Integumentary Condition Flashcards by Sophie Grasso

Integumentary changes as children grow from newborn to adolescent age
NEWBORN

thin, blisters on friction, ECCRINE glands functional throughout, APOCRINE glands nonfunctional, color light for ethnicity, avoid sunexposure

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Phases of Wound Healing

Phases of wound healing
Inflammation – lasts 2-5 days
Proliferation – lasts 2 days-3 weeks
Remodeling (figure 31.2) – lasts 3 weeks-2 years

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Inflammation lasts

2-5 days

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Proliferation lasts

2days - 3weeks

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Remodeling lasts

3weeks-2years

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Most common bacterial skin disorder

Most common during adolescents

Acne Vulgaris

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Signs and symptoms
Comedones – open and closed
Inflammation
Cysts/nodules

Acne Vulgaris

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What type of moisturizer do you use with Acne Vulgaris?

water-soluble moisturizer

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Caused by bacterial invasion of an opening in the skin – Staph and Strep

Impetigo or Cellulitis

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Signs and symptoms
Highly contagious
“honey-colored” crust is hallmark sign

Impetigo

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Medication used to treat Impetigo?

Bactroban

Oral antibiotics

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Signs and symptoms

Edema, erythema, hot to the touch, localized pain

Cellulitis

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Nursing Care for Cellulitis

Antibiotics

Note that a severe case requires hospitalization and IV antibiotics

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Complication of Cellulitis

abscess with drainage

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Bacterial Infections

Acne
Impetigo
Cellulitis

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Sign and symptoms
Rough, raised, and flesh-colored
Occur anywhere on the body

Human Papilloma Virus: Warts

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Nursing Care for Human Papilloma Virus: Warts

Usually no intervention needed
Will resolve spontaneously within weeks to a few years
Discuss over-the-counter or prescription medications that are available

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Painful blisters on mucosal surfaces of the skin

HSV-1 (cold sore)

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genital herpes

HSV-2

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S/S
Watery, painful, tingling blisters
Latency and exacerbations – based on stressors
Highly-contagious

Herpes Simplex Virus

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Nursing Care for Herpes Simplex Virus

No Cure

Medications topical and oral

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Viral Infections

HPV

HSV

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Caused by allergen or skin irritant
Signs and symptoms
Skin irritated, inflamed, and pruritic
Vesicles and bullae may be present

Contact Dermatitis

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fluid-filled sacs or lesions that appear when fluid is trapped under a thin layer of your skin

bullae

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Drying agent used on contact dermatitis

Domeboro

Nursing Care for Contact Dermatitis

Domeboro Cool baths Topical Hydrocortisone Avoid Trigger

Chronic - idiopathic Signs and symptoms Red, raised rash that is pruritic and painful Rash in infants usually presents on head, face, creases of arms and legs

Atopic Dermatitis

Nursing Care for Atopic Dermatitis

Prevent secondary infection | Provide good hygeine

Fungal infection to the scalp (“cradle cap”)

Seborrheic Dermatitis

S&S of Seborrheic Dermatitis

Red to pink patches with loose yellow greasy scaling

Nursing Care for Seborrheic Dermatitis

Use antifungal therapy or topical corticosteroids | Selenium shampoo with scrubbing

Manifestation of an allergic response

cutaneous skin reactions

exanthema; type of cutaneous skin reaction

eruption

urticarial; type of cutaneous skin reaction

itching

4 types of cutaneous skin reactions

types-exanthema (eruption), urticarial (itching), blistering (swelling), or pustular The allergic reaction can be mild or severe

Nursing Care for Cutaneous skin reactions

Assess for facial swelling (especially lips and tongue) Educate about removing and avoiding allergen Antihistamines and topical corticosteroids

Triggered by medications Signs and symptoms Begins with nonspecific upper respiratory infection Bullae often appear in a target-like pattern Shedding of skin

Stevens Johnson Syndrome (Erythema Multiforme)

Nursing Care of Stevens Johnson Syndrome (Erythema Multiforme)

Eliminate the causative agent and treat skin lesions Use an air/fluid-filled bed, nutritional support, IV fluids, and pain management Antibiotics may be necessary

Signs and symptoms | Infest the body but primarily choose areas that have longer hair: nape of neck and behind the ears

Lice (Pediculosis)

Nursing Care

Visually inspect | EDUCATION! To prevent further spread and effective elimination

Signs and symptoms Rash is red streaked and appears linear from the burrowing Intense itching especially at night

Mite Infestation (Scabies)

Medication used for MIte Infestations (Scabies)

Scabacide (permethrin)

Nursing Care for Scabies

Use scabacide (permethrin) Give warm bath and apply cream or lotion (repeat in 1 week Family needs treated

The third leading cause of death in children

BURNS

Between the ages of 1 and 4 who is more likely to get burned, girls or boys

boys twice as likely as girls

Average age of pediatric burn patient is how old?

32months

Most common type of burn

Thermal

Types of Thermal burns:

Flame-ignition of combustible material (fireworks) Flash-explosions (fuels) Scald-hot liquid spills Contact-hot object

Types of Burns:

Thermal Chemical Electrical Radiation

First degree burns are _______.

Superficial

Secondary Burns effect what part of the skin

superficial partial thickness or deep partial thickness

Third degree burns effect what part of the skin

full thickness

TBSA - Calculations rule of 9s ADULT

``` Adult head - 9% arms - 9%each trunk - 18% legs - 18%each groin - 1% ```

TBSA - Calculations rule of 9s INFANT

``` head - 18% arms - 9%each trunk - 18% front, back legs - 14%each groin - 1% ```

Fluid Resuscitation

IV fluids—lactated Ringer’s solution | Monitor urine output – should be 1-2mL/kg/hr

Formula for Urine Output

1-2mL/kg/hr

Parkland Formula

4mL of IVF X kg X %TBSA give 1/2 over first 8hr from burn give 1/2 over the next 16hrs

Caloric Requirement for a patient with a burn covering >30% of body

2000-2200 calories/day

When is enteral feeding initiated after burn and at what type of feeding

within 6hrs of burn; 2g/kg of protein

What type of pain medications are used for burns

morphine or fentanyl

what type of anxiety medications are used for burns

versed

nonpharmalogical intervention for burns

distraction

Is PTSD associated with burns?

yes

Wound care for burns

Initially decontaminate wound Debride wound (tub or enzyme collagenase) Clean wound Apply transparent occlusive dressings so the wound can be easily assessed for infection

Types of temporary skin replacement

Biobrane™, Transcyte™

Types of permanent skin replacement

Xenograft, cadaver skin (allograft) Integra™, Apligraf™ Cultured epithelial autograft (CEA), autografting

A graft of tissue obtained from a donor of the same species as, but with a different genetic make-up from, the recipient, human to human

allograft

The six "C's" of nursing care for minor burns

``` Clothing-remove Cooling – cool water, no ice Cleaning – soap and water Chemoprophylaxis - bacitracin Covering - gauze Comforting ```