Nursing Care of the Child: Contact Dermatitis

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Questions and Answers

Which of the following treatments for contact dermatitis is aimed specifically at relieving itching?

Antihistamines (correct)

Soothing oatmeal baths

Gentle cleansing of lesions

Corticosteroids

What percentage of children is expected to develop atopic dermatitis by the age of 5?

90% (correct)

50%

25%

75%

Which of the following statements about contact dermatitis is correct?

It always requires antibiotic treatment.

This condition can result from numerous allergens including latex and nickel. (correct)

Rashes typically require occlusion to promote healing.

It is a systemic response to allergens.

What is a common characteristic of atopic dermatitis in children?

Chronic inflammation with dry skin. Signup and view all the answers

Which treatment for contact dermatitis would likely be least beneficial for managing inflammation?

Caladryl® lotion Signup and view all the answers

What is the primary distinction between food allergies and intolerances?

Allergies result from an immune response, while intolerances are nonimmunologic. Signup and view all the answers

Which of the following substances is most commonly associated with IgE-mediated allergic reactions?

Milk Signup and view all the answers

What characterizes a biphasic anaphylaxis response?

Symptoms recur after an initial period of improvement. Signup and view all the answers

Which of the following is NOT a symptom of anaphylaxis syndrome?

Localized swelling and itching Signup and view all the answers

What is the role of histamine in an IgE-mediated allergic reaction?

It induces vasodilation leading to erythema and edema. Signup and view all the answers

What is the maximum dose of epinephrine recommended for the treatment of anaphylaxis?

0.3 mg Signup and view all the answers

Which treatment should be administered if shock persists in a patient experiencing anaphylaxis?

Diphenhydramine 1.0 mg/kg Signup and view all the answers

In the context of treating anaphylaxis, which intervention is indicated to provide ventilation if necessary?

Establish a patent airway and intubate Signup and view all the answers

What percentage of hospitalizations in children is attributed to diarrhea?

20% Signup and view all the answers

What role does intravenous fluid play in the treatment of anaphylaxis?

To treat hypotension Signup and view all the answers

What is the primary use of albuterol in the management of anaphylaxis?

To relieve bronchospasm Signup and view all the answers

What is the primary mode of transmission for Shigella infections?

Contaminated water and food Signup and view all the answers

Which of the following symptoms is NOT typically associated with a Salmonella infection?

Chronic cough Signup and view all the answers

What is the recommended antibiotic treatment for severe cases of Shigella infection?

Aminoglycosides or doxycycline Signup and view all the answers

How long after Salmonella infection do symptoms typically begin to appear?

12-72 hours Signup and view all the answers

What is a potential serious complication of Salmonella infection?

Life-threatening sepsis Signup and view all the answers

What is the treatment duration for TMP-SMZ in cases of Shigella infection?

7-10 days Signup and view all the answers

In which population is antibiotic prophylaxis usually contraindicated for Salmonella infections?

Children Signup and view all the answers

What is the approximate number of Salmonella infections in the United States annually?

4 million Signup and view all the answers

What distinguishes hypovolemia from dehydration?

Dehydration affects electrolyte concentrations. Signup and view all the answers

In pediatric fluid deficit management, what is the recommended replacement schedule?

Replace a quarter of the deficit in the first hour and the remainder over three hours. Signup and view all the answers

Which of the following is typically not a cause of hypervolemia?

Severe dehydration. Signup and view all the answers

What is the appropriate fluid replacement ratio for blood loss in infants and neonates?

3 mL lactated Ringer's for every 1 mL blood loss. Signup and view all the answers

What can lead to a significant increase in serum sodium levels?

Dehydration. Signup and view all the answers

Which symptom is most commonly associated with Crohn's disease?

Diarrhea with rectal hemorrhage Signup and view all the answers

What is a characteristic feature of the inflammation seen in appendicitis?

Transmural and focal with ulcerations Signup and view all the answers

What is the primary location of inflammation in Crohn's disease?

Cecum and terminal ileum Signup and view all the answers

Which of the following is NOT a common sign of fluid volume deficit?

Increased urine output Signup and view all the answers

Which treatment is NOT commonly used for Crohn's disease?

Antiparasitic drugs Signup and view all the answers

What primary compartment of body fluid comprises about 20-30% of total body fluid?

Extracellular fluid Signup and view all the answers

Which statement about the symptoms of strongylodiasis is correct?

Weight loss and diarrhea are common Signup and view all the answers

What complication may arise from the inflammation in Crohn's disease?

Intestinal perforation Signup and view all the answers

Which of the following is a possible late symptom of advanced Crohn's disease?

Fistula formation Signup and view all the answers

How does body fluid primarily move between compartments?

Via diffusion and osmosis Signup and view all the answers

Which treatment is considered contraindicated in the management of certain conditions due to its potential to increase toxin release?

Oral antibiotics Signup and view all the answers

What percentage of individuals with chronic renal problems may develop lifelong complications following certain medical conditions?

50-60% Signup and view all the answers

Which of the following symptoms may indicate celiac disease in children after initiating a solid food diet?

Chronic diarrhea Signup and view all the answers

What is the primary component that children with celiac disease must avoid to prevent intestinal damage?

Gluten Signup and view all the answers

Which vitamin deficiencies are commonly associated with celiac disease?

Folate and B12 Signup and view all the answers

What condition is characterized by a deficiency of intestinal lactase leading to discomfort after consuming dairy products?

Lactose intolerance Signup and view all the answers

In which population is screening for celiac disease particularly recommended due to the increased prevalence of the condition?

Infants with trisomy 21 Signup and view all the answers

Which treatment option is utilized to remove antibodies from the blood in some cases of severe complications?

