Dermatologic Conditions Flashcards
1. Assess and plan care for the child with a rash. 2. Differentiate between contact dermatitis and infectious dermatitis. 3. Discuss the nursing interventions for the child with burns.
What aggravates most skin rashes?
Heat aggravates most skin rashes and increases pruritus (itching); coolness decreases pruritus.
Macular rash
a flat rash with color changes in circumscribed areas
Papular rash
raised small solid lesions with color changes in circumscribed ares
Vesicular rash
small, raised circumscribed lesions filled with clear fluid
Urticaria
also known as hives and may accompany other symptoms of allergy
erythema
redness
Interventions for rashes
1. Apply cool, soothing soaks, give baths with added baking soda, or dab site with calamine lotion.
2. Administer antipruritics; give antihistamines if the rash is from an allergy.
3. Distract the child and provide projects that make use of the hands.
4. Keep the affected area clean and pat it dry; expose the affected area to air.
5. Do not apply powder or cornstarch, as they encourage bacterial growth.
6. Do not use commercially prepared diaper wipes on broken skin unless they are alcohol free, as they will irritate and burn.
7. Apply moisturizer to wet skin.
8. Prevent the spread of infection.
a. Teach good hand washing.
b. Keep weeping lesions covered.
c. Teach the child to not share combs or hats and not to scratch.
9. Prevent secondary infections by cutting nails and applying mittens/restraints if needed.
10. Suggest light, loose, nonirritating clothing, such as cotton.
11. A humidifier in the home may improve dry skin.
Contact Dermatitis
Diaper Rash
Overview
- Related to moist, warm environment within the plastic diaper lining.
- May be caused by clothing dyes or soaps used to wash diapers.
- May be caused by body soaps, bubble baths, tight clothes, and wool or rough clothing.
a. Limit soaps. - Skin may be further irritated by acidic urine and stool or the formation of ammonia in the diaper.
Contact Dermatitis
Diaper Rash
Interventions
-
Keep the diaper area clean and dry.
a. Change the diaper immediately after voiding/stools.
b. Wash the area with mild soap and water. - Keep the area open to air, if possible.
- Apply vitamin A and D skin cream or other creams for diaper rash to help skin heal.
Contact Dermatitis
Poison Ivy
Overview
- Poisonous oil on the plant leaf causes a delayed hypersensitivity (T-cell) response; trauma to the leaves releases the sap, which is dragged across the skin.
- The rash appears 5 to 21 days after the first exposure but 1 to 2 days after subsequent contact.
- Oils that remain on the clothes and skin are contagious to others; the eruptions are not a source of infection and will not spread the disease.
- Animals may carry the oils to humans.
Contact Dermatitis
Poinson Ivy
Assessment
- Assess for pruritus.
- Observe for red, localized streaks that preced vesicles; vesicles break and fluid crusts.
Contact Dermatitis
Poinson Ivy
Interventions
- Wash the oils from the skin with soap and water as soon as possible after contact to prevent absorption through the skin.
- Do not touch other body parts until the area has been cleansed.
- Carefully wash resin out of clothes.
- Apply calamine lotiona dn admin anihistamines, if ordered.
- Prevent secondary infection from scratching.
Impetigo
Overview
- A superficial infection of the skin caused by group A β-hemolytic streptococci; may also be due to staphylococci
-
Highly contagious until all lesions are healed
a. The infection is spread by direct contact.
b. The incubation period is 2 to 5 days after contact. - Commonly seen on the face and extremities, but may be spread on other parts of the body by scratching.
- Can be spread by biting and stinging insects
- Common in children ages 2 to 5 years
Impetigo
Assessment
- Assess for a macular rash that progresses to a papular and vesicular rash, which oozes and forms a moist, honey-colored crust.
- Assess for puritis.
- Ask about bug bites.
- Ask about others who may have the same rash.
Impetigo
Interventions
- Apply moist soaks to soften the lesions; remove the crusts gently three to four times a day and wash the area.
- Cover the child’s hands, if necessary to prevent secondary infection; cut the child’s nails.
- Cover the lesions to prevent their spread.
- Administer antibiotics for their full course.
- Explain the finectious nature of the condition to parents.
a. Patient should use separate towels and linens.