The child with skin disorders part #2

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Questions and Answers

What is the defining characteristic of a papule?

It is elevated, firm, and less than 1 cm in diameter. (correct)

It is irregularly shaped, noncircumscribed, and greater than 2 cm in diameter.

It is superficial, filled with purulent fluid, and less than 1 cm in diameter.

It is flat, nonpalpable, and greater than 1 cm in diameter.

Which lesion is characterized as elevated, circumscribed, superficial, and filled with serous fluid?

Cyst

Vesicle (correct)

Pustule

Papule

What distinguishes a nodule from a papule?

A nodule is less than 1 cm in diameter while a papule is 1 to 2 cm in diameter.

A nodule is deeper in the dermis and larger than a papule. (correct)

A nodule is firm and circumscribed while a papule is not.

A nodule is circular and filled with serous fluid.

Which statement about vesicles is accurate?

They are elevated, circumscribed, and less than 1 cm in diameter. Signup and view all the answers

What best describes a macule skin lesion?

Flat and nonpalpable, greater than 1 cm in diameter. Signup and view all the answers

How is a plaque distinguished from a papule?

Plaques are coalesced papules and greater than 1 cm in diameter. Signup and view all the answers

Which of the following best describes a pustule?

An elevated lesion filled with purulent fluid. Signup and view all the answers

In assessing a lesion that is less than 1 cm and palpable, which finding should the nurse expect?

It is smooth, firm, and well-circumscribed. Signup and view all the answers

What is the primary method of treatment for a child with warts?

Local destruction Signup and view all the answers

Herpes zoster has a specific affinity for which part of the nervous system?

Posterior root ganglia and posterior horn of the spinal cord Signup and view all the answers

Which medication is most likely included in the treatment plan for a child with herpes simplex virus?

Oral antiviral agent Signup and view all the answers

What is the causative agent of tinea capitis?

Fungus Signup and view all the answers

What is the expected treatment for a school-age child diagnosed with tinea capitis?

Administration of oral griseofulvin Signup and view all the answers

What should the nurse inform parents about the effects of scratching poison ivy lesions?

Scratching the lesions may lead to secondary infections. Signup and view all the answers

Which symptom is most commonly associated with scabies?

Pruritus Signup and view all the answers

What is usually the only symptom experienced by a child with pediculosis capitis?

Itching Signup and view all the answers

Which option is not an effective treatment for warts?

Corticosteroids Signup and view all the answers

In which location are lesions from herpes zoster primarily found?

Skin supplied by affected sensory nerves Signup and view all the answers

What is the primary role of topical antibiotics in treating viral infections?

They help prevent secondary bacterial infections. Signup and view all the answers

Which of the following conditions is characterized by intense itching due to hypersensitivity?

Scabies Signup and view all the answers

What is the primary treatment for poison ivy exposure that leads to dermatitis?

Corticosteroids to reduce inflammation Signup and view all the answers

What technique is commonly used for the destructive treatment of warts?

Surgical excision Signup and view all the answers

Which description accurately fits a plaque in dermatological terms?

An elevated, flat-topped, firm, rough papule greater than 1 cm Signup and view all the answers

What method is most recommended for cleansing a laceration in a school-age child?

Wash the wound thoroughly with mild soap and water Signup and view all the answers

How should a puncture wound be cleansed effectively?

Soak the foot in warm water and soap Signup and view all the answers

What is the primary nursing consideration when caring for a child with impetigo contagiosa?

To prevent the spread of infection through hand hygiene Signup and view all the answers

What can be expected to happen to the skin of a child after impetigo contagiosa has healed?

There will be no scarring Signup and view all the answers

Which organisms are typically responsible for causing cellulitis?

Streptococcus or Staphylococcus organisms Signup and view all the answers

In which condition is lymphangitis frequently observed?

Cellulitis Signup and view all the answers

What causes human warts in children?

Virus Signup and view all the answers

Which statement regarding patches is true?

Patches are nonpalpable and irregularly shaped, greater than 1 cm Signup and view all the answers

For which purpose is a Wood lamp primarily used?

To detect fluorescent materials in skin lesions Signup and view all the answers

Which form of treatment is contraindicated for lacerations due to its cytotoxic effects?

Hydrogen peroxide Signup and view all the answers

What is a key characteristic of a macule?

