Pediatrics Test 2: Integumentary Dysfunction Flashcards
What is the medicine for diaper dermatitis?
White petrollium: ointment creates barrier from getting to skin
Zinc: usually white. Essential mineral for skin integrity. Desiden and don’t want to get in the crevice
What is irritant diaper disorder?
Occurs from moisture trapped in diaper or contact dermis is from the allergens
Peak age of 9-12 months, as they grow you don’t change them as much
Associated with frequency of dearer change and new foods which changes urine and poop pH
Convex surface (less on creases)
Red, excoriation
Rx: keep clean, air dry; barrier ointment
What is Candidiasis?
Bright red, confluent lesions with raised border and satellite lesions (away from primary irritation)
In folds, painful
Can spread to mouth (thrush): white patches on cheeks and tongue. If it wipes off with a q-tip its milk, if it adheres its carditis. Altered flora secondary to antibiotic use.
Rx: anti fungal powder or cream (Nystatin) but on cheek and down middle.
What is atopic dermatitis?
Chronic inflammatory skin condition
What are common allergies
Hereditary tendency
Food: peanuts, milk, soy, eggs, gluten, fish, orange juice, tomato juice
Material: wood, plastic in diaper, bottle and pacifier, nylon
Inhalants: house dust, dander, pollen
Where does atopic dermatitis start?
On cheek and spreads extensor
Worry about secondary infection
What are clinical manifestations of Atopic Dermitis?
Erythema Vesicles or populses Weeping/oozing Crusting Scaling Dry skin Keratosis pilaris: chicken skin Lichenification: scales Pursuits
What is the treatment for atopic dermatitis?
Maintain hydration via tepid bath, mild or no soap, emollient within 3 minutes. Soak and seal. thick cream Eucarin & Cetaphil
Cover patches with soft cotton cloth
Colloid baths with oatmeal
Short nails to avoid itch and scratch
What is prevention and treeatment of atopic Dermitis?
Topical antihistamines Oral antihistamines Hypoallergenic food Avoidance of chemical,msolvent, soap, detergent, fragrance, smoke and care products Occasional oral corticosteroids
What are the different types of skin wounds?
Abrasion: superficial scrape
Avulsion: forcefully dig out tissue (Sams leg)
Laceration: slice through skin
Incision: straight with scalpel
Penetrating wound: something went in and extended
Puncture: small open compared to depth of penetration
What causes a delay in wound healing?
Decrease blood flow Malnutrition Illness/immune compromised Picked at, irritated, infected Foreign bodies in it Environments to dry Medications: chemo, corticosteroids Antiseptics: hydro peroxide, bedodine
What is impetigo contagiosa?
Superficial bacterial skin infections from staphylococci.
How does Impetigo Contagiosa spread?
Scratiching
What are signs and symptoms of Impetigo Contagiosa?
Vesicles that weep and crust over (honey colored)
Dry/itching
What is the prevention of Impetigo Contagiosa?
Hand washing
Remove with 1:20 burrow solution and treatment Bactrian ointment
What are the risk factors of Impetigo Contagiosa?
Poor hygiene
Insect bite
Larger congregate setting
What are Furnucle/Carbuncle?
Boils/abscesses
Cause is MRSA (staphylococcus areoles)
What are the sign and symptoms of Furnucles?
Sweeping Elevation Erythema Warm Density
How do you treat Furnucles?
Hot pack, head open and drain, incision and drainage, vancomycin
What is cellulitis?
Inflammation of skin and subcutaneous tissue.
What are the signs and symptoms of cellulitis?
Warm, red, swelling, streaking, lymphnode enlargement
How do you treat cellulitis?
Antibiotic
Hot/moist pack
Rest
What is Verruca vulgarisms?
Warts caused by HPV. Disappear at some point
What is the treatment of Verruca vulgaris?
Ignore Electrocotory Cryotherapy (liquid nitrogen) Seeds are terminal ends of capillary Hand washing and clean shower
What is the Herpes Simplex Type 1?
Group vesicles (cold sores)
What irritates herpes simplex 1?
Stress
Sun
Acids
What is the prevention of herpes simplex 1?
Sunblock
Avoid secondary infection
What’s the signs and symptoms of herpes simplex 1?
Lips Nose Genitalia Itch Burn
How do you treat Herpes simplex 1?
Zofrax
Cold compress
Oral or IV acylovera
What is Herpes Zoster?
Shingles
Lays dormant
What is Herpes Zoster secondary to?
Chicken pox
Along posterior root ganglia
Unilaterally
How do you treat Herpes Zoster?
Pain
Narcotics
Local moist compressor
Acyclover
What are the signs and symptom of Herpes Zoster?
Neurological pain
Hypersensitive
Pain
Itch
What is Molluscum contagiousum?
Raised flesh colored papulle with umbilicated with caseous plugs
Seen in toddlers
Resolves in 18 months, spread
What is the treatment of Molluscum contsgiosum
Cover it
Cryotherapy
What are the different types of Dermatophytosis
Tinea capitis
Tinea corporis
Tinea pedis
Tinea cruris
What is Tinea capitis?
Scalp fungus Silver scales Difficult to treat Use oral Ketocon, Azol and shampoo Superficial fungal infections
What is Tinea corporis?
