Skin Dysfunction Flashcards
1
Q
Contact Dermatitis
A
Inflammatory reaction of the skin after contact with an irritant or allergen
2
Q
What causes contact dermatitis?
A
allergic or irritant with sensitivity to it
3
Q
Irritant causes inflammation or contact dermatitis to
A
everyone
4
Q
Allergen causes inflammation or contact dermatitis to
A
specific individual sensitive to it
5
Q
Diaper Dermatitis Tx
- ointments?
A
Changing diaper ASAP
- Expose the bottom to air
Apply zincoxide,petroleum ointment, or Desitin
Wipes free of parabens
do not need to clean the cream off when changing bc you can layer over time
6
Q
Why are cornstarch powders like Talcum be avoided with diaper dermatitis?
A
not ingested and cause respiratory distressed
- are safe when applied to your hand and bottom
7
Q
Contact Dermatitis Tx
A
isolate the cause, limit exposure, and rinse area
Topical (small)
- Corticosteroids (Hydrocortisone)
- Lotions (Calamine)
PO (large like fabric)
- antihistamines (Benadryl)
- Steroids
Skin patch testing
8
Q
What are the topical agents used for contact dermatitis and when do you use it?
A
small spots
- Corticosteroids (Hydrocortisone)
- Lotions (Calamine)
9
Q
What are the oral agents used for contact dermatitis and when do you use it?
A
Large like fabric
- antihistamines (Benadryl)
- Steroids
10
Q
Atopic dermatitis =
A
eczema
11
Q
Eczema is
A
chronic relapsing inflammatory skin disorder
12
Q
Atopic dermatitis results of/Associated with
A
of genetic factors, environmental agents (allergies or irritants)
13
Q
Atopic dermatitis risk factors
A
family history of eczema,asthma, food allergies
(genetic link possible)
- auoimmune
14
Q
Atopic dermatitis involvement (asymmetrical or symmetrical)
A
symmetrical on both location
15
Q
Difference between contact dermatitis and atopic dermatitis?
A
Location and symmetry
CD = asymmetrical and anywhere
ad = SYMMETRICAL AND SPECIFIC
16
Q
Atopic dermatitis S/S
A
severe pruritis (itching)
17
Q
Atopic dermatitis Infant typical sites
A
face, inside the elbows, and behind the knees
18
Q
Atopic dermatitis in older children’s typical sites
A
antecubital and popliteal area, neck, wrists and feet
19
Q
Atopic dermatitis adolescents look like
A
Lichenification
20
Q
Lichenification
A
leathery skin due to relapse over time
21
Q
Atopic dermatitis Tx
A
hydrate (tepid or colloid)
- emollient application immediately after bath
relieve itching
reduce inflammation
prevent/control secondary infections
22
Q
Tepid means
A
slightly cooler
23
Q
Colloid
A
adding oatmeal or bran
24
Q
Pattern to take care of eczema skin
A
tepid or colloid bath
Pat dry no rubbing
emollient skin immediately after (neurtogena, Aquaphor)
25
Relieve itching of Atopic dermatitis by
Colloid bath, cool wet compresses, topical corticosteroids, oral antihistamines
26
Reducing inflammation of Atopic dermatitis
Topical corticosteroids
Non-steroidal immunomodulator creams
27
How to prevent secondary infections of Atopic dermatitis
short/clean nails
soft cotton clothes not wool
antibiotics if an infection does occur
28
Seborrheic Dermatitis
sebum exposed
- chronic, recurrent, inflammatory reaction of skin
29
Seborrheic Dermatitis is most common in
early infancy and adolescents
**cradle cap**
30
Seborrheic Dermatitis locations
Eyelids (oily gloss)
External canal
Vasolabial folds
Inguinal region
**Scalp** - cradle cap
31
Seborrheic Dermatitis looks like
thick
yellow
scaly and oily patch
- possible itching (irritable)
32
Seborrheic Dermatitis Tx
**Shampoo twice a day**
- allow to sit for crusts to soften
- rinse
- **fine tooth comb/soft brush to remove crusts**
33
Impetigo is caused by
bacterial skin infection
34
Impetigo is caused by what bacterial contagions?
