T4 INTEGU Flashcards
why are compression bandages used in burn patients?
prevent contractures
decrease scarring
if a 6 yr old has full thickness burns on face, chest & back - what should be the priority in the care plan?
Inserting an IV line for fluid resuscitation
what’s the best way to prevent infection with burn patients?
meticulous handwashing
what would be recommended to a 12y pt with acne on how to manage it?
use non comedogenic makeup
how do you care for a partial thickness burn when dressing change?
sterile technique
what degree of burn would involve the epidermis+part of the dermis & cause blistering & intense pain?
second
edu to give parents about scabies?
wash all bedding & clothing in hot water
if a pt presents with persistant diaper rash, which antifungal is commonly used topically to treat diaper dermatitis caused by candida albicans?
NYSTATIN
what is the proper treatment for impetigo?
topical mupirocin
what causes diaper candidias?
fungus
questions to ask in a pt hx for acne?
when did it start?
does it get worse with menses?
diet & hygiene
a patient that has acne with pustules/scarring would likely be prescribed what? & edu?
Tetracycline
It will make you more sensitive to sun
Benzathine penicillin (Bicillin LA) is used to treat what? & how is it administed?
Cellulitis
IM - 22g/1in
if a pt has already been treated once with lindane (Qwell) for lice, what is the next step the nurse would recommend?
switch to malathion (ovide) to see if that works better
edu acne prevention?
avoid oil based
non comeodengic makeup
don’t pick, rub
an increase in what often causes acne?
androgenic hormones (puberty)
sebum
OTC meds for acne?
salicylic acid
benzoyl peroxide
antimicrobials for acne?
erythromycin
clindamycin
tetracycline
retinoids for acne?
trention A
tazarotene (tazorac)
accutane
when is the best time to apply acne meds for adherence?
night/bedtime
tetracycline, minocycline & doxycycline edu?
increase photosensitivity
avoid pregnancy - stain baby teeth
isotretinoion (Accutane) edu?
severe birth defects - avoid pregnancy
tests before, monthly & 1 month cessation
2 forms of birth control
what is Impetigo?
bacterial or strep infection (S.Aureus)
around mouth/nose
impetigo lesions?
red swollen vesicle/pustule
then burst
honey colored crusty lesions
treatment for impetigo?
!!! Topical mupirocin (limited skin lesions)
PO abx if widespread (amox/ceph)
edu about impetigo?
- Keep child homes for 24 hr after start of ABX
- change pillowcase nightly until lesions dont ooze
- wash your hands
possibly monitor what lab/function with acne meds?
kidney/liver
nursing care of cellulitis patient?
marking the circumference of red area w/ marker to see if is spreading
if theres a hx of medical non adherence/pt cant take medicine as precribed, what is the next action?
single dose of IM penicillin G (Bicillin LA)
or 3 day of ceftriaxone (Im)
pearl like, shiny, firm round pink papules is what infection?
molluscum contagiosum
edu about molluscum contagiosum?
self limiting
bathe by self
clean tub after bath/shower
what is cutaneous candidiasis?
fungal infection from candida alb
who is at risk for cutaneous candidiasis?
infants
children who use corticosteroid inhalers
oral s/sx of C.Candidiasis?
white plaques that cant be removed
skin s/sx of C.Candidiasis?
Fine, red/pink papules with scalloped border
s/sx of Tinea’s?
itchy rash with round scaly pink/red lesions
circular lesion (central clearing)
when removing oral thrush, the nurse should remember ?
removing can cause bleeding
prevention edu about tinea’s?
check pets
don’t share fomites (towels/combs etc)
nursing care for Tinea’s?
- Everyone in fam needs to be treated
- hair can take 6-12 to grow back (if at all)
atopic dermitis is often linked to?
allergies and asthma
s/sx of atopic derm?
- itchy, red raised rash
- on cheeks, head, neck or elbow in younger
edu for atopic derm?
- keep fingernails short
- avoid vigorious scrubbing
- moisture immediate after bath
cutaneous candidiasis prevention?
- clean nipples with soap/water
- keep diaper area dry - barrier creams
- rinse mouth after corticosteroid use
what do lice (louse) eggs live/look like?
pearlescent teardrop
anywhere near shaft of hair
blue under Wood’s lamp
if Lindane (Kwell) doesnt work for lice what should next action be?
try malathion (Ovide)
for those older than 2, what is the recommended lice treatment?
Malathion (Ovide)
Permethrin (nix) contraindication?
infants under 2m
edu if child is unable to tolerate use of lice shampoo?
use petrolatum or olive oil
when to recheck for lice?
7-10 days
edu for scabies?
wash clothes/bedding/towels etc. in hot water then dryer
permethrin ointment
what is cat scratch disease?
self limiting
lasts 6-12 wk
s/sx of cat scratch disease?
tender lymph nodes of head, neck & UE
general malaise/lowgrade fever
papule at bite site
when does cat scratch disease appear?
3-10 days after injury
typical burns in infants?
scalds from being placed in bathtub
radiation burn - hot objects
electrical cord
toddler typical burns?
from “finding independence”
pulling down hot items from tall surfaces
flame burn from trying to ignite a candle
what is included in superficial thickness burn?
red painful for 2-3 days (like sunburn)
intact epidermis with erythema
what is a superficial partial thickness?
blister formation
very painful
epidermis & outer portion of dermis
scarring & heal in 3 wk
deep partial thickness burn?
white/pale tissue
huge blisters
infection big risk
full thickness burn
destroys epidermis/dermis
eschar is visible
may damage bones/nerve (probs doesnt feel pain)
how do you gauge burn scale in adolescents?
rule of nines
how do you scale burns in infants?
Lund & Browder
best outcomes of burn care
burn assessment
fluid resuscitation
prevent infection/sepsis/pneumonia
how to tell if a child is tolerating fluid resuscitation?
urine output (0.5-1ml/kg/hr)
primary survery/assessment for burn injury?
circulation
airway
breathing
fluid resuscutation
how can you decrease pain in burn pt with dressing change?
IV pain meds 20-30min before
IV morphine sulfate
how can you help decrease pain with dressing change non pharm?
let child help with dressing change (over 3Y)
what must be with an intubated child when being transported?
AMBU bag
suction equipment
cardiorespiratory monitor
ET tubes
intervention to decompress burn
fasciotomy (full thick)
compression garments
how often do you weight a burn pt?
2x/wk
meds for itch relief/nerve impulses
Topical doxepin (sinquan)
Colloidal oatmeal
do MINOR burns need to be cooled?
yes - NO ICE
saline soaked gauze (54)
