Pediatrics- Skin Flashcards
1
Q
What is contact dermaTitus?
A
Inflammatory hypersensitive reaction of the skin
2
Q
What causes diaper dermatitis?
A
Caused by detergent, soaps, or chemicals that come in contact with genital area
3
Q
What is seborrheic dermatitis?
A
Cradle cap
4
Q
What is an expected findings in contact dermaTitus
A
Red bumps that can form moist, weeping blisters
Skin, warm and tender to touch
Using drainage or Crust
Skin scaley raw or thickened
5
Q
What is expected findings in diaper dermatitis?
A
Bright, red rash
Fiery red Skelly areas on genitalia
Pimples blisters, ulcers, large bumps plus field sores
Small, red patches
6
Q
Nursing care for a diaper dermatitis
A
Remove soil diaper
Clean perineal area with Nunn irritating cleanser
Use disposable diapers
Apply skin barrier, such as zinc oxide
Do not wash skin barrier off
7
Q
What should you do if there’s contact derma Titus
A
Remove irritant and limit further exposure
8
Q
What do you do if someone has a poisonous plant exposure?
A
Cleanse exposed area with cold, running water than soap
Apply calamine lotion
Use topical corticosteroids gel
9
Q
What do you do with seborrheic dermatitis?
A
Gently scrub the scalp to remove scales in crusted areas
Use fine tooth comb to remove the loosen crust
Shampoo daily
10
Q
What can be a result of Candida albicans
A
Diaper dermatitis
11
Q
What is client education for a diaper dermatitis?
A
Change diapers frequently
Avoid bubble baths and harsh soaps
12
Q
What is a complication of of contact derma Titus
A
Bacterial infections caused by brakes and skin from scratching
13
Q
How do you prevent bacterial infections in contact derma Titus?
A
Can you finger nails trim short?
Cleanse the area with mild soap and water
14
Q
What is atopic dermatitis?
A
A type of eczema characterized by pruritus associated with history of allergies
15
Q
Can a topic dermatitis be cured
A
No
16
Q
Risk factors for a topic dermatitis
A
Presence of allergic condition
family history,
previous skin disorder
17
Q
Physical assessment findings in a topic dermatitis
A
Skin can appear dry and rough
Hypo pigmentation of skin in small diffuse areas
Pallor surrounds nose, mouth ears
Bluish discoloration under eyes
18
Q
Onset of atopic dermatitis in an infant
A
2 to 6 months who is spontaneous remission by three years
19
Q
What does the distribution and lesions of atopic dermatitis in an infant looks like?
A
Generalize, distribution on cheeks, scale, trunk hands, and feet
That have erythema vesicles, papules, weeping, oozing crusting scaling lesions
20
Q
What does the distribution and lesions of atopic dermatitis in an child looks like?
A
Lesions in the flexural areas anti-cubital in popliteal neck, Ris ankles, and feet with symmetric involvement
Clustered erythematous or flesh colored papules Dry lesions.
21
Q
When is the onset of atopic dermatitis in a child?
A
2 to 3 years of age of 90% of children having manifestations by five
22
Q
When is an onset of a adolescent with a topic dermatitis?
A
12 years and continue onto adulthood
23
Q
Which is the nurse do if a patient has a topic dermatitis
A
Keep skin hydrated with tepid bath’s
Apply emollient with three minute of bathing
Two or three baths may be given daily with one prior to bedtime
Pet skin dry do not rub
Cotton clothing
Avoid excessive heat
Keep clients nails, short and filed
24
Q
what is acne
A
Most common skin condition that is self limiting and non-life-threatening, but poses a threat to self image and self-esteem
25
What is tretinoin?
Medication that interrupts abnormal keratinization that causes acne
26
Client education for a patient on tretinoin
Can irritate skin
Wait 30 minutes after washing the face before application
Use pea sized
apply at night
Avoid sun
27
What is a good client education of benzol peroxide
Can bleach, bed, linens towels, clothing, but not skin?
28
 What is client education of a topical anti-bacterial agent for acne
Every other day application, decreases adverse effects(drawing of skin, burning sensation, erhythmia)
Avoid sun exposure
29
What is isotretinoin?
Accutane
30
How is isotretinoin prescribed
Only through a dermatologist for severe acne that is unresponsive to other therapies
31
What does adverse effects of isotretinoin?
Dry skin,mucus membranes, and eyes
Decrease night vision
Headaches
Photosensitivity
Depression
Suicidal ideation
32
What is the importance of education for women and isotretinoin?
It is a teratogenetic and contraindicated in women of childbearing age
If sexually active client must agree to two forms of effective contraceptive for one month before and during treatment in one month, following treatment
33
How can oral contraceptive pills help acne in women
Decrease endogenous, androgen production
34
A nurse is teaching the guardian of an infant who has seborrheic dermatitis of the scalp which of the following instruction should the nurse include in the teaching?
You can use petroleum to help soften and remove patches from your infant scalp
When patches are present, you should keep your infant away from others
You should avoid washing your infants hair will patches are present on the scalp
One patches are present. It indicates that your infant has a systemic infection.
