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NR283 IWorksheet I 3 ISkin Iand IRespiratory
SKIN
1 Define Ithe Ifollowing:and Igive Ian Iexample Iof
IeachIa Macule Less Ithan I 1 Icm, Iflat, Iwell Idefined Iborder. IIncludes Ifreckles Iand Imeasles.Ib Papule Small Ifirm Iand Iusually Ielevated, I< I 1 Icm, Isolid Imass, Icircumscribed Iborder. IIncludesImoles Iand Iwarts c Nodule Elevated, Isolid, Ipalpable Imass, I1-2 Icm. IIncludes Ismall Ilipoma, Isquamous Icell Icarcinoma IandIfibroma. d Pustule Elevated, Ilesion, Iusually Icontains Ipurulent. IIncludes Iacne Iand IimpetigoIe Vesicle Circumscribed, Ielevated, Ipalpable Imass Ifilled Iwith Ifluid. IIncludes Ipoison Iivy, Ichicken Ipox,Iand Ishingles f Plaque Greater Ithan I 1 Icm, Islightly Ielevated Iwith Ia Iflat Isurface. IIncludes IpsoriasisIg Crust Dry Irough Isurface, Idry Iexudate, Ior Idry Iblood. IIncludes Ia Iscab. Ih Lichenification Thick, Idry, Irough Isurface Ithat Iis Ialmost Ilike Ileather. IIncludes IeczemaIi Keloid Raised, Iirregular, Iand Iincreasing Imass. IIncludes Iscar Iformation Iafter Isurgery.Ij Fissure Small, Ideep Icracks Iin Ithe Iskin Ithat Imay Ibe Ipainful. IIncludes Iathletes Ifoot.Ik Ulcer Cavity Iwith Iloss Iof Itissue, Iweeping, Ibleeding, I 4 Istages. IIncludes Ivenous Istasis IulcerIl Pediculosis An Iinfestation Iof Ilice, Iincludes Ihead Ilice.Im I Erosion Shallow, Imoist Icavity Ilocated Iin Ithe Idermis. IIncludes Ia Isecondary Ilesions Iof Iherpes IzosterIn Comedone Mass Iof Isebum, Ikeratin, Iand Idebris Iblocking Ithe Iopening Iof Ia Ihair Ifollicle. IIncludes IaIblackhead. o Urticaria
Hard, Iraised Ilesions Ion Ithe Iskin Idue Ito Ia Itype I 1 Ihypersensitivity Ireaction. IIncludes Ia IreactionIto Ishellfish. p Furuncles Also Iknown Ias Ia Iboil, Ian Iinfection Ithat Ibegins Iin Ia Ihair Ifollicle. IIncludes Ia Icarbuncle IwhichIis Ia Icluster Iof Ifuruncles. q Psoriasis Chronic Iinflammation Iof Ithe Iskin, IT Icells Iare Iproduced Iat Ia Ifaster Irate Ithan Inormal IcreatingIpatches Iof Ithick Iskin. IIncludes Iplaque Ipsoriasis.
2 Match Ithe Itypes Iof Iskin Idisorders Iwith Itheir Icausative Iorganisms.
- I I I ID Tinea A. IBacterial Iinfection
- I I I IA Impetigo B. IVaricella Ivirus
- I I I IB Chicken Ipox C. IHuman IHerpes IVirus I 8
- I C Kaposi Isarcoma D. IFungal Iinfection
- I E_Plantar IWarts E. IHuman IPapillomavirus
3 Discuss Ian Iimportant Icomponent Iin Iteaching Iskin Icancer Iprevention. An Iimportant Icomponent Iof Iteaching Iskin Icancer Iprevention Iis Imaking Isure Ipatients Iuse IsunscreenIevery Itime Ithey Igo Iout Iin Ithe Isun.
4 What Iis Ithe Imost Iinvasive Iskin Icancer Ithat Inurses Imust Iteach Ipatients Ito Iidentify Iand Itreat Iearly?ISquamous Icell Icarcinoma Iis Ithe Imost Icommon Iform Iof Iskin Icancer Iand Iis Ithe Imost Iaggressive.