Flat and nonpalpable under 1 cm Signup and view all the answers

What is the effect of applying topical corticosteroids in cases of bacterial infections?

Not indicated in such infections Signup and view all the answers

What is a risk associated with improperly cleansing a puncture wound?

Secondary infection due to cytotoxic agents Signup and view all the answers

What is the first intervention the nurse should implement for a patient with frostbite?

Rapid rewarming of the fingers by placing in warm water Signup and view all the answers

Which characteristic best describes a full-thickness (third-degree) burn?

Destruction of all layers of skin evident with extension into subcutaneous tissue Signup and view all the answers

What should the nurse suspect for a child with burns on the lips and singed nasal hairs?

Inhalation injury Signup and view all the answers

What physiological response explains the edema formation occurring with burns?

Increased capillary permeability Signup and view all the answers

What is the most immediate threat to life in children with thermal injuries?

Shock Signup and view all the answers

What is the primary complication during the healing phase after a burn injury?

Infection Signup and view all the answers

What is the appropriate action when dealing with major burns?

Remove burned clothing and jewelry Signup and view all the answers

What treatment is recommended for a young child with a minor burn to the foot?

Cleanse the wound with mild soap and tepid water Signup and view all the answers

What type of burn is characterized by only affecting the epidermis?

First-degree burn Signup and view all the answers

Which statement about fourth-degree burns is correct?

They extend through all skin layers and involve underlying structures. Signup and view all the answers

What nursing intervention should be avoided in assessing a child with burn injuries?

Giving oral fluids immediately Signup and view all the answers

Which is a common assessment finding in a patient with an inhalation injury?

Stridor and hoarseness Signup and view all the answers

How long after a burn injury does maximal edema typically occur in larger burns?

18 to 24 hours Signup and view all the answers

What is a critical initial step to prevent infection in a burn patient?

Keep the burn covered with dry gauze Signup and view all the answers

What is one of the first signs of overwhelming sepsis in a child with burn injuries?

Disorientation Signup and view all the answers

Which strategy should be employed to effectively reduce stress during burn dressing changes for a child?

Give the child as many choices as possible. Signup and view all the answers

What is a critical consideration for a nurse when changing dressings on a child's burns?

Wash hands and forearms before and after dressing change. Signup and view all the answers

What sun exposure advice should a nurse provide for a family with a 4-month-old infant?

Keep the infant in total shade at all times. Signup and view all the answers

What is the recommended frequency for shampooing an infant's hair suffering from seborrheic dermatitis?

Daily with an antiseborrheic shampoo. Signup and view all the answers

Which option is a misconception regarding the application of topical medication for children with burns?

Topical medication can be spread with bare hands. Signup and view all the answers

When treating cradle cap in infants, which advice should be given to the parent?

Shampoo daily using a mild soap. Signup and view all the answers

What is the safest way to remove dressings that have adhered to burn wounds?

Soak them in tepid water or saline. Signup and view all the answers

Which of the following is the correct reassurance a nurse can give to a child undergoing a painful dressing change?

It might feel uncomfortable but is necessary. Signup and view all the answers

What should a nurse emphasize to prevent sun exposure in infants?

Keeping infants in the shade is optimal. Signup and view all the answers

Which method is essential for effectively managing pediculosis capitis?

Using an extra-fine tooth comb or tweezers to remove nits Signup and view all the answers

What is the initial treatment for a child who has been stung by a bee or wasp?

Carefully removing the stinger and applying cool compresses Signup and view all the answers

If a child is bitten by a black widow spider, what should the parent do?

Take the child to the emergency department Signup and view all the answers

When a child is stung by a scorpion, what is the most appropriate recommendation for the caregiver?

Keep the child in a resting position and go to the emergency department Signup and view all the answers

What organism is responsible for causing Rocky Mountain spotted fever?

Ticks Signup and view all the answers

Which statement accurately describes Lyme disease?

It is transmitted through tick bites. Signup and view all the answers

What is the likely cause of perianal inflammation with satellite lesions in a 12-month-old child?

Fungal infection caused by Candida albicans Signup and view all the answers

What is NOT a necessary precaution when treating a child for head lice?

Cutting the child's hair very short Signup and view all the answers

Which of the following is an incorrect practice when dealing with a bee sting injury?

