Peds 28-32

• —Narrowing of the distal end of the foreskin (prepuce) covering the head of the penis
• —Normal from birth until the age of 3
• May interfere with urination
• Circumcision to cure

• Hypospadias: Urinary meatus is on the undersurface of the penis
• Epispadias: Urinary meatus is on the upper surface of the penis
• Do not circumcise
• Surgery between 6 - 18 months
• Catheter 7-14 days post, pain mgmt, family teaching

• —Bladder is opened & exposed
• —Urine leaks & excoriates surrounding skin

• Surgery, antibiotics
• Position on back or side

• Urethritis: Infection of the urethra
• Cystitis: Infection of the bladder
• Pyelonephlitis: Infection of the kidney & renal pelvis

• Caused by alkaline urine, vesicoureteral reflux (urine backs up into ureters)
• Frequent UTI - suspect sexual abuse

• Abrupt & severe
• High fever
• Febrile seizures
• Pallor
• Anorexia
• Vomiting
• Diarrhea
• Frequent urination
• Foul smelling urine
• Flank pain
• Abdominal tenderness

• Sulfonamides
• Amipcillin/Rocefin
• Increase fluids
• I&O
• Skin care
• Cranberry juice
• No tubs

• Unknown cause - lasts 18 months
• albuminuria, hypoalbuminemia, edema, anasarca, high blood cholesterol, hematuria
• Boys 2-7
• Slow onset
• Edema, resp distress, irritable, anorexia, diarrhea, acites, low resistance to infection
• Steroids, I&O, daily weight, skin care, semi-fowlers, measure abdomen, no salt, increase protein

• Allergic reaction to group A beta-hemolytic streptococcus (1-3 weeks post strep infection)
• glomerulus inflamed/blocked
• Boys 3-7
• Hematuria, edema, fever, HA, malaise, HTN, smoke colored urine. oliguria (restrict potassium)
• Anti-infectives

• Grows within the renal capsule
• constipation, vomiting, abdominal distention, dyspnea, weight loss, pallor, anemia
• Do not palpate abdomen
• Nephrectomy, chemo/radiation

• Undescended Testes
• Increased incidence of testicular cancer, testicular torsion & decreased fertility or sterility
• HCG or surgery

—Water/edema accumulates in the membrane that surrounds the testes (swells)

—Treatment involves aspirating fluid out of the sac & part of the sac is removed

• —Involuntary urination beyond when control of urination is acquired
• psychological or physical
• physical work up to rule out physical cause

• žA discolored spot that is even with the skins surface
• Example: Freckles

• žA circumscribed, solid elevation of the skin
• Examples: Elevated mole, warts

• A small circumscribed elevation of the skin containing fluid
• Example: Cold sore

• A small, circumscribed elevation of the skin containing purulent matter
• Example: Infected pimple

• Blood, pus or serum that has dried on the surface of the skin after the injury
• Examples: Scab,eczema

• A circumscribed, slightly reddened papule or irregular plaque of edema of the skin, usually accompanied by intense itching
• Examples: Insect bites, hives

Purplish patch caused by extravasation (leaking) of blood into the skin; like petechiae but >3 mm diameter

Redness

Stork bite

• Small reddened vascular lesions common in newborns on the eyelids, forehead & back of neck
• Will fade & disappear

• Nevus Flammeus
• dilated dermal capillaries
• deep purple to pink flat & clearly demarcated lesions
• darkens with age
• laser therapy to treat

Strawberry Mark

Miliaria

• Seborrheic Dermatitis
• Accumulation of secretions from oil glands & cellular debris

• Thick, yellow, oily, adherent & crustlike scales form on the scalp & forehead
• Caused by insufficient hygiene
• Shampoo, baby oil

• Caused by prolonged exposure to urine, feces, detergents, chemicals, food changes
• Red skin, scales, blisters, ulcerations
• Change diapers often, no fabric softeners, loose diapers, air out

• žInflammation of the skin
• Common up until the age of 2 years
• Heredity, allergic reactions
• Cheecks --> arms, legs, trunk
• red papules, vesicles
• pruritis
• Can become infected
• ID allergen, oatmeal baths, no vaccines, steroids, antihistimines

• umbilicus & circumcision site
• pustules
• Contact isolation, antibiotics, handwashing

• žSuperficial skin infection, usually caused by staphylococci in the newborn & by group A beta-hemolytic streptococci in the older child
• Easily spread

• Red papules, vesicles, pustules surrounded by a reddened area (nose/mouth)
• Vesicles break & area weeps

Contact isolation, antibiotics, cleanse lesions 4 times a day, topical antibiotics, prevent scratching

• Ringworm
• capitus: scalp
• corpitus: body
• pedis: feet
• cruris: groin
• antifungals, avoid sun

• Lice
• capitus: head
• corporis: body
• pubis: pubic
• pruritis, nits
• RID, NIX, Kwell, fine tooth comb, treat family

• žThermal: Fire, scalding
• žChemical: Corrosive substance
• žElectrical: Electricity
• žRadiation: Exposure to radiation, the most common type being sunburn
• Airway, hypovolemic shock
• IV fluids