Transcript Renal Disorders

Skin Disorders
Marlene Meador RN MSN
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
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
Impetigo
http://www.emedicine.com/emerg/topic283.htm
Impetigo became infected
 Hemolytic

Strept 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 or
cooties!)


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
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 replace (2-3 weeks)
Care:

Fresh laundered linen and underclothing
should be used.
 Contacts should be reduced until treatment
is completed.
Acne
http://www.pathology.iupui.edu/drhood/acne.html
ACNE
Assessment

Closed lesions

Open lesions

Inflamed lesions
Medication Therapy:

Topical

Oral
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
Thank you,
let me know if you have any
questions regarding my
lectures.
>^,,^<