Applying antibiotic ointment immediately Signup and view all the answers

What should not be done after a child is stung by a scorpion?

Applying warm compresses to the sting site Signup and view all the answers

Why is it important to recognize viable from nonviable nits when managing head lice?

It is not important to distinguish between them Signup and view all the answers

In teaching about Lyme disease prevention, which practice should be emphasized?

Wearing long pants and tucking them into socks Signup and view all the answers

What is an inappropriate initial response to a child experiencing intense pain from a scorpion sting?

Keeping the affected limb elevated Signup and view all the answers

What should parents be cautioned against when managing a child's head lice?

Cutting the child's hair very short Signup and view all the answers

What feature characterizes an infection caused by albicans?

A maculopapular rash with satellite lesions Signup and view all the answers

Which method is most effective for preventing diaper rash when a baby's skin is slightly red?

Exposing the skin to air Signup and view all the answers

What is the primary treatment approach for a child diagnosed with psoriasis?

Tar and exposure to sunlight Signup and view all the answers

What characteristic is true of atopic dermatitis in infants?

Linked to a hereditary tendency Signup and view all the answers

What is the main focus of nursing care for infants with atopic dermatitis?

Preventing infection Signup and view all the answers

Which instruction is important for a patient using tretinoin (Retin-A) for acne treatment?

Wait 20 to 30 minutes before application Signup and view all the answers

What indicates the correct situation for prescribing isotretinoin (Accutane) for acne in adolescents?

Other treatments have not been effective Signup and view all the answers

Which option represents a potential risk when treating diaper rash in infants?

Applying powder in the creases Signup and view all the answers

What is an effective preventive measure against diaper rash caused by urine and feces?

Choosing breathable diaper materials Signup and view all the answers

Which of the following statements about impetigo is accurate?

It presents with irregular margins and sharp outlines. Signup and view all the answers

Which description best fits the lesions caused by contact dermatitis, related to chemical irritation in an infant?

Localized primarily around the diaper area Signup and view all the answers

What is a potential complication associated with untreated atopic dermatitis in infants?

Increased risk of secondary infections Signup and view all the answers

What is a recommended intervention when managing an infant with eczema?

Take measures to minimize scratching Signup and view all the answers

What is the most effective initial treatment for a minor burn?

Hold the burned area under cool running water. Signup and view all the answers

What is the primary dietary objective for a child with major burns?

Promote healing without protein loss. Signup and view all the answers

Why are fentanyl and midazolam used before burn débridement?

To provide pain relief and sedation. Signup and view all the answers

What is the main purpose of administering nitrous oxide to a child with severe burns?

To provide anesthesia during painful procedures. Signup and view all the answers

What is the primary function of hydrotherapy in treating extensive burn wounds?

To débride the wounds effectively. Signup and view all the answers

What is the priority nursing goal during the débridement of partial-thickness burns?

Minimize the patient's pain during the procedure. Signup and view all the answers

When applying biologic dressings to partial-thickness burns, what is the key concern for the nurse?

Watch for signs of infection in the wound. Signup and view all the answers

What is NOT a recommended treatment for a minor burn?

Breaking blisters with a sterile needle. Signup and view all the answers

Why is a high-calorie diet critical for a burn patient?

To satisfy increased nutritional needs for healing. Signup and view all the answers

What is the immediate action a nurse should recommend for a child with a minor burn?

Hold the area under cool water to cool it. Signup and view all the answers

What would be an inappropriate response from a nurse to a parent regarding their child's high-protein diet for burn recovery?

It helps your child grow. Signup and view all the answers

What action is essential during the hydrotherapy of burn wounds?

Loosen sloughing tissue and medications. Signup and view all the answers

Which medication is primarily used for providing anesthesia to burn patients?

Nitrous oxide for anesthetic purposes. Signup and view all the answers

What should a nurse expect when managing a child's anxiety during burn débridement?

