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vesicle
- elevated fluid filled blister
- ex: chicken pox
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ecchymosis
black and blue marks
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pustules
- elevated, pus filled
- ex: impenitgo, acne
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wheal
- raised red irregular
- ex: allergic reaction to a misquito bite
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strawberry nevus
- dialted capillaries in the demal space and my not become apparent for a few weeks after birth.
- usually disappears without treatment by age 5
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treatment for stawberry nevus
- laxer treatment or excised of becomes ucerated
- easily get infected
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things to chart with leasions
- size
- color
- configuration
- itching
- location
- is it localized or all over
- raised or non raised
- temp?
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port - wine nevus
- present at birth and caused by dilated dermal capillaries
- flat lesions
- leasions darkens wiht age
- usually around the ear, back of head
- will darken with age
- don't mistaken for a birthmark
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miliaria
- prickley heat, a rash that is caused by excess body heat and moisture.
- tiny pinhead sized redden papules with occ. clear vesicles
- seen in the folds of the skin
-
treatment for miliaria
- removing of extra clothing, vathing skincare and frequent diaper changes
- all baby have it will go away with time and age
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intertrigo
dermatitis that occurs in the fold of the skin red, moist pathches located in the neck, inguinal, and gluteal folds.
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what triggers intertrigo
- urine
- feces
- heat
- moisture
- often seen with cutting teeth
-
treatment of intertigo
- PREVENTION IS THE KEY
- exposed area to air and light will help the healing process.
- treat secondary infections
- use antilfungal cream
- -not lamosil for under age of 13
- oral nystatin
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seborrheic
(cradle cap)
- inflammation of the skin that involves the sebaceous glands.
- sebaceous glands are clogged
- thick, yellow, oily, adherent crustlike scales on the scalp and forehead
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treatment for seborrheic
- daily shampooing of the head and apply oit to scalp.
- soft brush to remove loose particles
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diaper dermatitis
(diaper rash)
red mois maculopapular rash with poorly defined borders resulting from amonis, heat and moisture
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treatment for diaper dermatitis
- frequent diaper changes with exposure to air and light
- physicians will prescribe ointment is the rash persists or candidia infection
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acne vulgaris
inflammationof the sebaceous glands and hair follicles in the skin
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open comedones
blackheads
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closed comedones
whiteheads
-
treatment for acne vulgaris
- tetracycline, Vit A, benwyl peroxide gels or lotions, retin - A, erythromycin, doxycyclin, or mincycline
- accutane or ortho tri cyclen
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herpes simplex 1
- cold sore
- viral infection begins with tingling, itching, or burning on the lip followed by and eruption of vesicles`
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triggers for herpes 1
- stress
- sun
- menstruation
- fever
- illness
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treatment for herpes 1
- typcial acyclovir
- swish and swallow helps with pain
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infantile eczema
- inflammation of genetically hypersensitive skin. erythematous papules and vesicles with weeping, oozing, and crust on the face and body.
- child is sensitive to some type of allergen (food, dust, pollen, wool, soap, strong sunlight, insect bites, or vaccines)
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treatment for infantile eczema
- to releived intching and inflammation, hydrating skin, and prevent infections
- oatmeal, cornstarch, and baking soda, baths are helpful
- dove and neutrogena soap
- corticosteroids topically or systemic
- antibiotics for infections
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staphloccocal infeciton
skin infection occurs first then an abscess develops. If infection enters the bloodstream will develop septicemia with pneumonia, osteomylitis, or menigitis may result. primary site for invasion of bacteria is umbilicus of circusion
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treatment of staphloccocal infection
antibiotics and isolation
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impentigo
- caused by staph or strep
- moist, thin-roofed vesical
- vesicals rupture to a thick honey colored crust
- VERY CONTAGIOUS!!!!
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where does impetigo occur?