5 Why Iis Ithis Iskin Icancer Iimportant Ito Iidentify Iand Itreat Iearly? It Iis Iimportant Ito Itreat Ithis Icancer Iearly Ibecause Iit Ican Igrow Irapidly Iand Ispread Ito Iother Iparts IofIthe Ibody Icausing Imore Icomplications.
RESPIRATORY
- Define Ithe Ifollowing:
a. Apnea The Istoppage Iof Ibreathing Iusually Ioccurring Iat Inight b. Cyanosis This Iis Idue Ito Ipoor Icirculation, Ifingers Iand Ilips Imay Iturn Iblue c. Clubbing This Ioccurs Iwhen Ithe Inail Ibeds Iare Igreater Ithat I 180 Idegrees.
d. Dyspnea Difficulty Ibreathing e. Hemoptysis IThrowing Iup Iblood f. Hypoxemia Low Ilevels Iof Ioxygen Iin Ithe Iblood g. Hypercapnia High Ilevels Iof Icarbon Idioxide Iin Ithe Iblood h. Orthopnea IShortness Iof Ibreath i. Rales Crackling Isound Iwhen Icoughing j. Stridor A Ihigh Ipitched Icrowing Isound Iwhen Ibreathing Iusually Idue Ito Ian Iobstruction Iof Ithe IupperIairways k. Wheezing A Iwhistling Isound Iwhen Ibreathing Iusually Idue Ito Ian Iobstruction Iof Ithe Iairways
- Discuss Ithe Icolor Iand Isignificance Iof Iabnormal Isputum I(see Ipage I281)
a. Yellow-green A Isign Iof Ia Ibacterial Iinfection b. Rusty Ior Idark A Isign Iof Ipneumococcal Ipneumonia c. Large Iamounts Iof IpurulentIA Isign Iof Ibronchiectasis d. Thick Itenacious I- IMay Ibe Iblood ItingedIAIsign Iof Ituberculosis e. Blood ItingedIHemo ptysis
- Discuss Ilaryngotracheobronchitis I(croup). IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. ICroup Iis Ia Icommon Iviral Iinfection Iusually Ifound Iin Ichildren I1-2 Iyears Iof Iage. IIt Ibegins Ias Ian Iupper Irespiratory Icondition Iwith Ia Icough Iand Inasal Icongestion. IThe Ilarynx Iand Isubglottic IbecomeIinflamed Idue Ito Iswelling Iand Iexudate. IThis Icauses Iobstruction Iand Ia Ibarking Icough, Ihoarse Ivoice,Iand Iinspiratory Istridor. IIt Iis Iusually Imore Isevere Iat Inight.
- Discuss Iepiglottis. IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. An Iacute Iinfection Icaused Iby IH. IInfluenzae Itype IB Imost Icommon Iin Ichildren I3-7 Iyears Iof Iage IbutIcan Ibe Ifound Iin Iadults. IThe Ilarynx, Isupraglottic Iarea, Iand Iepiglottis Istart Ito Iswell Iobstructing Ithe Iairway. IThe Imanifestations Iinclude Ia Ifever Iand Ia Isore Ithroat Icausing Ithe Ichild Ito Irefuse Ito Iswallow. IChild Ibecomes Ianxious Iand Ipale, Isits Iin Ithe Itripod Iposition, Iwith Ia Irapid Ipulse Iand Irespirations.
- Discuss Ilobar Ipneumonia. IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. Lobar Ipneumonia Ioccurs Iin Ione Ior Iboth Ilobes Iand Iis Icaused Iby IStrep. IPneumoniae. IThe IalveolarIwall Ibecomes Iinflamed. ICells, Ifibrin, Iand Ifluid Ibegin Ito Ileak Iinto Ialveoli Iwhich Icauses Ia
consolidation. IManifestations Iinclude Ia Ihigh Ifever, Ichills, Iproductive Icough Iwith Irusty Isputum, IandIrales.