You can use petroleum to help soften and remove patches from your infant scalp
35
A nurse is caring for a child who has contact derma Titus due to poison ivy, which of the following action should the nurse take (select)
Remove the clothing over the rash
Initiate contact isolation precautions well the rash is present
Expose the rash to a heat lamp for 15 minutes
Cleanse the infected skin with hydrogen peroxide solution
Apply calamine lotion to the skin
Remove the clothing over the rash
Apply calamine lotion to the skin
36
The nurse is caring for an adolescent who has acne and prescription for isotretinoin from the dermatologist which of the following laboratory findings. Should the nurse plan to monitor
Cholesterol and triglycerides
BUN and creatinine
Blood potassium
Blood sodium
Cholesterol and triglycerides
37
A nurse is planning to care for an infant who has a diaper dermatitis, which of the following action should the nurse include in the plan of care( select)
Apply talcum powder with every diaper change
Allow the buttocks to air dry
Used commercial baby wipes to cleanse the area
Use cloth diaper until the rash is gone
Apply zinc oxide ointment to the affected area
Allow the buttocks to air dry
Apply oxide ointment to the affected area
38
A nurse is assessing an infant who is eczema which of the following findings should the nurse expect(select) 
Generalize distribution of lesions
Papules
Ekhymosis in flexural areas
Crusting lesions
Keratosis Pilaris
Generalize distribution of lesions
Papules
Crusting lesions
39
What should a child with eczema avoid
Avoid latex products, secondhand smoke, free, pets, dust in molds
40
What are the five different burns you can have
Thermal, cold, chemical, electrical and radioactive
41
What is a first-degree burn
A superficial burn, where there is damage the epidermidis
42
What is the appearance of superficial burn?
Pink to red in color with no blisters blanches with pressure
43
What is the sensation/healing of a first-degree superficial burn
Painful heels within 3 to 7 days no scars
44
What is a second-degree superficial partial thickness burn
Damage to the entire epidermis
Dermal elements are intact
45
What is the appearance of a second-degree superficial partial thickness burn?
Painful Moiz red in color with blisters mild to moderate edema no eschar
Blanches with pressure
46
What is the sensation/healing of a second-degree superficial partial thickness burn
Painful heals in less than 21 days
Variable amounts of scarring
Sensitive to temperature changes exposure to air and light touch
47
What is a second-degree deep partial thickness burn
Damage to the entire epidermis, and some parts of the dermis
Sweat, glands and hair follicles remain intact
48
What is the appearance of a second-degree deep partial thickness, burn
Modeled red to white in color with blisters in Moderat edema
Blanches with pressure
49
What is the sensation/feeling of a second-degree deep partial thickness burn?
Painful
Sensitive to temperature changes and light touch
Healing time can extend beyond 21 days
Scarring likely
50
What is a third-degree full thickness burn
Damage to the entire epidermidis and dermis, and possible damage to the subcutaneous tissue
Nerve endings hair follicles and sweat glands are destroyed
51
What is the appearance of a third-degree full thickness burn
Reggaeton black brown or waxy white in color
Dry, leathery appearance
No blanching
52
What is the sensation/healing of third degree full thickness burn
As Burn heals, painful sensations return in severity of pain increases
Heels within weeks to months
Scarring present
Autographing is required
53
What is a fourth-degree deep full thickness burn
Damage to all layers of the skin that extends to muscle facia and bones
54
What is the appearance of a fourth degree deep, full thickness, burn
Color variable
Dull and dry
Charring
Possible visible ligaments, phone or tendons
55
What is the sensation or healing of a fourth degree, deep, full thickness, burn
No pain is present
heals within weeks to months
scarring is present
autographing is required
amputation possible
56
Risk factors for burns
Abuse, neglect, lack of supervision, developmental growth of the child
57
Expected finding in a burn of a younger child
Younger children have deeper injuries due to thinner skin
Children, less than two years old, have a higher mortality, due to decreased proteins stores in immature, renal an immune function
58
What is TBSA
Total body surface area
Charts that determine the extent of injury to body surface
Infant skin is thin so injury is likely to be deeper
59
Severity grading system of classification of burns
Severity of the injury depends on the child’s age
Minor
Moderate
Major
60
Minor burns are treated where
Outpatient setting
61
Moderate burns are treated where
Hospital with expertise in Burn care
62
Major burns are treated where
Require medical services of burn center
63
What is the severity grading system of a minor partial thickness burn?
Less than 10% of TBSA
64
What is the severity grading system of a moderate partial thickness burn?
10% of 20% of TBSA
65
What is the severity grading system of a major partial thickness burn?
Greater than 20% of TBSA
66
And what is nursing care for a minor burn?
Stop the burning process
Remove clothes in your jewelry that can conduct heat
Apply tepid water
Do not use ice
Flush burns, caused by liquid chemical
Brush, dry chemicals from skin
Cover burn with clean cloth
Provide analgesia
Provide warms
Administer tetanus vaccine
Avoid using Greasy lotions or butter on burns
67
What position should you place a child in for a minor burn
horizontal position, enroll him in a blanket to extinguish the fire
68
What kind of dressing should you apply to a minor burn?
