Integumentary Disorders & Burn Care — Wound Management, Skin Conditions, and NCLEX Nursing Priorities | Chapter 39: Saunders NCLEX-PN Review

Integumentary Disorders & Burn Care — Wound Management, Skin Conditions, and NCLEX Nursing Priorities | Chapter 39: Saunders NCLEX-PN Review

Chapter 39 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides a thorough exploration of skin anatomy, wound healing, common integumentary disorders, and comprehensive burn care. This chapter equips nursing students with the skills to assess, treat, and prevent complications in patients with skin-related conditions — a critical area for NCLEX-PN success.

Watch the video above for a focused review, then follow along with the expanded written summary below to reinforce your understanding. Subscribe to Last Minute Lecture for more high-yield nursing exam preparation.

Book cover

Skin Anatomy & Wound Healing

The skin’s layers — epidermis, dermis, and subcutaneous tissue — protect the body from pathogens, regulate temperature, and facilitate sensory input. Wound healing occurs in three phases: inflammatory, proliferative, and maturation. Accurate staging and timely intervention are essential for preventing complications.

Common Integumentary Disorders

  • Candida albicans: Yeast infection treated with antifungals and hygiene measures.
  • Herpes zoster: Painful vesicular rash along dermatomes; antivirals and vaccination reduce severity.
  • Herpes simplex: Recurring blisters; antiviral therapy for symptom control.
  • MRSA: Requires contact precautions, wound drainage management, and targeted antibiotics.
  • Cellulitis/Erysipelas: Bacterial skin infections treated with antibiotics and warm compresses.
  • Poison ivy/oak/sumac: Allergic dermatitis from urushiol oil; corticosteroid treatment for severe reactions.
  • Psoriasis: Chronic immune-mediated disorder causing silver-scaled plaques; managed with topical and systemic therapies.
  • Stevens-Johnson Syndrome: Severe medication reaction; requires hospitalization and supportive care.
  • Acne: Management includes topical agents, oral medications, and skin care education.

Skin Cancer

Types include basal cell carcinoma (pearly nodules), squamous cell carcinoma (scaly red patches), and melanoma (irregular borders, varied pigmentation). Nursing care focuses on patient education, early detection, sun protection, and postoperative care after excision or Mohs surgery.

Burn Classification & Assessment

  • Superficial: Red, painful, no blisters.
  • Partial-thickness: Blisters, moist surface, severe pain.
  • Full-thickness: Dry, leathery, insensate areas requiring grafting.

Burn size estimation uses the Rule of Nines, while depth guides treatment planning. Early priorities include airway management, fluid resuscitation, and prevention of shock.

Burn Care Phases

  1. Emergent (Resuscitative): Focus on ABCs, IV fluids, oxygen therapy, and tetanus prophylaxis.
  2. Acute: Wound debridement, infection prevention, pain control, and nutritional support.
  3. Rehabilitative: Physical therapy, scar management, and psychosocial support.

Special Burn Interventions

Procedures like escharotomy and fasciotomy relieve pressure and restore circulation. Graft care — including autografts, xenografts, and synthetic coverings — requires strict infection control and careful dressing changes.

Other Skin Emergencies

  • Pressure Injuries: Staged I–IV; managed with repositioning, dressings, and possible surgical intervention.
  • Frostbite: Rapid rewarming, sterile dressing, and monitoring for compartment syndrome.
  • Arthropod bites/stings: Varying treatments from ice packs to antivenoms, depending on the species.

NCLEX-PN Nursing Priorities

  • Maintain airway and breathing in burn patients with inhalation injury.
  • Implement contact precautions for infectious skin conditions.
  • Educate patients on skin cancer prevention and self-examination.
  • Monitor graft sites for signs of rejection or infection.

Conclusion

Integumentary disorders and burn care require prompt recognition, skilled intervention, and compassionate patient education. Mastery of these topics supports both NCLEX-PN success and excellence in clinical nursing practice.

If you found this breakdown helpful, be sure to subscribe to Last Minute Lecture for more chapter-by-chapter textbook summaries and academic study guides.

Explore the full playlist for Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) here: Complete NCLEX-PN Review Playlist

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