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Flashcards in 12 - Diaper Rash Deck (15)
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1
Q

What is a Diaper Rash?

A

Acute inflammatory rxn
in the area of skin covered by a diaper

MOST common in infants 9-12 months

Can also occur in adults w/ diapers
for continence issues
SAME as infants

2
Q

What CAUSES diaper rash?

A

Increased PERMEABILITY
skin hydration / increased pH / fecal enzymes / microorganisms

  • *Compromised Skin -> Diaper Dermatitis**
  • *chemical irritants** / fecal enzymes / mechanical irritation
  • *C. albicans infection**
3
Q

How to PREVENT/Treat Diaper rash

A

INCREASE diaper changes

INCREASE Bath frequency

Medication + Protectants

4
Q

Risk Factors for DIAPER RASH in infants

+ Complications

A

Bottle fed (vs breast fed)

Introduction of Solid Foods

CLOTH diapers

Oral Antibiotics
related to risk of diarrhea + secondary infection w/ yeast

Complications
Bacterial overgrowth = Staph/strep –> pustules w/ crusting

Fungal infection = C.Albicans –> RED / satellite lesions

5
Q

EX-ST

for Diaper Rash

A

Lesions on body OUTSIDE diaper area

>7 days or no improvement after 3-4days treatment

Physiological changes = NVD + Fever
constitutional symptoms = lethargy / behavior changes

BROKEN SKIN
Ulceration / blistering / peeling

  • *SECONDARY infection**
  • *pus / oozing lesions / satellite lesions**
  • *Comorbid Condition**
  • *HIV / organ transplant / immunosupression**
6
Q

NON-Pharmacologic Management

of Diaper Rash

A

Remove source of irritation
“Diaper-Free” time

Frequent Change = >6 times / day

Thoroughly CLEAN + DRY the diaper area after each change

Proper diaper use:
disposables / properly-laundered cloth diapers

7
Q

PROTECTANTS

Pharmacologic Management of Diaper Rash

Various Products + MoA

A

DECREASE Skin Friction
Non-Powders = protect from contact w/ moisture
Powders = absorb moisture

Allantoin / Calamine / Cocoa Butter / Cod liver oil
Colloidal Oatmeal / Dimethicone / Glycerin / hard fat
Kaolin / Lanolin / Mineral Oil / Petrolatum
Topical CORNSTARCH
Zinc Acetate/Carbonate/oxide

TALC = acceptable ingredient but is consiered a COSMETIC agent

8
Q
  • *PROTECTANTS**
  • *instructions for use**

Pharmacologic Management of Diaper Rash

A

AAA or Area @ Risk
with EVERY diaper change

are should be CLEAN + DRY
BEFORE application

9
Q

Protectants
Caution + ADR

Pharmacologic Management of Diaper Rash

A

Generally considered safe, no OD risk

Hydrophobic may be difficult to REMOVE from skin

Powders should be kept away from FACE
inhalation issue

TALC = should NOT be used on broken/oozing skin

Lanolin may cause contact dermatitis

10
Q

Agents to AVOID

Pharmacologic Management of Diaper Rash

A
  • *Topical Analgesics**
  • *CAMPHOR**
  • *Antiseptics**
  • *Boric Acid** / Benzalkonium Chloride / Calcium undecyclenate
  • *AntiMicrobials + AntiFungals**
  • unless recommended by MD*

Topical Anti-Inflammatories
Corticosteroids, unless recommended by MD = use LOW potency

11
Q

Selecting a PRODUCT

Agents for diaper rash

A

there are NO contraindicated combinations
many products have >1 apporoved protectants

Review inactive ingredients
to ensure NO undesireble agents

Select agent with LEAST inactive ingredients

Comparable products, let caregiver have preference

12
Q

PHARMacologic Management of

INFECTED Diaper Rash

A

After DIAGNOSIS of 2ndary fungal infection

Treat w/ OTC antifungal agent:
Miconazole / Clotrimazole

clean / DRY affected area
Apply antifungal to AA BID-TID
do NOT apply with EVERY diaper change!
Apply protectant for interim diaper changes

13
Q

What OTC medication can be used if

2ndary Fungal Infection was DIAGNOSED by MD?

A

LOTRIMIN AF
Miconazole or Clotrimazole

Comes in creams / powders / sprays

14
Q

PREVENTION of Diaper Rash

A

Proper Diaper Hygiene = KEY
Frequent change / avoid plastic pants
completely CLEAN + DRY diaper area

Recommend use of Protectants PREVENTITIVELY when
@risk of diaper rash = Antibiotic use / Diarrhea
can be PREVENTED w/ appropriate us

do NOT use antifungals PREVENTATIVELY

15
Q

Desitin

A

PROTECTANT for Diaper Rash

ZINC OXIDE
Paste / Cream / Ointment (petrolatum)

also good for PREVENTION of diaper rash
most important is proper diaper hygiene / changing

See MD if >7days