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From Flashcardlet > 1229 Exam 8: Impetigo, Lice, and Scabies > Flashcards

1229 Exam 8: Impetigo, Lice, and Scabies Flashcards

0
Q

What are the two types of impetigo?

A 
Impetigo contagious 
Bulbous impetigo (easy to rupture)
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1
Q

What is impetigo?

A

It’s highly contagious, bacterial skin infection. Localized inflammation and infection of the epidermis

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2
Q

Incidence and etiology of impetigo:

A
  • most prevalent mid- late summer, high humidity
  • most prevalent in infants and children (peak age 2-6 years)
  • poor sanitation and living conditions increase risk
  • can happen to any group or population
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3
Q

Patho for impetigo?

A
  • staph aureus and group A beta hemolytic streptococci can cause impetigo
  • bulbous caused by staph aureus
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4
Q

What are clinical manifestations of impetigo?

A 
Lesions
erythema
prurtius
burning
secondary lymph node involvement
drainage
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5
Q

Lesions:

A

Begin as small, red macular sand progress to small, thin- roofed vesicles or pustules, that rupture easily and export weeping, denuded skin. Lesions may get up to 1-2 cm, can get satellite leans, common- travel away down from the main one.

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6
Q

Drainage:

A

-characteristic honey color drainage forms crust (may be around mouth and nose because they scratch and then go to these areas.)

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7
Q

Billlous impetigo:

A
  • begin as small, red macula. However, lead to lesions that rapidly progress to distinct vesicles.
  • vesicles then enlarge to form Bullard in shiny erosions of the skin or produce a honey colored crust.
  • large, fluid filled sac type vesicles
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8
Q

Do you pop the vesicles?

A

NO!!! (ESP in older people with diabetes. It causes further problems.)
Doctors like the skin to era sorb the fluid.

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9
Q

Diagnosis of impetigo:

A
  • based on clinical presentation
  • presence of honey colored crust in considered the hallmark characteristics
  • important to assess underlying skin disease, atopic dermatitis, herpes, or contact dermatitis that have become secondary infection.
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10
Q

Treatment for impetigo?

A
  • focused on elimination of causative organisms while focusing on comfort measures and preventing complications
  • topical antibiotic ointment (Bactriban— only use end of Q tip once)
  • systemic antibiotic ointment therapy (cephalosporins, penicillin, ect..)
  • ensure no linens are to be shared.
  • hand washing and NO SHARING
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11
Q

Nursing management assessment:

A
  • assess regional lymphadenopathy and any underlying skin disorders
  • previous exposure to people with similar lesions
  • character and extent of lesions
  • observe for increase TPR and BP and comfort measures
  • location of the first lesion, what manner, and how quickly it’s being spread.
  • ask if changed anything in house, laundry, detergent, food, etc…
  • note character and extent of lesion, presence of vesicles.
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12
Q

Nursing diagnosis of impetigo:

A
  • infection r/t presence of infective organisms
  • impaired skin integrity r/t presence of lesions
  • risk for secondary infection r/t scratching or picking of lesions
  • knowledge deficit r/t treatment and measure to control and prevent the spread of infection
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13
Q

Goals for impetigo:

A
  • infections resolved, lesions will heal without scarring
  • infections will not spread outside primary site
  • caregivers will verbalized understanding of the treatment regimens and implements strategies to prevent spread of infections
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14
Q

Planning and implementation:

A
  • careful hand washing
  • wear gloves
  • general reminders to children.
  • general soaking and removing of crusts with warm soapy water
  • take antibiotics (even if infection appears gone)
  • instruct on good personal hygiene
  • short nails
  • clean environment (clean with bleach)
  • do NOT share personal items
  • watch others for s/s of infection
  • notify school
  • stay home 24-48 hours after initiation of oral antibiotics
  • seek med help if not going away with antibiotics
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15
Q

What is pediculitis?

