescribed for individuals with severe cases of psoriasis?

Methotrexate Signup and view all the answers

What is a significant risk factor for developing acne vulgaris?

Hormonal changes Signup and view all the answers

Which of the following is a key focus in managing eczema?

Minimizing allergen exposure Signup and view all the answers

What is a common misconception about comedones in acne vulgaris?

They are a form of dirt Signup and view all the answers

What lifestyle adjustment can help manage systemic lupus erythematosus?

Regular use of sunscreen Signup and view all the answers

Which medication may require liver function tests before use?

Isotretinoin Signup and view all the answers

What type of rash is indicative of pediculosis?

Inflamed patches with scaling Signup and view all the answers

What is a key symptom of discoid lupus?

Scaling patches Signup and view all the answers

What medication is typically NOT used in the management of lupus?

Antidiabetic agents Signup and view all the answers

Study Notes

Contact Dermatitis

Caused by an allergic reaction to a substance the person has contacted.
Common causes include changes in soap, detergent, chemicals, plants, new clothes, metals, and food.
Symptoms: Erythema, edema, ruptured vesicles, encrustation, severe pruritus, burning, and pain.
Objective data: Erythema, papules, vesicles, excoriations, and edema.
Management: Identify the cause and treat symptoms.
Nursing interventions:
- Use cool, wet dressings with Burrow's solution to prevent dryness.
- Apply cold compresses for edema.
- Perform daily baths to cleanse the skin.
- Keep fingernails trimmed short.
- Advise wearing lightweight, loose-fitting clothing.
Medications: Corticosteroids for inflammation; antihistamines like Benadryl for itching and edema.
Non-contagious

Dermatitis Venenata

Allergic reaction to plants, primarily poison ivy and poison oak.
Symptoms: Mild to severe erythema with pruritus.
Mechanism: Initial exposure sensitizes the body. Subsequent exposure triggers a reaction involving lymphocytes releasing irritating chemicals and causing inflammation, edema, and vesiculation.
Management:
- Immediately wash affected area with cool water and soap if exposure occurs.
- Corticosteroids to reduce inflammation.
- Apply cool wet dressings.
- Use calamine lotion to soothe itching.
- Provide Benadryl for itching relief.

Dermatitis Medicamentosa

Allergy to a medication.
Symptoms: Range from mild to severe, potentially including respiratory arrest and anaphylaxis.
Management: Identify the drug and discontinue it.
Nursing intervention: Notify the provider.
Note: Allergies can develop over time with any medication.

Urticaria (Hives)

Allergic reaction manifesting as wheals or hives.
Causes: Drugs, food, insect bites, inhalants, emotional stress, heat or cold exposure.
Appearance: Reddish outer rim with a pale or whitish center.
Mechanism: Histamine release from the body's antigen-antibody reaction.
Management:
- Administer antihistamines such as Benadryl.
- Provide epinephrine (adrenaline) for severe reactions.
- Identify and eliminate triggers.

Angioedema

Form of urticaria with localized edema in subcutaneous tissue.
Causes: Same as urticaria.
Locations: Eyelids, hands, feet, tongue, larynx, gastrointestinal tract, genitalia, lips.
Management:
- Administer antihistamines (Benadryl).
- Administer epinephrine.
- Administer corticosteroids (Solu-Medrol IV).
- Apply cold compresses.
Note: Potential for respiratory distress if tongue, larynx, or lips are affected.
- Advise using a Medic Alert bracelet.

Eczema (Atopic Dermatitis)

Chronic inflammatory skin disorder, often commencing in infancy.
Associations: Allergies to chocolate, eggs, wheat, or orange juice.
Link: Strong association with asthma in children with eczema.
Mechanism: Heredity plays a role.
Management: Minimize allergen exposure.
Symptoms: Papules and vesicles surrounded by erythema, rupture, exudate, crusting, and intense itching.
Note:
- Children may exhibit fussiness, irritability, and anorexia due to discomfort.
- Commonly affects the scalp, forehead, cheeks, neck, and extremities.
- The affected area is erythematous and dry.
- Thick scales often form in dry areas.
Key management:
- Hydration: Soak in warm water for 15-20 minutes and gently pat dry (avoid rubbing).
- Occlusive ointment: Apply a thick layer of ointment to moist skin (petroleum jelly, corticosteroid ointments, vegetable shortening).
- Lotion: Employ lotions like Eucerin, Curel, or Lubriderm for maintenance.

Acne Vulgaris

Inflammatory papulopustular skin eruption involving sebaceous (oil) glands.
Common in adolescence, but can occur at any age.
Risk factors:
- Diet (debatable).
- Stress.
- Heredity.
- Hormonal imbalances.
- Grease and oil-containing cosmetics.
- Perspiration.
- Oil production, dead skin cells, clogged pores, and bacteria.
Mechanism: Oil glands become occluded.
Locations: Face, neck, upper chest, shoulders, back.
Symptoms: Tender area, edema, and comedo (blackhead).
Note: Comedo is not dirt; it's a reaction of oil and epithelial cells with oxygen.
Management:
- Topical, systemic, or intralesional medications.
- Refer to Table 43-4 (page 1326) for common medications (retinoids, isotretinoin, antibiotics).
- Isotretinoin is hepatotoxic. Require liver function tests and pregnancy tests. Avoid pregnancy while on this medication.
- Medications help cleanse, dry, decrease inflammation, reduce bacteria, and decrease sebum production.

