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Pediatrics > Integumentary System > Flashcards

Integumentary System Flashcards

1
Q

Skin functions

A
  • protection
  • impermeability
  • fluid regulation
  • heat regulation
  • sensation
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2
Q

Dev differences in kids

A
  • epidermis loosely bound to dermis
  • skin thinner, BV closer to surface (more likely to get abrasion than bruise)
  • more permeable and sus to superficial bac infx
  • more likely to have assoc systemic sx with infx
  • more apt to respond to a primary irritant
  • less pigmentation
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3
Q

General interventions for skin issues

A
  • no powder or cornstarch (aerosolized)
  • light, loose, non-irritating clothing (no wool for eczema)
  • keep skin clean and dry
  • prevent secondary infx; cut nails, apply mittens at night
  • prevent infx spread; good handwash, cleaning toys, keep open wounds covered, teach kids not to share combs and hats
  • avoid commercial diaper wipes on irritated skin
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4
Q

Diaper dermatitis

A
  • contact or irritant type
  • candida albicans (thrush)
  • or bacterial infx
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5
Q

Causes of contact dermatitis

A

Compromised skin…
- chemical irritation
- mechanical irritation
- infection (candida albicans)
- fecal enzymes
- inc skin/diaper pH
- skin wetness

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6
Q

CM of contact diaper dermatitis

A

Erythema in convex surfaces like thighs, butt, perineum, waist, lower abdomen
- can be bleeding
- not in creases bc skin on skin protects the space

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7
Q

NC for diaper dermatitis

A
  • dry affected area and prevention of contact with the irritant
  • keep area open to air as much as possible (while nap, leave diaper open under them, while running around with long shirt on)
  • often seen when sleeping through the night
  • change wetness immediately
  • PREVENTION–ointment like zinc oxide (desitin) or petroleum to barrier when they pee
  • wash off feces with water and mild soap
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8
Q

Candida albicans infection (monilia or thrush)

A
  • beefy red, extends into creases, satellite lesions
  • precipitate by abx use, immunosupp, exposure to yeast
  • treat with anti-fungal cream like nystatin until gone and several days after
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9
Q

MRSA

A
  • bacterial infx caused by strep
  • beefy red
  • oral med, amoxicillin
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10
Q

Seborrheic dermatitis

A
  • chronic, recurrent inflam scaling dx of the scalp (Cradle cap) and face
  • unknown cause
  • only in early infancy
  • lesions–thick, adherent, yellowish, scaly, oily patches; may be pruritic
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11
Q

Cradle cap NC

A
  • aggressive scrubbing of scalp may prevent
  • use olive oil or anti-seborrheic shampoo (may burn) and leave on scalp until crusts are soft, rinse through
  • use soft brush to remove softened crusts in morning
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12
Q

Eczema (atopic dermatitis)

A
  • Pruritic inflammation of the skin associated with allergy and a hereditary tendency
  • infantile, childhood, and adolescent versions
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13
Q

Eczema management

A
  • find source of allergen or irritation
  • relieve pruritis; colloid baths, oral antihistamines
  • hydrate skin; don’t dry off after bath and coat in lotion
  • dec inflam with topical steroids
  • prevent or control secondary infx
  • dye free and perfume free products
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14
Q

Eczema NC

A
  • long sleeves and pants
  • mild cotton, no scratch
  • dye free and perfume free
  • humidifier in room
  • avoid enviro triggers
  • keep nails short (less scratching)
  • watch for infx signs
  • avoid latex bc more susceptible to allergies
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15
Q

Contact dermatitis

A
  • Causes–response to an antigenic substance exposure (often nickel or dye, exposure to allergic plants)
  • reddened irritation caused by allergen pressing on skin that can cause hyperpigmentation
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16
Q

Contact dermatitis NC

A

Put nail polish, tape, cloth between the allergen and skin if metal; avoid plants

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17
Q

Poison ivy

A
  • redness, swelling, itching at site of contact; advances to streaked or spotty blisters
  • flush area immediately after contact with cold, running water
  • wash clothing and pets
  • scratching does not spread rash but could cause secondary infx
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18
Q

Impetigo

A
  • strep or staph cause
  • honey crusted lesions often in moist areas like armpits, creases, around mouth and under nose
  • pruritic
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19
Q

Impetigo tx

A
  • soften crusts with moist soaks
  • topical bactericidal ointment
  • oral abx; cephalexin or PCN
  • no school for 24h–spread thru direct contacts
  • cover lesions
  • no share linens
  • prevent scratching
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20
Q

Cellulitis

A
  • deep, locally diffuse infx of skin with systemic manifestations
  • caused by strep or H. influenza B
  • CM–fever, swelling, heat, tenderness of involved skin; malaise, regional lymphadenopathy
  • concern is getting to bone
21
Q

Cellutitis management

A
  • oral abx
  • rest and immobilization
  • warm, moist compresses
  • hospitalization if joint or facial involvement
22
Q

Herpes simplex

A

Viral infx of skin and mucus membranes
- clusters of vesicles filled with clear fluid
- CM: burning, itching, vesicles on inflam base which dries forming a crust followed y exfoliation and spontaneous healing in 8-10 days
- worse in times of stress
- tx with topical, warm compresses
- eating and hydration considerations

23
Q

Verruca (warts)

