• Save
Nursing Lecture on the Integumentary System
Upcoming SlideShare
Loading in...5
×
 

Nursing Lecture on the Integumentary System

on

  • 8,046 views

http://1nurses.com Here's a nursing lecture on the Integumentary system for you Nursing Review. Get more free nursing resources at 1nurses.com

http://1nurses.com Here's a nursing lecture on the Integumentary system for you Nursing Review. Get more free nursing resources at 1nurses.com

Statistics

Views

Total Views
8,046
Views on SlideShare
7,985
Embed Views
61

Actions

Likes
8
Downloads
0
Comments
1

9 Embeds 61

http://www.zeadmph.com 30
http://www.slideshare.net 24
http://translate.googleusercontent.com 1
http://faytechcc.blackboard.com 1
http://ccccblackboard.blackboard.com 1
https://bb.greatoaks.com 1
https://imperial.blackboard.com 1
https://blackboard.watc.edu 1
https://learn.vccs.edu 1
More...

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
  • helpful website that help others. This website has practice exams for various nursing classes as well as videos, presentations, notes, nclex help, and many other tools . Hope they help


    http://www.rnpedia.com/
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Nursing Lecture on the Integumentary System Nursing Lecture on the Integumentary System Presentation Transcript

  • Brought to you by : http://1nurses.com
  • Disclaimer
    • All information and pictures presented in this slideshow were meant for EDUCATIONAL purposes only. 1Nurses.com does not claim any liability from the use of this slide and does not guarantee any action that might result from the use of this material. 1Nurses.com does not claim any ownership for the images and articles presented in this report. All articles and Images are the respective Copyright property of their respective owners.
  •  
  • MEASLES
    • An acute, highly communicable viral disease with prodromal fever, conjunctivitis, coryza, cough and small spots with white centers on an erythematous base on the buccal mucosa (Koplik spots)
  • Causative agent:
    • Measles virus, a member of the genus Morbilivirus of the family Paramyxoviridae
  • Incidence:
    • Endemic in all large cities of the world recurring in epidemic form every 2 years usually occurs during cold weather.
  • Mode of transmission:
    • Direct contact with nasal and throat secretions
    • Droplet infection
    • Less commonly, by articles freshly soiled with nose and throat secretions
  • Incubation period:
    • 9- 20 days
    • Average: 10 days
  • Period of communicability:
    • Ranges from 3 to 4 days before the onset of the symptoms to 5 days after the rash appearance
  • Stages
    • 1. Incubation period (average of 10 days)
    • 2. Pre-eruptive stage or stage of invasion (3-6 days)
    • 3. Eruptive stage
    • 4. Desquamation Stage
  • Pre-eruptive stage or stage of invasion
    • from the appearance of the first sign/symptoms to the earliest evidence of the eruption.
    • fever, severe cold
    • frequent sneezing
    • profuse nasal discharge
    • eyes are red and swollen, with mucopurulent discharge (lids stick together)
    • Stimsons sign: (puffiness of lower eyelids with definite line of congestion on the conjunctivae)
  • Pre-eruptive stage or stage of invasion
    • redness of both ear drums
    • vomiting, drowsiness
    • hard dry cough
    • Koplik’s spot (appears on 2nd day): small, bright red macules or papules with tiny bluish-white specks on the center and can be found on the buccal cavity
    • maculopapular rashes (seen late in 4th day), occurs first on the cheeks or at the hairline
    • true measles rash: slightly elevated small red papules, dry and hot sensation to touch
  •  
  •  
  •  
  • Eruptive stage
    • Characterized by a general intensification of all local constitutional symptoms of the pre-eruptive stages with the appearance of bronchitis and loose bowels
    • Maculo-papular rashes starting from head to feet
    • Irritability and restlessness
    • Red and swollen throat
    • Enlargement of cervical glands