- around mouth
- nose
- neck
- axilla
- and groin
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treatment for impentigo
- systemic antibiotics
- frequent handwashing
- wash lesiond three to four times a day to remove crust with warm h2o
- apply topical ointments as perscribed
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when can are child with impetigo return to daycare
48 hours after abx treatment
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tenia capitis
- ringworm of the scalp
- often seen in school age kids
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s/s of tenia capitis
patches of hair loss followed by papules then pustules which progress into scales
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DX of tinea capitus
- history
- appearance
- wool's light test
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treatment for tinia capitis
- antifungal suspension (can take up to 8 - 12 weeks)
- avoid sun
- do not share hats, combs, or other personal items
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tinia corporis
ringworm of the skin
-
s/s of tinia corporis
- oval scaly inflamed ring with clear center
- seen on face, neck, arms, and hands
-
tx for tinia corporis
antifungal ointment bid for 2 - 4 weeks
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tinia pedis
- athletes foot (most common)
- found between the toes ont the instep or soles
-
tx for tinia pedis
- topical anti fungal, may need oral antibiotics
- clean and air dry foot prior to applying cream
-
tinea cruis (jock itch) treatment
tinactin or agtat liquid or powder
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pediculosis
lice infecstation
-
pediculosis capitis
head lice
-
pediculosis corporis
body lice
-
pediculosis pubis
crabs or pubic lice
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treatment for all 3 pediculosis
- aimed at ridding the parasite
- treaterthe excoriated skin
- prevent reinfestation
- if shampoo/soap is used more than directed it can cause neurological problems
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pediculosis capitis
- nits attach to the hair
- hatch within 3 - 4 days
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tx for pediculosis capitis
- RID or NIX shampoo
- retreat 7 - 10 days
- washe everything
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scabies
parsite infection caused by sarcaptes scabiei, itch mite
-
s/s of scabies
- intense itching especially at night
- vesiculopustular lesion
-
tx of scabies
- Elimite
- treat all family members
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leading cause of accidental death in the home for children the age of 1 to 4
burns
-
4 types of burns
- thermal - hot water or cofee
- chemical - cleaner
- electrical - can have cardiac arrest
- radiation - due to x-ray or radioactive substance
-
1st degree burn
- no break in the skin
- red, hot to touch and painful
-
tx for 1st degree burn
- cold water to stop burning process
- appy antimicrobial ointment (sylavadine)
-
2nd degree burn
partial thickness
- epidemis and most of dermis
- moist, pink or red skin with blister ( do not pop that creates open line to infection)
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tx for partial thickness 2nd degree burn
- coldwater
- strerile dressing or clean cloth
- seek medical attention
-
2nd degree burn
deep dermal
- deep in to demis
- can develop infection, trauma, or poor blood supply.
- red, tan, or dull white blisters seen
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tx for deep derma burn
- cold water
- cover with sterile dressing or cloth
- call 911
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3rd degree burn
- full thickness
- involves entire skin and all of its structures
- dull, brown, black or pearly white that does not blanch or refill
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tx for 3rd degee burn at home
- cold water
- cover with clean sheet or sterile dressing
- call 911
-
ER care for the burn
- stop burning process
- evaluate injury
- cover the burn
- transport to the hospital
-
care of the minor thermal burn
- clean the wound with sterile water
- aplly antimicrobial ointment with loose dressing
- teache warning signs of infection
- give Td and DTaP if needed
- pain meds
-
care of the major burn
- establish airway (give o2)
- endotracheal intubtion used when inadequate airway is present
- inadequat chest movement may require escharotomy.
- stat ABGs, CMP,CBC, and blood type and cross matching
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medication for major burn
- IV morephine
- demerol can cause seizures
- IV fluids with LR
-
s/s of inhaled flames
- cyanosis
- singed nose hairs
- charred lips
- stridor
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what is escharotomy
put to sleep and slice the chest wall to open skin and help allow rise and fall of the chest
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tx for major burns
- LR IV solutioin initiated
- albumin or plasma will be given with in 24 - 48 hours
- foley for hourly I and O
- NG tube
- Td or DTaP
- IV antibiotics
-
what type of technique used in cleaning the burn
strict sterile technique
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when are temp skin grafts used
acute stage of recoveryto prevent infeciton and reduce fluid loss
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homograft
graft from disease free cadavier or donor
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xenograft or heterograft
- tissue from disease free animal
- usually a pig
-
biological dressing
- come from the neonate foreskin
- forskin combined with nylon mesh and they freeze it
- can only be used if it has been less that 6 hours since burn occured
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nursing care for grafts
- protective isolation
- strict sterile technique
- report any signs of infection immediatly
- s/s of fluid overload
- accurat I&O, daily wt, food consumed
- ROM, turn q 2 hours,
- emotional support for child and parents
-
what vit do we give to promote healing and stimulate appetite?
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frost bite
chilblain is cold injury with erythema, vesicles and lesions that occur as result if vasoconstriction
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s/s of frostbite
- pale
- hard without sensation
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tx for frostbite
- warm moist O2
- warming blanket
- warm IV fluids
- accurate I&O
- frequent VS
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