Nonadherent fine mesh gauze
Hydrocollide occlusive dressing
69
What kind of nursing care should you administer too major Burns
Maintain airway and ventilation
Provide 100% supplemental oxygen
Check vitals,
Maintain, cardiac output
Initiate IV access with large bore catheter
Avoid I am or sub Q injection’s
Use IV opioid
Administer pain meds prior to dressing change 
70
Why is fluid replacement important in major Burns?
Fluid placement is important during the first 24 hours
Isotonic crystalloid solution (lactated ringers) are used in the early stage
Colloid solution(albumin or plasma) maybe used after first 24 hours to 48 hours
71
What are manifestations of shock in a major burn patient
Confusion
Increase capillary refill
Spiking fever
Modeled or cool extremities
Decreased bowel sounds
Tachycardia and tachypnea
Decrease urine output
72
How do you prevent infection in a patient with a major burn?
Restrict plants and flowers
Change position frequently
Limit visitors
73
How do you provide nutritional support in a patient with major Burns?
Increase caloric intake to meet, increase metabolic demands and prevent hypoglycemia
Increase protein intake to prevent tissue breakdown and promote healing
74
What is the medication used to treat second and 3rd degree burns
Silver sulfadiazine
Mafenide acetate
75
What is wound care and a burn patient
Premedicate as prescribed
Remove previous dressing
Assess odors, drainage, and discharge
Provide hydrotherapy
Monitor for cold stress
76
What is hydrotherapy?
Play burn patient affected extremity and warm tub of water or use warm running water as the shower to cleanse the wound
Use once or twice a day. Use mild soap to gently wash, burns, and rinse with tepid water.
77
What is a biological skin covering?
Used to promote healing of large burns requires repeated surgical application
78
What is an allograft (homograft)
Skin from a human cadaver that is used for partial and full thickness burn wound
79
What is a xenograft
Obtained from animals(pigs) for partial thickness, burn wound
80
What is a synthetic skin covering?
Use for partial thickness, burn wounds
81
What is artificial skin?
A biological product that allows the dermis to regenerate used for partial and full thickness burns
Promotes healing faster
82
What is a permanent skin covering?
Maybe the treatment of choice for burns covering large areas of skin
83
What is an autograph?
Client skin
84
What does sheet graft
Sheet of skin use to cover the wound
85
What is a mesh graft
Sheet of skin placed in a mesher so skin graft has small slits in it allows graft to cover larger areas of burn wound
86
What is cultured epithelium?
Epithelial cells, cultured for use when grafting sites are limited
87
What are nursing actions for wound care of a burn patient
Maintain immobilization of the graft site
Elevate the extremity
Check for unstable body temperature
88
What are signs of infection before and after skin coverings of graft are applied to a burn patient
Discoloration of unburned skin surrounding burn wound
Green colors to subcutaneous fat
Degeneration of granulation tissue
Development of subeschar hemorrhage
89
What is education you should teach her patient who has a burn
Perform range of motion exercises
Assessed for infection
Avoid sun exposure
Expect delays and growth and wait for up to three years post for an injury
90
What is a direct thermal injury?
Occurs when burns of the face and lips damage occurs after inhalation of heated gasses
Can be delayed 24 to 48 hours
91
What are findings in a direct thermal injury
Wheezing
Increase secretions
Hoarseness
What rails in the lungs?
Cinch nasal hairs
92
A nurse is caring for a client who has a superficial partial thickness burn, which of the following action should the nurse take
Administer IV INFUSION OF 0.9% SODIUM CHLORIDE.
APPLY COOL, WET COMPRESS TO THE AFFECTED AREA
Clean the affected area using a soft bristle brush
Administer morphine sulfate
Apply cool, wet compresses to the affected area
93
A nurse is caring for a client who has a major burn in suspected septic shock, which of the following findings are consistent with a septic shock (select)
Increase body temperature
Altered sensorium
Decrees capillary refill time
Decreased urine output
Increased bowel sounds
Increase body temperature
Altered sensorium
Decreased urine output
94
A nurse is caring for a client who has a major Byrne and is experiencing severe pain which of the following action should the nurse implement to manage the clients pain
Administer morphine sulfate IVV, a continuous infusion
Administer meperidine IM as needed
Administer acetaminophen PO every four hours
Administer hydrocodone PO every six hours
Administer morphine sulfate IV via continuous infusion
95
A nurse is caring for a client who has a skin graph which of the following manifestations indicate infection (sleect)
Pink color to subcutaneous fat
Unstable body temperature
Generation of granulation tissue
Subseschar hemorrhage
Change in skin color around the affected area
Unstable body temperature
Subeschar hemorrhage
Change in skin color around the affected area
96
A nurse is caring for a client who has a moderate burn which of the following action should the nurse take
Maintain immobilization of the affected area
Expose the affected area to the air
Initiate a high protein, high calorie diet
Implement contact, isolation
Initiate a high protein, high calorie diet