Plasmapheresis Signup and view all the answers

Which symptom is least likely associated with celiac disease?

Increased energy levels Signup and view all the answers

What dietary adjustment is recommended for individuals suffering from lactose intolerance?

Dairy-free diet Signup and view all the answers

Study Notes

Contact Dermatitis

Localized skin response to allergens resulting in a rash, blisters, or itching.
Common allergens: poison oak, poison ivy, latex, nickel, and preservatives.
Treatment methods include identifying the allergen, corticosteroids, soothing baths, and antihistamines.
Lesions should be gently cleansed and observed for secondary infections.
Open rashes are encouraged to dry, with avoidance of allergens to prevent recurrence.

Atopic Dermatitis (Eczema)

Chronic inflammatory skin disorder affecting about 10% of children, often starting in infancy.
Associated with dry skin (xerosis) and allergies.
Forms include infantile and childhood eczema, often leading to skin barrier dysfunction.

Adverse Food Reactions

Divided into allergies (immune response) and intolerances (non-immune).
Common allergens include cow's milk, peanuts, tree nuts, eggs, soya, wheat, fish, and shellfish.
Symptoms range from mild (swelling, itching) to severe (anaphylaxis) that may involve life-threatening reactions.

Anaphylaxis Syndrome

Acute systemic response to allergens mediated by IgE or non-IgE mechanisms.
IgE-mediated reactions typically worsen with repeated exposure.
Symptoms include weakness, severe edema, hypotension, respiratory distress, and gastrointestinal upset.
Biphasic anaphylaxis can occur, requiring careful monitoring post-treatment.

Treatment for Anaphylaxis

Ensure airway patency; provide high-flow oxygen.
Administer epinephrine for immediate reaction, with additional medications as needed.
IV fluids for hypotension and monitor vital signs closely.

Diarrhea in Children

Common condition linked to various infections, accounting for 20% of pediatric hospitalizations.
Shigella infections characterized by bloody diarrhea and abdominal pain; typically resolves within 3-4 days.
Salmonella leads to numerous infections, primarily affecting young children; symptoms include bloody diarrhea, vomiting, and fever.

Celiac Disease

A gluten-sensitive enteropathy causing malabsorption due to villi damage in the intestines.
Screening is critical, especially for children with trisomy 21.
Symptoms include chronic diarrhea, vomiting, and failure to thrive; managed by a strict gluten-free diet.

Crohn's Disease

Inflammatory bowel disease that can cause complications like strictures and fistulas.
Symptoms include abdominal pain, chronic diarrhea, weight loss, and anemia.
Treatment options include corticosteroids, antibiotics, and immunomodulatory agents.

Hypovolemia and Dehydration

Dehydration leads to electrolyte imbalance, often caused by diarrhea or vomiting.
Indicators of dehydration include lethargy, tachycardia, and decreased urinary output.
Fluid requirements and replacement therapy need to be calculated according to age and weight.

Appendicitis

Inflammation of the appendix often misdiagnosed as abdominal pain.
Key symptoms: right lower quadrant pain, anorexia, and fever.
Treatment primarily involves antibiotics and surgical excision of the inflamed appendix.

Bacterial Meningitis

Caused by several organisms, with pathogens varying by age group.
Symptoms include fever, irritability, seizures, and signs of meningeal irritation.
Diagnosis involves lumbar puncture, and treatment includes IV antibiotics and supportive care.

Viral Meningitis

Most common CNS infection in children, often caused by enteroviruses.
Symptoms are similar to bacterial meningitis but generally milder.
Diagnosis through spinal fluid examination; recovery typically occurs within a few weeks.

Management of Meningitis

Supportive care for symptoms, monitoring of fluid intake, and management of increased intracranial pressure.
Long-term effects may require physical and occupational therapies for recovery.

Fluid Balance

Body fluid consists of intracellular and extracellular components, stabilizing by age three.
ECF and ICF are balanced, with signs of fluid deficit including increased thirst and lethargy.
Fluid changes should be monitored closely to maintain homeostasis.### Total Leukocyte Count by Age
Variation in total leukocyte count occurs with age.
Neonates have the highest total leukocyte count ranging from 9,000 to 30,000 cells/m3.
At one month, the count decreases to 5,000-19,500 cells/m3.
The count for children aged 1-3 years is 6,000-17,500 cells/m3.
For ages 8-13, the total count ranges from 4,500 to 13,500 cells/m3.
Adults (greater than 18 years) have a normal range of 4,500 to 11,000 cells/m3.

Differential White Blood Cell Count

Differential is the percentage representation of each type of white blood cell (WBC) from the total.
Myelocytes are not present (0%).
Neutrophils (bands) constitute 3-5% of the differential.
Mature neutrophils (segs) account for 54-62%.
Lymphocytes represent 25-33% of the differential count.
Monocytes make up 3-7%.
Eosinophils are 1-3% of total WBCs.
Basophils are minimally present at 0-0.75%.

Impacts of Leukemia

Leukemia involves uncontrolled proliferation of abnormal cells in the bone marrow, competing for nutrients.
The condition leads to a decrease in erythorcyte (RBC) production, resulting in anemia.
A reduction in neutrophil count raises the risk of infections.
Lower platelets contribute to a decreased clotting factor, causing increased bleeding risks.
Bone marrow invasion can weaken the periosteum, leading to a higher likelihood of physiological fractures.
Infiltration of organs such as the liver, spleen, and lymph glands can lead to their enlargement and fibrotic changes.

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Description

This quiz focuses on the nursing care aspects related to contact dermatitis in children. It covers common allergens and the identification and treatment options for localized allergic reactions. Enhance your understanding of the nursing approaches to managing skin conditions in pediatric care.