[Exam 4] Chapter 45 –Alteration in Tissue Integrity/Integumentary Disorder Flashcards
Differences in Skin Between Adult/Child: What to know for friction?
Infant’s skin contains much more water. Therefore, friction can easily cause separation of the layers resulting in blistering.
Differences in Skin Between Adult/Child: Dark-skinned children tend to have more prominent what?
Papules, follicular responses, and vesicular reactions
Differences in Skin Between Adult/Child: What to know about hyertrophic scarring and keloid formation?
Occurs more often in dark-skinned children
Common Medical Tx: Why is wet dressing done?
In presence of itching, crusting, or oozing, helps to remove cruts
Common Medical Tx, Health Hx: Determine child’s chief complaint, which is usually what?
Pruritus, scaling, or cosmetic disruption.
Common Medical Tx, Physical Exam: Note whether the rash is what?
Macular, papular, pustular, or vesicular
Common Medical Tx, Physical Exam: Describe lesions according to what criteria?
Linear : In a line
Shape: Are they round, oval?
Morbilliform: Rose, maculopapular rash
Target lesions: like bull’s eye
Common Medical Tx, Labs: What does POtassium Hydroxide (KOH) prep determine?
Fungfal infections
Bacterial Infections: What is Impetigo?
Readily recognizable skin rash.
Bacterial Infections: When does nonbullous impetigo occur?
Follows some type of skin trauma , or may arise seconary to a bacterial infection
Bacterial Infections: What is bullous impetigo?
Demonstrates sporadic occurence pattern and develops on intact skin, resulting from toxin production
Bacterial Infections: What is Folliculitis, and why does it occur?
Infection of hair follicle, and comes from occlusion of hair follicle. May result from poor hygiene or prolonged contact with contaiminated water.
Bacterial Infections: What is cellulitis?
Localized infection and inflammation of the skin adn subcutaneous tissues.
Bacterial Infections: When does staphyloccal scalded skin syndrome occur?
Results from infection with S. Auresu that produces a toxin, which then causes exfoliation. REsults in diffuse erythema (reddening of skin) and skin tenderness
Bacterial Infections: Where does CA-MRSA most commonly occur?
As a skin or soft tissue infection, such as cellulitis
Bacterial Infections: Risk factors for CA-MRSA?
Turf burns, towel sharing, or participation in team sports.
Bacterial Infections: Therapeutic mx of these infections?
topical or systemic antibodies and appropriate hygiene
Bacterial Infections, Nursing Assessment: Note history of skin disruption such as?
cut, scrape, or insect or spider bite.
Bacterial Infections, Nursing Assessment: Body piercings can lead to what?
Impetigo or cellulitis
Bacterial Infections, Nursing Assessment: FEver may occur with what?
Bullous impetigo or cellulitis , common with scalded skin syndrome
Bacterial Infections, Nursing Mx: What should you do for impetiginous lesions?
Soak them with cool compreses or Burrow solution to remove crusts before applying topical antibiotics
Bacterial Infections, Nursing Mx: How to prevent transmission of nosocomial MRSA?
Isolating children
Bacterial Infections, Nursing Mx: How to reduce risk of scarring with scalded skin syndrome?
minimal handling, avoiding corticosteroids and applying soothing ointments.
Bacterial Infections, Nursing Mx: How does nonbullous impetigo appear?
Papules progressing to vesicles, then painless pustules. Honey-colored exudate, and then crust after rupture
Bacterial Infections, Nursing Mx: Treatment for nonbullous impetigo?
Topically with mupirocin ointment.
Numerous lesiosn = cephalosporin
Bacterial Infections, Nursing Mx: Treatment for nonbullous impetigo, what may be needed for MRSA?
Clindamycin.
Bacterial Infections, Nursing Mx: How to remove honey-colored crust with nonbullous impetigo?
Cool compress twice daily
Bacterial Infections, Nursing Mx - Bullous Impetigo: Skin findings here?
Red macules and bullous eruptions.
Size may be from few mm to cm
Bacterial Infections, Nursing Mx - Bullous Impetigo: Treatment?
Oral cephalosporin and good hygiene
Bacterial Infections, Nursing Mx - Folliculitis: Skin findings?
Red, raised hair follicles
Bacterial Infections, Nursing Mx - Folliculitis: Treatment?
