NURS 190 PA MIDTERM EXAM STUDY GUIDE, LATEST, A RATED.1. Pt with malignant melanoma; risk factors; what will the skin look like? ABCDE
ABCDE of Melanoma
• Asymmetry
• Border Irregularity
• Color Variation
• Diamet
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NURS 190 PA MIDTERM EXAM STUDY GUIDE, LATEST, A RATED.1. Pt with malignant melanoma; risk factors; what will the skin look like? ABCDE
ABCDE of Melanoma
• Asymmetry
• Border Irregularity
• Color Variation
• Diameter Greater than 6mm
• Evolving Changes
Risk Factors
• Sun sensitivity, difficulty tanning, hx of prolonged sun exposure, use of tanning booths, occupational exposure to chemicals like tar and radiation
QUIZ QUESTION: Nevi this big and has color variation should be alerted for? – Malignant Melanoma
2. How to assess for central cyanosis?
Look at patient’s oral mucosa
QUIZ QUESTION: How to assess central cyanosis? – check the oral mucosa
3. Contact dermatitis
Inflammation of the skin due to an allergy to a substance that comes into contact with the skin
Redness, hives, vesicles or scales accompanied by intense itching
4. 3 Tineas; signs and symptom
Tinea Corporis – fungal infection of the body
Tinea Capitis – fungal infection of the scalp
• Need to further assess the cause of pruritus of the scalp because this can be due to lice
Tinea Pedis – fungal infection of the feet (athlete’s foot)
5. COPD, configuration of chest
Barrel chest; AP:T diameter is equal
QUIZ QUESTION: Expected finding with patient with COPD?
• Barrel chest
• Kyphosis
• Hollow Clavicle
• Protruding Sternum angle of Louie
6. Scoliosis, kyphosis, lordosis, torticollis
Scoliosis – lateral curvature and rotation of the thoracic and lumbar spine (S back); most common in female
Kyphosis – exaggerated posterior curvature of the thoracic spine (hunchback); associated with aging.
Lordosis – exaggerated curvature of the lumbar spine (swayback); compensation for pregnancy, obesity, and skeletal changes.
Torticollis – muscle spasm by spinal accessory nerve, causing lateral flexion contracture of neck muscle
7. Physiological changes in older adult for all the systems discussed
Skin, Hair, and Nails
• Decreased elasticity, sebum production, perspiration, and melanin
• Increased sensitivity to light
• Nails become thicker, and more brittle
Head, Neck and Lymphatics
• Loss of subcutaneous fat in the face
• Decreased reproductive hormone
• Hair change, tooth loss, limited ROM
• Complaints of tired or weak feeling due to thyroid dysfunction
Eye
• Decreased vision acuity
• Presbyopia – age-related near vision difficulty
• Cataract – thickened yellow lens; decreased lens clarity
• Macular Degeneration – loss of central vision
Ears, Nose, Mouth and Throat
• Loss of hearing frequency
• Gradual hearing loss (presbycusis)
• Chelitis (angular stomatitis)
• Decreased sense of taste and smell, saliva production,
• Receding gum, tooth loss
Respiratory
• Decreased respiratory efficiency, cough ability
• Changes in breath depth
• Increased RR, effect of infection
Breast and Axillae
• Limited ROM for examinations
• Modification of BSE
• Changes in breast tissue composition
• Gynecomastia in males
• Increased breast cancer risk with aging
Cardiovascular
• Loss of ventricular compliance and vascular rigidity
• Conduction system loses automaticity
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