Nursing care of the child with an integumentary disorder Flashcards
Exam 4 (Final)
Difference in Skin Between Children and Adults
How are infants’ epidermis?
Infant’s epidermis is thinner and blood vessels are closer to the surface.
Difference in Skin Between Children and Adults
Infant’s epidermis is thinner and blood vessels are closer to the surface.
How does this effect heat?
Infant loses heat more readily through skin surface.
Difference in Skin Between Children and Adults
Infant’s epidermis is thinner and blood vessels are closer to the surface.
How does this effect absorption?
Allows substances to be absorbed through skin quicker.
Difference in Skin Between Children and Adults
Infant’s epidermis is thinner and blood vessels are closer to the surface.
When does infants’ skin reach adult thickness?
Does not reach adult thickness until late teen years.
Difference in Skin Between Children and Adults
What does infants skin contain more of compared to adults?
Infant’s skin contains more water.
Difference in Skin Between Children and Adults
Infant’s skin contains more water.
How is epidermis?
Epidermis is loosely bound to the dermis.
Difference in Skin Between Children and Adults
Infant’s skin contains more water.
What can effect layers of skin?
Friction may easily cause separation of layers, resulting in blistering or skin breakdown.
Difference in Skin Between Children and Adults
Infant’s skin contains more water.
Why is infants skin at more risk for UV damage?
Infant’s skin is less pigmented, therefore at risk for UV damage.
Causes of Integumentary Disorders in Children:
What can they be exposed to that could lead to integumentary disorders?
Exposure to infectious microorganisms.
Causes of Integumentary Disorders in Children:
What kind of reactions can occur?
Hypersensitivity reactions.
Causes of Integumentary Disorders in Children:
What are other causes of skin disorders?
Genetic predisposition.
Injuries.
Causes of Integumentary Disorders in Children:
How does darker skin compare to fairer skin?
Darker skin tends to develop hypertrophic scarring and keloids more so than fair skin.
Common Laboratory and Diagnostic Tests
Labs:
Immunoglobulin E (IgE)
Culture and sensitivity of wound drainage
Potassium hydroxide (KOH) prep
Patch or skin allergy testing
Wood lamp
Common Laboratory and Diagnostic Tests
What kind of labs are done?
Labs: CBC, erythrocyte sedimentation rate (ESR)
Terms to Describe Alterations in Integument
Macule
Papule
Annular
Pruritus
Vesicle, pustule
Scaling, plaques
Hypo-, hyperpigmented
Erythematous
Types of Infections of the Skin
Bacterial:
Fungal
Viral
Types of Infections of the Skin
Bacterial: What are examples?
bullous and nonbullous impetigo, folliculitis, cellulitis, MRSA, Staphylococcal scalded skin syndrome.
Types of Infections of the Skin
Bacterial: What are they often caused by?
Often caused by Staph aureus or group A β-hemolytic streptococcus (normal flora).
Types of Infections of the Skin
Fungal: What are examples?
multiple types of tinea (pedis, corporis, versicolor, capitis and cruris), Candida albicans.
Types of Infections of the Skin
Viral: What are examples?
viral exanthems, Herpes simplex.
Fungal Infections of the Skin
Tinea pedis:
Tinea corporis:
Tinea versicolor:
Tinea capitis:
Tinea cruris:
Fungal Infections of the Skin
Tinea pedis
fungal infection on the feet.
Fungal Infections of the Skin
Tinea corporis:
fungal infection on the arms or legs.
Fungal Infections of the Skin
Tinea versicolor:
fungal infection on the trunk and extremities.
Fungal Infections of the Skin
Tinea capitis:
fungal infection on the scalp, eyebrows, or eyelashes.
Fungal Infections of the Skin
Tinea cruris:
fungal infection on the groin.
Risk Factors for CA-MRSA
Turf burns.
Towel sharing.
Participation in team sports.
Attendance at day care or outdoor camps.
Types of Inflammatory Skin Conditions
Acute hypersensitivity reactions
Chronic hypersensitivity disorder
Chronic inflammatory skin disorders not from hypersensitivity
Types of Inflammatory Skin Conditions
Acute hypersensitivity reactions: What are examples?
Diaper dermatitis,
contact dermatitis,
erythema multiforme,
and urticaria.
Types of Inflammatory Skin Conditions
Chronic hypersensitivity disorder
Atopic dermatitis.
Types of Inflammatory Skin Conditions
Chronic inflammatory skin disorders not from hypersensitivity
Seborrhea and psoriasis.
Contact Dermatitis:
Causes:
Response to an antigenic substance exposure.
Allergy to nickel or cobalt in clothing, hardware, or dyes.
Exposure to highly allergenic plants: poison ivy, oak, and sumac.
Contact Dermatitis:
Complications
Secondary bacterial skin infection.
Lichenification or hyperpigmentation.
Prevention and Management of Diaper Dermatitis
Prevention:
What should be done with diapers?
Change diapers frequently.
Change stool-soiled diapers as soon as possible.
Prevention and Management of Diaper Dermatitis
Prevention:
What should be avoided?
Avoid rubber pants.
Prevention and Management of Diaper Dermatitis
Prevention:
What should be done to manage?
