atopic dermatitis akaeczema/ the itch that rashes90% of eczema is diagnosed by age5what is the etiology of eczemaunknown! however often associated with allergies, family history, and immunologic alterationsexternal factors that affect atopic dermatitisDry skin, soaps, fabrics, foods, environmental antigens, etcCM of acute atopic dermatitis-intense itching
-chronic or repeatedly occurring symptoms
- Personal or family history of atopic disorders (eczema,allergies, asthma)where does eczema appear most commonly in infantsoften appear on face, trunk, extremitieswhere does eczema appear most commonly in childrenflexural creases, wrists and ankles, behind the knees, between fingerswhere does eczema appear most commonly in adolescents· flexural creases, hands, face and neck (hand glove area)Nursing Education for Atopic Dermatitis- Skin care as priority
- Daily bathing with unscented soap
- Topical steroids if prescribed, then
- Lubrication, lubrication, lubrication when they are still wetcommon bacterial skin infectionsimpetigo and pediatric abscessesWhat is impetigo?Highly contagious bacterial infection marked by clusters of small blisters around the mouth/facedescribe the appearance of impetigoVesicles that easily rupture forming honey crusted lesionsresponsible organisms from impetigoStaphylococci or streptococcus, or bothmethycillin resistant staphylococcus aureus (MRSA)resistant staph infection that is now the most common cause of abscesses in all patientsCA-MRSAcommunity-associated MRSA infectiontreatment for CA-MRSA- I& D (to expel all of the debris and bacteria out)
- +/- antibiotic tx if needed
- keep wounds covered
-wash hands
-bathe regularly
-avoid sharing hygiene productsCA-MRSA risk factors- Crowded living conditions, group homes
- Sharing of personal items (towels, razors, sports equipment,
etc)
- Frequent skin to skin activities
- Frequent antibiotic useare viral skin infections of concern in childrenthey can range from benign and self limited to life threateningParvovirus B19 (fifth disease)viral skin infection in peds presenting as red cheeks (slapped cheek) the works its way down the body
May also be associated with accompanying systemic sxs: URI, low grade fever, chills, body achesis the parvovirus rash contagiousthe rash is not contagious but the systemic sxs like fever can beorganism causing hand, foot, mouth diseasecoxsackievirus and enterovirushand foot mouth diseaseacute viral illness presenting with: vesicular exanthem on tongue, gums, palate, oral mucosa papulovesicular exanthem on hands, feet, legs and buttocksdescribe the progression of hand foot mouth diseaseprodromal period is the virus
then it manifests as rash and oral ulcers (very sore! making child highly susceptible to dehydration)risk with hand foot mouth dxchild is at risk for dehydration due to very sore oral ulcers on the mouthHSV-1herpes simplex virus type 1 (oral herpes) - non-sexually transmitteddescribe outbreaks of HSV 1Primary outbreaks more severe than subsequentdistribution and location of HSV1 viral skin infectiono Vesicular lesions over lips, tongue, gingiva, buccal mucosa and palate - looks very painful
Bigger lesions, larger vesicles, clustered
Febrile, irritablerisks associated with HSV 11. dehydration
2. spreading to all other parts of the body
3. dormant virusif a child has HSV 1, what precautions should the parent takewrap the child's hands in no-no's or mittens to prevent further spread of the virus to other body partscommon fungal infections in childrentinea corporis and tinea capitistinea corporissuperficial fungal infection in an annular plaque formations
aka ringwormtreatment for tinea corporisRespond readily to topical antifungal creamss/s tinea capitisErythema and scaling of underlying scalp, broken off hairtx for tinea capitisNeeds treatment with oral antifungals (NOT topicals)causes of burns in children- Inadequate adult supervision
- Child inquisitiveness
- Inability to get away from burning agent
- Intentional abuse
- Experimentation/risk taking activities (teens, young adults)most common type of burn in childrenthermal80% of all thermal burns in toddler are fromhot liquids or greaseThe most common type of inflicted burn (intentional), particularly between the ages of 1-3scalds% of burns in children due to abuse25%chemical burnscaused by ingestion of toxic substancesanticipatory guidance for chemical burnspoison controlwhy are electrical burns particularly hard to treatburning from the inside out so will present as tingling before outward appearances occurtemperature and time to cause a full thickness burn:
150 -
140 -
125 -
120 -- 150°F (66°C) 2 seconds
- 140°F (60°C) 6 seconds
- 125°F (52°C) 2 minutes
- 120°F (49°C) 10 minutesanticipatory guidance to prevent burns in childrenKeep hot water heaters at max 120 º
Do not hold a child when drinking a cup of coffee
Smoke detectors
90% of unintentional scald burns are not tap water scalds, they are from opening a microwave, older children cooking, noodle soupsproper burn managementMust keep the burn moist! Keep blister intact for as long as possible
