NUR 155 Exam 3
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1. Epidermis: Outermost layer of the skin and the thinnest of the laters
Despite lack of blood supply, it has the ability to regenerate every 4-6 weeks
2. 5 Layers of Epidermis: Stratum Corneum
Stratum Lucidum
Stratum Granulosum
Stratum Spinosum
Stratum Germinativum/Basale
3. Stratum Corneum: Made up of flattened dead cells
Can be seen being removed with bathing or rubbing
Important for providing protection from outside dangers and regulation of fluids and electrolytes
4. Stratum Lucidum, Stratum Granulosum, Stratum Spinosum: Middle three layers
Help in the reduction of friction and shear (skin pulled in one direction while underlying tissue moves in opposite
direction)
5. Stratum Germinativum/ Basal: Very active single layer of cells
Constantly produces new cells that are pushed upward through the other layers
6. Dermis: Layers between the epidermis and the deeper subcutaneous later
Much thicker than epidermis (thickness varies depending on part of body)
Irregular, interconnected projections link with the epidermis above
Connective tissue with its elastin and collagen fibers, provides strength and elasticity
Provides necessary oxygen and blood
Contains sebaceous glands, sweat glands, hair, nail follicles, nerves, and lymphatics
7. Rete Ridges or Papillary Dermis: Provide the "stick" that anchors these layers of the skin together,
preventing them from sliding back and forth
8. Subcutaneous Layer: Layer of adipose tissue, or fat
Attaches to the dermis to the underlying muscles and bone
Delivers the blood supply to the dermis
Provides insulation and cushioning
Size varies depending on the body location and person's weight, sex, and age
9. Factors Affecting Skin Integrity: Wounds
Vascular Disease
Diabetes
, NUR 155 Exam 3
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Malnutrition
Age
10. Medical Adhesive-Related Skin Injuries (MARSIs): When superficial layers of skin are
removed by medical adhesive
11. Wound Classification: Skin Integrity
Wound Depth
Amount of Contamination
Healing Process
12. Skin Integrity: Open wound
Closed wound
13. Open Wound: An actual break in the skin's surface
Ex: Abrasion, puncture wound, and a surgical incision
Some chronic wounds can be from pressure or vascular diseases
14. Closed Wound: Seen with bruising, the skin is still intact
15. Phases of Wound Healing: Inflammatory Phase
Proliferative Phase
Maturation Phase
16. Inflammatory Phase (Healing Phases): Healing begins with the body's initial response to
wounding of the skin and lasts about 3 days
Bleeding occurs
Formation of a clot to stop the bleeding (coagulation cascade)
Cytokines released
Increase pain, redness, warmth, and swelling
Macrophages and neutrophils are drawn to the site and start cleaning it of bacteria and debris
At the end, the wound bed is clean and ready to begin the actual repair process
17. Proliferative Phase (Healing Phases): Repair of the defect, filling the wound bed with new tissue
(granulation tissue), and resurfacing the wound with skin
Lasts several weeks, but can be short her with a surgically closed wound or longer if is large or left to health by secondary
intention
Development of new blood fells to support new tissue, collagen synthesis, wound contraction, and epithelialziation
18. Maturation Phase (Healing Phases): Last phase
Known as the remodeling phase
, NUR 155 Exam 3
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Can last up to a year
Collagen continues to be deposited and remodeled, and scare tissue is formed and strengthens
19. Factors Affecting Wound Healing: Oxygenation and tissue perfusion
Diabetes
Nutrition
Age
Infection
20. Oxygenation and Tissue Perfusion (Healing Factors): All cells in the body need oxygen
to function properly.
