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Pediatrics - Skin
Skin - Stack #194831
| Question | Answer |
|---|---|
| What are the 4 etiologic factors that result in skin lesions | Contact agents (infection, toxic chemicals), Heredity factors, Allergens, Systemic diseases |
| A large fluid-filled blister (pinky width vessicle/cyst) | Bulla |
| A small area of color change often less than 1.5cm width with a smooth surface | Macule |
| A small palpable lesion usually less than 0.5cm diameter (elevated mole) | Papule |
| A large area of color change with a smooth surface (macule greater than 1 pinky width | Patch |
| A palpable flat lesion greater than 0.5cm diameter mostly elevated but can be thick area w/o raised surface (width rough) | Plaque |
| An oedematous papule or plaque caused by swelling in the dermis (ring) | Wheal |
| A small fluid-filled blister less than 0.5cm diameter (clear fluid) | Vesicle |
| A purulent vesicle filled with neutrophils (zit, pimple) | Pustule |
| Secondary lesions arise from ___ lesions | Primary |
| Name the 5 secondary skin lesions | Scale (irregular), Crust (scab), Lichenification (thick skin), Excoriation (abrasion, scratch), Fissure (crack) |
| The medical term for diaper rash is ___ | Diaper Dermatitis |
| ___% of young children suffer from diaper rash | 35% |
| Diaper dermatitis peaks at age __ to __ months | 9-12 mo |
| 5% of children have ____ ____ with diaper dermatitis | severe problems |
| Which babies are more prone to diaper rash: bottle or breast fed? | bottle-fed babies b/c feces from breast-fed babies has lowe fecal enzyme activity and lower pH |
| What are the causes of Diaper Dermatitis? | Prolonged/repetitive contact with irritants (feces, urine, soap, or friction) |
| Why does urine cause diaper dermatitis (dipper rash)? | Irritant quality of urine is related to the increase pH from the breakdown of urine in the presence of fecal urease |
| ___ ___ can be a factor in causing irritation in diaper dermatitis? | Candida albicans - it causes painful, bright red lesions with raised borders |
| What are the clinical manifestations of diaper rash? | seen where the diaper came in contact with skin in convex surfaces of buttocks, inner thigh & parineal area |
| What is the nursing care management of diaper rash | change diaper as soon as it is wet or soiled; expose area to air; use protective barrier (zinc oxide); if fungal, use mycostatin powder; use other diaper pastes (butt balm, super dooper diaper do) |
| T/F Petrollium Jelly can be used to treat diaper dermatitits? | True |
| ___ have helped significantly in decreasing diaper dermatitis? | Superabsorbent disposable diapers |
| ___ is more effective in reducing friction and cakes less when wet so it is better than talc. | Cornstarch |
| ___ is more dangerous than cornstarch as it can easily be inhaled by the baby (best not to use). | Talc or (baby powder) |
| What ever powder is used it should be shaken into the ____ first and then applied? | should be shaken into the caregivers hand first then applied. |
| ___ is a chronic recurrent inflammatory reaction of the skin? | Seborrheic Dermatitis |
| Seborrehic Dermatitisoccurs on the scalp as ____ but can also occur on the eyelids _____ or external ear canal _____? | Seborrheic dermatitis occurs on the scalp as cradle cap but can also occur on the eyelids as blepharitis or external ear canal as otitis externa |
| What is the cause of seborrheic dermatitis? | The cause is UNKNOWN |
| Seborrheic dermatitis is common in early infancy ___ production is increased? | sebum production is increased |
| How do you treat cradle cap? | daily shampoo with soft soap. Leave soap on it for a while to soften crusts. Then rinse and brush with soft brush. |
| T/F Parentswith children who have seborrheic dermatitis are afraid of shampooing their childs hair? | True parents can be fearful of shampooing the "soft spots" |
| Thick, yellow, oily scaly, patches are called ____? | seborrheic dermatitis or craddle cap |
| What is Atopic dermatitis? | Eczema |
| ___ is a general term used to describe a condition of readness, scaling, vesicles, and crusting | Eczema |
| ____ is a common chronic, relapsing pruritic type of eczema and usually occurs in individuals who have allergies or a family Hx of such? | Atopic Dermatitis (AD) |
| ___ refers to an allergy with a hereditary tendency? | Atopic Dermatitis (AD) |
| What are the 3 forms of Atopic Dermatitis? | 1. Infantile 2. Childhood 3. Preadolescent and adolescent |
