This begins as a reddish macule, becomes vesicular, then ruptures leaving a superficial, moist erosion with the characteristic honey colored crust. It's very common in preschool aged children and it spreads like wildfire because children can't stop picking and scratching at it. It's not their fault though... staphylococcus is really to blame..
What is impetigo?
See Table 50.1 p. 1527
https://my.clevelandclinic.org/health/diseases/15134-impetigo
True or False?
For splinter removal in a child, parents can apply household (Elmer's type) glue in a thin layer over the foreign body, allow it to dry, and then peel it off and in doing so, remove the foreign body.
That's TRUE!
Ch. 50, p. 1534
Splinters, thorns, small cactus prickles, and other small slivers can be difficult to remove, especially with an uncooperative child.
Though reclusive, this spider will bite if annoyed or threatened. Bite symptoms include mild stinging at the time of the bite, with erythema that transforms into a bleb/blister, and can also involve systemic reactions such as N/V, joint pain & restlessness.
What is a brown recluse spider bite?
Ch. 50, p. 1535, Table 50.5
Redness & swelling of the skin is called _________ and usually occurs when extremities, usually the hands, are exposed to cold temperatures. It can cause edematous, reddish blue patches that itch & burn.
Though anyone can get this parasitic infestation, it is often a cause for ridicule in school-aged children. Hallmarks of this infestation are nits (eggs) and intense scalp pruritis.
What is pediculosis capitis? a/k/a head lice
Ch. 50, p. 1536
**See the Community & Home Health Considerations Box on p. 1538 for Focus on Preventing the Spread & Recurrence of Pediculosis
Well circumscribed gray or brown elevated firm papules, with a roughened texture. Usually appears on fingers, hands, face, and soles of feet.
What are warts?
See Table 50.2, p. 1529
Also known as verruca, and are caused by the Human Papilloma Virus (HPV)
List three things (animate or inanimate) that can carry the potent plant oil on poison ivy, sumac, or oak, and can result in symptoms in humans by transfer.
Ch. 50 p. 1529
Any of the following:
1. Pets' fur
2. Animals' saliva
3. Shoes
4. Tools
5. Toys
6. Golf balls
The number ONE drug for an anaphylactic reaction is
______________________.
You are the nurse on duty, and a person arrives with frostbite to both feet. You remember from your training that ice crystals have formed in the tissues, and that rapid rewarming is better than a slow thaw. The question is, should you massage the frostbitten area?
NO! YOU SHOULD NOT!
Massage can cause permanent damage to tissues due to the ice crystal formation.
https://www.mayoclinic.org/diseases-conditions/frostbite/symptoms-causes/syc-20372656
What are the three things nursing interventions are aimed at to combat diaper dermatitis?
2. pH
3. Fecal irritants
Also, the nurse should consider not only diaper dermatitis, but also a concurrent candida infection may be present also, requiring prescription nystatin ointment for relief.
Preceded by pruritis, crops of vesicles are confined to a dermatome. May be accompanied by constitutional symptoms. In the 70's, parents had parties to go ahead and get this now vaccinatable disease out of the way!
What is Varicella? Varicella is the virus that causes chicken pox and shingles.
See Table 50.2, p. 1529
How is poison ivy, oak, or sumac treated?
List two possible treatments.
Ch. 50, p. 1532, Any two of the following:
1. Calamine lotion (topical application)
2. Burrow solution
3. Aveeno baths
4. Topical corticosteroids or oral corticosteriods for severe reactions
5. Diphenhydramine as needed PRN for pruritis
How should a tick be removed from the skin?
Ch. 50, p. 1535 Table 50.5
Grasp it with tweezers as close as possible to the point of attachment and pull up straight & steady.
*Inspect skin after being outside in a wooded area.
This type of burn involves the epidermis and varying layers of the dermal layer. These wounds are extremely sensitive to temperature changes, exposure to air, and light touch. These burns may appear mottled, waxy, and may have blisters and edema formation.
