UNIT 11 INTEGUMENTARY Flashcards
Skin differences in children
Skin blisters easily
Skin is thinner in infants
Skin is more susceptible to superficial bacterial infection
They are more frequently affected by chronic atopic dermatitis (eczema)
Infant’s skin is more prone to develop a toxic erythema as a result of skin
eruptions or drug reactions
Which of the following statements are true following the skin differences in children?
A. A Childs skin is thicker in the infant stage than toddler stage.
B. Due to passive immunity infants are less susceptible to superficial bacterial infection
C. Children are more frequently affected by eczema.
D. Toxic erythema is life-threatening
C. Children are more frequently affected by eczema.
S/s of skin disorders in children
HISTORY & SUBJECTIVE SYMPTOMS
Pruritus(itching)
Pain or tenderness
Stinging; burning; prickling; crawling
Alterations in local feeling
Previous allergic conditions or skin disease
Onset
Your pediatric patient has just been admitted . He presents with honey-crusted blisters around the lips and nose. What skin disorder would you suspect this patient having?
A. Lice
B.Insect bite
C. Ezema
D. Impetigo
D. Impetigo
What is included in the assessment of skin for a pediatric patient?
OBJECTIVE FINDINGS
Physical examination
Rash: describe, size, texture, location
Type of lesion: primary & secondary
LABORATORY STUDIES
Blood work (CBC, ESR); specifics to r/o systemic diseases
Microscopic exams, cultures, skin scrapings, biopsy
Allergic skin testing
Which of the following statements is the priority teaching for a patient with impetigo?
A. Your child can join sports with Impetigo because it does not contract easily.
B. Ensure that you wash your hands and that you teach your child proper hand hygiene.
C. The child can go back to school the same day they are diagnosed.
D. Keep your child’s nail long to relieve itchiness.
B. Ensure that you wash your hands and that you teach your child proper hand hygiene.
S/S of impetigo
- Blisters and honey-colored crusts
- Erythema
- Pruritus
- Burning
- Secondary lymph node involvement can be present
What is impetigo and how is it caused
Impetigo is a contagious bacterial infection of
the skin caused by group A streptococcus (GAS; Streptococcus pyogenes) and Staphylococcus aureus; it occurs most commonly during hot, humid months.
How is impetigo treated? Patient teaching for Impetigo
Remove crusts,
topical antibiotic
Prevent spread
To prevent skin cracking, apply emollients and instruct parents in the use of emollients. Keep the child’s fingernails short.
Instruct parents in the methods to prevent the spread of the infection, especially careful handwashing.
Inform parents that the child needs to use separate towels, linens, and eating utensils and dishes. Bleach the bathtub after each use.
Inform parents that all linens and clothing used by the child need to be washed with detergent in hot water separately from the linens and clothing of other household members.
Acne
Experienced by 50% of adolescents by end of teenage years
Cause of acne
Testosterone;
stimulation of sebaceous glands
How can acne be treated
Overall healthy lifestyle
Proper hygiene
Low fat diet (cholesterol)
Instruct the client in prescribed skin-cleansing methods, with emphasis on not scrubbing the face and using only prescribed topical agents.
- Instruct the client in the administration of topical or oral medications as prescribed.(thin layer)
- Instruct the client not to squeeze, prick, or pick at lesions.
- Instruct the client to use products labeled non- comedogenic and cosmetics that are water-based and to avoid contact with products with an excessive oil base.
- Instruct the client on the importance of follow- up treatment.
What is Lice(Pediculosis Capitis)
Parasitic infection that is common in childhood. Easily spread
Pediculosis capitis refers to an infestation of the hair and scalp with lice.
The most common sites of involvement are the occipital area, behind the ears at the nape of the neck, and occasionally the eyebrows and eye- lashes.
S/S of Lice
Child scratches scalp excessively.
■ Pruritus is caused by the crawling insect and insect saliva on the skin.
■ Nits (white eggs) are observable on the hair shaft (it is
mportant to differentiate nits from lint or dandruff, which flakes away easily).
■ Adult lice are difcult to see and appear as small tan or grayish specks, which may crawl quickly.
Nursing Intervention for Lice
Application of pediculicides & manual removal of the nits.
Permethrin 1% cream rinse (Nix) (available w/out prescription)
(most products used to treat pediculosis cannot be used on children younger than 6 months of age).
Malathion (need prescription, more potent)
Prevent spread
Daily removal of nits with an extra-fine-tooth metal nit comb needs to be done as a control measure after use of the pediculicide product (gloves need to be worn for removal of nits); hairbrushes or combs would be discarded or soaked in boiling water for 10 minutes.
Instruct parents that siblings may also need treatment; grooming items would not be shared, and a single comb or brush needs to be used for each individual child.
Instruct parents that bedding and
clothing used by the child for the previous 2 days before diag- nosis should be laundered in hot water with de- tergent and dried in a hot dryer for 20 minutes; bedding and clothing need to be changed daily and laundered.
Instruct parents that nonessential bedding and clothing can be stored in a tightly sealed plastic bag for 2 weeks and then washed.
Teach the child not to share clothing, headwear, brushes, and combs.
Lice on the eyelashes or eyebrows may need to be removed manually.