Acne Vulgaris Nursing Interventions

Maintain skin cleanliness and dryness.
Address any psychological concerns (e.g., low self-esteem).
Instruct clients to avoid touching their face with hands or hair to minimize oil transfer.
Advise wearing loose-fitting clothing to promote air circulation.
Wash hair daily.
Wash skin 2-3 times daily with medicated soap.
Use water-based cosmetics.
Note: Improvement may take 3 weeks of treatment. Low-dose oral contraceptives may be helpful.

Psoriasis

Non-infectious, hereditary, chronic, proliferative skin disorder.
Mechanism: Epidermis produces cells rapidly (faster than normal 28-day cycle).
Locations: Scalp, elbows, chin, trunk.
Symptoms:
- Papules that develop into plaques.
- Red skin patches covered with silver scales.
Severity: Mild, moderate, or severe.
Note: Report any psychosocial issues (depression, loneliness, self-consciousness) occurring due to this condition.

Psoriasis Management

Medications:
- Topical corticosteroids (hydrocortisone, betamethasone) for inflammation.
- Keratolytic agents (tar preps, salicylic acid) to decrease shedding of the outer skin.
- Photochemotherapy with methoxsalen orally and UV light.
- Methotrexate (for severe cases).
- Vitamin D to decrease epidermal proliferation.
- Cyclosporine.
- Acitretin.
- Infliximab (biological for severe plaque disease).

Discoid Lupus

Inflammatory skin condition with the potential to progress to systemic lupus erythematosus.
Symptoms: Red, inflamed patches showing scaling and encrusting.
Locations: Face, ears, scalp, and other body parts.
Note: Protect exposed skin from sun.

Systemic Lupus Erythematosus (SLE)

Chronic, incurable, multi-system autoimmune disorder.
Mechanism: Body produces antibodies against its own tissues.
Locations: Skin, joints, kidneys, serous membranes.
Triggers: Genetic, hormonal, and environmental factors.
Prevalence: More common in women of childbearing age.
Genetics: Genetic predisposition.
Sex difference: Three times higher rate in African Americans.
Survival rates: Increasing, with longer survival times (over 15 years) after diagnosis.
Clinical Manifestations: Skin, joint, kidney, and serous membrane issues (not all listed).

Lupus

Lupus is an autoimmune disorder where the body's immune system attacks its own tissues and organs.
Anemia is a common complication of Lupus.
Coagulopathy is a blood clotting defect, increasing risk for bleeding and clotting disorders.
Diagnosis requires multiple tests and at least three specific criteria.
Lupus treatment aims to relieve symptoms, induce remission, and prevent complications.
Medications used include NSAIDs, aspirin, antimalarials (like Plaquenil), corticosteroids, anti-neoplastic drugs, and anti-infective agents.
Annual eye exams are necessary for those using antimalarial drugs.
Tapering high-dose corticosteroids is crucial to prevent complications.
Moderate to severe kidney damage may necessitate peritoneal or hemodialysis.
Therapy also includes analgesics, diuretics, and stress reduction techniques.

Pediculosis (Lice)

Pediculosis is a parasitic skin disorder, often linked to poor hygiene and living conditions, but can affect anyone.
Transmission via intimate contact and contaminated items like hats, clothing, and grooming supplies.
Lice ingest blood from their host.
Adult lice perish after a day without a blood source.
Lice lay eggs (nits) on hair shafts or skin.
Types include head lice (pediculosis capitis), body lice (pediculosis corporis), and pubic lice (pediculosis pubis).
Head lice attach to hair, lay ~10 eggs daily, and survive for up to 30 days.
Nits are commonly observed at the back of the neck and behind the ears.
Body lice cluster around the neck, waist, and thighs; they can be found within seams of clothing.
Pubic lice, similar to crabs, use pincers to attach to pubic hair; transmission happens via sexual contact or affected linens.
Treatment options include over-the-counter medications (e.g., Quellada [lindane], RID [pyrethin]) and prescription medications (e.g., benzyl alcohol, malathion).
Multiple treatments may be needed.
Management also involves cool compresses, corticosteroid ointments, and thorough cleaning of furniture, linens, stuffed animals, and clothing.
For children under two years old and pregnant women, petroleum jelly can be used instead of medications.

Scabies

Scabies arises from a female itch mite that burrows into skin and lays eggs.
Transmission is through extended contact with an infected person or their belongings (e.g., bedding, clothing).
Commonly present in crowded or impoverished living conditions, but occurs across socio-economic groups.
The mite burrows create light brown, thread-like lines on the skin.
Scabies causes intense itching, especially at night, and predisposes individuals to secondary infections.
Common locations include hands, arms, body folds, and genitalia.
Diagnosis depends on symptoms and confirmed by skin scraping and laboratory testing.
Treatment aligns with pediculosis protocols.
Thorough cleaning of the house and items is vital to halt re-infection.

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Test your knowledge on contact dermatitis and its management strategies. This quiz covers common causes, symptoms, nursing interventions, and medications used for treatment. Understand the differences in allergic reactions and effective care techniques.