diseases of the hair, skin and nails pn 111 2007

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  • Slide 1
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  • Diseases of the Hair, Skin and Nails PN 111 2007
  • Slide 3
  • Causes of Skin Disturbances and examples Congenital Inflammation Obstruction Malignant Lesions Unknown Causes Degeneration Aging Trauma
  • Slide 4
  • Promotion, maintenance and Restoration Potential Nursing Diagnosis Psycosocial Responses Local Care Pharmathereapeutics Physicial agents
  • Slide 5
  • Review of Skin
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  • Epidermis:
  • Slide 7
  • Function of the Skin regulation of body temperature protective surface sensory structure excretion immunity blood reservoir synthesis of vitamin D
  • Slide 8
  • Physical Assessment Includes mucous membranes, scalp, hair, and nails Skin is a reflection of overall health Disorders often correspond to disease in other organ systems
  • Slide 9
  • General Appearance colour temperature moisture dryness skin texture (rough or smooth) lesions vascularity, mobility, hair, nails
  • Slide 10
  • Diagnostic Evaluation Skin Biopsy Immunofluorescence Patch Testing Skin Scrapings Tzanck Smear Wood Light Exam Clinical Photos
  • Slide 11
  • Congenital: angiomas
  • Slide 12
  • Capillary vascular malformation
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  • Figure 66-14 Senile (cherry) angiomas
  • Slide 14
  • Angiomas(port wine, strawberry lessions) Benign vascular tumors involving the skin and the subcutaneous tissues present at birth violet red patches (port wine) to raised bright red nodular lesions (strawberry) Strawberry-involute in first few years port wine persist
  • Slide 15
  • Inflammation: Bacterial Impetigo
  • Slide 16
  • Cellulitis of the legs
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  • Boils
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  • Viral: Herpes Simplex
  • Slide 19
  • Herpes Whitlow
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  • Herpes Zoster
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  • Viral: Herpes Zoster Shingles on the forehead
  • Slide 23
  • molluscum
  • Slide 24
  • Warts
  • Slide 25
  • Fungal Infections: Thrush Oral Candidiasis (Yeast or Thrush)
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  • Treatment: Fungal Hygiene pharmaceutical prevention of re infection or spread
  • Slide 28
  • Tinea pedis and tinea unguium
  • Slide 29
  • Athlete's Foot
  • Slide 30
  • Mould Infection (aspergillus)
  • Slide 31
  • Parasitic Infection Pediculosis
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  • Pubic Lice
  • Slide 33
  • Pubic lice in the eye
  • Slide 34
  • Scabies
  • Slide 35
  • Cradle Cap (Seborrheic)
  • Slide 36
  • Dermatitis: eczema
  • Slide 37
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  • Psoriasis
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  • Corticosteriods Steroids are absorbed at different rates from different parts of the body. A steroid that works on the face may not work on the palm. Conversely, a steroid which works well on the palms may cause side effects on the face.
  • Slide 40
  • Topical Absorption For example: Forearm absorbs 1% Armpit absorbs 4% Face absorbs 7% Eyelids and genitals absorb 30% Palm absorbs 0.1% Sole absorbs 0.05%
  • Slide 41
  • Long term effects of Cortical Steroid use
  • Slide 42
  • Skin Impairment: Obstruction Acne
  • Slide 43
  • Pressure Ulcers Tissue damage skin and underlying soft tissue compressed between bone and external surface Over a period of time Sacrum, hip, ankles, any body part Ischemia-infarction-necrosis
  • Slide 44
  • Clients At Risk Unable to feel Unable to communicate Limited mobility Cant change position Friction and shear
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  • Pressure Ulcer Prevention Prevention
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  • Pressure Ulcer Prevention Prevention Assessment Observation Movement Turning positioning Avoid Moisture Avoid soap No massage Nutrition Friction and Shear Mental Status
  • Slide 47
  • Pressure Ulcer tx &mx TX and MX Moist, cleanse, dressing Diet; fluid Mattress; room humidifyer DebridmentLift with a lift sheet Infection prevention
  • Slide 48
  • Burns Causes: dry; moist; contact; chemical; electrical; radiation
  • Slide 49
  • Burns: Rule of 9s
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  • Burns: the Lund Method Age (Years) Area 0-1 1-4 5-9 10-15 Head 19 17 13 10 Neck 2 2 2 2 Anterior trunk 13 13 13 13 Posterior trunk 13 13 13 13 Buttock 5 5 5 5 Genitalia 1 1 1 1 Arm 4 4 4 4 Forearm 3 3 3 3 Hand 2 2 2 2 Thigh 5 6 8 8 Leg 5 5 5 6 Foot 3 3 3 3
  • Slide 51
  • Depth of Burn Traditionally 1st, 2nd, 3rd More accurate to describe the level burned: Superficial Partial thickness full thickness subdermal
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  • Classification 25% = local + systemic response
  • Slide 54
  • Burns: Rule of 9s
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  • How burns heal
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  • Compensatory Respones Inflammatory Sympathetic Nervous System
  • Slide 57
  • Figure 68-8 The physiologic actions of the sympathetic nervous system compensatory responses to burn injury (early phase)
  • Slide 58
  • Consequences of Burns Cardiac Changes Pulmonary Changes Gastrointestinal Changes Metabolic Changes Immunologic Changes
  • Slide 59
  • Nursing Interventions Impaired skin integrity Risk for infection Imbalanced nutrition Impaired physical mobility Disturbed body image
  • Slide 60
  • Collaborative problems Grieving Family coping Self-care deficits Sexual dysfunction Disturbed sleep pattern Social isolation Potential for pneumonia; septicemia