Child Needing Nursing Care II PDF

2/15/2024 The Child Needing Nursing Care II NP03L009 ELO C · Version 2.0 The Child with a Skin Condition Introduction to Maternity and Pediatric Nursing, 8th ed., pp. 699-718 1 TERMINAL LEARNING OBJECTIVE Determine nursing care required for a pediatric patient. 2...

2/15/2024 The Child Needing Nursing Care II NP03L009 ELO C · Version 2.0 The Child with a Skin Condition Introduction to Maternity and Pediatric Nursing, 8th ed., pp. 699-718 1 TERMINAL LEARNING OBJECTIVE Determine nursing care required for a pediatric patient. 2 ENABLING LEARNING OBJECTIVE Describe care of the pediatric patient with a skin disorder. 3 1  2/15/2024 SKIN DEVELOPMENT AND FUNCTIONS FUNCTION PROTECTION 1ST LINE OF DEFENSE REGULATE TEMPERATURE RECEIVE STIMULI STRUCTURES HAIR SKIN FINGERNAILS TOENAILS COMPOSITION 2 LAYERS EPIDERMIS DERMIS 4 SKIN DISORDERS AND VARIATIONS 5 SKIN Texture Color pH Moisture 6 2  2/15/2024 HAIR Inspection Color Texture Quality Distribution Elasticity 7 CHECK ON LEARNING Name the differences between the skin of a child and that of an adult. 8 CONGENITAL LESIONS: STRAWBERRY NEVUS Harmless Disappears without treatment Flat Raised Dark red, elevated, sharply demarcated 9 3  2/15/2024 CONGENITAL LESIONS: PORT-WINE NEVUS Flat , sharply demarcated and purple to pink Darken as child gets older 10 SKIN MANIFESTATIONS OF ILLNESS 11 Café au lait Associated with Neurofibromatosis Tuberous sclerosis 12 4  2/15/2024 Hypopigmented Macules Associated with Tuberous sclerosis 13 Butterfly Rash Associated with Photosensitive Systemic Lupus Erythematosus 14 Scaling Skin Eruption Associated with Zinc Deficiency in Infants Diarrhea Failure to Thrive 15 5  2/15/2024 Vascular Birthmarks Resemble a bruise Changes in appearance Around the Chin are associated with airway problems Appearing around the lumbar region may be associated with spinal problems Treated with topical timolol maleate, an alternative to oral propranolol 16 CHECK ON LEARNING Name the two congenital lesions seen in the pediatric patient. 17 CHECK ON LEARNING Describe the lesion that is associated with a Strawberry Nevus. 18 6  2/15/2024 SKIN INFECTIONS 19 Miliaria Excessive body heat Blocked or inflamed sweat glands Tiny pinhead-sized, reddened papules with occasional clear vesicles Pruritus 20 Intertrigo Chafing Folds of the skin Prevention Keep clean and dry Expose area to air and light Lead to secondary infections Zinc Oxide Remove with mineral oil 21 7  2/15/2024 Seborrheic Dermatitis Inflammation of the skin involving the sebaceous glands Thick, yellow, oily, adherent, crust like scales Skin beneath may be red Secondary bacterial infection Commonly known as: Cradle cap Resembles Eczema Treatment: Nonmedicated Shampoo apply oil before shampooing Rinse well Soft Brush 2% Ketoconazole 22 Diaper Dermatitis Diaper Rash Increased pH of skin Secondary Candida albicans infection Prevention: Frequent diaper change Clean with warm water Non-alcohol wipe OTC ointments 23 Acne Vulgaris Inflammation: Sebaceous Gland Hair Follicles Lesions: Comedones Papules nodulocystic growths Treatment: Hygiene Medications 24 8  2/15/2024 Herpes Simplex Type 1 Viral Vesicles and crusts form Spread by Direct Contact Serious in Newborns and Immunocompromised Treatment: Topical acyclovir 25 Infantile Eczema Atopic Dermatitis Local vasodilation Lichenification Triad: Eczema, asthma, and hay fever Increased Eosinophiles and IgE Allergies Treatment Hydrate Lubricate 26 NURSING IMPLICATIONS Assess coping skills Control itching Apply ointments Keep fingernails short Avoid wools and stuffed animals Use mild soaps with no fragrances Teach Hygiene 27 9  2/15/2024 CHECK ON LEARNING What methods can the nurse teach the family of a child with seborrheic dermatitis to soften and remove the scales? 