Transcript Renal Disorders

Pediatric Skin Disorders
Revised Summer 2007
Compare skin differences
 Infant: skin not mature at birth
 Adolescence: sebaceous glands become
enlarged & active.
Skin Assessment
 Assess history
 Assess exposure
 Assess character
 Assess sensation
Atopic / Contact Dermatitis
 Atopic/Eczema
– Cause unknown
– Genetic family hx
– Develop asthma or
allergic rhinitis later
– Symptoms begin age 1
to 4 months
 Contact Dermatitisskin inflammation
from skin-to-irritiant
contact
– Soaps/detergents
– Clothing dyes
– Lotions, cosmetics
– Urine ammonia
Atopic dermatitis
 Prevalence increasing
 Some immune dysregulation
 3 stages: infancy, childhood, adult
 Secondary infections common
– Staph aureus most common
– Hyperpigmentation may occur
Assessment & Diagnosis
 Infants- Papulovesicular rash and scaly red
plaques
 Extremely pruitic and dry skin
 Childhood- increases with emotional upset,
sweating, irritating fabrics
 Other triggers- milk, eggs, wheat, soy,
peanuts, fish
Interventions & Nursing Care
 Prevent secondary infection- control
itching
 Moisturize skin
 Remove irritants
 Medication
 Parent teaching- long term
Diagnosis / Assessment
 Infancy
 Childhood
Tzanck test

Impetigo
http://www.emedicine.com/emerg/topic283.htm
Impetigo became infected
 Hemolytic Strep infection of the skin
 Incubation period is 2-5 days after contact
 Begins as a reddish macular rash,
commonly seen on face/extremities
 Progresses to papular and vesicular rash
that oozes and forms a moist, honey
colored crust. Pruritis of skin
 Common in 2-5 year age group
Therapeutic Management
 Apply moist soaks of Burrow’s solution
 Antibiotic therapy
 Patient education
Candiditis- Thrush
Overgrowth of Candida albicans
Acquired through delivery
Assessment
 Inspect mouth
 Assess for difficulty eating
 Assess diaper area
Therapeutic Interventions
 Medication
 Nursing Care
Dermatophytosis (Ringworm)
 Tinea Capitis
 Transmission:
– Person-to-person
– Animal-to-person
S&S:
 Scaly, circumscribed patches to patchy,
gray scaling areas of alopecia.
 Pruritic
 Generally asymptomatic, but severe, deep
inflammatory reaction may appear as
boggy, encrusted lesions (kerions)
http://www.ecureme.com/quicksearch_reference.asp
Diagnosis
 Potassium hydroxide examination
 Black Light
Medication Therapy
 Oral- systemic
 Topical
Patient Teaching
 transmitted by clothing, bedding, combs
and animals
 may take 1-3 months to heal completely,
even with treatment
 Child doesn't return to school until lesions
dry
Pediculosis Capitis (lice)

http://www.emedicine.com/emerg/topic409.htm
 a parasitic skin disorder caused by lice
 the lice lay eggs which look like white
flecks, attached firmly to base of the hair
shaft, causing intense pruritus
Diagnosis
 Direct identification of egg (nits)
 Direct identification of live insects
Pediculosis

Medication Therapy
 treatment: shampoos RID, NIX, Kwell(or
Lindane) shampoo: is applied to wet hair
to form a lather and rubbed in for at least
amount of time recommended, followed by
combing with a fine-tooth comb to remove
any remaining nits.
Patient Teaching
 Follow directions of pediculocide
shampoos
 Comb hair with fine-toothed comb to
remove nits
 Transmission, prevention, and eradication
of infestation
Scabies
http://www.nlm.nih.gov/medlineplus/scabies.html
Sarcoptes scabei mite. Females are 0.3 to 0.4 mm long and 0.25 to 0.35 mm
wide. Males are slightly more than half that size.
 a parasitic skin disorder (stratum corneumnot living tissue) caused by a female mite.
 The mite burrows into the skin depositing
eggs and fecal material; between fingers,
toes, palms, axillae
 pruritic & grayish-brown, thread-like lesion
http://www.aad.org/pamphlets_spanish/sarna.html
Scabies between thumb and index finger
On foot
Therapeutic Interventions
 transmitted by clothing, towels, close contact
 Diagnosis confirmed by demonstration from skin
scrapings.
 treatment: application of scabicide cream which
is left on for a specific number of hours (4 to
14)to kill mite
 rash and itch will continue until stratum corneum
is replaced (2-3 weeks)
Care:
 Fresh laundered linen and underclothing
should be used.
 Contacts should be reduced until treatment
is completed.
Acne
Assessment
 Closed lesions
 Open lesions
 Inflamed lesions
Medication Therapy:
 Topical
 Oral
Acne vulgaris treatment
Therapeutic Management
 Goal- to prevent scaring and promote
positive self image in the adolescent
 Individualized according to the severity of
the condition
 3 to 5 months required for optimal results
(4 to 6 weeks for initial improvement)
Nursing Implications
 Provide information regarding the
treatment regimen
 Provide support and promote positive self
image
 Provide accurate information on the length
of time required for effective treatment