To utilize distraction techniques. Signup and view all the answers

Study Notes

Skin Lesions in Children: Clinical Findings and Management

Papule: Elevated, palpable, firm, circumscribed lesion less than 1 cm in diameter. May be various colors (brown, red, pink, tan, bluish red).
Plaque: Elevated, flat-topped, firm, rough, superficial papule greater than 1 cm in diameter, often coalesced papules.
Nodule: Elevated, 1-2 cm in diameter, firm, circumscribed, palpable, deeper in the dermis than a papule.
Vesicle: Elevated, circumscribed, superficial, less than 1 cm in diameter, filled with serous fluid.
Macule: Flat, nonpalpable, circumscribed, less than 1 cm in diameter. May be various colors (brown, red, purple, white, tan).
Patch: Flat, nonpalpable, irregularly shaped macule greater than 1 cm in diameter.
Scale: Heaped-up keratinized cells, flaky exfoliation, irregular, thick or thin, dry or oily, varied in size, typically silver white or tan.
Cyst: Elevated, circumscribed, palpable, encapsulated, filled with liquid or semisolid material.
Pustule: Elevated, superficial, similar to a vesicle but filled with purulent fluid.

Wound Cleansing in Children

Minor Lacerations/Puncture Wounds: Cleanse gently with mild soap and water or normal saline. Avoid hydrogen peroxide, povidone-iodine, or harsh solutions as they can damage healthy tissue.
Soaking: For puncture wounds or minor contamination, soaking the affected area in warm water and mild soap can help loosen debris.

Skin Infections in Children: Management

Impetigo Contagiosa: Prevent spread by thorough handwashing. Treat with topical or oral antibiotics. Carefully remove crusts with moist compresses; avoiding infection concerns.
Cellulitis: Commonly caused by Streptococcus or Staphylococcus organisms. Frequently involves lymphangitis (streaking). May require hospitalization for IV antibiotics.
Warts: Caused by human papillomavirus. Treated with local destruction methods (removal, electrocautery, cryotherapy, etc), not vaccination, antibiotics, or corticosteroids.
Herpes Simplex Virus (HSV): Treated with oral antiviral agents.

Fungal Infections in Children

Tinea Capitis (Ringworm): Caused by a fungus. Treat with oral griseofulvin.

Contact Dermatitis in Children

Poison Ivy: Avoid scratching, as this can spread the irritant and lead to secondary infection.

Other Skin Conditions in Children

Scabies: Characterized by intense itching (pruritus) as the primary symptom.
Pediculosis Capitis (Head Lice): Characterized by itching. Treat with pediculicide and manual removal of nits with fine-tooth comb or tweezers.
Bee/Wasp Stings: Apply cool compresses; remove stinger carefully.
Black Widow Spider Bites: Immediate transport to the emergency department for antivenin.
Scorpion Stings: Keep the child quiet and the injured area in a dependent position.
Rocky Mountain Spotted Fever: Caused by a tick bite.
Lyme Disease: Caused by a spirochete transmitted by ticks, early treatment with antibiotics helps prevent secondary infections.
Diaper Rash: Avoid frequent use of harsh wipes and keep the skin exposed to air between diaper changes.
Seborrheic Dermatitis (Cradle Cap): Treat with daily shampooing with mild soap or antiseborrheic shampoo. Use a fine-tooth comb to remove loosened crusts.

Burns in Children

Frostbite: Rapid rewarming in water at 37.8° to 42.2° C (100° to 108° F).
Thermal Burns: Remove burned clothing and jewelry promptly. Treat major burns with cool running water. Avoid ice application.
Inhalation Injuries: Suspect if there are facial burns or singed nasal hairs.
Burn Care: Address pain first using appropriate analgesics. High calorie, high protein diets are important for wound healing to avoid protein breakdown.
Wound Management: Cleanse with mild soap and tepid water. Cover with antimicrobial ointment.
Sepsis: Disorientation is an early warning sign.
Stress Reduction: Offer choices; explain procedures clearly.

Acne Treatment

Isotretinoin (Accutane): Used for severe cystic acne. Only prescribed when other therapies have failed. Pregnant or potentially pregnant adolescents should not be prescribed this medication.
Tretinoin (Retin-A): Apply sparingly, not until 20 to 30 minutes after washing. Avoid sun exposure as it can cause severe sunburn.

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Description

This quiz focuses on the clinical findings and management of various skin lesions in children, such as papules, plaques, nodules, vesicles, macules, patches, scales, and cysts. Participants will be tested on their knowledge of the characteristics and classifications of these lesions. Perfect for medical students and healthcare professionals.