A
  • epidermal benign tumor caused by human papilloma virus
  • CM–solitary flesh-colored papule with an irregular, scaly surface; may have pin point black spots
  • Tx: cryotherapy, salicylic acid paints
  • education; most disappear with time, repeated irritation may worsen
24
Q

Erythema infectisum (fifth disease)

A

From parvovirus
- rash, minor itching, tiredness, sore throat, fever
- fetal death if mom gets while preg
- aplastic crisis–kids with hemolytic disease or immunodeficiency

25
Q

Fifth disease rash

A
  • slapped face that disappears w/i 1-4 days
  • maculopapular red spots, upper and lower extremities, lacey appearance on trunk
  • don’t really treat
26
Q

Chicken pox (Varicella)

A
  • caused by varicella zoster virus
  • spread primarily via resp tract secretions and contact with skin lesions
  • communicable; one day before rash appears until all lesions are crusted over (no school until all CRUSTED)
  • incubation period–14-21 days
27
Q

Varicella CM

A
  • slight fever
  • malaise
  • anorexia
  • itchy rash
28
Q

Varicella tx

A
  • help with itching
  • cool bath
  • calamine lotion
  • acycline
  • watch for secondary infx like pneumonia
29
Q

Varicella NC

A
  • strict iso when hospitalized
  • immunize at 12M and 4Y
  • may bet varicella-zoster immune globulin (VZIG)
  • iso at home until all crusted
  • good skin care
  • no aspirin
30
Q

Tinea corporis

A

Ringworm on body

31
Q

Tina capitis

A

Causes alopecia and inflam, crustiness

32
Q

Tinea cruris

A
  • jock itch
  • in groin crease
33
Q

Tinea (Ringworm)

A
  • transmitted person to person or animal to person
  • tx with topical or oral antifungal infx
  • capitis needs oral (hard on liver so get liver enzymes after 6W on it)
34
Q

Tinea (ringworm) NC

A
  • emphasize good health and hygiene
  • examine household pets
  • teach kids not to share hats, scarves, helmets
35
Q

Pediculosis (head live)

A
  • infestation of the hair or scalp by pediculus humanus capitis
  • lice or nits (eggs) found in hair usually behind ears, nape of neck
  • intense pruritis; possible excoriation of skin
36
Q

Lice tx

A
  • permetherin rinse or shampoo for 10 minutes (made of chemicals)
  • malation on dry hair for 8-12h
  • Kwell shampoo–toxic, non-ovicidal
  • must pick nits out of hair
37
Q

Education for head lice

A
  • avoid shampoo contact with eyes
  • don’t treat in bathtub or shower
  • apply only to infected area on infected individuals
  • wash bedding, cloths in hot water and dry in hot dryer for 20 minutes 1x/W
  • comb out nits with fine tooth comb
  • soak brushes and combs
  • store unwashables in sealed plastic for 2W
38
Q

Scabies

A

Impregnated mite burrows into the stratum corneum of the epidermis and deposits her eggs and feces
- intense itchy
- maculopapular lesions, intertriginous areas

39
Q

Scabies management and NC

A
  • whole household sleeps with Permethrin on skin
  • Neurotoxic Lindane for resistance cases
  • Ivermectin CI in kids under 5
  • follow directions carefully
  • treat all contacts
40
Q

Sunburn prevention and tx

A
  • PABA free sunscreen after 6M (lotion is better than aerosol)
  • avoid exposure btwn 10-4
  • tx with cool water (not direct ice)
  • NSAIDs for pain
  • clean dressing
  • don’t pop blisters of peel dead skin
  • stay hydrated
41
Q

Facial acne in adolescent

A
  • caused by inc production of sebum in sebaceous glands, familial aspect
  • blackhead, whitehead, cystic lesions
  • negative body image affect
42
Q

Acne intervention

A
  • good facial hygeine
  • squeezing not recommended
  • first line–OTC benzoyl peroxide–can dry skin so good facial lotion
43
Q

Bites and stings

A

Minor rxn
- bite or sting mark
- stinger, tentacle or venom sac
- redness
- swell
- pain or tenderness
Severe rxn
- anaphylaxis

44
Q

sting tx

A
  • apply icepack
  • remove stinger with credit card or tweezer
  • NSAID
  • watch for swelling–Benadryl–esp around airway
  • call 911 if known allergy
  • wash with soap and water
45
Q

Tick bites

A
  • not poisonous but can transmit Rocky mt spotted fever or Lyme disease
  • bite into skin, embed mouth parts
  • can remain for days if undetected
  • tx not needed but watch for Lyme disease
46
Q

Lyme disease CM

A
  • rash
  • fever
  • chills
  • severe HA
  • joints and muscle aches
  • go into clinic
47
Q

Preventing tick bites

A
  • keep lawn mowed, brush cleaned up, wood piles stacked
  • wear socks, tuck long pants in
  • wear light colored clothes
  • don’t lay linens on ground
  • walk in middle of paths
  • comb thru hair after being in infested area
  • CHECK BODY after hikes
  • teach how to look for s/s
48
Q

First aid for tick bites

A
  • removed by grasping close to skin with tweezers, pull gently until tick lets go
  • wash area with soap and water
  • antiseptic or topical antibac on site
49
Q
A

Pediatrics (26 decks)

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