Care for Child w/ Integumentary Condition Flashcards by Jess St John

A common bacterial skin disorder in adolescents that varies in severity; non-inflammatory and inflammatory pustules.

Treatment includes OTC medication (salicylic acid, benzoyl peroxide), Rx topical or oral antibiotics and retinoids, and Accutane

Acne vulgaris

How well did you know this?

Not at all

Perfectly

Androgen exposure and Resolves spontaneously

neonatal acne

How well did you know this?

Not at all

Perfectly

What can cause acne?

Medications: Anabolic steroids, Corticosteroids, Phenytoin (Dilantin), lithium

Other Triggers: Friction of the skin (hair bands, helmets, hats), oil-based cosmetics, hormonal changes, stress

How well did you know this?

Not at all

Perfectly

Bacterial infection found around the face and mouth. Staph Aureus is most common cause. Treat w/topical and/or oral antibiotics.

Impetigo contagiosum

How well did you know this?

Not at all

Perfectly

Gram + bacteria found on nose and skin. Usually, community acquired but can be nosocomial. Can result in an infection of the skin and soft tissue. Treat w/ oral antibiotics & monitor for cellulitis.

MRSA (Methicillin-Resistant Staphylococcus Aureus)

How well did you know this?

Not at all

Perfectly

Infection when bacteria enters through a break in the skin. Treated w/oral or IV antibiotics & tylenol/ibuprofen.

cellulitis

How well did you know this?

Not at all

Perfectly

S/sx of cellulitis

Red
Swollen
Warm
Tender to touch

How well did you know this?

Not at all

Perfectly

Viral infection of skin (pox virus) caused by direct contact with infected skin or contaminated objects. Presents as firm, round papules, pink to skin color. Can have exudative plug. Self Resolving.

Molluscum contagiosum

How well did you know this?

Not at all

Perfectly

Transmitted by direct skin-to-skin contact or mucous membrane contact. Three types in children: common warts, plantar warts, and flat warts. Treated w/liquid nitrogen, salicylic acid plasters, pulsed-dye laser, & keratolytic agents.

Human papillomavirus (warts)

How well did you know this?

Not at all

Perfectly

Also known as a cold sore. HSV virus enters the body and can become latent. A trigger will cause flare up. Treat w/ supportive care & magic mouthwash.

Herpes Simplex Virus 1

How well did you know this?

Not at all

Perfectly

S/sx & triggers of Herpes Simplex Virus 1

Sx: Watery blisters around face (lips), itching, & pain

Triggers: fever, stress, & sunburn

How well did you know this?

Not at all

Perfectly

Magic mouthwash is used to treat HSV1. It is made of Benadryl, lidocaine, & Mylanta. Mylanta is used to

help the other ingredients adhere to the oral mucosal surfaces

How well did you know this?

Not at all

Perfectly

Tinea Capitis

scalp/head

How well did you know this?

Not at all

Perfectly

Tinea Corporis

body

How well did you know this?

Not at all

Perfectly

Tinea Cruris

AKA ”Jock Itch”

groin

How well did you know this?

Not at all

Perfectly

Tinea Manum

hands

How well did you know this?

Not at all

Perfectly

Tinea Pedis

AKA ”Athletes Foot”

feet

How well did you know this?

Not at all

Perfectly

Tinea Unguium

nails

How well did you know this?

Not at all

Perfectly

Topical treatments for Corporis, Cruris, Manum, Pedis, Unguium

Topical antifungals (Ketoconazole, Miconazole, Clotrimazole)
Use twice a day for 4-6 weeks

How well did you know this?

Not at all

Perfectly

Oral antifungal, Giseofulvin, is a med given with fatty foods to treat

tinea capitis

How well did you know this?

Not at all

Perfectly

Large, tender, boggy mass on scalp; seen w/ tinea capitis

kerion

How well did you know this?

Not at all

Perfectly

Risk factors for oral candidiasis (thrush)

Antibiotics
Prematurity
Skin irritation
Immunocompromised
Steroids
Newborns-mother with Candidiasis

How is thrush treated?

Oral Nystatin/Clotrimazole applied to tongue and mouth

Rash on skin and in skinfolds
Bright-red beefy plaques with sharp margins
Small papules and pustules that can rupture

Treated w/antifungal topical applied before barrier product. Topical should be continued for three days after the rash clears.

Candida albicans

Known as the “itch that scratches” Genetic predisposition with environmental risks

atopic dermatitis

Common locations for atopic dermatitis

Infants: cheeks, neck, elbow & neck creases Children: folds of arms and legs, eyelids, neck, chronic can lead to lichenification

Patches w/papules, vesicles, exudate, crusts, excoriation. Some "weep". Dry cracked skin (xerosis). Erythema. Chronic cases will have Darkened, thickened, lichenification (prominent skin lines), excoriation, dryness, scaling.