| Infantile atopic dermatitis occurs ___ months with spontaneous remission by __ years of age? | 2-6 months with spontaneous remission by 3 years of age |
| Childhood atopic dermatitis ___ years of age. 90% manifest disease by ___ years? | Childhood atopic dermatitis 2-3 years of age. 90% manifest disease by 5 years of age |
| Preadolescent and adolescent atopic dermatitis begins about ___ years of age and continues into ____? | Preadolescent and adolescent begins about 12 years of age and continues into adulthood. |
| What are the manifestations of infantile atopic dermatitis? | Erythema, vesicles, papules, weeping areas, oozing, crusting, and scaling. ITCHING |
| In Infantile atopic dermatitis where are the lesions located? | Generalized cheeks, scalp, trunk, extermeitites !!!!Mainly extensor surfaces, face elbows and knees!!!!! |
| How is the childhood form of atopic dermatitis manifested? | Clusters of papules, dry, may be hyperpigmented, lichenification with thickened skin especially in creases |
| How is the adolescent form of atopic dermatitis manifested? | same as childhood form, dry, thick lesions with lichenification itching with both and unaffected skin dry and rough |
| How is the adolescent atopic dermatitis unaffected skin appear? | dry and rough |
| What is the cause of atopic dermatitis? | UNKNOWN |
| ___ is better in humid weather and worse in fall and winter when homes are heated? | atopic dermatitis. |
| In ___ the skin gives off water loss? | atopic dermatitis |
| ___% of children with atopic dermatitis (AD) develop asthma? | 50% |
| T/F the majority of AD have a family history of eczema, food allergies or allergic rhinitis? | True |
| What are some nursing management of atopic dermatitis? | hydrate skin; relieve itching; reduce flare-ups and inflammation; control infection; avoid allergens, avoid overheating, avoid skin moisture loss; topical medications |
| Tepid baths w/ mild soap (Dove,___) or no soap, or ___ oil; Once/twice a day, no bubble bath; Lotions such as aquaphor,__,__; nightime bath followed by emollient (__is good)& ___ pjs help alleviate nighttime itching are all ways to hydrate skin? | Tepid baths w/ mild soap (Dove, neutrogena) or no soap, or emulsifying oil; Once/twice a day, no bubble bath; Lotions such as aquaphor, cetaphil, eucerin; nightime bath followed by emollient (vaseline is good)& cotton pjs help alleviate nighttime itching |
| For puritis of Atopic Dermatitis, __ __ such as __ and Benadryl may be helpful at night | oral antihistamines; atarax |
| During the day, for puritis of atopic dermatitis, it can be helpful to use __ __ such as Claritin and __ or topical __; for secondary infections, use systemic __ | Nonsedating antihistamines such as claritin and allegra or topical corticosteroids; secondary infections treat with systemic antibiotics |
| One method to reduce flarups of Atopic Dermatitis you can use? | Wet wraps:corticosteroid ointment followed by cool, wet wrap 4 10min followed by ointment and moisturizer |
| Another method for reducing flarups of Atopic Dermatitis? | Topical Immunomodulators (steroids): Tacrollmust (TAC) & pimecrolimus ointmentsbest at beginning of flareup, mild burning sensation on skin |
| Additional nursing care for atopi dermatitis | short, clean nails; cotton gloves to prevent scratching; avoid wool materials and irritating soaps/detergents; dress for the climate; watch lesions for infection; cleanse skin with neutral pH |
| T/F: Food allergens like eggs, milk, and peanuts can be a common cause of atopic dermatiits. | True |
| T/F: A hypoallergenic diet is effective in a short time. | False; diets take time b/4 effects are seen, education important for parents to read labels. Parents need reassurance/support |
| Exacerbations of atopic dermatitis can be caused by | Airborne allergens & emotional stress |
| Atopic dermatitis scarring will not occur unless __ __ presents | secondary infection |
| Parents may want to do what to their houses if they have a child with atopic dermatitis? | "Allergy proof their homes" |
| Impetigo is a common contagious superficial skin disorder caused by? | Impetigo is a commn contagious superficial skin disorder caused by group A beta-hemolytic streptococcus or Staphylococcus aureus or a combination of each |
| T/F Impetigo is minimally contagious? | False Impetigo is highly contagious |
| Impetigo is common in __ and __? | Impetigo is common in toddlers and preschool |
| What are the areas of the body that can be infected with impetigo? | Exposed areas of the body; face, hands, neck, extremities |