- Discuss Iaspiration Ipneumonia. IInclude Ithe Ipathophysiology, Irisk Ifactors, Iand IclinicalImanifestations. Aspiration Ipneumonia Ioccurs Iwhen Isome Isort Iof Iliquid Ileak Iinto Ithe Ibronchi. IThey Icause Iinflammation Icausing Ithe Iairway Ito Inarrow Iand Iincreased Isecretions. IThis Imakes Iit Idifficult Ifor Ithe Ilungs Ito Iexpand. IRisk Ifactors Iare Idrinking Ifluids Itoo Ifast, Iinhaling Itoxic Isubstances, Iand Iage.IManifestations Iinclude Icoughing, Ichest Ipain, Ishortness Iof Ibreath, Iand Icyanosis
- Discuss Icystic Ifibrosis. IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. a Icommon Iinherited Idisorder Ifound Iin Ichildren. IIt Iis Icaused Iby Ithe Igene Imutation Ito Ithe ICFTR Igene Iand Irelates Ito Ia Iprotein Iinvolved Iin Ichloride Iion Itransport Iin Ithe Icell Imembrane. IThere Iis Ia Idefect Iin Ithe Iexocrine Iglands Ithat Ileads Ito Ithick Isecretions. IThe Imain Ieffects Iare Ifound Iin Ithe Ilungs Iand Ithe Ipancreas Iwhere Ithe Isecretions Ican Iobstruct Ithe Iairways. IWithin Ithe Ilungs, Ithe Isecretions Iobstruct Iairflow Iin Ithe Ibronchioles Iand Ismall Ibronchi Icausing Iair Ito Iget Itrapped Ithat Icauses Idamage Ito Ithe Ibronchial Iwalls. IIn Ithe Idigestive Itract, Ithe Ismall Iintestine Iis Iblocked Ipreventing Ithe Iexcretion Iof Imeconium Ishortly Iafter Ithe Ichild Iis Iborn. IIn Ithe Ipancreas, Ithe Iexocrine Igland Iducts Iare Iblocked Icausing Ia Ideficit Iof Ithe Ipancreatic Idigestive Ienzymes. IThe IbileIducts Iin Ithe Iliver Ican Ialso Ibe Iblocked Ipreventing Ibile Ifrom Ireaching Ithe Iduodenum, Iinterfering Iwith Idigestion Iand Iabsorption Iof Ifats. IManifestations Iinclude Isalty Iskin, Isigns Iof Imalabsorption,Ichronic Icough, Ifrequent Irespiratory Iinfections, Ihypoxia, Ifatigue, Iand Ifailure Ito Imeet Inormal Igrowth Imilestones.
- Discuss Ilung Icarcinoma. IInclude Ithe Ipathophysiology, Irisk Ifactors, Iearly Iand Ilate IclinicalImanifestations. The Ilungs Iexperiences Imetaplasia, Ia Ichange Iin Ithe Iepithelial Itissue Iusually Idue Ito Ismoking IorIchronic Iirritation. IThe Ilung Itissue Ibecomes Imore Ilikely Ito Ibe Iaffected Iby Iirritants Iand Iinflammation. ISmoking, Ioccupational Ior Iindustrial Iexposure Ito Icarcinogen, Iand ICOPD. IEarlyIsigns Iinclude Ipersistent Iproductive Icough, Idyspnea, Iwheezing, Ihemoptysis, Ichest Ipain, Iand Ihoarseness. ILate Isigns Iand Isymptoms Iinclude Iweight Iloss, Ianemia, Iand Ifatigue.
- Discuss Iasthma. IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. Asthma Iis Ithe Iobstruction Iof Ithe Ibronchioles Iin Ia Iperson Ithat Ihas Ia Ihypersensitivity. IAsthma Ican IbeIacute Ior Ichronic Iand Iits Itwo Ipain Itypes Iare Iextrinsic Ior Iintrinsic Iasthma. IExtrinsic Iasthma Iis Iassociated Iwith Iacute, Ishort Iepisodes Iand Iis Icaused Iby Ia Itype I 1 Ihypersensitivity. IIntrinsic Iasthma Ibeings Ilater Iin Ilife Iand Iis Idue Ito Ihyperresponsive Itissues Iwithin Ithe Iairway Itract. IManifestations Iinclude Icoughing, Iwheezing, Itachycardia, Ihypoxia, Irespiratory Ifailure, Iand Irespiratory Idistress.