Eczema

Goals of eczema treatment

-skin hydration & lubrication -reduce inflammation -prevent/reduce secondary infections -minimize itching -maintain skin barrier -optimal quality of life

Occurs after contact w/allergen or skin irritant. S/sx include: -Irritated, inflamed, and pruritic rash within 48 hours of contact with the offending agent -Vesicles and bullae may be present in the area -Urticaria (hives) when there is contact with an allergen -Vesicles that may weep serous fluid

contact dermatitis

Diaper management for contact dermatits

Water-impermeable barriers Protective sealants Avoid powder Frequent diaper changes Expose to air when possible Wash w/ warm water (caution w/ baby wipes)

An allergic response to an environmental trigger

cutaneous skin reaction

Anaphylaxis Symptoms w/ cutaneous skin reaction

Drooling, dysphonia, moderate to severe swelling in effected area, cyanosis, wheezing, stridor

Emergency treatment for anaphylaxis symptoms

-Reversal of causative agent -Decrease swelling with medications (Epinephrine, Benadryl) -Oxygen

-Recurrent inflammatory skin condition- yeast overgrowth -Found where sebaceous glands most plentiful -Infants-3 mos. and Adolescents -Can have waxy scaling of scalp -Treat with emollient and use soft toothbrush

Dermatitis: Seborrheic

Highly contagious, caused by the mite. Spread by skin to skin and sexual contact. Treated w/ OTC lotion (Elimite permethrin 5%)

scabies

S/sx of scabies

Rash with papules and pustules, lesions that are linear, threadlike. SEVERE itching-worsens at night

Highly contagious, caused by the louse parasite. Spread by skin to skin and sexual contact. Treated w/ OTC shampoo (age restrictions on some types)

lice

S/sx of lice

-pearl colored, tear drop shape -causes itching

How to treat infestations of lice & scabies

Education for both will include: -Treating other family members that have been in contact with child -Washing all clothing/sheets in HOT water -NO sharing of items such as brushes, hats, etc.

Tick born disease prevention includes:

-Avoid tick infested areas -Wear protective clothing -Check child for ticks everyday (hide in hair) -Insect repellents-DEET safe for children >2 months -Check pets that may carry and transfer to child -Remove ticks immediately using fine tipped forceps/tweezers

What stage of Lyme disease Rash that clears but leaves a "Bulls eye" mark, HA, joint pain, and fever

Stage I 3-30 days after bite

What stage of Lyme disease Same s/sx as stage I, along with neck pain, conjunctivitis, cranial nerve palsy, carditis, meningitis

Stage II 2-10 weeks after initial bite until chronic symptoms show up

What stage of Lyme disease Lyme arthritis (joint swelling), Bell's Palsy, encephalopathy, behavioral changes, migraines, and carditis

Stage III Weeks to months after initial bite

Lyme disease treatment

-Amoxicillin, Ceftin for 2 weeks in children 8 and under -Doxycycline, Tetracycline for children over 8 -Supportive care

Self-limiting illness after a bite or scratch from a cat (can carry Rochalimaea henselae)

Cat scratch disease

S/sx of Cat Scratch disease

-Tender lymphadenopathy (swollen lymph nodes) of the head, neck, and/or upper limbs -General malaise and low-grade fever -Headache -Papule at site of original bite or scratch

-Superficial thickness. -Damage to the outer layer only Ex. Sunburn, scalding -Redness and blanching with pressure -Peeling will occur after a few days -Treatment includes supportive care: pain meds, education on measures to take when outdoors

First degree burn

-Superficial partial thickness -Involves the epidermis and upper dermis layer- some sweat and oil glands may be damaged Ex. Flash flame, scalding -Usually heals within 10-14 days with minimal scarring -Blisters, redness, blanches with pressure, pain (esp. with exposure to cold air)

Second degree burn

-Deep Partial Thickness -Involves epidermis, dermis, and underlying tissue (including nerve endings, sweat glands, and hair follicles) Ex. Contact with hot objects -No blanching with pressure, area can be a variety of colors (red, brown, black), pain (depends on extent of nerve damage)

Third degree burn

-Full thickness which includes the muscle, fascia, and possibly bone -No blanching, wound can be a variety of colors -Most will not be able to feel pain

Fourth degree burn

Three phases of burns

Initial, recovery, and rehab

Fluid resuscitation is needed IMMEDIATELY when treating burns in order to

Restore circulating volume, optimize perfusion, and minimize burn shock

What severity scales are used for burns?

-Lund and Browder scales are used for infant, toddler, pre-school, & school-age children -Rule of nines scale is used for adolescents