PEDS Exam II Skin Disorders
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Created by:
j1u2l3jule on March 26, 2012
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61 terms
Terms | Definitions |
|---|---|
 Variations in pediatric skin | epidermis is thinner, blood vessels lie closer to the surface, decreased amount of subcutaneous fat, lose heat more readily, absorbance is quicker through skin, contains more water and is less pigmented |
| differences in dark-skinned children | more prominent papules, scarring and keloid formation |
| Suncreen | all children over 6 mo of age |
| corticosteroids | anti-inflammatory, immunosuppresive |
| Benzoyl peroxide, Retinoids, Accutane | acne treatments |
| Silver sulfadiazine | used for burns |
| bacterial skin infections | impetigo, folliculitis, cellulitis, staphylococcal scalded skin syndrome caused by staph aureus and group A beta-hemolytic streptococcus (normal flora) |
| Impetigo | skin rash bullous- sporadic pattern and develops on intact skin from s. aureus nonbullous (crusted)- follows some type of skin trauma or from a secondary skin infection, honey colored exudate |
| Tx of Impetigo | antibiotic topical/oral for 7-10 days (oral first generation cephalosporin) Clindamycin for MRSA cool compresses, Antibacterial soap, good hygiene |
| Cellulitis | localized infection and inflammation of the skin and subcutaneous tissues caused by strep, staph aureus, haemophilus influenza |
| s/s of cellulitis | erythema, pain, edema, warmth at site, Systemic-fever, lymphangitis |
| Diagnosis of cellulitis | CBC, blood cultures, culture the affected area |
| Treatment of cellulitis | IV or IM doses of antibiotics, then 10 days of PO antibiotics mild- cephalexin, amoxicillin mod/severe- IV cephalosporins Warm soaks q 4 hours rest, elevate extremity Frequent hand washing |
| Diaper Dermatitis | inflammatory reaction of the skin covered by the diaper caused by irritation of urine/feces, detergents not rinsed from clothes, chemical irritations |
| Management of Diaper Dermatitis | Prevention Topical ointments, creams containing vit A,D, E, zinc oxide, petrolatum are helpful barriers to the skin (oil based) do not use Powder |
| Eczema (Atopic dermatitis) | in the same family family as asthma and allergic rhinnitis Chronic disorder characterized by extreme itching, inflamed, reddened, swollen skin in response to a specific allergen Infants: cheeks and trunk, wrists Older children: anywhere on body |
| Nursing management | skin hydration: avoid hot water, bathe in warm water twice a day, use milk soaps, pat skin dry, apply fragrance free moisturizer Maintaining skin integrity/prevent infection: cut fingernails short, avoid tight clothes, use of antihistamines |
| Contact Dermititis | inflammatory reaction of the skin to chemical substances Ex: poison ivy, oak, wool, dyes, soaps |
| S/S of contact dermititis | onset of rash that is red, papulovesicular that may be weeping, itching |
| Management of Contact dermititis | avoidance with the allergen topical/systemic corticosteroids |
| Seborrheic Dermititis | recurrent inflammatory reaction of the skin scalp in infants: cradle cap scalp in adults: dandruff |
| s/s of seborrhea | thick, flaky greasy yellow scales |
| Tx of seborrhea | wash the affected area with mild soap, apply anti-inflammatory creams, apply mineral oil to scalp, shampoo and gently lifft off crusts use selenium sulfide shampoo to help remove |
| Acne | the most common skin condition occurring in childhood inflammation of the sebaceous follicle of certain body parts more severe in boys, occurs later in males |
| Acne neonatorum | occurs in response to the presence of maternal androgens appears between 2-4 weeks and lasts up to 6 months usually no treatment, educate parents to avoid squeezing the pimples Wash with clear water daily |
| Acne Vulgaris | occurs in adolescents and adults most frequently on the face, chest and back |
| Risk factors for acne | male sex, oily complexion, corticosteroid use, stress, family predispoition, lack of sleep, occlusive creams/cosmetics |
| Management of Acne | gently cleanse twice per day meds: benzoyl peroxide, retinoids, oral antibiotics, Accutane (severe cases) |
| Fungal infections | superficial infections that live on the skin dermatophytoses, tinea Examples: tinea capitis, tinea corporis, tinea pedis, candidiasis |
