Peds-Integumentary

A 2-year-old child is admitted to a hospital burn unit with partial- and full-thickness burns involving 35% of body surface area. After admission assessment and review of the health care provider's prescriptions, the priority nursing intervention should focus on which action?

Inserting a Foley catheter

The school nurse is conducting pediculosis capitis (head lice) assessments. Which finding indicates a child has a "positive" head check?

White sacs attached to the hair shafts in the occipital area

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin?

Fine grayish red lines Eczema: Thick, honey-colored crusts are characteristic of impetigo or secondary infection in eczema. Herpesvirus: Clusters of fluid-filled vesicles are seen in herpesvirus infection.

Permethrin 1%

Medication used for both scabies and head lice this medication is applied to the hair after shampooing and left for 10 minutes before rinsing.

The nurse is monitoring a child with burns during treatment for burn shock. The nurse understands that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation?

Neurological assessment

The nurse is verifying that a mother understands how to care for her infant who has thrush. Which comment by the mother would indicate that further teaching is indicated?

"I can put the medication in my son's bottle for him to drink." Thrush is a fungus caused by Candida albicans. The white patches resemble mild curds and are visible on the tongue, inner lips, oral mucosa, and gums. An antifungal topical medication may be prescribed and needs to be slowly administered in each cheek of the baby's mouth after eating to increase the time that the medication is in contact with the mucous membranes. It is not placed in the baby's bottle. medication is not added to a child's bottle because the infant may not finish drinking everything from the bottle.

The nurse is collecting data on a child brought to the health care clinic by the mother with a 1-week-old cat scratch. While assessing the scratch the nurse notes redness, heat, swelling, and red streaking surrounding the area. The child states that the scratch hurts. Cellulitis is diagnosed. When providing home care instructions, which statement by the mother indicates a need for further teaching?

"I will apply cool moist soaks every 4 hours." A nurse reinforces instructions to the mother of a child diagnosed with pediculosis (head lice). Permethrin 1% (Nix) has been prescribed. Which statement by the mother regarding the use of the medication indicates a need for further teaching this medication is applied to the hair after shampooing and left for 10 minutes before rinsing.

The nurse is providing a yearly summer educational session to parents in a local community. The topic of the session is prevention and treatment measures for poison ivy. The nurse instructs the parents that if the child comes into contact with poison ivy to take which action?

Shower the child immediately, lathering and rinsing the exposed skin several times.

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply.

A delay in growth may occur after a burn injury An immature immune system presents an increased risk of infection for infants and young children. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults. Pediatric considerations in the care of a burn victim include the following: Scarring is more severe in a child than in an adult. A delay in growth may occur after a burn injury. An immature immune system presents an increased risk of infection for infants and young children. The higher proportion of body fluid to mass in a child increases the risk of cardiovascular problems. Burns involving more than 10% of total body surface area require some form of fluid resuscitation. Infants and young children are at increased risk for protein and calorie deficiencies because they have smaller muscle mass and less body fat than adults.

A topical corticosteroid is prescribed by a health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream?

Apply a thin layer of cream and rub it into the area thoroughly.

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction?

Lesions most often are located on the arms and chest." Impetigo is a contagious bacterial infection of the skin caused by b-hemolytic streptococci or staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose, but may be present on the hands and extremities

Permethrin (Elimite) is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment?

Permethrin (Elimite): used for scabies Apply the lotion to cool, dry skin at least 30 minutes after bathing. Permethrin is massaged thoroughly and gently into all skin surfaces (not just the areas that have the rash) from the head to the soles of the feet. Care should be taken to avoid contact with the eyes. The lotion should not be applied until at least 30 minutes after bathing and should be applied only to cool, dry skin. The lotion should be kept on for 8 to 14 hours, and then the child should be given a bath. The child should be clothed during the 8 to 14 hours of treatment contact time.

Nursing care of the infant with eczema should focus on which action as a priority nursing intervention?

Preventing secondary infection of the lesions Eczema is a superficial inflammatory process involving primarily the epidermis. The major goals of management are to relieve pruritus, lubricate the skin, reduce inflammation, and prevent or control secondary infections.

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record?

The child is 18 months old Lindane is a pediculicide product that may be prescribed to treat scabies. It is contraindicated for children younger than 2 years because they have more permeable skin, and high systemic absorption may occur, placing the children at risk for central nervous system toxicity and seizures. Lindane also is used with caution in children between the ages of 2 and 10 years. Siblings and other household members should be treated simultaneously

The nurse is developing a plan of care for a 10-year-old girl with an exacerbation of eczema. Which problem should be addressed in the care for this child?

The client is at risk for infection related to scratching of pruritic lesions Eczema is a superficial inflammatory process involving primarily the epidermis. The major goals of management are to relieve pruritus, lubricate the skin, reduce inflammation, and prevent and control secondary infection. Secondary infection can occur when areas affected by eczema are scratched as a result of the itching because open skin is a portal of entry for pathogens. The lesions are not viral, and they do not present as thick, white crusty plaques. They appear as red and scaly lesions that can weep, ooze, and crust. They commonly occur in the antecubital and popliteal areas.

The nurse is counseling the young mother of a small child recently diagnosed with impetigo. The nurse should make which statement that provides the best information about impetigo?

You will need to prevent any of the fluid from the blisters around your daughter's mouth from coming into contact with your other children, especially if they already have skin injuries. Impetigo is a highly contagious bacterial infection of the skin. Fluids are important but are not a component of the main treatment for this infection. Additionally, fluids should never be forced. The infection is communicable for 48 hours beyond initiation of antibiotic treatment.