    • Fever subsides
  • Desquamation Stage
    • follows after the rashes fade, dry, and feel off
    • follows the order of distribution seen in the formation of eruption
  • Summary
    • Cough, colds, coryza (3C’s)
    • 3 rd day: Characteristic red blotchy rash appears on the 3 rd to 7 th day
    • Rash begins on the face  becomes generalized, lasts 4 – 7 days
    • Ends in desquamation
  • Diagnostic exam:
    • No specific diagnostic exam except only for the presence of leukopenia
  • Prevention:
    • Education of parents regarding the disease
    • Passive immunization of infants and children (gamma-globulin)
    • Active immunization (1st year of life)
  • Vaccine storage:
    • Freeze – dried measles vaccine is relatively stable and can be stored in a freezer or at refrigerator temperatures with safety  for a year or more
    • Reconstituted vaccine should be kept at refrigerator temperatures and discarded  after 8 hours
    • Both vaccine should be protected from prolonged exposure to ultraviloent light  which may inactivate the vaccine
  • Management:
    • 1. Drugs – Antibiotics for secondary bacterial infection)
    • 2. Isolation
    • 3. Meticulous skin care - warm alcohol cup to prevent pressure sores
    • 4. Good oral and nasal hygiene – increase oral fluids
    • 5. Proper care of the eyes - screen to avoid direct light: wear dark glasses
    • 6. Ears should be cleaned after bath, bath if there discharges – patient should lie the affected ear down or towards the bed
    • 7. Give ample of fluids during febrile stage
  • Complications:
    • 1. Otitis media
      • death rate is highest in the 1st 2 years of life.
    • 2. Bronchopneumonia
      • after 4 yrs. uncommon
    • 3. Severe bronchitis
      • overall mortality rate-less than 4%
  •  
  • GERMAN MEASLES
    • An acute infectious disease characterized by mild constitutional symptoms, rose colored macular eruption which may resembles measles and enlargement and tenderness of lymph nodes
  • Causative agent:
    • Rubella virus (family Togaviridae; genus Rubivirus)
  • Incidence:
    • Occurs mostly in spring and seen mostly in children over 5 years of age
  • Mode of transmission:
    • Contact with nasopharyngeal secretions of infected people
    • Droplet spread or direct contact with patients
  • Incubation period:
    • Period of 14 – 21 days
  • Period of communicability:
    • 7 days before to 5 days after the rashes appears
    • Infants with CRS may shed virus for months after birth
  • Clinical manifestations:
    • fever
    • loss of appetite
    • enlargement of lymph nodes
    • sweating
    • leucopenia
    • vomiting (in some cases)
    • headache, mild sore throat
    • desquamation follows the rash
  • Clinical manifestations:
    • enanthem of uvula with tiny red spots
    • rash (cardinal symptom) accompanied with cervical adenitis
    • begins on the face including the area around the mouth
    • oval, pale rose-red papules about the size of a pinhead
    • covers the body within 24 hours and gone by the end of 4th day
  •  
  • Prevention: vaccination
    • 1. Gammaglobulin – given to pregnant women with negative history and who have been exposed in the first trimester of pregnancy.
    • 2. Included in MMR given at 15 months to the baby.
  • Management:
    • 1. Isolation – (Catarrhal stage) to prevent infection to others
    • 2. Bed rest for first few days
    • 3. Meticulous skin care especially after the rash fades
    • 4. Good oral and nasal hygiene (use petroleum jelly if lips become dry)
    • 5. No special diet is necessary / increase fluid intake
  • Complications:
    • 1. Otitis media
    • 2. Encephalitis
    • 3. Congenital defects for babies whose mother were exposed in early pregnancy
  •  
  • VARICELLA
    • A very contagious acute disease usually occurring in small children, characterized by the appearance of vesicles, frequently preceded by papules , occasionally followed by pustules but ending in crusting
  • Causative agent:
    • Varicella zoster virus
