Integumentary Ch 53
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How much body weight does water makeup in the infant body vs adult
Infant - 4%
Adult - 70%
What skin considerations come in for each ethnic group:
B - palpate rashes, erythema is dark red/violet
W - less melanin, higher number of apocrine glands, risk for skin cancer
A - light pigment at birth, darkens by 2-3 month
H - pigmentation and varied hair
NA - pigmentation and varied hair
What are the 3 bacterial skin infections?
- Scalded Skin Syndrome
Honey colored crust, small red macules
- Keep nails short
- Soak lesions and remove crusts
- Bactroban (ointment)
- Keflex (PO)
- Strep. pyogenes
- Staph. aureus
Fever, chills, redness, warmth, pain
- Vancomycin (esp. with MRSA)
If an infant is less than 2 months old with cellulitis what is expected first?
Admittance to the hospital
Scaleded Skin Syndrome:
Skin peeling, blisters, fluid loss, infection
Oral or IV antibiotics
What are the two main fungal infections?
- Thrush (most common)
- Rash in diaper dermatitis
What should the nurse do for the mom if the baby has thrush?
- Evaluate her on breastfeeding
- Make sure the mom is hygenically clean
- Give nystatin
***Just because the baby has thrush does not mean to stop breastfeeding
Alopecia, scalp scaling
- Antidandruff shampoo
- Treat all members of the household
When giving oral griseofulvan, what is the minimum amount of time to take it?
What foods are best to give with it?
Minimum of 8 weeks
Foods high in fat for best absorption
What are the 3 viral infectious diseases?
- Herpes Simplex Type I
- Fifth Disease
Herpes Simplex Type I:
Small, painful vesicles with yellow exudate that last 2-3 weeks
Viral cultures (gold standard)
What are the main nursing teachings when is comes to managing herpes simplex type I?
- Good handwashing!
- No scratching
- Oral fluids
- Educate family on meds
Freeze with liquid nitrogen
Salicylic and lactic acid
"Slapped cheek rash on face"
Anemia associated sickle cell disease
What are the two main infestations?
Pediculus humanus capitis
- Human to human
- Contact with personal items
- Adult louse can live 48 hours from human host
- Eggs can hatch in 7-10 days
- Nix or RID shampoos
- Remove eggs with fine tooth comb
When can a child use Nix or RID in the treatment of lice?
After the age of 2
At risk for
Secondary bacterial infection
- Permethrin cream on ALL skin for 8-14 hours
- Treat everyone in household
What are the main chronic skin conditions?
- Diaper Dermatitis
- Seborrheic Dermatitis
- Contact Dermatitis
Weeping vesicles that crust over
Coal tar prep and medicated baths
Steroids and antihistamines
What treatments do you want to avoid with eczema?
- Baby wipes
- Problem foods
- Fluid filled vesicles
Wash with soap
Passive vs Active prophylaxis of rabies?
P - Vaccine that is take on days 1, 3, 7, 14, 28
A - Immune globulin given IM in or near wound
What are the steps of treating an insect bite?
- Remove stinger
- Use cool, wet compresses
- Give benadryl and acetaminophen
Babies of dark skinned cultures are typically born with this type of birthmark
What skin condition comes from dilated capillaries?
Port wine stain
What kind of dressing is used for wounds primarily?
(NOT wet and NOT dry)
What measures are used to prevent skin breakdown?
- Assess risk with Braden
- Float heels
- Use lift sheet
- Do not elevate HOB beyond 30 degrees
What is the biggest risk when it comes to burns?
First 48 hours
Shock from fluid loss
What is the best way to recover from burns, nutrition-wise?
- High protein diet
- Increase vitamin A and C
- 2-3 times more calories
Why do burn victims need to maintain physical mobility?
Because they will have contractures
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