Integumentary Dysfunction

Question 1

Skin lesions can be a result of what factors

Answer 1

*Contact with injurious agents
*Hereditary factors
*External factor that produces a reaction in the skin (allergens)
*Systemic disease in which lesions are a manifestation (measles)

Question 2

cause of diaper dermatitis

Answer 2

prolonged and repetitive contact with an irritant (Urine, feces, soaps, detergents, ointments, friction)

Question 3

diaper dermatitis primary location

Answer 3

convex surfaces or in folds

Question 4

nursing interventions for diaper dermatitis are aimed at altering what three factors

Answer 4

wetness, pH, and fecal irritants

Question 5

peak age of occurrence for diaper dermatitis

Answer 5

9 to 12 months of age, and the incidence is greater in bottle-fed infants than in breastfed infants.

Question 6

interventions to control diaper rash

Answer 6

*Keep Skin dry - use superabsorbent disposable diapers
*Expose skin to air
*Apply ointment (zinc oxide)
*Avoid over-washing skin - do not use perfumed soaps or commercial wipes

Question 7

seborrheic dermatitis

Answer 7

cradle cap

Question 8

what is seborrheic dermatitis (cradle cap)

Answer 8

*Chronic, recurrent, inflammatory reaction usually on the scalp
*Thick, adherent, yellowish, scaly, oily patches

Question 9

care for seborrheic dermatitis (cradle cap)

Answer 9

Shampoo is applied to the scalp and allowed to remain on the scalp until the crusts soften. Then the scalp is thoroughly rinsed.
A fine-tooth comb or a soft facial brush helps remove the loosened crusts from the strands of hair after shampooing.

Question 10

what is Atopic Dermatitis (Eczema)

Answer 10

Atopic dermatitis (AD) is a type of pruritic eczema that usually begins during infancy and is associated with an allergic contact dermatitis with a hereditary tendency (atopy)

Question 11

infant manifestation of AD (eczema)

Answer 11

*Usually begins at 2 to 6 months of age;
*Generally undergoes spontaneous remission by 3 years of age

Question 12

childhood manifestation of AD (eczema)

Answer 12

*occurs at 2 to 3 years of age

Question 13

preadolescent and adolescent manifestation of AD (eczema)

Answer 13

*Begins at about 12 years of age;
*May continue into the early adult years or indefinitely

Question 14

diagnosis for Atopic Dermatitis (Eczema)

Answer 14

*A combination of history, clinical manifestations, and in some cases, morphologic findings
*family history of eczema, asthma, food allergies, or allergic rhinitis

Question 15

cause of Atopic Dermatitis (Eczema)

Answer 15

*Unknown but appears to be related to abnormal function of the skin including alterations in perspiration, peripheral vascular function, and heat tolerance.

Question 16

Distribution of Lesions Infantile:

Answer 16

*Generalized, especially cheeks, scalp, trunk, and extensor surfaces of extremities

Question 17

Distribution of Lesions childhood:

Answer 17

*Flexural areas (pit of elbow or knee), wrists, ankles, and feet

Question 18

Distribution of Lesions *Preadolescent and adolescent:

Answer 18

*Face, sides of neck, hands, feet, face, and pit of elbow or knee (to a lesser extent)

Question 19

Appearance of Lesions infantile:

Answer 19

Erythema, vesicles, papules, weeping, oozing, crusting, scaling, often asymmetric

Question 20

Appearance of Lesions childhood:

Answer 20

Symmetric involvement with clusters of small erythematous or flesh-colored papules or minimally scaling patches.

Question 21

Appearance of Lesions Adolescent or Adult:

Answer 21

Same as childhood manifestations with dry, thick lesions (lichenified plaques) common. Papules may merge together.

Question 22

therapeutic management for AD (eczema)

Answer 22

*Hydrate the skin, relieve pruritus (tepid baths, emollient lotions)
*Antihistamines (Diphenhydramine (Benadryl))

Question 23

SE of Diphenhydramine (Benadryl)

Answer 23

Drowsiness, dizziness, fatigue, disturbed coordination
*Children: Nightmares, nervousness, and irritability are more likely to occur

Question 24

how to prevent flare ups or inflammation for AD (eczema)

Answer 24

*Keep nails cut short
*Topical steroids
*New topical immunomodulators available by prescription

Question 25

controlling secondary infection for AD (eczema)

Answer 25

Antibiotics - topical or oral

Question 26

Interprofessional Care of Atopic Dermatitis

Answer 26

*Hypoallergenic diet may be prescribed
*Emotional stress is increased during acute phases

Question 27

impetigo contagiosa manifestations

Answer 27

*Begins as a reddish macule à vesicular
*Ruptures easily
*Exudate dries to form heavy, honey-colored crusts
*Pruritus is common

Question 28

impetigo contagiosa is…

Answer 28

VERY CONTAGIOUS

Question 29

management of impetigo contagiosa

Answer 29

*Topical bactericidal ointment, mupirocin (Bactroban) or triple antibiotic ointment
*Oral or parenteral antibiotics for severe or extensive lesions (Penicillin is used)
*Vancomycin for lesions due to MRSA
*Tends to heal without scarring

Question 30

cellulitis manifestations

Answer 30

*Inflammation of the skin and subcutaneous tissues
*Intense redness, swelling, firm infiltration
*“Streaking” often seen
*Involvement of the reginal lymph nodes
*May progress to abscess formation

Question 31

systemic effects of cellulitis

Answer 31

fever and malaise

Question 32

management of cellulitis

Answer 32

*Oral or parenteral antibiotics
*Rest and immobilization of both affected area and the child
*Hospitalization may be required (of child with systemic symptoms)

Question 33

Pediculosis Capitis

Answer 33

Lice

Question 34

Pediculosis Capitis (Lice) manifestations

Answer 34

itching

Question 35

common sites of Pediculosis Capitis (Lice)

Answer 35

occipital area, behind the ears, nape of the neck

Question 36

louse

Answer 36

Lice; A blood-sucking organism
*Female lays eggs (nits) at night at the junction of the hair shaft and close to the skin - hatch in 7-10 days

Question 37

Pediculosis Capitis (Lice) management

Answer 37

*Application of pediculicides
(Permethrin 1% cream rinse (Nix))
-Second treatment 7-10 after first treatment
*Manual removal of nits
*Daily removal with a specialized comb

Question 38

education for lice

Answer 38

Lice do not fly or jump, can be transmitted from one person to another on personal item

Children are cautioned against sharing combs, hair ornaments, hats, caps, scarves, coats, or other items used on or near the hair