A

(LICE)

  • ectoparasites: live on the surface of the body
  • require several meals of human blood each day. Will die away from the human host if any longer than two days.
  • infestations are troublesome, but the louse is NOT a vector of human disease.
16
Q

Incidence and etiology:

A
  • most common on healthy children 3-10 years old.
  • girls increased risk because of long hair and they share hair accessories.
  • all socioeconomic groups affected
  • most common in Caucasians.
17
Q

Patho of lice —

A
  • transmitted primarily through head to head contacts. (Hats, combs, coats, scarves, bedding,etc)
  • do not jump or fly.
  • crawl quickly in dry hair and they like clean hair.
18
Q

Female lice?

A
  • lays o. Scalp
  • lays 4-10 eggs daily
  • attach to hair shafts. (Nits attach firmly to th proximal end of the hair shaft in the egg case)
  • water insoluble glue like substance holds nits to hair
  • nymphs emerge after 7-10 days and mature in 7-14 days.
  • life span is 30 days.
19
Q

Where are eggs usually deposited?

A
  • posterior auricular (around the ears)

- occipital areas (warm and moist for incubation)

20
Q

Clinical manifestations-

A
  • itching on the scalp
  • intense itching at night
  • prurtius (caused from the crawling and the bites)
  • saliva can cause an allergic reaction.
  • scratching my lead to infection. (Mild fever, malaise, and regional lymphadenopathy.
  • neck irritation (can go as far as the shoulders)
21
Q

Diagnosis of lice?

A

Either live louse or nit

22
Q

Treatment of lice:

A
  • pediculocides along with removal of nits for children 2 or younger.
  • a solution of 1% permethrin (nix) is considered the treatment of choice. (One treatment)
  • less potent: kwell, scabene (have to retreat in one week)
  • RID, A-200: retreat net is neccessary
23
Q

Treatment failure?

A
  • poor technique, non compliance, or reinfestation
  • oral trimethoprim (bactrim) or sulfamethoxazole (septoria) in combination with 1% permethrin has been effective for children with multiple treatment failures or suspected lice related resistance.
  • very labor intensive and very costly
24
Q

Nursing management for lice?

A
  • careful hand washing
  • separate hair into sections and use tongue depressor or pencil
  • note findings
  • focus on comfort, resolution. And education
25
Q

Family teaching for lice?

A
  • do not use cream rinse or conditioner before treatment
  • do not rehash hair for 1-2 days following treatment, but read instructions and follow them.
  • follow all directions on packaging
  • all potentially contaminated linens/toys need to be washed in HOT water or dry cleaned.
  • bag toys for at least two weeks (sack and seal)
  • boil or soak brushes in alcohol.
  • floors, furniture, and vehicles should be thoroughly vacuumed and or fumigated with spray
  • teachers may need to spray carpets Nd children’s backpacks.
26
Q

What is scabies?

A
  • infestations are significant worldwide, but most are in underdeveloped countries.
  • disbursed everywhere
  • usually those who are alreadyimmunocompromisedare at risk.
  • any age, but most Re under 2 years or in the elderly in nursing homes.
27
Q

Patho of scabies?

A
  • person to person contact
  • incubation ranges 2-6 weeks (asymptomatic carriers may transmit to another)
  • mites burrow and poop
  • females burrow into skin to lay eggs every 2-3 days
  • eggs hatch every 3-8 days.
28
Q

Clinical manifestations of scabies:

A
  • inflammatory response occurs anywhere the mite has traveled
  • prurtius, itching increases at night
  • minute,grayish brown thread like burrow tracts with black dot at the ends.
  • lesions may range from a few erythematous papules, vesicles, and pustules to numerous excoriated lesions.
  • can range from small to numerous lesions
  • distribution is generally intertiginous (skin to skin contact— interdigitally, ax, cubical)
  • in infants face, head, neck, palms, and soles
29
Q

Diagnosis for scabies?

A
  • careful history and complete physical exam

- scraping for a papule for a definitive diagnosis

30
Q

Treatment for scabies?

A
  • 5% permethrin cream (Elamite cream) is treatment of choice
  • low risk of toxicity
  • safely used in infants less than 2 months old
  • one application is usually successful
  • all house hold members and known contacts are treated.
31
Q

Nursing management for scabies:

A
  • WASH HANDS!!!
  • wear gloves for any contact
  • monitor for itching and any secondary skin infections
  • teaching about medical treatment and comfort measures
  • strategies to prevent re infection

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