Exam 4 - Customized Flashcards
When the circulations of blood vessels is obstructed by abnormally shaped RBCs causing ischemia & infarction
Sickle Cell Disease
Physical Cues of Sickle Cell Disease
Extreme fatigue or irritability
Pain in abdomen, thorax, joints, and digits
Dactylitis
Cough, increased WOB, fever, tachypnea, hypoxia (Acute Chest Syndrome s/s)
Splenomegaly
Jaundice (from hemolysis) or pale conjunctiva, palms, soles, and skin
Sickle Cells Labs
Decrease H&H and reticulocyte count
Increase Platelets (SC increase plt activation)
Sickle Cell Vaso-Occlusive Episodes
Pain Control (Distraction, NSAIDS, acetaminophen, warm compression - PCA or regular schedule)
Hydration (double maintenance fluid requirement (150 ml/Kg/day)
Hypoxia (O2 via NC if SpO2 <92, incentive spirometry)
Radiation Skin Integrity Care
Wash skin with mild soap and water
Avoid lotion/powder/ointments
Avoid sun and heat exposure
Diphenhydramine or hydrocortisone cream for itching
Antimicrobial cream for desquamation
Moisturize with aloe vera
BM aspirate Medication
Fentanyl and Versed (anesthetic and sedation meds)
BM Aspirate Post-procedure
Hold pressure and monitor for bleeding and infection
Neutropenia Precation
Assess for infection Q8H and PRN
No raw fruits, vegetables, fresh flowers, or live plants
Other precautions: Private room, avoid invasive procedures, soft toothbrush, and wear mask when child is outside.
Lab test for Skin
Blood test (CBC, ESR, IgE)
Culture and sensitivity
KOH prep (positive fungal hyphal indicates ringworm)
Allergy testing
Woods Lamp (light exposure)
KOH can make me shine
I prefer hanging out on arms and legs and a contagious personality
My nickname is ring worm
Tinea Corporis
Topical antifungal
Clotrimazole - use for at least 4 weeks, and used clothing, etc have to be washed to reduce spread
Tinea pedis Education
Do not walk barefoot
Tinea Versicolor
Resolve by itself in several months
Medication for Tinea Capitus
Oral Griseofulvin (4-6 wks) cannot use topical
Verruca Cues
warts - Elevated, rough, gray-brown firm papules, single or in groups
Viral
Molloscum Contagiosum
Flesh-colored papules on stalk (extremities, face, and trunk) - Resolves spontaneously in 18 months
Complicated cases can use chemical or curettage, cryotherapy, or electro-dissection to remove
Viral
Daiper Dematitis Non-candida Care
Skin Barriers - Zinc Oxide, A,D, and E ointment, petroleum)
Daiper Dematitis Candida Medication
Nystatin (antifungal)
Temperature Change and sweating makes me come out to play
I can make you wiggle and scratch all day and night
Sometimes I bring my friend Wheeze
I amke IgE levels Rise
Eczema - Atopic Dermatitis
Atopic Dermatitis Physical cues
Extreme itching, erythema, and inflammation
Lesions/rash (plaques, papules, scaling, vesicles) can affect everywhere but abd, chest, hands, and feet.
Atopic Dermatitis Management
Topical Corticosteroids and Immune modulations tacrolimus
Avoid hot water but shower 2 times a day in warm water
Do not use soaps containing perfumes, dyes or fragrances but you can use moisturizers
Use 100% cotton product
When Staph aures or MRSA come to town that’s when I come around
My favorite hang outs are around the nose and mouth
My spots fill up with fluid then erupt
Some say I look liekt he color of honey
Impetigo
Impetigo Cues
Honey color skin lesions; itchy and painful
Impetigo Treatment
Soak impetigo with appropriate solution and apply topical or oral antibiotics
Staph Aurues is my name and producing toxin is my game
I can make babies’ skin weep and peel
I sometime look like a bad sunburn
SSSS - Burn-like appearance
SSSS Treatment and Education
Mild: Oral antibiotics
Sever: IV antibiotics, fluid management, and burn treatment
Localized infection
Cellulitis
Cellulitis treatme
Oral or parental antibiotics
Rest and immobilize affected areas
What are the bacterial skin infection
Cellulitis
Impetigo
SSSS
I come in many different shapes and sizes
Mom says this, Dad says that of how I came to be
Poverty, prematurity, and chronic illness can lead to me
The buttocks, back and thighs are hiding places of these
Pattern marking can be key
Intentional Skin Injuries (posterior location are the most suspecious)
Risk factor of injuries
Poverty, prematurity, chronic illness, intellectual disability, parent with abuse history, and extreme stressor
15 year-old male presents with areas of comodones on forehead and cheeks and scattered pustules on back with hypertrophic scaring
Acne
Hx and Physical Cues of Acne
Family Hx,endocine disoreder,comodones, oily skin and hair
Management of Acne
Avoid oil-based product cosmetics
Avoid picking comodone
Medication
Tretinoin, benzoyl peroxide, antibacterial, isotretinoin (severe cases), and oral contraceptives
Can lead to infections and cellulitis
Sensorineural hearing loss Causes
Aging
Noise damage
Drug side effect
Auditory tumors
Explosion/blast
Meningitis
CMV
Conductive Hearing Loss Causes
Fluid, foreign object, allergies, rupture eardrum, impacted earwax, and OM
Mixed Hearing Loss Causes
Genetic, infection, Head trauma
Glaucoma
Grey/Gray red reflex
Enlarged eyeball
Excessive tearing or conjunctivitis
After Surgery
No rough-housing or contact sport for 2 wks
Neuroblastoma Diagnosis and cues
24 Hr urine test - elevated HVA and VMA
Unilateral Proptosis
Often Metastasize to other organs
Lymphoma Cues
Night sweats (>10% wt loss)
ALL cUE
eNLARGED lIVER AND lYMPH NODES