  • Incidence:
    • Occurs before the 6th year especially in winter
  • Mode of transmission:
    • From person to person by direct contact
    • Droplet or airborne spread of vesicle fluid or secretions of the respiratory tract
    • Indirectly through articles freshly soiled by discharges from vesicles and mucous membranes of infected people
  • Incubation period:
    • 2 – 3 weeks
    • Commonly 14 – 16 days
  • Period of communicability:
    • Highly contagious from 2 days prior to rash to 6 days after rash erupts
    • Patient remain contagious until the lesion have crusted completely
  • Clinical Manifestations:
    • Slight fever: first to appear
    • Body malaise, muscle pain
    • Eruption (maculopapular) then progresses to vesicle (3-4 days)
      •  begins on trunk and spreads to extremities and face (even on the scalp, throat and mucus membranes)
    • Intense pruritus
    • Vesicles ended as a granular scab
    • Irritability
  •  
  • Prevention:
      • 0.5 mL SC varicella vaccine
      • And for immunization of children up to 12 years of age who have not had varicella
  • Management:
    • 1. Drugs
        • Penicillin: can be used when the crusts are severe or infected to prevent scarring or secondary invasion
        • Acyclovir, Immunosin – anti virus
        • Hydrocortisone lotion 1% for itching
    • 2. Isolation in a room by itself
    • 3. Provide a well-ventilated, warm room to the patient
    • 4. Warm bath should be given daily to relieve itching (may use baking soda)
    • 5. Avoid injuring the lesions by using soft absorbent towel and the patient should be potted dry instead of rubbed dry
    • 6. Maintain good oral hygiene. If lesions are found in the mouth or nasal passages, antiseptic prep may be used
  • Complications:
    • 1. Pneumonia
    • 2. Nephritis
    • 3. Encephalitis
    • 4. Impetigo
    • 5. Pitting or scarring of the skin
  •  
  • HERPES ZOSTER
    • Acute viral infection of the peripheral nervous system due to reactivation of varicella zoster virus.
    • The consequence of a reactivation of latent VZV from the dorsal root ganglia.
    • Contagious to anyone who has not had varicella or who is immunosuppressed.
  • HERPES ZOSTER
    • Occurs at all ages, but its incidence is highest among individuals in the 6 th through the 8 th decades of life
    • Approximately 2 % of patients with herpes zoster will develop a second episode of infection
    • Factors responsible for the reactivation of VZV are not known
  • Clinical manifestations
    • Neuralgic pain
    • Malaise
    • Burning sensation
    • Fever
    • Cluster of skin vesicles along course of peripheral sensory nerves ( unilateral and found in trunk, thorax or face): appears 3-4 days.
  • HERPES ZOSTER
  • Management:
    • 1. Drugs
      • Analgesics
      • Corticosteroids
      • Anti virals (acyclovir, famcyclovir, valacyclovir)
    • 2. Isolate client
    • 3. Apply drying lotions (calamine)
    • 4. Administer medications as ordered
    • 5. Instruct client on preventive measures
  •  
  •  
  •  
  •  
  • SCABIES
    • A parasitic infection of the skin caused by a mite
    • Penetration is visible as papules, vesicles or tiny linear burrows containing the mites or their eggs
    • Lesions are prominent around finger webs, anterior surfaces of wrists and elbows, anterior axillary folds, belt portion of the buttocks
  •  
  • SCABIES
    • In infants, the head, neck, palms, and soles may be involved; these areas are usually spared in older individuals
    • Common in individuals living in areas of poverty where cleanliness is lacking
  • Causative Agent:
    • Sarcoptes scabiei, a mite
  • Mode of transmission:
    • Direct contact with infested skin and can be acquired during sexual contact
    • Transfer from undergarments and bedclothes occurs only if these have been contaminated by infested people immediately beforehand
  • Clinical Manifestations:
    • Intense itchiness especially at night, but complications are limited to lesions secondarily infected by scratching