Gently wash the diaper area with a soft cloth, avoiding harsh soaps.
Prevention and Management of Diaper Dermatitis
Prevention:
What should be noted about wipes?
Use baby wipes on most children, but avoid wipes that contain fragrance or preservatives.
Prevention and Management of Diaper Dermatitis
What to do if a rash has appeared?
Do all the prevention measures (in previous cards)
Allow the infant or child to go diaperless for a period of time each day to allow the rash to heal.
Blow-dry the diaper area/rash area with the dryer set on the warm (not hot) setting for 3 to 5 minutes.
Classification of Acne
Mild
Moderate
Severe
Classification of Acne
Mild acne manifestations include?
Primarily noninflammatory lesions (comedones)
Classification of Acne
Moderate acne manifestations include?
Comedones plus inflammatory lesions such as papules or pustules (localized to face or back)
Classification of Acne
Severe acne manifestations include?
Lesions similar to moderate acne, but more widespread, and or presence of cysts or nodules.
Associated more frequently with scarring
Classification Criteria for Burns
How is it assigned?
Assigned by extent of injury:
Classification Criteria for Burns
Assigned by extent of injury:
Superficial:
Partial thickness:
Deep partial thickness:
Full thickness:
Classification Criteria for Burns
Assigned by extent of injury: Partial thickness:
involves epidermis and portions of dermis.
Classification Criteria for Burns
Assigned by extent of injury: Superficial:
only epidermis.
Classification Criteria for Burns
Assigned by extent of injury: Deep partial thickness:
extends deeper into dermis.
Classification Criteria for Burns
Assigned by extent of injury: Full thickness:
extend through the epidermis, dermis, and hypodermis.
Criteria for Transfer to a Burn Unit
How much of total body surface is affected?
Partial thickness burns greater than 10% of total body surface area.
Criteria for Transfer to a Burn Unit
Burns that involve what part of the body?
Burns that involve the face.
Burns that involve the hands and feet, genitalia, perineum, or major joints.
Criteria for Transfer to a Burn Unit
Burns caused by what?
Electrical burns,
including lightning injury.
Chemical burns.
Inhalation injury.
Hypersensitivity Reactions and Causative Agents
What kind of reaction is it? What is it due to?
Hypersensitivity reaction is an inflammatory reaction in the skin due to exposure to a local noxious agent (bee sting) or as a result of a systemic reaction to an allergen (erythema multiforme).
Hypersensitivity Reactions and Causative Agents
How can hypersensitivity reactions present?
Can be acute or chronic (atopic dermatitis).
Hypersensitivity Reactions and Causative Agents
Can be acute or chronic (atopic dermatitis).
Erythema multiforme (EM):
Stevens–Johnson and toxic epidermal necrolysis are extreme forms of EM.
Common Medical Treatments
Wet dressings
Occlusive dressings
Emollient lotions and creams
Therapeutic bathing
Skin biopsy
Common Medications
Antibiotics (topical, systemic)
Corticosteroids (topical)
Antifungals (topical, systemic)
Topical immune modulators (moderate to severe atopic dermatitis)
Antihistamines
Isotretinoin (cystic or severe acne)
Coal tar preparations (psoriasis, atopic dermatitis)
Silver sulfadiazine 1% (burns)
Common Medications
Antibiotics- how are they used?
Antibiotics (topical, systemic)
Common Medications
Corticosteroids- how are they used?
Corticosteroids (topical)
Common Medications
Antifungals- how are they used?
Antifungals (topical, systemic)
Common Medications
Topical immune modulators - what are they used for?
Topical immune modulators (moderate to severe atopic dermatitis)
Common Medications
Isotretinoin - what are they used for?
(cystic or severe acne)
Common Medications
Coal tar preparations - what are they used for?
Coal tar preparations (psoriasis, atopic dermatitis)
Common Medications
Silver sulfadiazine 1% - what are they used for?
(burns)
Nursing Assessment for Urticaria:
What should you collect?
Detailed history of new foods, medications, symptoms of recent infection, changes in environment, or unusual stress.
Nursing Assessment for Urticaria:
What should you inspect?
Inspect the skin for raised edematous hives on body or mucous membranes.
Nursing Assessment for Urticaria:
What should you assess? Why?
Assess airway and breathing as hypersensitivity may affect respiratory status.
Causes of Urticaria
Foods
Drugs
Animal stings
Infections
Environmental stimuli
Stress
Drug reactions:
Where are adverse drug reactions most often seen? What are the most common reactions?
Adverse drug reactions are most often seen in skin (rashes most common reaction)
Drug reactions:
How does the adverse drug reaction occur?
May be immediate or delayed following administration of drug
Drug reactions:
Treatment
Discontinue drug
Antihistamines
Corticosteroid therapy if very severe
Teaching Points for Avoiding Animal Bites
Never provoke a dog with teasing or roughhousing.
Get adult permission before interacting with a dog, cat, or other animal that is not your pet.
Do not bother an eating, sleeping, or nursing dog.
Avoid high-pitched talking or screaming around dogs.
Display a closed fist first for the dog to sniff.
Keep ferrets away from the face.
If a cat hisses or lashes out with the paw, leave it alone.