- Discuss Ichronic Iobstructive Ipulmonary Idisease I(COPD). IInclude Ithe Ipathophysiology, Irisk Ifactors,Iand Iclinical Imanifestations. COPD Iare Ichronic Irespiratory Idisorders Iwith Itissue Idegeneration Iand Iobstruction Iwithin Ithe Ilungs. IThe Ipathophysiology Istarts Iwith Idamage Ito Ithe Iairways Iand Iair Isacs Iin Ithe Ilungs. IThe Idamage Iis Iunchangeable Iand Iprogressive Iand Imay Iresult Iin Irespiratory Ifailure. IManifestationsIinclude
- Discuss Ipulmonary Iedema. IInclude Ithe Ipathophysiology, Irisk Ifactors, Iand Iclinical Imanifestations. Ithe Ifluid Icollecting Iin Ithe Ialveoli Iand Iinterstitial Iarea Ireducing Ithe Iamount Iof Ioxygen Ientering Ithe Iblood Iand Iinterfering Iwith Ilung Iexpansion Iwhich Ialso Ireduces Ithe Ioxygenation Iof Ithe Iblood. Risk Ifactors: Ihigh Ipressure Iin Ithe Ipulmonary Icirculation, Ileft-sided Icongestive Iheart Ifailure,Iinflammation Iin Ithe Ilungs, Ihypoproteinemia. Manifestations: Icough, Iorthopnea, Irales, Ihemoptysis, Ifrothy Isputum, Ilabored Ibreathing, IdrowningIfeeling, Icyanosis, Ihypoxemia, Iand Iparoxysmal Inocturnal Idyspnea.
- Discuss Ipulmonary Iembolus. IInclude Ithe Ipathophysiology, Irisk Ifactors, Iand Iclinical Imanifestations.IA Iblood Iclot Ior Imass Imaterial Ithat Iobstructs Ithe Ipulmonary Iartery Ior Ia Ibranch Iof Iit Ithat Iblocks Ithe Ifloe Iof Iblood Ithrough Ithe Ilung Itissue. IEmboli Iare Iusually Ithrombi Ior Iblood Iclots Ithat Ioriginate IfromIthe Iveins Ideep Iin Ithe Ileg. ISmall Iemboli Iare Iusually Iasymptomatic, Imedium Isized Iemboli Icause Irespiratory Iimpairment Icausing Ivasoconstriction, Ilarge Iemboli Icause Iright- sided Iheart Ifailure. Risk Ifactors: Itraveling Ifor Ilong Iperiods Iof Itime, Isedentary Ilifestyle, Itrauma Ior Isurgery, Ichildbirth,Icongestive Iheart Ifailure, Idehydration, Icancer, Iand Iincreased Icoagulability Iof Ithe Iblood. Signs Iand Isymptoms: Ismall Iemboli Icause Ichest Ipain, Icough, Ior Idyspnea. ILarge Iemboli Icause IchestIpain, Icough, Ideep Ibreathing, Itachypnea, Ihemoptysis, Iand Ifever. IMassive Iemboli Icause Icrushing Ichest Ipain, Ilow Iblood Ipressure, Irapid Iweak Ipulse, Iand Iloss Iof Iconsciousness.
