Integumentary Dysfunction Flashcards
Skin lesions can be a result of what factors
*Contact with injurious agents
*Hereditary factors
*External factor that produces a reaction in the skin (allergens)
*Systemic disease in which lesions are a manifestation (measles)
cause of diaper dermatitis
prolonged and repetitive contact with an irritant (Urine, feces, soaps, detergents, ointments, friction)
diaper dermatitis primary location
convex surfaces or in folds
nursing interventions for diaper dermatitis are aimed at altering what three factors
wetness, pH, and fecal irritants
peak age of occurrence for diaper dermatitis
9 to 12 months of age, and the incidence is greater in bottle-fed infants than in breastfed infants.
interventions to control diaper rash
*Keep Skin dry - use superabsorbent disposable diapers
*Expose skin to air
*Apply ointment (zinc oxide)
*Avoid over-washing skin - do not use perfumed soaps or commercial wipes
seborrheic dermatitis
cradle cap
what is seborrheic dermatitis (cradle cap)
*Chronic, recurrent, inflammatory reaction usually on the scalp
*Thick, adherent, yellowish, scaly, oily patches
care for seborrheic dermatitis (cradle cap)
Shampoo is applied to the scalp and allowed to remain on the scalp until the crusts soften. Then the scalp is thoroughly rinsed.
A fine-tooth comb or a soft facial brush helps remove the loosened crusts from the strands of hair after shampooing.
what is Atopic Dermatitis (Eczema)
Atopic dermatitis (AD) is a type of pruritic eczema that usually begins during infancy and is associated with an allergic contact dermatitis with a hereditary tendency (atopy)
infant manifestation of AD (eczema)
*Usually begins at 2 to 6 months of age;
*Generally undergoes spontaneous remission by 3 years of age
childhood manifestation of AD (eczema)
*occurs at 2 to 3 years of age
preadolescent and adolescent manifestation of AD (eczema)
*Begins at about 12 years of age;
*May continue into the early adult years or indefinitely
diagnosis for Atopic Dermatitis (Eczema)
*A combination of history, clinical manifestations, and in some cases, morphologic findings
*family history of eczema, asthma, food allergies, or allergic rhinitis
cause of Atopic Dermatitis (Eczema)
*Unknown but appears to be related to abnormal function of the skin including alterations in perspiration, peripheral vascular function, and heat tolerance.
Distribution of Lesions Infantile:
*Generalized, especially cheeks, scalp, trunk, and extensor surfaces of extremities
Distribution of Lesions childhood:
*Flexural areas (pit of elbow or knee), wrists, ankles, and feet
Distribution of Lesions *Preadolescent and adolescent:
*Face, sides of neck, hands, feet, face, and pit of elbow or knee (to a lesser extent)
Appearance of Lesions infantile:
Erythema, vesicles, papules, weeping, oozing, crusting, scaling, often asymmetric
Appearance of Lesions childhood:
Symmetric involvement with clusters of small erythematous or flesh-colored papules or minimally scaling patches.
Appearance of Lesions Adolescent or Adult:
Same as childhood manifestations with dry, thick lesions (lichenified plaques) common. Papules may merge together.
therapeutic management for AD (eczema)
*Hydrate the skin, relieve pruritus (tepid baths, emollient lotions)
*Antihistamines (Diphenhydramine (Benadryl))
SE of Diphenhydramine (Benadryl)
Drowsiness, dizziness, fatigue, disturbed coordination
*Children: Nightmares, nervousness, and irritability are more likely to occur
how to prevent flare ups or inflammation for AD (eczema)
*Keep nails cut short
*Topical steroids
*New topical immunomodulators available by prescription
controlling secondary infection for AD (eczema)
Antibiotics - topical or oral
Interprofessional Care of Atopic Dermatitis
*Hypoallergenic diet may be prescribed
*Emotional stress is increased during acute phases
impetigo contagiosa manifestations
*Begins as a reddish macule à vesicular
*Ruptures easily
*Exudate dries to form heavy, honey-colored crusts
*Pruritus is common
impetigo contagiosa is…
VERY CONTAGIOUS
management of impetigo contagiosa
*Topical bactericidal ointment, mupirocin (Bactroban) or triple antibiotic ointment
*Oral or parenteral antibiotics for severe or extensive lesions (Penicillin is used)
*Vancomycin for lesions due to MRSA
*Tends to heal without scarring
cellulitis manifestations
*Inflammation of the skin and subcutaneous tissues
*Intense redness, swelling, firm infiltration
*“Streaking” often seen
*Involvement of the reginal lymph nodes
*May progress to abscess formation
systemic effects of cellulitis
fever and malaise
management of cellulitis
*Oral or parenteral antibiotics
*Rest and immobilization of both affected area and the child
*Hospitalization may be required (of child with systemic symptoms)
Pediculosis Capitis
Lice
Pediculosis Capitis (Lice) manifestations
itching
common sites of Pediculosis Capitis (Lice)
occipital area, behind the ears, nape of the neck
louse
Lice; A blood-sucking organism
*Female lays eggs (nits) at night at the junction of the hair shaft and close to the skin - hatch in 7-10 days
Pediculosis Capitis (Lice) management
*Application of pediculicides
(Permethrin 1% cream rinse (Nix))
-Second treatment 7-10 after first treatment
*Manual removal of nits
*Daily removal with a specialized comb
education for lice
Lice do not fly or jump, can be transmitted from one person to another on personal item
Children are cautioned against sharing combs, hair ornaments, hats, caps, scarves, coats, or other items used on or near the hair
