SKIN- Exam 3

tinea pedis

"Athlete's foot", toes, feet

The parents of a child diagnosed with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse?

"Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis."

Tinea cruris

"Jock itch", thigh, scrotum

which metabolic changes are expected with burn injuries?

- hypermetabolism - elevated catecholamines - hyperglycemia - increased nutritional intake due to protein deficits - negative nitrogen balance

top 2 nursing priorities for ten y/o bitten on lower posterior arm by a dog

- risk for infection - impaired skin integrity

The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is mostcharacteristic of this type of burn?

= blisters appear

Tinea corporis

Body, fingernails

Candidiasis

Diaper, Oral, Vaginal, Breasts, Skin Folds

Erythema multiforme

Hypersensitivity reaction to a drug or Infectious trigger (HSV, mycoplasma) Targetoid rash with central clearing, with NO mucous membrane involvement

What are major differences in children's skin versus adults?

Infants have thinner skin than older children Newborns cannot localize infection Melanin Amount Increases with Age Greater UV protection Many skin conditions in pediatrics are linked to age Many contagious diseases present with skin rashes Includes many BENIGN viral related rashes Immunizations exist to prevent many of the more serious contagious diseases with an associated rash

skin care plan

Keep affected area clean Promote good nutrition/hydration Apply topical agents as indicated Administer antimicrobials orally or intravenously, if needed Keep skin open to air as much as possible, but cover as necessary Prevent further injury and secondary infection-Education! Fever management-Antipyretics, environment Isolation precautions Psychosocial and family support

Acne vulgaris

Neonatal - will go away with time Adolescent: Variety of OTC topicals Prescription topicals and oral agents* Use with caution as some are teratogenic —contraception education

Lice

Pediculosis Capitis Parasite: Blood sucking organism Needs host to survive Female lays eggs at night Nits: eggs hatch in 7 - 10 days posterior of the head Symptom: Itching Treatment: Permethrin 1% cream rinse (Nix) Nit find comb, killing shampoo 2 TREATMENTS a week apart WEAR A HAIR NET Clean house, wash clothes and linen (HOT WASHING MACHINE) soak combs, plastic bag items for 14 days

Seborrhea

SEBORRHEIC DERMATITIS (CRADLE CAP)

Tinea capitis

Scalp

Contact dermatitis

Treatment: • Flush skin with cold water • Calamine, Aveeno baths, Corticosteroid ointment, Benadryl, Oral corticosteroids • Launder clothing

Roseola

any rose-colored rash marked by maculae or red spots on the skin

Atopic dermatitis

eczema

fourth degree burn would

extend even deeper to fat layer

Urticaria

hives

urticaria

hives - type 1 sensitivity reaction

should babypowder be used on NB?

no due to risk of aspiration - "talc"= talcum powder can cause accidental aspiration, pneumonia

erythrocyte sedimentation rate (ESR)

nonspecific test to detect presence of infection or inflammation

first degree burn

only involves the epidermis; redness, slight edema, and pain; heals within days

A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer?

second degree or partial thickness burn

The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite?

second-degree frostbite Second-degree frostbite demonstrates blistering with erythema and edema. First-degree frostbite results in superficial white plaques with surrounding erythema. In third-degree frostbite, the nurse would note hemorrhagic blisters that would progress to tissue necrosis and sloughing when the fourth degree is reached.

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)?

stocking-glove pattern on hands or feet usually circumferential ring appearing around the extremity points to the caregivers forecfully holding the child under extremely hot water

impetigo

superficial bacterial skin infection - NB usually have bullous (blister- like fluid filled) - older child will have nonbullous lesions and *honey colored crusted* appearance - *contact precaution*= highly contagious

third degree burn

would involve nerve endings as well as destruction of *epidermis + dermis*

Diaper Dermatitis

• Clean after soiling • Use soap and water-avoid wipes with alcohol • Allow to dry thoroughly • Allow open to air • Apply creams in THICK layers • Once HEALED, apply ointments

Cellulitis

• Inflammation of the skin • Antibiotics • Soaks, compresses • Can be severe

Poison Ivy

• Localized streaked, oozing, painful lesions

Rocky moutain spotted fever

• May have gradual or abrupt onset • Tick acquired disease • Maculopapular rash on extremities • Tetracyline and supportive treatment • Prevention important • Light colored clothing, tuck pants into socks, tick checks, Deet repellents

Scabies

• Mite burrows into the epidermis (webbing of toes and hands) • Often see linear lesion distribution • Black dot at end • Pruritus: severe • 30 - 60 days after contact unless the previous episode • Treatment: Permethrin 5% (Elimite) from the neck down • Treat entire family • Wash all linen/clothes in hot water

Fifth disease (erythema infectiosum)

• Preschool/Young School age • "Slapped Cheek" appearance and lace-like rash on the trunk • Can result in spontaneous abortion • Treatment-supportive

Impetigo

• Staphylococcus bacteria • Break in skin barrier • Vesicle: ruptures easily • Crusts: honey color • Spreads easily • Antibiotic ointment (bactorban)

Lyme disease

• Tick borne disease • Disease can be severe • Treatment: Amoxicillin if younger child, Doxycyline if older • Prevention important • Light colored clothing, tuck pants into socks, tick checks, Deet repellents

Hand-foot-mouth disease

• Usually not serious • Very contagious, caused by two different viruses—contact and respiratory spread • Kids <5 years old most common • Fall and spring most common • Fever/flu-like symptoms with mouth sores and rash • Treatment is supportive