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Peds

Unit 2 - Integumentry, Cardiac & Muscoloskeletal

QuestionAnswer
Functions of the integumentary system (5) protection, impermeability, heat regulation, sensation & vitamin D production
Impetigo def superficial skin infection; appears on face, hands, neck or extremity
Impetigo cause, tx, complications bacterial-staph/ strep, highly contagious until lesions heal, lesions progress from red macule -pustule-honey colored crusts, pruritis; tx - antibiotics, soaks, good handwashing & contact precautions, complications - glomerulonephritis & rheumatic fever
Ringworm (tinea) def and categories (4) def - caused by fungus & transmitted person to person or from animals; tinea capitis, tinea corporis, tinea cruris (jock itch), tinea pedis
tinea capitis & tx scalp - scaly patches, alopecia, pruritis; treated with oral and/or topical antifungal
tinea corporis & tx round or oval scaling ring w/clearing in center, pruritis; tx - oral & topical antifungal
tinea cruris (jock itch) similar to corporis but localizes in medical and proximal aspects of thigh and groin - rare
tinea pedis & tx scaly patches w/ pin sized vesicles on soles of feet or cracking/scaling of skin between toes, pruritis common; tx - antifungal powders and creams
Miliaria Rubra (prickly heat) def & tx sweat glands block d/t high temps & humidity; sweat escapes to surrounding tissue causing itching (prickly feeling), tiny papules surrounded by erythema in skin folds on chest & neck; tx - caution parents not to overdress child, bath clear h2O & mild soap
infantile eczema/atopic dermatitis cause (4) unknown cause but thought to be allergic response. Hereditary, hypersensitivity of deeper skin layers to protein or protein-like allergens. Specific allergens which may be ingested, inhaled or direct contact
infantile eczema/atopic dermatitis sx cheeks are where usually 1st seen but may spread to forehead, scalp, neck, trunk, arms & legs; starts as reddened areas followed by papule & vesicle formation; open areas prone to infection
infantile eczema/atopic dermatitis dx start with elimination of foods, etc to try to determine cause
infantile eczema/atopic dermatitis tx (4) hydrate slain - use lotions, calamine, aveeno; relieve pruritis - benadryl, decrease inflammation - use claritin; prevent/control infection - antibiotics, hydrocortizone
Pediculosis capitis (lice) def def - infestation of scalp by parasite
Congenital Talipes Equinovarus def aka club foot; can affect one or both feet; foot inverted, heel drawn up, front of food adducted - inward; maybe d/t positioning in utero or maybe fixed deformity - bone abnormality - need surgery to correct
Congenital Talipes Equinovarus dx, tx, ni dx - ultrasound, xray - usually one foot is smaller/shorter than the other; tx - cast application - up to mid-thigh;changed frequently, possibly orthopedic shoes or Denis Browne splint, surgery to release tendons; NI - cast care
Congenital Hip Dysplasia def aka DDP, malformation of acetabulum so femoral head can dislocate
Congenital Hip Dysplasia sx, tx shortening of femur, uneven thigh and gluteal folds, limited abduction of hip along w/ "click", more common in females than males, if dx & treated before 2 months more success; tx - keep hip abducted position, braces, pavolic harness, possibly surgery
Congenital Hip Dysplasia NI teach parents how to triple diaper, observe pts hips, tell parents baby has to be in harnass all the time; hip spica - watch breathing and vomitting because to tight
muscular dystrophy def group of inherited diseases that causes muscle degeneration & wasting. d/t absense of dystrophin - protein involved in maintaining muscle integrity; most common form - Duchenne dystrophy; genetic sex linked carried by mother & given to son
muscular dystrophy sx 1st 3-4 years of life; difficulty standing & walking; trunk muscle weakness develops, tripping, falling, waddling gait, lordosis, gowers manuever used to get to upright position, maybe mental impairment, 10-20 yrs w/c - death from respiratory paralysis
muscular dystrophy dx, tx dx - observation serum creatinine phosphokinase (CPK) levels - muscle biopsy; tx - no cure - keep child as active as possible, PT brace, w/c prn, respiratory & cardiac probs b/c focus near end
muscular dystrophy NI prevent complications, keep independent, family support, educate, PT, OT
Juvenile Rheumatoid Arthritis def and 3 types def - chronic autoimmune disorder - most common CT disease in children; onset 1-3 or 8-12; 70% will go into remission by adult hood. 3 types - systemic - most involved; pauciarticular - 4 or fewer joints; polyarticular - 5 or more joints
Juvenile Rheumatoid Arthritis sx joint inflammation and pain; can result from irreversible changes in joint cartilage, ligaments and mensicus; systemic sx include fever, lymphadenopathy, splenomegaly and hepatomegaly
Juvenile Rheumatoid Arthritis dx, tx dx - lab tests; tx - pain relief - NSAIDS, ASA, steroids, immunosuppressants, PT, hydrotherapy, splints to immobolize joints for pain relief, moist heat;
potential complications for Juvenile Rheumatoid Arthritis joint deformity requiring replacement, chronic & acute uveitis - inflammation of structures including iris, ciliary body & choroid - can lead to vision loss
Scoliosis def including structural & functional classifications def - lateral curvature of spine with rotation of spin * ribs; functional - d/t posture, muscle spasms or unequal leg length; structural - more common. unknown cause; most commonly occurs during early adolscense - girls more than boys
Scoliosis s/sx, dx s/sx - shoulder & hip different heights, maybe one-sided hump & prominent scapula from rotation of vertebra & ribs, spinal column curved when child bends over; dx - screening followed by xray confirmation
Scoliosis tx depends on degree of curvature, mild may be treated w/ exercise, moderate will need brace - Boston or Milwaukee - worn 23 hrs/day slows progression - not a cure, if bad enough will put in traction and/or surgery
Created by: breinard