Fungal Skin infection

frequently transferred from mother

white patches that dont easily wipe off

Bacterial Skin Infections

Frequent lymphadenitis

strep-staph or H flu

Bacterial Skin Infections

Develops honey colored crust

and what is it caused by

Impetigo 

Staph is causative agent

Generalized, cheeks, scalp, trunk, extensor surfaces

Skin disorder

Erythema

Vesicles

Papules

Weeping

Intense itching

lichenification

secondary infections

hydrate skin

relieve pruritis

reduce flare-ups inflammation

prevent, control secondary infections

flakey, oily skin patches

occurs scalp, eyelids, external ears

nasolabial folds and inguinal area

Sharply demarcated edges

exposure to wet, soaps, diapers

Tx with topical antifungals

Tx with oral griseofulvin (weeks to months)

assess what?

Ringworm

liver and renal function

asymptomatic

HPV

tx with cryotherapy, curettage, laser, or caustic solutions

most common STD

HPV

linked to development of cervical cancer

intense Puritis-excoriations

interdigital, axillary-cubital, popliteal folds, inguinal areas

look for papules, burrows and vesicles

bortonella henselai 

gram neg bacterium

8 nursing interventions for skin rashes

avoid overheating

loose clothing

keep nails short

antipyretic medicine

avoid aspirin

push fluids

encourage rest

support parents

Body Surface Area

relatively larger, allows more fluid loss than adults

GI illness- vomiting/diarrhea

Febrile illness (temp rises)

Burns- skin integrity

Post op- NPO, anesthesia- upset stomach

kidney disease

Diabetes

Electrolyte deficit exceeds water deficit, 

plasma Na usually <130 meq/L

Shock may occur r/t movement of H20 from ECF to ICF

Shock is greatest threat d/t decreased circulating volume

Plasma Na 132-141

Water loss greater than electrolyte loss with plasma

Na>150 mEq/L

may cause seizure with fewer symtoms

most dangerous ICF to EC 

more neurologic disturbances

Dehydration

when compensatory mechanisms fail...

hypovolemia... renal impairment

tissue hypoxia

metabolic acidosis

BP drop... circulatory collapse

Dehydration

nursing interventions

push appropriate fluids

prevent contamination

teach family to monitor fluid intake and output - weigh diapers

provide ORT

monitor urine USG

From an increase in rate and depth of ventilation

(blow off too much CO2, reduces plasma CO2 and pH)

lowered plasma pH from process that reduce HCo3 concentration

(ketoacidosis, starvation, hypoxia, severe infection or trauma, vomiting diarrhea) 

Compensate by deep, rapid breathing

(kussmaul or air hunger)

hypovolemic-blood/fluid loss

distributive-anaphylaxis, sepsis

cardiogenic-after <3 surgery, CHF, dysrhythmia 

Ventilation-establish airway, give O2

fluid administration- restore blood or fluid volume a ordered

Cardiovascular support-vasopressors, Epinephrine

General support- keep child flat with legs above heart level, warm and calm

1 degree burn characteristics

example of 1st degree burn

minimal tissue damage

protective functions of skin intact

main symptom is pain

heals 3-6 days

example-sunburn

further into dermal layer

capillaries destroyed

some nerves destroyed

more swelling

depth determines degree of injury

damage through dermis

may involve muslces, bones

leathery, pale brown and black

nerves destroyed

changes i appearance over first several days

high risk for excessive fluid loss- hypovolemic shock

cardiac effects

renal effects

electrolyte imbalances

Group A-Beta hemolytic strep

fever, sore throat, vomiting, head ache

white to red strawbery tongue

beefy orapharynx

patches of exudate

fine, sandpaper pink rash

penicilliin-gold standard

isolate till medicated 24 hrs.

OM

peritonsillar abscess (emergency)

glomerulonephritis (immune activated affects kidneys)

polyarthritis (joints)

carditis (valves in heart)

direct contact/ droplet

indirect

Roseola transmission

febrile seizures

rare encephalitis 

fever and malaise

coryza, cough, conjunctivitis 

koplik spots

flat rash 3-4 days into illnes 

head down-confluent

Measles 

Rubeola

OM

pneumonia

encephalitis

laryngitis

lo-grade fever, cough, conjucivitis, lymphadenopathy

flat (maculopapular)reddish rash-gone in 3 days

moves from face down

most benign

teratogenic effect of fetus

slapped cheek rash on face

symmetric maculopapular rash on extremities

erythema infectiosum

(fifths disease)

isolation for erythema infectiousum

transmission

no isolation

direct contact

arthralgias (stiff, sore joints)

aplastic crisis if child is immunodeficient (low blood count)

fetal death if mother infected (not terotogenis)

fever, anorexia, malaise preceed

Pruritic rash

macule, papule, vesicle, crust

concentrated on trunk and face

secondary bacterial infections-sepsis

encephalitis

thrombocytopenia (low platelets)

parotid gland enlargement

earache common

tender to touch

orchitis (ball swelling)

Transmission of mumps

when communicable

direct contact of respiratory secretions

communicable at time of swelling

encephalitis

orchitis

sterility

meningitis

sensorineural deafness

starts as a URI for 1-2 weeks

paroxysmal coughing

rapid cough with thigh pitched crowing

thick mucous plugging of airways

vomiting with coughing

transmission of pertussis

period of communicability

direct contact or respiratory secretions

1-2 weeks before cough starts

pneumonia

atelectasis (collapsed part of lung)

hemorrhage 

hernia

prolapsed rectum

seizures

3 forms

infection damages only the nerves that control movement

paralysis

respiratory arrest

hypertension

causitive agent

cattarrhal- URI symptoms

organism passes through mucosal barrier

Meningitis

Epiglotiis

Sepsis

Pneumonia

Cellultis

Death 

Causitive agent Orthomyoviridae (type A&B)

catarrhal- abrupt onset of fever with URI symptoms

OM

asthma exacerbations

pneumonia

encephalitis

rye's syndrome (aspirin)

Guillain-Barre

caused by Epstein Barr virus