Treat with aggressive hygiene like warm compresses after washing.
Topical mupirocin, with oral anitbiotics
Bacterial Infections, Nursing Mx - Cellulitis: Skin findings
Localized reaction with erythema, pain, edema and warmth
Bacterial Infections, Nursing Mx - Cellulitis: Treatment?
Mild = Cephalexin or Amoxicillin
Severe= IV Cephalosporins
Bacterial Infections, Nursing Mx - Staphlyococcal Scalded Skin Syndrome: Findings here?
Flattish bullae that rupture within hours
Red , weeping surface left, common on face, groin, neck
Bacterial Infections, Nursing Mx - Staphlyococcal Scalded Skin Syndrome: Treatment?
Mild-moderate: Oral Cephalexin or Amoxicillin
Severe = Fluid Management and IV Oxacillin or CLindamycin
Fungal Infections: What is Tinea?
Fungal disease of skin occuring on any part of body. Part of body affected determines second word in name.
Fungal Infections: Tinea Pedis location?
Fungal infection on feet
Fungal Infections: Tinea Corporis location?
Fungal infection on arms or legs
Fungal Infections: Tinea Versicolor location?
Fungal infection of trunk or extremities
Fungal Infections: Tinea Capitis location?
Fungal infection on scalp, eyebrows or eyelashes
Fungal Infections: Tinea cruris location?
Fungal infection on groin
Fungal Infections: Theraptuic management invovles?
Appropriate hygiene and admin of antifungal agent
Fungal Infections, Nursing Assess: Get history, noting exposure to what?
Person with fungal infection or exposure to a fet.
Fungal Infections, Nursing Assess: Note areas that child may have gone to including?
Barber (Tinea Capitis), and damp areas like locker room and swimming pools or use of nylon socks
Fungal Infections, Tinea Corporis (Ringworm): Skin findings?
Annular lesions with raised peripheral scaling and central clearing
Fungal Infections, Tinea Corporis (Ringworm): Treatment
Antifungal cream for 4 weeks
Fungal Infections, Tinea Capitis): Tinea capitis skin finding?
Patches of scaling in scalp with central hair loss. .
Risk of kerion development (inflamed, boggy mass filled with psutules)
Fungal Infections, Tinea Capitis: Tinea capitis treatment?
Oral griseofulvin for 4-6 weeks
Selenium sulfie shampoo to decrease contagiousness
No schhol for 1 week
Fungal Infections, Tinea Versicolor: Skin finding?
Superificial tan or hypopigmented lesions.
Mote noticeable in summer
Fungal Infections, Tinea Versicolor: Treatment?
Apply selenium sulfide shampoo all over body once a week for 4 weeks
Topical antifunals may be used too
Fungal Infections, Tinea Pedis (Athlete’s Foot): Skin finding?
Red, scaling rash on soles and between toes
Fungal Infections, Tinea Pedis (Athlete’s Foot): Treatment?
Topical antifungal cream, powder
Foot hygiene
Fungal Infections, Tinea Cruris: Skin finding?
Erythema, scaling, maceration in inguinal creases and inner thighs
Fungal Infections, Tinea Cruris: Treatment?/
Topical antifungal for 4-6 weeks
Fungal Infections, Diaper Candidiasis (Monilial Diaper Rash): Skin findings?
Fiery, red lesions, scaling in skin folds, and setellite lesions
Fungal Infections, Diaper Candidiasis (Monilial Diaper Rash): Treatment?
Topical nystatin with diaper changes.
Fungal Infections, Nursing Mx: What to know for tinea corporis?
Contangeous, but can return to schoo once treatment begins.
Fungal Infections, Nursing Mx: What to tell parents for tinea capitis?
Hair will regrow in 3-12 months and wash sheets in hot water
Fungal Infections, Nursing Mx: What to tell child with tinea versicolor?
Normal skin pigmentation may take several months.
Diaper Dermatitis: What is this?
Inflammatory reaction of the skin in the area covered by a diaper
Diaper Dermatitis, Nursing Assess: Inspect skin in the diaper area for what?
Erythema and maceration.
Diaper Dermatitis, Nursing Assess: How does this start appearance wise?
Starts as a flat red rash in the convex skin creases. May appear red and shinny and may or may not have papules.