28 CHECK ON LEARNING Which interventions can be used to treat diaper dermatitis? (Select all that apply.) a. Expose diaper area to air and light. b. Use non-alcohol baby wipes for cleaning. c. Apply ointments and vitamin A and D and lanolin. d. Cleanse with mild soap and water. e. Apply corticosteroid ointment. 29 CHECK ON LEARNING The principle of care in the treatment of infantile eczema includes which of the following? (Select all that apply.) a. Hydrate the skin, prevent infection, and relieve itching. b. Keep skin dry, and clean with mild soap. c. Use elbow restraints to prevent scratching and increase fluid intake. d. Dress warmly, bathe often with clear water, and administer antibiotics. 30 10  2/15/2024 STAPHYLOCOCCAL INFECTION Common bacteria found in dust and on the skin Primary infection in newborn Umbilicus Circumcision Small Pustules on newborn report immediately Treatment: Antibiotics Ointments 31 Scalded Skin Syndrome S. aureus Lesions Mild erythema Sandpaper texture Vesicles -> Rupture -> Peeling -> Bright red surface Abuse suspected IV antibiotics Strict Isolation Prevent secondary Infection 32 IMPETIGO Staphylococci Group A beta-hemolytic streptococci Contagious Bullous lesions are red papules Crust formation Treatment: Antibiotics Hygiene Ointments 33 11  2/15/2024 FUNGAL INFECTION Tinea = worm = ringworm The name denotes the part of the body involved Preference for: Stratum corneum’ Hair Nails Spread from: Person-to-Person Animal-to-Person 34 TINEA CAPITIS Ringworm of the Scalp Appearance Patches of Alopecia Hair may have loss of pigmentation Papules Pustules Red scales Diagnosis History Appearance Treatment Oral medication Shake well Take as long as ordered 35 TINEA CORPORIS Ringworm of skin Face Neck Arms Hands Appearance Oval Scaly Inflamed ring with clear center Treatment Topical 36 12  2/15/2024 TINEA PEDIS Athlete’s foot Foot Between toes Instep Soles Treatment Topical Ventilation Clean socks 37 TINEA CRURIS Jock Itch Thigh Groin Appearance Small raised and scaly lesion Treatment Topical Good Hygiene 38 PEDICULOSIS Lice Types Head (Capitis) Body (Corporis) Pubic area (Pubis) 39 13  2/15/2024 PEDICULOSIS: CAPITIS Parasite More common in girls Easy transmission Manifestations Itching Matted hair Treatment Special Shampoo Nits Wash 40 CHECK ON LEARNING If a child gets recurrent impetigo what should the nurse suspect? 41 TRACTION ALOPECIA Hairstyles Tight Braids Tight Ponytails Hair Twisting Gels and Pomades Block hair follicles Acne 42 14  2/15/2024 SCABIES Sarcoptes Scabies = Itch Mite Permethrin (Elimite) All family members nee to be treated Wash Linen 43 BURNS Types Thermal Chemical Electrical Radiation Burns near face require prompt assessment due to possible edema and restricted or loss of airway 44 BURNS Response Different than Adults More serious depth at lower temperatures Greater fluid, electrolyte and heat loss Shock and heart failure Increased protein and calorie needs Formation of large scars Infections Effects growth and development 45 15  2/15/2024 BURNS: CLASSIFICATION 46 BURNS: TREATMENT Electrical: Assess entry and exit wounds Monitor with electrocardiography, vital signs, and cardiac enzymes Emergency Care Stop Brush Off ABC’s Remove Cover Transport 47 BURNS: THERMAL Minor burns treated at home Do not disturb blisters Dressings as ordered Tetanus Vaccination Relieve Pain ROM Major Burns ABC’s Shock Eschar IV infusions Laboratory Wound Care Skin Grafts Biological Dressings Wound Vac Closure Post Healing Care 48 16  2/15/2024 CHECK ON LEARNING What are the differences in response for a child with burns? 49 SUMMARY A. Development and function of the skin. B. Lesions. C. Skin Infections D. Burns 50 17