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N114 Integument
N114 - Integument dysfunction
| Question | Answer |
|---|---|
| What is a highly contagious, superficial bacterial skin infection characterized by local inflammation & infection? | Impetigo |
| How is impetigo contracted? | By a portal of entry, scratch or insect bite allows introduction of bacteria. |
| What bacteria can cause impetigo? | Staph or group A strep |
| What are the two forms of impetigo? | Impetigo contagiosa - crusted lesions & bullous impetigo - fragile bullae or fluid filled blister. |
| What are the clinical manifestations of impetigo? | Begins as small red macules and progress to small, thin roofed vesicles that rupture easily & expose weeping skin. Has a honey colored drainage. |
| What else can impetigo effect? | May cause regional lymphadenopathy. |
| Where do the lesions normally appear? | Most often appear on the face around the mouth and nose. Occasionally occur on back of knees and buttocks. |
| What treatment is used for impetigo? | Topical antibiotic therapy if only a few lesions are present. Keflex or Dynapen can be given orally if lesions are widespread and do not respond to topical treatment. |
| What nursing management is associated with impetigo? | Finish all antibiotics, use gentle soaking to remove crusts, keep nails cut short to prevent further infection, no sharing of towels or personal items, out of school for 24-48 hours after the start of antibiotics. |
| What is the clinical name for head lice? | Pediculosis Capitis. |
| How is head lice transmitted? | Head to head contact, sharing of hats, combs, bedding, & personal items. |
| What is the lifespan of a louse? | Females lay approx 4-10 eggs a day. Eggs are called nits. Nymphs emerge in 7-10 days and mature in 7-14 days. Life span is approx 30 days. |
| What are the symptoms of an infestation? | Persistent itching caused by crawling insect & saliva on skin. Most commonly located in the occipital area, behind the ears & nape of neck. |
| What is the preferred treatment for pedidulosis? | Nix will kill both the lice & nits with one applications. Other products Rid, A-200, Kwell, Scabene require retreatment after nymphs hatch. |
| What are some alternative treatments? | Listerine & Cetaphil |
| What causes scabies? | The scabies mite, Sarcoptes scabiei. |
| How is scabies transmitted? | Close person to person contact, fomite transfer may occur. |
| What happens after infection? | Incubation period is 2 to 6 weeks. Once on human skin, mites burrow into epidermis to deposit eggs & feces - travels in a linear fashion. |
| What is the major symptom of a scabies infection? | Inflammatory response occurs where the mites travel. Severe pruritis occurs usually at night. |
| How is scabies diagnosed? | A microscopic exam of scraping from papule. |
| What is the treatment for scabies? | 5% permethrine cream (Elimite) is preferred treatment. One application is usually sufficient. All household members should be treated. |
| What is atopic dermatitis? | Commonly know as eczema. |
| What causes eczema? | Does appear to be a relationship to allergies, family history of eczema, asthma. |
| What is the pathology of eczema? | It is thought to be an autoimmune disorder. |
| What are the symptoms of eczema? | Persistent pruritus and scratching. |
| What does an acute lesion look like? | Acute - pruritic erythematous papules, may have serous exudate & crusting. |
| What does an subacute lesion look like? | Subacute - papules are excoriated with fine scaling, mild linchenification may be present. |
| What is linchenfication? | Thickening of the skin |
| What does a chronic lesion look like? | Chronic - marked lichenfication is present. Fibrotic papules and hyper or hypopigmentation are present. |
| Where to the lesions occur? | Distribution varies by age. Infancy - primarily on face, scalp & extensor (outside) surfaces of extremities. By age 2 - lesions on the flexural surfaces of the body, antecubital, popliteal, wrists ankles & neck |
| What is the 1st goal to managing eczema? | Relieve pruritis - oral antihistamine, non-medical - cornstarch or oatmeal baths. |
| What is the 2nd goal to managing eczema? | Hydrate skin - moisturizing emollients - contain lipids - best used withing 3 minutes of bathing. |
| What is the 3rd goal to managing eczema? | Reduce inflammation - topical steroids, use least potent steroid that is effective |
| What is the 4th goal to managing eczema? | Prevent or control secondary infection - keep fingernails short, avoid irritants, use mild detergent, no wool clothing |
| What is the pathology of diaper dermatitis or diaper rash? | Skin breakdown occurs due to prolonged contact with physical & chemical irritants. Urine pH, stool consistency, frequency of urine & stool, type of diaper & friction. |
| What is the clinical symptoms of normal diaper rash? | Area is shiny red. In severe cases, vesicles, papules and scaling may occur. |
| How is candidal diaper dermatitis different? | Caused by overgrowth of Candida albicans. Site appears beefy read with satellite pustules. |
| How can diaper rash be prevented? | Frequent diaper changes. Use of barrier creams (desitin & butt paste). Avoid powder. |
| How is diaper rash treated? | Low dose steroid creams for severe cases. Candida infections require an antifungal agent like nystatin (Mycostatin). |
| What is seborrheic dermatitis? | Also known as cradle cap. |
| What can cause cradle cap? | Inflammatory changes thought to result from dysfunction of sebaceous glands & hormonal activity. May be caused by yeast overgrowth in adolescents. |
| What are the clinical manifestations of cradle cap? | Thick, adherent, whitish yellow, scaly, oily patches on scalp. |
| Where is cradle cap found? | Infants - mostly found on scalp. Adolescents - begins on scalp, may involve eyebrows, forehead, eyelids, external ear canals, inguinal region (groin). |
| What is the treatment for cradle cap in infants? | Daily washing of hair, let shampoo petroleum jelly, or mineral oil in place, then remove with a fine toothed comb. |
| What is the treatment for cradle cap in adolescents? | May use medicated shampoo containing sulfur or salicylic acid. Topical corticosteroid with or with out sulfur or salicylic acid may be used. |
| What causes acne (acne vulgaris)? | Has been associated with increased androgen & sebum production. |
| What other factors can contribute to acne? | Heat, oil-based cosmetics, menstrual cycle, steroid administration. Stress |
| What three factors are involved in the development of acne? | Excessive sebum production. Formation of comedones, either open (blackhead) or closed (whitehead). Overgrowth of propioni bacterium acnes-a benign organism always present on the skin. |
| What is comedonal acne? | Obstructive & noninflammatory. Comedones are the characteristic lesions, may be open or closed. |
| What is inflammatory acne? | Characterized by inflammatory papules-red lesions, pustules-contain pus & nodules-larger and deeper in dermis, more likely to cause scaring. |
| How is tretinoin (retin A) used? | Used for comedonal acne. Interrupts the process that forms comedones. |
| How is benzoyl peroxide used? | Kills propioni-bacterium acnes organism. Effective against both inflammatory & noninflammatory acne. |
| How are topical antibacterial agents used? | Used with inflammatory lesions accompany comedones. Clindamycin & Benzamycin |
| How do oral contraceptives help acne? | Reduce andogen production. |
| How is Accutane used? | Reserved for severe cystic acne. Decreased sebum production, given for 20 weeks. Can cause dry skin & eyes, decrease night vision, headaches, mood changes, depression & suicidal tendencies. Accutane has teratogenic effects. |
| What other therapies are used to treat acne? | Laser & light therapy to reduce sebum production. Chemical peel & microdermabrasion. |
Created by:
jrb265
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