Chapter 49: The Child with an Alteration in Tissue Integrity Flashcards
Adult female lays eggs under the skin, then larvae hatch and come to the surface, creating burrows and tunnels that are difficult to see
scabies
Burn with no pain except in outlying areas
full thickness burn
Symptomatic treatment for HSV includes OTC ______, antiviral __________, and ____________.
analgesics, acyclovir, hydration
Commonly passed from mother to infant through infective secretions in vaginal delivery
HSV-2
How does swimming affect the skin of those with atopic dermatitis?
Dries out skin
Use this technique to apply topical antibiotics and antimicrobial dressings to burns
aseptic technique
Treatment involves removing irritant, washing skin thoroughly, using cool compresses, and steroid cream
contact dermatitis
Birthmark that contains distended dermal capillaries; can get redder as infant cries
salmon patch
Hormonal changes that occur in adolescence increases ___________________________ in skin, resulting in _________________________.
sebum production, acne vulgaris
______________ or ______________ can treat acne vulgaris
Benzoyl peroxide, salicylic acid
Painful burns
partial thickness burns (superficial and deep)
In pediatric burn patients, rapid fluid resuscitation should be initiated quickly to prevent ____________________________________
fluid and electrolyte imbalance
To treat pediculosis capitis or scabies, wash clothing, bedding, and stuffed animals with what
Hot water
Treatment for scabies includes OTC ____________
permethrin 5%
Seborrheic dermatitis is a skin condition that begins in the first ________ and usually disappears by __________.
2-3 weeks of life, 12 months
Thoroughly clean pacifiers, bottles, and/or the mother to help treat this condition
thrush (candidiasis)
Birthmark that is caused by capillary malformation; gets darker as child ages and may become nodular by middle age adulthood
port wine stain
Cause of this skin condition is unknown, but thought that sebaceous gland dysfunction and overgrowth in fungi play a role
seborrheic dermatitis
___________ may be used if there is resistance to OTC treatments for acne vulgaris
Antibiotics
Treatment may include medications, surgery, radiation, or laser therapy
hemangiomas
OTC treatment with _____________ and __________ is recommended for pediculosis capitis
lice shampoo, nit comb
Three treatment goals for burns
Preventing infection
Facilitating tissue regrowth
Limiting functional impairments
Transmitted by direct contact
pediculosis capitis
Systemic infection in young infants possible
Herpes Simplex Virus
Burn with physiologic function intact
superficial burn
If inpatient, use these precautions for HSV
contact precautions
To treat burns, apply _____________ and ________.
antimicrobial agents, dressings
This method uses the child’s palm (1%) to estimate the extent of burns
Palmar method
Oral steroids may be needed for severe cases of this condition
contact dermatitis
Keep affected areas clean and dry
Tinea infections
Another name for seborrheic dermatitis
cradle cap
Burn that involves destruction of the epidermis and some dermis
superficial partial thickness burn
Secondary infection that often follows a small break in the skin and is highly contagious
impetigo
Treatment involves daily hair washing using a mild, OTC anti (condition) shampoo that contains sulfur and salicylic acid and fine-tooth comb to remove scales
seborrheic dermatitis
Treat surrounding environment, including family members
pediculosis capitis
Resolves on its own, but virus remains dormant and may reactivate during times of stress
HSV-1
Birthmark that contains pigment deep within the dermis
Mongolian spot
Do not shampoo hair for how long after the initial treatment for pediculosis capitis
24 hours
The hallmark signs of atopic dermatitis
dry, inflamed, pruritic patches of skin
Burn that involves destruction of epidermis
superficial burn
When to repeat treatment with OTC permethrin 5% after first treatment
in one week
Fungal infection that commonly appears in the mouth but may present in diaper region
candidiasis
Manifestations include heat, tender, redness, and swelling
cellulitis
Superficial fungal infections that can occur anywhere on the body
Tinea infections
Candidiasis that appears in the mouth is also known as this
thrush
Naturally disappears by 5-6 years
hemangiomas
Burn mortality and severity is (higher, lower) in pediatric patients
higher
Dry out shoes and change socks frequently, especially after becoming wet
Tinea pedis
Establish access to these three areas when treating a burn
IV access for fluids and antibiotics
NG tube for stomach decompression and nutritional support
Foley catheter to monitor I&O
Burn in which the skin may appear white or black
full thickness burn
Three key treatments for Stevens-Johnson syndrome
Remove affecting medication
Maintain hydration
Pain management
Good time to do ROM exercises for burn patients
during hydrotherapy
The severity of burns indicates how much ________ is disrupted
function (minor, moderate, or major)
Burn with functional impairment present
full thickness burn
Common contagious skin infection in crowded living quarters
scabies
Any substance that comes in prolonged contact with the skin can be this
irritant
Atopic dermatitis patches appear on which parts of the body in an infant
face, scalp, arms, legs
Burns that do not result in blisters
superficial, full thickness
Pattern of unintentional burns
splash
Why does myoglobinuria occur
myoglobin cannot be filtered effectively through kidneys
Overproduction of T-cells attracted to the skin initiates inflammatory response creating its hallmark signs
atopic dermatitis
Oral Nystatin is a treatment for this
thrush
Cold sore or “fever blister”
HSV-1
How often should burns receive care until closure
At least daily
Skin has ______ ability to regulate temperature in pediatrics
decreased
Another term for pediculosis capitis
head lice
Birthmark that is a proliferation of dilated capillaries and endothelial cells
hemangioma
Condition where inflammation is caused by direct contact with the skin and an irritant
contact dermatitis
Another name for atopic dermatitis
eczema
Treatment includes topical antibiotics (oral if severe) and washing lesions three times a day with a mild antibacterial soap