| Impetigo begins as a ____ and becomes a ___ easily ruptured? | Begins as a reddish macule and becomes a vesicle easily ruptured |
| What are the manifestations of imptetigo? | Begins as a reddish macule and becomes a vesicle easily ruptured; supperficial moist erosion; exudates dry to form heavy crust; Itching common |
| In ____ you want to remove skin crusts & soften with burrow's solution compresses? | Impetigo |
| In impetigo apply ____ ointment; oral/parenteral antibiotics such as ____are given if severe; and it will usually heal without scaring unless ____ infection is present? | In impetigo apply topical bactericidal ointment; oral/parenteralantibiotics such as penicillin if severe; and will usually heal without scaring unless secondary infection is present |
| Good hand wasahing is ____ with a child with impetigo both before and after contact with the child? | imperative |
| In what skin disorder is it importantto keep towels and washcloths separate from other family members and the clothes should be changed daily and washed in HOT water? | Impetigo |
| What does MRSA stand for? | Methicillin Resistant Staphylococcus Aureus infection |
| Common to find colonization of MRSA in ___ and ___ of atopic children? | common to find colonization of MRSA in nares and under fingernails of atopic children |
| ___ is easiliy spread by self-inoculation; Nusing precautions are similar to Impetigo; and we are seeing increased hospital admissions with skin abscesses and other infections due to this orgnaism? | MRSA |
| ___ is an infection of the skin involving streptococcus, staphylococcus, or haemophilus influenzae bacteria? | Cellulitis |
| In ____ streaking may be seen and there is invovlement of regional lymph nodes? | Celluliltis |
| ___ is the inflammation of the skin and subutaneous tissues with severe redness, swelling and firm infiltration? | Cellulitis |
| ___ may progress to form an abscess? | cellulitis |
| fever and malaise are also seen in ____? | cellulitis |
| What is the treatment of cellulitis? | Oral/parenteral antibiotics given; Rest & immobilization of both the child & affected part; Hot moist packs are helpful |
| When is hospitalization required with cellulitis? | hospitalization required with systemic symptoms |
| ___ are caused by various dermatophytes that infect the nonviable keratinized cutaneous tissues including skin, nail,and hair? | fungal infections |
| Fungal infection organisms live on and not in the ___? | skin |
| The term ___ is specific to the part of the body infected with a fungus? | tinea |
| What does tinea capitis mean? | ring worm/fungus in hair |
| What does tinea corporis mean? | ring worm on turnk, legs, and arms |
| What does tinea cruris mean? | ring worm groin, pubic area and thighs |
| What does tinea pedis mean? | ring worm athlete's foot |
| Technicall all tineas are ringworm although this term is usually limited to __ and ___ infestations? | hair and body infestations |
| Fungal releases an enzyme that digest and hydrolyzes the keratin of hair, nails, etc. The dissolved hair breaks off to produce ___? | bald spots (tinea capitis) |
| ___ are found on the edge of the inflamed border as they move outward from the inflammation? Diagnosis is made from ____ of scale on the periphery of the lesion? | The fungi are found on hte edge of the inflamed border as they move outward fromthe inflamation; diagnosis is made fromscrapings of scale on the periphery of the lesion |
| What are the clinical manifestions of tinea capitis? | Lesions are scaly circumscribed patches with areas of alopecia; lesions may extend to hairline or neck; pruritic |
| What is the clinical manifestions of tinea corporis? | Round or oval lesions with erythematous scaling that spreads peripherally and clears centrally |
| T/F Fungal Infections are transmitted from person to person and from animal to person? | True |
| In fungal infections is there permanet hair loss? | there is rarely permanent hair loss |
| In fungal infections ___ individuals are more susceptible? | atopic |
| Emphasize good hygiene; don not share persoonal care items or headgear if you have a ___? | fungal infection |
| fungal infection: Shampoos with ___ sulfide are applied for 5-10 mins at least 3x a week once therapy initiated may return to school? | selenium sulfide |
| with fungal infections what is importnant to due with oral griseofulvin? | important to maintain prescribed dose and schedule and take with high fat foods for best absorption; may be taken over a long period of time |