    • Sites:
      • Interdigital areas
      • Flexors surface of the wrist and palms
      • Nipples
      • Umbilicus
      • Axillary folds
      • Groin or gluteal folds
      • Penis and scrotum
  • Diagnostic Examination:
    • Presence on skin of female mites and ova upon skin biopsy or scraping
  • Medical Management:
    • Lindane solution (Kwell)
    • Crotamiton (Eurax)
    • Anti-histamines – to reduce itchiness.
  • Nursing Interventions:
    • Boiling of linens and clothes
    • Encourage to change clothing and linen frequently
    • Warm shower bath to remove scaling debris or crusts
    • Putting on a gown and gloves for health care provider
  •  
  • LEPROSY (Hansen’s Disease)
    • Chronic bacterial infection characterized by the appearance of nodules in the skin or mucous membrane, and by changes in the nerves leading to anesthesia or paralysis
  • Causative agent:
    • Mycobacterium leprae (acid fast bacilli)
    • The organism has not been grown in bacteriologic media or cell cultures
    • It can be grown in mouse foot pads
  • Incubation Period:
    • Ranges from 9 months to 20 years
    • The average is probably 4 years for tuberculoid leprosy and twice that for lepromatous leprosy
  • Period of Communicability
    • Clinical and laboratory evidence suggest that infectiousness is loss in most instances
      • with 3 months of continuous and regular treatment with dapsone or clofazimine
      • or within 3 days of treatment with rifampin
  • Mode of transmission:
    • Exact mode of transmission is not clearly established
    • Prolonged intimate skin-to-skin contact and to Nasopharyngeal secretions
  • TYPES:
    • 1. Tuberculoid
    • 2. Lepromatous
    • 3. Intermediate
  • Tuberculoid Type
    • Shows high resistance to Hansen’s bacilli
    • Patient can mount a cell –mediated defense against the bacilli.
    • 1 – 2 skin lesions only which are well defined, elevated and hypopigmented
    • (+) Lepromin test
  • Lepromatous Type
    • Minimal resistance to the multiplication
    • Severest form
    • Patient cannot mount a cell – mediated immune response
    • Acid fast bacilli are found everywhere
    • ( - ) Lepromin test
    • Clinical manifestations include:
      • Leonine facies – facial skin are thickened
      • Saddle nose deformity – nasal cartilage can be destroyed
      • Infertility – secondary to internal testicular damage
  • Clinical Manifestations:
    • Early Stage: “CLUMP”
    • C - changes in skin color (red or white)
    • L - lesion is hyposthetic and loss of sweating
    • U - ulcers that do not heal
    • M - muscle weakness or paralysis
    • P – painful and thickened nerves
  • Clinical Manifestations:
    • Late Symptoms: “CLISM”
    • C – clawing of fingers and toes
    • L – “leonine” appearance (due to thickened skin of the forehead and face)
    • I – inability to close eyelids (lagophthalmos)
    • S – sinking of nose bridge (saddle nose)
    • M – madarosis (loss of eyebrows)
  •  
  •  
  • Clinical Manifestations:
    • Cardinal Symptoms: “PPP”
    • P – presence of hansen’s bacilli on skin biopsy
    • P – presence of localized areas of anesthesia
    • P – peripheral nerve enlargement
  • Diagnostic Examinations:
    • Skin biopsy
    • Skin smear test
    • Lepromin test – (+) test develops a nodule on site of inoculation (1st – 3rd week )
    • Nerve involvement with acid – fast bacilli is pathognomonic of leprosy
  • Medical Management:
    • Multiple drug therapy (MDT)
    • (Rifampicin, Dapsone, and Clofazimine) over 6 – 9 months period or 18 – 30 months period
  • Nursing Interventions:
    • Full diet
    • A daily cleansing bath and change of clothing
    • Skin care
    • Self care, exercise, and physical therapy
    • TSB for fever
  • Prevention:
    • Separate infants from lepromatous parents at birth
    • Segregate and treat patients with open lesions
    • Public health supervision
  • Get More Free Nursing Lectures,Nursing Care Plans, & Nursing Resources @ http://1nurses.com