impetigo
This method that estimates the extent of burns is not recommended in pediatrics because it is not an accurate representation
Rule of Nines
Two fluids recommended for rapid fluid resuscitation in pediatric patients
normal saline, lactated ringers
when to treat pain in relation to other burn treatments
30 minutes before
Precautions to utilize for swimming with atopic dermatitis
Limit time
Moisturize well before and after
Burn that does not result in scarring
superficial burn
(Thicker/Thinner) skin in pediatrics increases susceptibility to _____________ and ____________
Thinner, irritants, infection
Inflammation from invading pathogen causes pustular lesions that weep honey-colored fluid which crusts over lesions
impetigo
Increase in bacteria and yeast lead to secondary infections
seborrheic dermatitis
Pediatric burn patients are at a(n) (increased, decreased) risk for ______ and _____ loss
increased, fluid, heat
Related to sloughing of skin cells, overgrowth of normal bacteria, hormonal fluctuations, stress, and hereditary factors
acne vulgaris
Patterns of intentional burns
Glove, stocking
Cardiac arrest, dysrhythmia, tissue damage, myoglobinuria, metabolic acidosis, loss of short-term memory, and altered emotional state are major complications of this
electrical injury
Bacterial infection of subcutaneous tissue
cellulitis
Burns with some functional impairment
partial thickness burns (superficial and deep)
Three conditions that atopic dermatitis has connections with
asthma, hay fever, allergic rhinitis
How long should OTC permethrin 5% be left on the body during a single treatment
8-14 hours (recommended to put on at bedtime)
Avoid colors and perfumes–> can increase itching
atopic dermatitis
When to repeat treatment for pediculosis capitis
On day 7-9
Treatment involves moisturizing areas thoroughly and frequently, controlling itching, removing known irritants, and preventing infection
atopic dermatitis
How to apply Nystatin in pediatric patients
Use Q-tip or gloved finger
(Pediatric patients may not be able to swish and spit)
Population most at risk for burns and why
Infants and toddlers are dependent on adults to ensure environment is safe
Two treatment goals for acne vulgaris
preventing scarring and preserving positive self image
Oral ____________ is recommended for Tinea capitis and is (difficult/easy) to treat.
griseofulvin, difficult
Atopic dermatitis patches appear on which parts of the body in childhood
flexor surfaces of limbs (wrists, elbows, backs of knees)
dorsal surfaces of hands and feet
Burns that result in blisters
partial thickness burns (superficial and deep)
Medication that can treat acne vulgaris resistant to other treatments
Accutane
Infection of skin and mucous membranes
Herpes Simplex Virus
This condition has an unknown cause but is thought to have a genetic component and be related to a malfunction within immune system
atopic dermatitis
Plaques in mouth from thrush may cause this
Difficulty eating (encourage hydration)
Has many side effects
Is teratogenic (severe birth defects, miscarriage)
Must sign form to consent to taking this medication
(Treatment for acne vulgaris)
Accutane
Birthmark that begins to disappear by one year of age and is completely gone by 5-6 years of age
hemangioma
Pediatric burn patients are at a(n) (increased, decreased) risk for ________________ scarring, _______________ problems, ___________, and __________ and _________ deficiency
increased, hypertrophic, cardiovascular, infection, protein, calorie
Avoid citrus and sodas (carbonation can increase inflammation)
Herpes Simplex Virus
Ratio of skin surface area to body volume is (lesser/greater) in pediatrics, allowing greater _______________ and ________________________
greater, absorption, fluid loss
Oral antihistamines and corticosteroid creams may be indicated for this condition
atopic dermatitis
Removal of dead material (eschar) is known as this
debridement
Another area that seborrheic dermatitis can occur
diaper area
Appear as red lesions and may have scaly appearance
Tinea infections
Treatment is not indicated in children, but makeup or laser therapy can be used
port wine stains
A chronic inflammatory condition of the skin that usually begins in infancy and clears up by 2-3 years of age but can continue into childhood and adulthood
atopic dermatitis
Cool compresses and OTC pain medications are used to treat this type of burn
superficial burn
An adaptive form that estimates the extent of burns in pediatrics
Lund and Browder method
Herpes in genital region
HSV-2
Keep nails short and clean
atopic dermatitis
scabies
Allergic, inflammatory reaction to medications or a result of an autoimmune disorder
Stevens-Johnson syndrome
Pop blisters or leave them alone
leave them alone
Itching can last for several weeks after treatment
scabies
__________________ for females can help treat acne vulgaris
Hormone therapy
How might thrush (candidiasis) end up in the diaper region
Traveling through GI tract from oral to anal region
When should the antiviral acyclovir be used
early in HSV infection
in the immunocompromised (not recommended for treatment right away in regular population)
Its oily, yellow scales block sweat and sebaceous glands, leading to inflammation.
seborrheic dermatitis
This condition presents as dry, inflamed, pruritic skin along the affected area
contact dermatitis
Sexual abuse should be considered when HSV-2 occurs in a child under which age
14 years
Rash and itching that worsens at night
scabies
Burn that involves destruction of the epidermis, dermis, and underlying tissue
full thickness burn
This skin infection can cause emotional distress in the adolescent population
acne vulgaris
Two primary goals for nursing interventions for skin inflammation disorders
Treat existing infection
Prevent secondary infection
Burn that involves destruction of the epidermis and dermis
deep partial thickness burn
Intubate quickly when burns affect these areas of the body
face and chest
Treatment includes antibiotics and warm compresses
cellulitis
Presents like a burn and has similar treatment
Stevens-Johnson syndrome
Treatment for Tinea corporis, cruris, and pedis
Topical antifungals (lotrimin, monistat)