| Name two types of topical antifungal treatments? | clotrimazole and miconazole |
| In applying antifungal treatments apply beyond the periphery of lesion and continue ___ weeks after lesion is gone? | 1-2 weeks |
| What is scabies caused by? | Caused by the scabies mite (sarcoptes scabiei). The impregnated female mite burrows into the stratum corneum of the skin where she lays her eggs and feces. Eggs hatch and mites travel |
| In Scabies an inflammatory response occurs after the host becomes ___ to the mite approximately ___ days? | An inflammatory response occurs after the host becomes sensitized to the mite approxiamately 30-60 days |
| What are the clinical manifestations of scabies? | Intense itching that leads to excoriation; maculopapular lesions are distributed to hands, wrists, knees, elbows and inguinal region; also see linear erythematous lesions that represent the areas where the mite has burrowed. |
| In ___ a black dot at the end of a thread like burrow is the mite? | scabies |
| In scabies ___ contact is usually necessary for transmission of the mite as it takes 45 minutes for it to burrow into the skin? | prolonged contact |
| Diagnosis of scabies is made by ___ exam of scrapings fromthe burrow? | Diagnosis is made by microscopic exam of scrapings from the burrow |
| To treat scabies ___ 5% creme (Elimite) for 8-14 hrs; cover entire body under finger nails and avoid the eyes. This is the preferred treatment. | permethrin 5% cream |
| T/F Lindane lotion can also be used to treat scabies? | True- should be applied just like permethrin 5% cream |
| T/F Touching and holding constantly are good for scabies pts? | False-touching and holding kept at a minimun. wear gloves |
| With scabies you need to wash previous worn clothing in ___ and dry on ___? | HOT water Hot dryer |
| In scabies the mite will be killed but inflammator reaction will not be eliminated for ____? | 2-3 weeks |
| What is pediculosis captits? | lice |
| Children between ___ years of age and their families are infected most with pediculosis captititis? | 3-10 years of age (head lice) |
| females have more head lice than males in a ___ ratio? | 2:1 ratio |
| Why are white children affected more often than black children by almost 99%? | Probably because North american species cannot grip the oval-hair shaft characteristic of african americans |
| How is Pediculosis capitis transmitted? | Direct physical contact: head to head; Lice cannot fly or jump. They crawl; Transmission can occur with shared use of personal belongings. Avoid sharing head gear, combs, etc |
| Pediculus humanus capitis is a common infestation in ___ children? | school-age children |
| ___ are small parasitic insect that resides on the scalp and neck hairs of a human host? | pediculosis capitis |
| What are the manifestions of pediculosis capitis? | itching caused by insect saliva |
| How is pediculosis diagnosed? | Diagnosis by presence of nits (white eggs) firmly attaced to the hair shaft; most eggs and cases are attached within 1/4 to 1/2 inch fromscalp; |
| ___ nits are colored and empty cases are ___? | viable nits are colored and empty cases are white |
| How is pediculosis capitis treated? | Application of pediculicides and manual removal of nit cases |
| ___ cream rinse is drug of choice (Nix) (nonprescription drug) and ____ is a prescription drug that may be used for pediculosis capitis? | permethrin 1% cream rinse is drug of choice and Malathion 5% is a prescription drug that may be used |
| T/F Daily removal of nits with a metal nit or flea comb following the pediculicide is essential for control of pediculosis capitis | True |
| What are the nursing interventions for pediculosis capitis? | complete combing of the child's entire head of hair every day until no more nits are found; encourage parents to read instructions on shampoo label & follow carefully; nits can be removed with tweezers & fingernails also; avoid eye irritation |
| What is the psychological effect of pediculosis capitis? | response of others to diagnosis of lice stressful to children. makesthemfeel ashamed or guilty |
| As a nurse what are some school preventions for pediculosis capitis? | Incidence of lice infection in shcools has become a serious concern for school nurses; school nurses coordinate prevention and control programs for lice; controversy over "no Nit" school policies |
| What is No Nits? | Where the children are not allowed back til all nits are gone |
Created by:
cgwayland
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