- Discuss Ipneumothorax. IInclude Ithe Ipathophysiology Iand Iclinical Imanifestations. A Ipneumothorax Iis Iair Iin Ithe Ipleural Icavity. IClosed Ipneumothorax- Ispontaneous, Iidiopathic, Iruptured Iemphysematous Ibleb. IAir Ienters Ifrom Iinside Ithe Ilung Ithrough Ia Itear Iin Ithe Ivisceral Ipleura. ISigns Iinclude Iabsent Ibreath Isounds Iand Ihypoxia. IOpen Ipneumothorax- Icaused Iby Ia Ipuncture IwoundIthrough Ithe Ichest Iwall. IAir Ienters Ifrom Ioutside Ithe Ibody Ithrough Ian Iopening Iin Ithe Ithorax Iand Iparietal Ipleura. ISigns Iinclude Ia Isucking Inoise, Itracheal Iswing, Idecreased Iblood Ipressure, Iand Imoderate Ihypoxemia. ITension- Iopen: Icaused Iby Ia Ipuncture Ithrough Ithe Ithorax. IClosed Icaused Iby Ia Itear Iin Ithe Ilung Isurface. IBoth Icontain Ia Iflap Ior Ione Iway Ivalve. ISigns Iincludes Iabsent Ibreath Isounds Ion Ithe Iaffected Iside, Itracheal Ideviation Ito Ithe Iunaffected Iside, Iincreasing Irespiratory Idistress, Ishock,Idistended Ineck Iveins, Icyanosis, Iand Isevere Ihypoxia. IAll Ipneumothorax Ihave Iincreased, Ilabored Irespirations Iwith Idyspnea, Itachycardia, Ipleural Ipain, Iand Iasymmetrical Ichest Imovements.
- Discuss Ituberculosis. IInclude Ithe Ipathophysiology, Iincidence, Irisk Ifactors, Iand IclinicalImanifestations. Tuberculosis Iis Ia Idisease Ifound Iin Iareas Iof Ihomelessness, Ipoverty, Ioverpopulation, Iand Ihigh IHIVIrates. IIt Iis Icaused Iby IMycobacterium Ituberculosis. IIt Iwas Ithought Ito Ibe Iunder Icontrol Ibut Iis Inow Istarting Ito Ioccur Imore Ioften. Tuberculosis Imost Icommonly Iaffects Ithe Ilungs, Ibut Iit Ican Ialso Iaffect Iother Iorgans. IIn Ithe IprimaryIinfection, Ithe Iperson Ihas Ifirst Icome Iinto Icontact Iwith Ithe Ivirus Iand Ithe Imicrobe Iis Iattacked Iby Imacrophages Icausing Iand Iinflammatory Iresponse. IA Igranuloma Icontaining Ibacilli Iis Iformed Iat Ithe Iinflammation Isite. IA Ihealthy Iperson Ican Iusually Iavoid Ithe Iinvasion Iand Inot Ihave Ian Iimmune Iresponse Ito Iit Ibut Ithe Itubercle Iwill Iremain Iin Ithe Iperson Ifor Iyears. IAn Iunhealthy Iperson Iwill Inot Ibe Iable Ito Iavoid Ithe Iinvasion Iand Ithe Iprimary Iinfection Imay Ibecome Iactive. IExtrapulmonary Ituberculosis Iis Ifast Iacting Idestroying Ithe Ilungs Iand Itissues. IIn Isecondary Ituberculosis, Ithe Ibacilli
have Ibecome Iactivated Iin Ithe Iperson Iusually Idue Ito Ia Isuppressed Iimmune Isystem. IThis IcausesItissue Idestruction, Ilarge Iopen Iareas Iin Ithe Ilungs, Inecrosis. Risk Ifactors Iinclude, Ipopulations Iof Iovercrowding, Iincrease Iin Ihomelessness, Itraveling Ioften ItoInew Iareas, Iincrease Iin IHIV/AIDs, Iand Ithe Iresistance Ito Iseveral Idrugs. Manifestations- Iusually Iasymptomatic Ibut Isystemic Isigns Iusually Ioccur Ifirst. IThey Iinclude Ianorexia, Imalaise, Ifatigue, Iand Iweight Iloss. IAIlow-grade Ifever Iand Inight Isweats Idevelop Ias ItheIdisease Igets Iworse. ICough Ibecomes Imore Isevere Iand Imore Iproductive.