| Candidiasis | infection of the skin, particularly in warm, moist area such as diaper areas |
| S/s of candidiasis | mouth- white or gray plaque skin- fine red, slightly raised rash |
| Tx of candidiasis | oral (nystatin) given orally after each feeding skin (nystatin) mycostatin, lotrimin, monistat- apply thin lay to infected area 2/3 x day |
| Tinea | corporis (ringworm) capitis (on the head) pedis( on the feet, athlete's foot) |
| s/s of tinea capitis | round, scaly lesions, bald area,s small black dots on scalp, itching |
| tx of tinea capitis | oral antifungal, antifungal shampoo, everyone in the family needs treatment |
| Drug reactions | most common symptoms is a development of a rash may be immediate or delayed |
| management of drug reactions | STOP the drug antihistamine corticosteroid |
| Scabies | mites burrow into epidermis and deposit eggs and feces |
| Patho of scabies | inflammation 30-60 days after burrowing transmitted via direct skin to skin contact Contact precautions |
| tx of scabies | topical- scabicides- 5% permethrin (Elimite) cream, lindane (Kwell) cream oral- ivermectin if 5 y/o and wt > 15 kg |
| Pediculosis Capitis | head lice |
| Patho of head lice | common in school aged children adult louse lives only 48 hours without humans |
| tx of head lice | pediculicides- Nix shampoo and comb out with a fine tooth comb Prevention- do not share head items (brushes, hats) |
| Human and Animal bites | common in school aged children |
| tx of bites | clean/irrigate the wound, suture or staple if necessary determine the rabies status of the animal (otherwise rabies prophylaxis treatment) topical/systemic antibiottics tetnus booster |
| Cat Scratch disease | common lymphandenitis in children caused by cat scratching s/s are fever, sore throat, malaise, loss of appetite treat with antibiotics |
| Cold injury | frostbite- freezing of body tissues exposure to extreme cold temperatures |
| s/s of cold injury | white plaques with surrounding erythema blistering, edema hemorrhagic blisters |
| tx of cold injuries | remove wet/cold clothing immerse affected part in 104 F water for 15-30 minutes thawing will cause significant pain |
| Sunburn | results as an overexposure to UV rays of the sun increases risk for cancer |
| S/S of sunburn | redness, blisters, purple hue redness appears within 4 hours blisters appear within 6 hours |
| tx of sunburn | cool compresses, cooling lotion, oral NSAIDs (aloe vera gel) Educate on prevention |
| Burn injuries | children are at an increased risk for burns due to curiosity and lack of knowledge |
| Superficial burns (1st degree) | involve only epidermal injury and usually heal without scarring in 4/5 days pain, redness, swelling, sensitive to touch, blanched when light pressure applied |
| partial thickness burns (2nd degree) | injuries occur in epidermis and portions of the dermis painful, redness, blistering heal within 2 weeks with little scarring |
| Deep partial thickness burns | take longer to heal, may scare, result in changes to hair/nail appearance may require surgical interventions |
| full thickness burns (3rd degree) | significant tissue damage through the epidermis, dermis, hypodermis extensive scarring, hair follicles destroyed, sweat glands destroyed require significant time to heal if bones/tendons are involved may be termed 4th degree burn skin grafting is usually necessary |
| severity of burns | mild: < 10% TBSA treat at home/outpatient moderate: 10-20% TBSA, treat in hospital, burn treatment major: >20% TBSA treat in specialized burn center |
| Tx of burns | assess airway (inhalation injury requires intubation) monitor VS, assess for shock remove clothing, jewelry cover wound with clean cloth keep victim warm fluid/electrolyte replacement antibiotics, analgesics, anesthesia |
| Care of major wounds | Primary Excision Wash with cool water/soap Debridement hydrotherapy prevent wound infection- topical antibicrobial agents, tetanus booster Antibiotics used if infection is present Biological skin coverings- allograft (one person to another), xenograft (baboon to human, or other non human species), skin substitutes |
| Rehabilitation of burns | maintain fluid/electrolytes, nutrition prevent infection, provide comfort measures emotional support Management of contractures |
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