What is a partial thickness burn?
Formerly known as a second degree burn.
Construct a nursing diagnosis for the adolescent dealing with acne vulgaris, relating to psychological impact of altered appearance.
Alteration in body image related to presence of deep, cystic lesions on face as evidenced by verbal complaints of disliking one's own appearance.
(Answers may vary)
Nurses should NOT underestimate the effect acne has on teens.
Ch. 50 pp. 1545-46
Caused by closely related filamentous fungi, this group of superficial infections live on the skin. They are designated by a Latin word meaning "bookworm", and then a reference to the part of the body currently infected.
What is tinea? Tinea are classified as dermatophytoses (fungal infections).
See Table 50.3 p. 1530
This is the name of the offending substance people come into contact with when they brush up against poison ivy, oak, or sumac.
What is urushiol?
Urushiol is an extremely potent plant oil that is highly irritating to skin.
Ch. 50, p. 1529
1. What two vaccinations must be considered with all animal bites?
2. Where are young children most likely to be bitten, especially by dogs?
1. Rabies & Tetanus
2. Upper extremities & face
Ch. 50, p. 1540
Teach children how to interact and respect animals or do not place animals and children in the same space.
Shot records of dogs are very important, and any break in the skin required tetanus consideration. Most dog bites will require antibiotics also.
*See Community & Home Health Considerations box on p. 1540
Rank the following in order of priority when it comes to burn care:
Temperature management (keeping the patient warm)
Airway
Stopping the burning process
Pain management
Fluid replacement
Burn dressings
Ranked in order of priority, 1-5:
1. Stopping the burning
2. Airway
3. Pain management *don't forget, YOU are an ADVOCATE for your patient. Ibuprofen is not a sufficient pain medication if a child has dumped a microwave-heated, scalding hot cup o' noodles down their chest and is blistered and screaming.
4. Temperature management
5. Fluid replacement
6. Burn dressings
Ch. 50 pp. 1551-52
Aside from hives, redness, pruritis, list 3 signs/ symptoms of an acute allergic reaction to a wasp/hornet/bee sting.
What are:
1. Generalized edema
2. N/V
3. Shortness of breath
Ch. 50, Table 50.5, p. 1534 under "Hymenopterans" manifestations
https://www.youtube.com/watch?v=cpO4ESK9Rwg
Dry vesicles with a burning sensation, normally located near mucocutaneous junctions. Vesicles will dry, forming a crust followed by exfoliation and spontaneous healing in 8-10 days.
What is Herpes Simplex Virus (HSV)?
See Table 50.2 p. 1529
HSV 1: Cold sore, fever blister
HSV 2: Genital
HSV 1 & 2 are same virus in different locations. There is NO cure for HSV, only antiviral treatment to lessen the intensity of symptoms.
What is the immediate treatment for exposure to a poisonous plant?
Ch. 50, p. 1533
1. Wash the area with cold water
2. Avoid harsh soaps or rubbing
3. All clothing/ bedding that has come into contact with the plant needs to be removed and washed in hot water
4. Prevention is key- look for and remove poisonous plants from the immediate environment
5. Remember, the rash cannot spread child to child; it takes direct contact with the potent plant oil to cause infection.
Caused by a pregnant female mite, this infestation occurs when the mite burrows into the skin depositing her eggs and feces. Intense pruritis results, along with maculopapular lesions in interdigital areas, popliteal folds, and the inguinal region.
What is scabies? Sarcoptes scabiei
Ch. 50, p. 1536
This type of skin graft is obtained from members of a different species, primarily porcine.
What is a xenograft?
Ch. 50 Box 50.7 p. 1554
Name the three phases of burn care, and the priority for each phase.
Ch. 50 pp. 1555-57
1. Acute phase: IV hydration and closely watching UOP
2. Management phase: Prevention of infection and other complications; pain control
3. Rehabilitative phase: Closing the burn, healing, preventing contractures as much as possible, psychological support