Staph aureus
Strep
35
What is a highly contagious bacterial infection most common on the face?
Impetigo
36
Impetigo is commonly seen on the
face, around mouth → spreads peripherally
37
Impetigo is spread by _______ contact
direct
38
Impetigo Primary at
site
bite
infection
39
If impetigo is itchy and caused by strep, it can lead to
glomerulonephritis
40
Impetigo Post-Op care
**no daycare or school**
HAND WASHING before and after touching infected areas,
**separate child clothes and linens,**
short and clean nails,
**warm washing of cloths**
**gently remove the crust and debris**
41
Impetigo Tx
Antibiotics (topical)
- Mupirocin (Bactro-van)
- Penicillin for systemic
Gentle cleansing of crusted areas
**Don’t rupture the blisters – spread infection and increase secondary infection**
42
Impetigo ruptures should not be ruptured because
spread infection and increase secondary infection
43
Impetigo is highly communicable for ___________ after antibiotics.
24 hours
44
Impetigo Nursing Interventions
Institute **strict contact precautions**
Strict hygiene practices – hand washing
Educate family and visitors on necessary precautions to prevent the spread of infection
45
Cellulitis is caused by what bacteria
**Staph
Strep***
H. influenzae
46
Cellulitis S/S
Inflammation with **intense redness**
Pain
Swelling and firm infiltration
Warm to touch
**Lymphangitis “ streaking”** - common
Possible systemic effects (fever, malaise)
Swollen regional lymph nodes
47
Is cellulitis contagious?
no, deeper layers of the skin
- caused by in open skin like IV
48
Cellulitis is what type of infection?
- and who can be affected?
opportunistic (not contagious)
- area od broken skin
- immunocompromised/diabetes
49
Cellulitis Tx
Antibiotics
Oral - Choice
Elevation, immobilization
Pain relievers
50
Type 1 Herpes Simplex
Cold sore/fever blister
51
Type 2 Herpes Simplex
Genital/sexually transmitted
52
Varicella skin lesions are
(pruritic rash – itchy
papules and vesicles
Weeping
**Crust over within 7 days (no longer contagious)**
53
Varicella s/s systemic
fever
malaise
contagious 1-2 days before rash to crust
54
Varicella isolation
airborne and contact
- skin to skin or respiratory
55
Varicella Tx
- stop the itch (apply topical diphenhydramine cream
- acetaminophen (no aspirin = reye syndrome risk
- Immunocompromised (Acyclovir – antiviral)
- No longer infectious after lesions crust over
56
T1 Herpes Simplex once exposed to it then it is
always present
57
Herpes Simplex Triggers
58
Herpes Simplex S/S
Tingling, numbness, burning, itching
Small erythematous, tender area clusters of blisters
Blisters begin to dry yellow crusting
Healing occurs in 8-10 days
59
Herpes Simplex HEALS after
8-10 days
60
Herpes Simplex Tx
control outbreaks
Antivirals
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
Pain relievers
61
Herpes is what type of infection
viral
62
Dermatophytoses- Tinea aka
Ringworms
63
Dermatophytoses- Tinea is what type of infection
fungal
64
Dermatophytoses- Tinea (Ringworms) live where
lives **on**
- not in the skin or nails
65
Tinea capitis is located where
Ringworms on the head
66
Tinea capitis is transmitted by
person to person
animal to person
67
Tinea capitis Tx
Oral antifungals
**Grisiofulvin** or terbinafine
**Selenium sulfide shampoo**
- twice a week
- Severe drying and smell
68
Tinea capitis Tx should be used for how long
Griseofulvin and selenium sulfide shampoo for 2 weeks
69
Tinea capitis lookslike
Lesions of the scalp and hair falls out temporary
70
If tinea capitis is untreated then
go deeper and cause kerion and scar
71
Griseofulvin needs to be taken with
