Skin PowerPoint Flashcards
3 layers of the skin
epidermis
dermis
subcutaneous
is the skin thinner or thicker in children
thinner
due to the think skin they have increased or decreased absorption of chemicals and topical meds
increased
as the infant grows the skin
toughens
primary lesions
lesions arise from previously healthy skin
example of primary lesion
macules
papules
patches
tumors
nodules
vesicles
secondary lesion
lesions that result from changes in primary lesions
example of secondary lesions
crusts
scales
keloids
erosions
ulcers
drug reaction examples
erythematous macule, papule, pruitis, urticaria
mites examples
pruritis, papular/pustular/vesicular
infection examples
edema, erythema, papular/vesiclar lesion
injuries example
punctures, burns, pressure ulcers
what to assess for a lesion
location
size
type
pattern
discharge
coining/cupping
cultural variation
aren’t lesions
atopic dermatitis
eczema
infant skin manifesations
birthmarks
early childhood skin manifsations
eczema
adolescent skin manifestations
acne
infected tattoos
ABCD’s of skin documentation
asymmetry
border
color and configuraiton
diameter and drainage
tinea capitis affects where
scalpe
tinea capitis apperence
scaly pusualr, yellow greasy scales which are lighter than skin color
tinea capitis kerion
large purulent tender body mass on scalp with drainage
tinea capitis tx under 12
oral griseofulvin
tinea capitis tx over 12 years
fluconazole
tinea capitis shampoo
selenium sulfide or ketonazole 2-3 times weekly and let sit for 10 mins
tinea corporis affects where
trunk
tinea corporis manifesations
pink scaly circular patch expanding border with slightly raised borders
tinea corporis how to contract
contact with infected human, animal, or contaminated object
tinea corporis treatment
topical cream
selenium sulfide 2 times a week on the body
where to assess for lice
nape of neck and behind ears
lice like warm areas
if you see lice moving what does that tell you about the infestation
large
when to repeat lice treatment again after the first treatment and why
7-10 days after since nits are resistant to treatment
when can children with lice go back to school
after 2nd treatment
adult lice can live for how long without human blood and what does that mean for washing clothes
72 hours, wash combs, coats, hats, sheets, stuffed animals with hot water in a hot dryer
lice only reproduce on
humans
how is lice transmitted
direct hair to hair contact or through sharing of hair accessories
how many nits does the female lay per day
10
how long until nits hatch
7-10 days
how do lice look at birth
black
lice s/s
bugs in hair, sticky dandruff
lice tx
pediculides, and removal of nits with the special comb
is scabies contagious
VERY
scabies how is it transmitted
skin to skin contact and sexual contact
scabies immediate s/s
they are not immediate
when to see scabies s/s
2-4 weeks after exposure
s/s scabies
inflammation and severe pruritis
widespread rash with papules and pustules
complain of restlessness and itching that is worse at night cause the mites are more active
hands, axilla, neck, legs, and butt
may see tunneling
what should we do with nails of scabies kids
keep them short so they don’t break skin
tx of scabies
5% permethrin cream and antihistamines
- antibiotics for secondary infection
- clean all linen (like lice)
impetigo
bacterial infection that is highly contagious
impetigo s/s
red sores on face around nose and mouth and hands and feet
sores burst and develop honey colored crusts
when can impetigo return to school
48hr after antibiotic initaiton
treatment of impetigo
mupirocin and/or erythromycin
do you wash of crust with impetigo and if yes how
yes with warm soapy washcloth 3 times a day
keep what short in impetigo
finger nails
how to prevent spread of impetigo
handwashing
candicial infection
fungal
what can precipitate candidial infection
antiobitocs
kids who don’t have immune system
candida in mouth
thrush
thrush s/s
white coating to the tongue and or buccal mucosa, redness, burning, or pain
candidate diaper dermatitis s/s
dark red shiny rash with satellite lesions
tx for canddidal
nystatin
- topical or oral
eczema cause
ineffective function of the proteins that form a skin barrier as the barrier is broken down the skin loses moisture and becomes irritated and overly sensitive and prone to infection
6 findings of eczema
erythema
papules/edema
exudation - oozing and crusting
scale
excoriations and linear erosions from scratching
lichenification - thickened, hyper pigmented leathery skin due to rubbing (accumulated skin markings
what is licheinficiation
thickened, hyper pigmented leathery skin due to rubbing (accumulated skin markings
pts with eczema usually have what elese
another autoimmune disorder like asthma
rank the order of best to least for treatment of eczema
- cream
-oinment
- lotion
ointment
cream
lotion
some treatment for eczema
bathe every day or every other
warm bath
5-10 min bath
pat dry
apply moisturizer while skin is still damp
treat rash for eczema
- mediation
steroids
treat itching for eczema
- med
antihistamines
how to prevent infection
wash well and do not scrub
4 main types of burns
thermal
chemical
electrical
radioactive
thermal burn example
flame, water
chemical burn example
bleach and amonia
electrical burn example
wire, curling iron
radioactive burn example
sunburn
2 common accidental injury patterns
hot drink scalds (pull water off stove)
contact burns (hair curler)
non accidental burn injury
glove and stocking scalds (dipping)
sharp demarcation and absence of splash marks
story that doesn’t match
parents waited to bring child in
other injuries present (bruising)
repeated presentation
first degree classification
superficial partial thickness
first degree apperecnce
painful nd red
first degree healing
few days
first degree exmaple
sunburn
first degree layers
outer later of skin
- epidermis
second degree classification
partal thickness
second degree layers
epidermis and upper layers of the dermis
healing for second degree
10-14
third degree classification
full thickness
third degree layers
all of the epidermis and dermis
- may involve underlying tissue
third degree nerve involvement
nerve endings are destroyed
treatment of third degree
skin grafting
when to know the full damage of third degree burn
3-5 days later because the burn continues
what is the requirement to go to children burn hospital
any partial greater than 10% or any full thickness
head front and back percent
18
chest percent
18
back percent
18
arm percent
9 each
perineum percent
1
legs perent
13.5 each
rule of palm
palm of the person who is burned is about 1% of the body, and you use the palm to measure the body surface area burned
first priory for burns
AIRWAY
what to assess for airway
any inhalation injury
- burned facial hair
- soot in mouth or nose
- stridor
why can burns to the trunk cause impaired ventilation
children use the diaphragm to breathe
we replace burns with
LR
- or isotonic
why do burn patients lose fluids rapidly
destruction of epidermis
what is parkland formula
4 mL x %TBSA x pt weight in kg = total fluid in first 24 hours
is the parkland replacement or maintence
replacement, will need to add the mainentce
when to give the parkland replacement formula
half in first 8 hours and other half in remaining 16 hours
what is the method of pain management route
IV
do we do IM with birns
no
do children lose heat early
yes
how to clean a child initially with a burn
with temped NS then place sterile gauze over burn
children with burns need what times more energy and protein than normal
2-3
if there is eschar what do we do
remove it
goals for burns
remove necrotic tissue to allow healthy tissue to develop
maintain moist environment with circular
- hydrogel
maintain fluid and body temp
prevent infection and minimize scaring
