Medical-surgical Nursing Demystified

(^400) Medical-Surgical Nursing Demystified

How the Integumentary System Works

The outside covering of the body, or the skin, serves three major purposes. It pre-

vents dehydration, regulates body temperature, and is the major deterrent of infec-

tion in the body. When this barrier is broken, whether by surgical incision, wound,

cut, or scrape, the primary defense is no longer intact. Superficial breaks in the skin

may be treated on an outpatient basis. However, deeper wounds, and those involv-

ing the face and neck, may need more intense care with IV antibiotics. Skin is com-

prised of several layers and is waterproof. Many skin manifestations are described

using common terms. Macules are small, flat-topped lesions, less than 1 cm in diam-

eter, similar to a freckle. Papules are elevated lesions, also smaller than 1 cm in

diameter. A wheal is a raised area filled with fluid and usually temporary, such as

in hives. A vesicle is a fluid-filled blister, often seen in shingles. Bullae are larger

than 1 cm in diameter and are fluid-filled blisters. A plaque (sticky deposits that

attaches to the inner lining of an artery) is greater than 1 cm in diameter, raised, and

shallow. A nodule is a solid lesion, up to 1 cm in diameter with depth. A tumor is

larger than 1 cm in diameter, and is solid with depth. A pustule is an elevation con-

taining purulent material. Petechiae are smaller than 1 cm in diameter and are usu-

ally round areas of deposits of blood. A purpura is a large petechia.

Key Terms

Atopy

Basal cell carcinoma

Braden scale

Cryosurgery

Debrided

Eczema

Erythema

Eschar

Fibroblastic phase

First-degree burn

Hydrocolloids

Hyperpigmentation

Immunosuppressant

Lymphedema

Melanoma

Mohs’ surgery

Proliferative phase

Pruritis

RAST testing

Second-degree burn

Squamous cell

Third-degree burn

Vesicles

Learning Objectives

Burns

Dermatitis

Skin cancers

Cellulitis

Pressure ulcers

Wounds and healing

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