high-fat foods for better absorption and less GI upset
- same time
72
Selenium sulfide shampoo
applied for 5-10 minutes 2-3 times per week
- severe drying and smell
73
Tinea corporis
Ringworm of the body, skin, nails
74
Tinea corporis tranmisson
infected pet
human, soil, or fomite
75
Tinea corporis looks like
Small lesion and larger with a clear center and ring appearance
- leaves scaly patch
76
Tinea corporis Tx
Griseofulvin only
77
Tinea cruris aka
Jock Itch
78
Tinea cruris s/s and location
Pruritic
**Medial proximal aspect of thigh/crural fold (may involve scrotum in males)**
79
Tinea cruris Tx
local application of antifungal creams
80
Tinea pedis
Athlete's foot
- Ringworm
81
Tinea pedis s/s and location
Pruritis
Lesions on **plantar surface of foot, between toes**
82
Tinea pedis Tx
Local application of antifungal creams
Oral antifungals
**Soaks with Burrow solution (water with aluminim acitate)**
83
Tinea pedis common areas to get
Fungus grows in moist areas
- Locker room, swimming pools, and showers
84
Tinea pedis Teachings
don’t share, well-ventilated shoes, light socks,
85
Lyme disease is caused by
tick infected with **Borrelia burgdorferi**
86
Prevention of Lyme Disease
wear repellent
check daily
shower after outdoors
HCP if fever or rash
87
Erythema Migrans
bullseye rash in Lyme disease
88
S/S of Lyme Disease
rash (bullseye)
fatigue
swollen joints
LOC decline
fever with HA
SENSITIVE TO LIGHT AND DARK
no sleep and night sweats
neuro
skin outbreaks
heart prob
mood swings
89
Lyme disease can develop how long after the tick bite
3-30 days
90
If Lyme disease is left untreated
bacteria migrate to the nervous, heart and joint systems
91
With Lyme disease what does the tick do?
attaches and buries head in the skin
- module at the site
92
When removing the tick from the skin,
get the body AND HEAD out of the skin
93
If Lyme disease is suspected o confirmed by lab test, then
single dose antibiotics
94
What antibiotic is used for children over 8 with Lyme Disease?
Doxycycline
95
What antibiotic is used for children under 8 with Lyme Disease?
Amoxicillin or Cefuroxime
96
What lab test is run for Lyme Disease?
97
Sarcoptes scabiei aka
Scabies
- skin infestation with microscopic mite
98
Sarcoptes scabiei is spread by
direct prolonged 6contact with the infected person
99
Sarcoptes scabiei can live how long inside of a person
1-2 months
100
Sarcoptes scabiei can live how long outside of a person?
48-72 hours
101
Sarcoptes scabiei does what to the skin
burrows into the skin and lays eggs
- makes a trail
102
In Sarcoptes scabiei, how long until the s/s appear?
30-60 days
- everyone in contact with them between that time will need to be tested
103
Sarcoptes scabiei s/s
Burrow tracks
Severe pruritis
Small, lesions develop into blisters
Usually on hands, wrists, feet or ankles
104
Sarcoptes scabiei Tx and who?
- Whole family and anyone with contact
Scabicide - Permethrin (Elimite)**
Treat personal items
Lotions
Topical steroid for itch
Antibiotics- secondary infections
105
Permethrin (Elimite)** needs to be applied
from neck down to toes in skin folds and nails
- left on 8-14 hours (bedtime with bath in the morning to remove)
106
Sarcoptes scabei personal items
Vacuum everything furniture wise
All clothes and bedding need to be washed in hot water (BURN)
Conceal in plastic bag for 2 weeks to suffocate
107
Pediculosis capitus aka
head lice
108
Pediculosis capitus is what type of infection
parasitic
109
Pediculosis capitus common in
school-aged children
110
Pediculosis capitus transmission
person to person
object to person
NOT ANIMALS
111
Do Pediculosis capitus jump or fly?