Chronic tissue hypoxia that is associated with a reduction in collagen formation, a decrease in the action and
proliferation of fibroblasts, a reduction in leukocytes, and an impairment of the cell's ability to migrate
Comorbid conditions (heart disease, peripheral vascular disease, and pulmonary disease can cause longer healing
process
21. Diabetes (Wound Factors): Changes the microvascular and macrovascular systems, leading to a
thickening of the vessel wall and occlusion of blood flow with decreased supply of nutrients and oxygen
Reduction in collagen syntheses
Decrease in the strength of that collagen, impaired functioning of leukocytes, and reduction in the number and action
of macrophages
22. Nutrition (Healing Factors): Needs additional to recover and health
Increase protein intake
Increase vitamins C and A and trace minerals zinc and copper
23. Age (Healing Factors): Decreased or delayed inflammatory response
Action of macrophages and fibroblasts are reduced
24. Infection (Healing Factors): Can cause complication of wound healing
Can cause prolongation of the inflammatory phase, delays collagen synthesis, prevents epithelialization, and can lead
to additional tissue destruction
25. Complications of Wound Healing: Dehiscence
Evisceration
Fistula Formation
26. Dehiscence: Partial or complete separation of tissue layers during the healing process
Splint the incision with a pillow or folded blanket or use an abdominal binder
Cough, deep breathing, and movement may cause this
Study online at https://quizlet.com/_i9y0d7
1. Epidermis: Outermost layer of the skin and the thinnest of the laters
Despite lack of blood supply, it has the ability to regenerate every 4-6 weeks
2. 5 Layers of Epidermis: Stratum Corneum
Stratum Lucidum
Stratum Granulosum
Stratum Spinosum
Stratum Germinativum/Basale
3. Stratum Corneum: Made up of flattened dead cells
Can be seen being removed with bathing or rubbing
Important for providing protection from outside dangers and regulation of fluids and electrolytes
4. Stratum Lucidum, Stratum Granulosum, Stratum Spinosum: Middle three layers
Help in the reduction of friction and shear (skin pulled in one direction while underlying tissue moves in opposite
direction)
5. Stratum Germinativum/ Basal: Very active single layer of cells
Constantly produces new cells that are pushed upward through the other layers
6. Dermis: Layers between the epidermis and the deeper subcutaneous later
Much thicker than epidermis (thickness varies depending on part of body)
Irregular, interconnected projections link with the epidermis above
Connective tissue with its elastin and collagen fibers, provides strength and elasticity
Provides necessary oxygen and blood
Contains sebaceous glands, sweat glands, hair, nail follicles, nerves, and lymphatics
7. Rete Ridges or Papillary Dermis: Provide the "stick" that anchors these layers of the skin together,
preventing them from sliding back and forth
8. Subcutaneous Layer: Layer of adipose tissue, or fat
Attaches to the dermis to the underlying muscles and bone
Delivers the blood supply to the dermis
Provides insulation and cushioning
Size varies depending on the body location and person's weight, sex, and age
9. Factors Affecting Skin Integrity: Wounds
Vascular Disease
Diabetes
, NUR 155 Exam 3
Study online at https://quizlet.com/_i9y0d7
Malnutrition
Age
10. Medical Adhesive-Related Skin Injuries (MARSIs): When superficial layers of skin are
removed by medical adhesive
11. Wound Classification: Skin Integrity
Wound Depth
Amount of Contamination
Healing Process
12. Skin Integrity: Open wound
Closed wound
13. Open Wound: An actual break in the skin's surface
Ex: Abrasion, puncture wound, and a surgical incision
Some chronic wounds can be from pressure or vascular diseases
14. Closed Wound: Seen with bruising, the skin is still intact
15. Phases of Wound Healing: Inflammatory Phase
Proliferative Phase
Maturation Phase
16. Inflammatory Phase (Healing Phases): Healing begins with the body's initial response to
wounding of the skin and lasts about 3 days
Bleeding occurs
Formation of a clot to stop the bleeding (coagulation cascade)
Cytokines released
Increase pain, redness, warmth, and swelling
Macrophages and neutrophils are drawn to the site and start cleaning it of bacteria and debris
At the end, the wound bed is clean and ready to begin the actual repair process
17. Proliferative Phase (Healing Phases): Repair of the defect, filling the wound bed with new tissue
(granulation tissue), and resurfacing the wound with skin
Lasts several weeks, but can be short her with a surgically closed wound or longer if is large or left to health by secondary
intention
Development of new blood fells to support new tissue, collagen synthesis, wound contraction, and epithelialziation
18. Maturation Phase (Healing Phases): Last phase
Known as the remodeling phase
, NUR 155 Exam 3
Study online at https://quizlet.com/_i9y0d7
Can last up to a year
Collagen continues to be deposited and remodeled, and scare tissue is formed and strengthens
19. Factors Affecting Wound Healing: Oxygenation and tissue perfusion
Diabetes
Nutrition
Age
Infection
20. Oxygenation and Tissue Perfusion (Healing Factors): All cells in the body need oxygen
to function properly.
Chronic tissue hypoxia that is associated with a reduction in collagen formation, a decrease in the action and
proliferation of fibroblasts, a reduction in leukocytes, and an impairment of the cell's ability to migrate
Comorbid conditions (heart disease, peripheral vascular disease, and pulmonary disease can cause longer healing
process
21. Diabetes (Wound Factors): Changes the microvascular and macrovascular systems, leading to a
thickening of the vessel wall and occlusion of blood flow with decreased supply of nutrients and oxygen
Reduction in collagen syntheses
Decrease in the strength of that collagen, impaired functioning of leukocytes, and reduction in the number and action
of macrophages
22. Nutrition (Healing Factors): Needs additional to recover and health
Increase protein intake
Increase vitamins C and A and trace minerals zinc and copper
23. Age (Healing Factors): Decreased or delayed inflammatory response
Action of macrophages and fibroblasts are reduced
24. Infection (Healing Factors): Can cause complication of wound healing
Can cause prolongation of the inflammatory phase, delays collagen synthesis, prevents epithelialization, and can lead
to additional tissue destruction
25. Complications of Wound Healing: Dehiscence
Evisceration
Fistula Formation
26. Dehiscence: Partial or complete separation of tissue layers during the healing process
Splint the incision with a pillow or folded blanket or use an abdominal binder
Cough, deep breathing, and movement may cause this