Ringworm Raised papulles Eryothemitis Scaling Superficial Treatment is anti fungal 2x day for 30 day Don't cover with anything
What is Tinea pedis?
Athletes foot
Start as papulles, gets scaley, starts between toes
Treat OTC antifungals, sandals, change socks, clean shower
Why is Tinea cruris?
Jock itch
Treat with topical antifungal
Get dry
What is scabies?
Spread by scabies mite to lay egg burrows in epidermis
Occurs 30-60 days after original contact
What are the signs and symptoms of scabies?
Intense itching
What is the treatment of scabies?
Eliminate
Apply all surfaces
Leave on 8-14 hours then bathe
Treat all household members may have itching 2-4 weeks after
What is Pediculosis Capitis?
Head lice common in pre-school age children
What are the signs and symptoms of Pediculosis Capitis?
Severe itching
Hair matting
Look for live lice, pustules or nits (egg sac) that are adherent to hair strand
What is the treatment for Pediculosis Capitis?
Permithisn or other shampoo/cream rinse
Fine tooth comb along entire head and pull out
Done every 7-10 days
Examine all close contacts
What s lyme disease carried by?
Ticks carry borelli burgdorferi carried in saliva and tick feces
What are the signs and symptoms of Lyme Disease?
3-30 day: erythema migrans at bite site. Bulls eye
3-10 wks: early disseminated disease. New lesions, fever, fatigue and headache
2-12 mo: systemic of neurological, cardiac symptoms
What is the treatment for Lyme Disease?
Oral amoxicillin or doxycycline (over 8years) for 14-21 days in the fist stage
Systemic treated with IM or IV penicillin G
What is the prevention of Lyme disease?
Avoid tick infected area Wear long sleeves and pants Check for ticks Remove - grasp with fine tweezers to skin - pull upward with steady, even pressure - clean the bite area and hands
What is acne vulgaris?
Most common presentation at 16-17 for girls and 18 to boys
Familial tendency
What is acne vulgaris?
Most common presentation at 16-17 for girls and 18 to boys
Familial tendency
How do you treat acne vulgaris nonpharmacologiclly?
Adequate rest Moderate exercise Well balanced diet Reduction of emotional stress Gentle cleansing with mild cleanser 1-2x days
How do you treat acne vulgaris medically?
Benzoyl peroxide
Topical retinoids: Tretinoin
Topical antibiotics: Clindamycin, erythromycin-metronidazole
Systemic antibiotics: tetracycline, erythromycin, minocycline, doxycycline
Oral retinoids: accutane
Oral contraceptive
What are burns resulted from?
Thermal, chemical, electrical or radioactive agent
Hot water burns common in children
Flame related burns in older children
10-20% associated in child abuse
1 in 10 from children playing with matches
What are some risk factors of burns?
Water heaters set to high
Access to hot liquids
Room heaters with pans of water for humidity
Access to stovetops or electrical appliances
Unguarded bathroom faucets
Young children left unattended in bathroom
Cooking without supervision
Plying with matches or fire
Child abuse
What is a 1st degree burn?
Superficial
Involves epidermis: outer layer
Tender, swollen, red
Like a sunburn
What s a 2nd degree burn?
Partial thickness
Involves epidermis and dermis
Blister formation or reddened discolored region with moist weeping surface
What is a 3rd degree burn?
Full thickness
Involves entire dermis and potions of subcutaneous tissue
Leathery brown with little surface moisture
Why is a 4th degree burn?
Full thickness
Involves subcutaneous, fascia, muscle and bone
What is a minor burn?
Superficial and partial thickness
First and second degree
<15% body surface but not face, hands, feet or genitalia
What are moderate burns?
Partial thickness
Second degree covering <30%
Why s a major burn?
Partial thickness
Second degree
What do burns cause beyond damaged skin?
Edema
Fluid loss
Circulatory changes
Renal impact: decrease blood flow to kidneys creates Oliguria
GI response
Hyper metabolism: rapid protein breakdown and muscle wasting
Increased capillary permeability and increased osmotic pressure that causes fluid leakage into skin.
Watt are complications of burns?
Airway compromise and severe shock Infection local or systemic Pulmonary edema Respiratory injury secondary to smoke inhalation or carbon monoxide Wound sepsis Contracture deformities Scarring Body image changes
What is the emergency management of minor burns?
Immerse in cold water to Duce pain and edema
Cleane with mild soap
Cover with fine mesh gauze lubricated with water soluble anti microbial ointment
Update tetanus is need
Provide analgesics
D not disturb blister
Emergency mangement for major burns?
Stop the burning process Assess the victims condition: ABC Call for EMS transport Cover burns with clean dressing. Decrease pain by decreasing air movement across burn Reassure and comfort child
What is the hospital management for burns?
Airway: oxygen, intubation, ventilation as needed Large bore IV, fluid resuscitation. Remove burned clothing a d jewelry Evaluate would extent and depth Nasogastric tube Foley catheter and hourly output Pain and anxiety management Scrape off all dead skin by bit and put in sterile tube
What is burn wound management?
Primary excision of Escher Hydrotherapy and debridment Dressing Topical anti microbial agent Temporary skin substitute Permanent skin covering Compression of garment, splint, physical therapy Maintain joint mobility by not allowing skin to heal tight.
