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NSG-316 Exam 1/146 Questions and Answers/100% Verified!!
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NSG-316 Exam 1/146 Questions andAnswers/100% Verified!!
ABCDE - -Helps identify early signs of melanoma
A: asymmetry
B: border
- Scalping, ragged edges
C: color
- areas of brown, tan, white, red
D: diameter
- greeted than 6 cm
E: elevation and enlargement
-Tinia Capitus - -Involves the scalp causing scaling, pruritus, and balding
areas
-Tinea pedis - -chronic fungal infection of the foot
-Candidiasis - -fungal infection found on the skin, mucous membranes, and
vagina
-Edema - -Excessive fluid accumulation within the interstitial spaces
-Turgor - -decreased skin elasticity as a result from dehydration
-Vesicle - -elevated, circumscribed lesion filled with fluid, less than 1 cm -
(as the result of varicella)
-Tumor - -Elevated, solid lesion, treated than 2 cm in diameter
-Bulla - -vesicle greater than 1 cm in diameter (blister)
-Wheal - -elevated, irregular shaped area of cutaneous edema (urticaria)
-Keloids - -Irregularly shaped, elevated scar
-Skin turgor - -How - sign of fluid loss
Why - diarrhea and vomiting
Normal - skin snaps rapidly back to its normal position
,Abnormal - poor turgor or "tenting" indicates dehydration especially
combined with delayed capillary refill and tachypnea. Also occurs with
malnutrition. Skin with poor turgor takes time to return to its normal position
-Normal nail findings - -Smooth, pink, 160 degrees
-Abnormal nail findings - -Brittle, ridged, or spoon-shaped (kiolonychia) ->
iron deficiency; splinter hemorrhages -> vitamin C deficiency; clubbing ->
heart or respiratory problems
-Capillary refill - -How - with the index or middle fingertip at heart level,
depress the nail edge at least 5 seconds to blanch and then release
Why - indicates the status of the peripheral circulation
Normal - normally color returns instantly or within a few seconds in a cold
environment. A healthy color return takes 1-2 seconds
Abnormal - cyanotic nail beds or sluggish color return; consider
cardiovascular or respiratory dysfunction, septic shock
-Primary lesions - -Macules
Papules
Patches
Plaques
Nodules
Wheals
Tumors
Urticaria
Vesicles
Cysts
Bullas
Pustules
-How to assess skin lesions - -Note the color, elevation (flat, raised, or
pedunculated), pattern or shape (grouping or distinctiveness of each lesion)
→ pattern may be a sign of a disease, size in cm, location and distribution on
body (generalized or localized?), any exudate → note color and odor
Palpate lesions → roll a nodule between the thumb and index finger to assess
depth
Gently scrape scale to see if it comes off → note the nature of the base and
note if it bleeds
Note skin temp
, Note if lesions blanch with pressure or stretch
Use magnifier and light for closer inspection
Use Wood's light to detect fluorescing lesions → with the room darkened,
shine the Wood's light on the area
Lesions that appear with blue-green fluorescent indicates fungal infection
-Macules - -solely a color change, flat and circumscribed, of less than 1 cm.
ex: freckles, flat nevi, hypopigmentation, petechiae, measles, scarlet fever
-Edema - definition and scale - -Edema - fluid accumulating in the interstitial
space; it is not present normally.
To check for edema, imprint your thumbs firmly for 3-4 seconds against the
ankle malleolus or the tibia
If pressure leaves dent on the skin → "pitting" edema
Masks normal skin color and obscures pathologic conditions such as jaundice
or cyanosis bc fluid lies between the surface and the pigmented and vascular
layers
Scale:
1+ → mild, slight indentation, no perceptible swelling
2+ → moderate, indentation subsides rapidly
3+ → deep, indentation remains for short time, appears swollen
4+ → very deep, indentation lasts long time, appears very swollen
-Papules - -papules - something you can feel (i.e.) solid, elevated,
circumscribed, less than 1cm diameter) caused by superficial thiening in
epidermis.
ex. elevated nevus (moles), lichen planus, molluscum, wart (verruca)
-Patches - -macules that are longer than 1 cm
ex: mongolian spot, vitiligo, cafe au lait spot, chloasma, measles rash
-Plaques - -Plaques coalesce to form surface elevation wider than 1 cm. A
plateau like, disk-shape lesion
ex. psoriasis, lichen planus
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