Care for Child w/ Integumentary Condition Flashcards
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
Androgen exposure and Resolves spontaneously
neonatal acne
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
Bacterial infection found around the face and mouth. Staph Aureus is most common cause. Treat w/topical and/or oral antibiotics.
Impetigo contagiosum
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)
Infection when bacteria enters through a break in the skin. Treated w/oral or IV antibiotics & tylenol/ibuprofen.
cellulitis
S/sx of cellulitis
Red
Swollen
Warm
Tender to touch
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
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)
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
S/sx & triggers of Herpes Simplex Virus 1
Sx: Watery blisters around face (lips), itching, & pain
Triggers: fever, stress, & sunburn
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
Tinea Capitis
scalp/head
Tinea Corporis
body
Tinea Cruris
AKA ”Jock Itch”
groin
Tinea Manum
hands
Tinea Pedis
AKA ”Athletes Foot”
feet
Tinea Unguium
nails
Topical treatments for Corporis, Cruris, Manum, Pedis, Unguium
Topical antifungals (Ketoconazole, Miconazole, Clotrimazole)
Use twice a day for 4-6 weeks
Oral antifungal, Giseofulvin, is a med given with fatty foods to treat
tinea capitis
Large, tender, boggy mass on scalp; seen w/ tinea capitis
kerion
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