no
112
Pediculosis capitus look like
dandruff but does not move
Small, grayish-tan, wingless insect
Visible
**Use claws to hold to the hair shaft**
113
Pediculosis capitus can live up to how long away from humans
2 days
114
What is the life span of a female head lice
1 month
115
Nymphs and eggs of head lice look like _________ and feed off of
white grayish specks and feed off the blood of scalp
116
Pediculosis capitus s/s
red lesions and constant scratching
- caused by crawling and saliva
117
Pediculosis capitus Tx
Daily Medicated shampoo (Nix)**with** mechanical removal with lice combs
- wash all linens
- vacuum dry clean non-laundry items
- seal in a plastic bag for 2 weeks
repeat Tx every 7 days
- antibiotics for secondary infection
118
Pediculosis capitus students are
Go home at the end of the day and only return after the treatment with sign
119
Acne vulgaris is a common skin problem of
adolsecence
120
Acne vulgaris has a link with
genetic
121
Acne vulgaris is an overgrowth of
P. acnes
122
Acne vulgaris formation
Comedone
- open (white)
- closed (black)
123
Acne vulgaris causes
**Hormones**, cosmetics, exposure to oils, possible link to dairy
124
Acne vulgaris Tx
General health promotion
Gentle cleansing, hair and scalp hygiene
Oil-free make-up
Keep your hands off!!
Lotions/creams
Medications
125
What medications are used for Acne vulgaris?
Retinoids – 1st (Retinae)
Topical Antibacterial Agent
Systemic Antibiotics
Oral Contraceptives
- Reduce antigen production and ability of sebum oil
126
If using topical creams, educate to avoid
sun or use sun screen
- Photosensitivity
127
In Burns, what guides Tx?
extent (TBSA)
- Rule of Nine an lund Browder
depth
- 1st - 4th degree
Severity
- TBSA %
- Location
- Child's age
- Health
128
Causes of burns
thermal (extreme heat, cold)
chemical
electrical
radioactive
Accidental
Intentional
129
Accidental burns types
inadequate supervision
curiosity
inability to escape burning agent
130
Rule of Nine in Infants
9% on each part
Front of head and Back of head = 18%
same with thoracic and lumbar both fully = 18% on both sides
Both arms = 9% each
Both legs = 14% each - chubs
the [palm and groin = 1% each
131
Rule of Nines difference for others
Head = 9
Front and Back = 18% each
Arms = 9 each
Leg = 18 each
palm and groin = 1%
132
1st degree Burn
superficial
-destruction of the e**pidermis only** (**Sensory intact**) – bad sunburn
133
2nd degree Burn
partial thickness
-**destruction of the epidermis and some of the dermis** (**blisters** within minutes and **sensory intact**)
– boiling water **(red and moist looking)**
134
3rd degree Burn
full-thickness
- **destruction of epidermis, dermis and underlying SQ** tissue
**(charry black look, visible veins) – feel no sensory or pain**
135
4th degree Burn
full-thickness
burned through the epidermis, dermis, sub Q, and **involves the fascia , muscle, and bone - feel no sensory or pain**
136
At what degree of burn do you not have sensory intact feeling?
3rd
137
With burn patients they are at risk for
sepsis
shock
138
Care of Minor Burns
Soothe with and vaccine?
**Apply cold compress/cold rinse**
Analgesia - pain
Cleanse with **soap/water – avoid friction**
**Tetanus** – wound by bacterial toxin
Antimicrobial ointment
**Loose clothing**
Sunburn – apply moisturizer
139
Care of Moderate and Severe Burns
1st**Maintain airway, Oxygen**
**Large bore IV fluids**
Observe closely for **s/s shock**
**Pain mgmt**
**Wound care/Escharotomy**
Nutritional support
**Skin and musculoskeletal care
Emotional/psychosocial support**
140
Atraumatic Care for Burn Care
* Have all materials ready before beginning the procedure.
* Administer appropriate analgesics and sedatives.
* Remind the child of the impending procedure to allow sufficient time to prepare.
* Allow the child to test and approve the temperature of the water.
* Allow the child to select the area of the body on which to begin.
* Allow the child to request a short rest period during the procedure.
* Allow the child to remove the dressings if desired
* Provide something constructive for the child to do during the procedure (e.g., holding a package
of dressings or a roll of gauze).
* Inform the child when the procedure is near completion.
* Praise the child for cooperation
