Ch 43: Peds Integumentary Flashcards
Eczema
(atopic dermatitis)
superficial inflammatory process involving primarily the epidermis
Forms of eczema
infantile: begins at 2-6 mo, decreases in incidence w aging, spon. remission by 3 yrs possible.
childhood: occurs at 2-3 yrs, may follow infantile form
preadolescent and adolescent: begins at 12 yrs and may continue into early adulthood or indefinitely
eczema locations
adolescent/ early adult: commonly occur in antecubital and popliteal areas
eczema treatment
administer antihistamines and topical corticosteroids as prescribed.
administer immunomodulator meds as prescribed.
administer prescribed abx if secondary infections occur.
Impetigo
a contagious bacterial infection of the skin caused by beta hemolytic streptococci or staphylococci, or both.
occurs most often in hot, humid months
thick honey colored crusts
Impetigo common sites
most common = on the face and around the mouth
then, hands, neck, and extremities
Impetigo symptoms
lesions begin as vesicles or pustules surrounded by edema and redness,
progresses to an exudative and crusting stage, vesicles rupture leaving honey colored crusts covering ulcerated bases
Impetigo treatment
contact isolation - highly contagious.
remove crusts to allow for healing.
apply topical abx ointments.
infection is communicable for 48 hrs beyond initiation of abx tx
oral abx prescribed if topical do not work.
Pediculosis capitis
(lice)
female louse lays her eggs (nits) on the hair shaft, incubation period is 7-10 dys.
lice can survive 48 hrs away from the host.
Lice tx
pediculicide product (usually permethrin 1% cream rinse (Nix)) as prescribed. daily removal of nits with an extra fine tooth metal nit comb. bedding / toys not washed = sealed in plastic bag for TWO WEEKS.
Scabies
parasitic skin disorder caused by an infestation of Sarcoptes scabiei (itch mite).
endemic among schoolchildren and institutionalized populations as a result of close personal contact.
Scabies incubation period
female mite burrows into the epidermis, lays eggs, and dies in the burrow after 4-5 wks.
the eggs hatch in 3-5 dys
Scabies infectious period
during the entire course of the infestation
Scabies assessment findings
pruritic papular rash
burrows on the skin (fine grayish red lines)
Scabies interventions
topical application of a scabicide (permethrin (Elimite)) kills the mites.
Lindane should not be used in children < 2yrs (more permeable skin) bc of risk for neurotoxicity and szs
permethrin is applied to all skin surfaces, massaged in, left on the skin for 8-14 hrs, and removed by bathing.
bedding / toys not washed = sealed in plastic bag for FOUR DAYS.
Priority Nursing Actions BURNS
- stop the burning process
- assess the ABCs
- begin resuscitation if the child is not breathing
- remove burned clothing and jewelry
- cover the wound with a clean cloth
- keep the child warm
- transport the child to the ED
Pediatric burn considerations
thinner skin
higher risk for fluid/heat loss, dehydration, and metabolic acidosis than adults
more body fluid proportion increases risk of CV problems
burns > 10& of BSA require fluid resus.
smaller muscle mass/ less body fat –> increased risk for protein / calorie deficit.
scarring is more severe
immature immune system
delay in growth may occur after a burn
rule of nines
inaccurate for children bc of different body proportions
age related charts to estimate burn area
fluid replacement therapy
to determine adequacy of fluid resus. assess: vital signs (esp HR) urine output adequacy of capillary filling sensorium status
fluid replacement fluids
crystalloid solutions are used during the initial phase of therapy; colloid solutions such as albumin, Plasma-Lyte (combo electrolyte solution), or fresh frozen plasma are useful in maintaining plasma volume
best way to assess fluid resus
neurological assessment
