NUR 4307- EXAM 1 PPTs, textbook, + supplemental
info/ar$cles
What is the fi h vital sign?
pain
What is the standards of care goal regarding pain?
elimina on of pain and reduc on of unpreventable pain
Inadequate pain control can lead to
a decrease effec veness of analgesia later
Unrelieved pain, even in early infancy, may have what types of effects?
Nega ve physiological/ psychological effects
(e.g Stress response behavior
& Increased pain sensi vity)
What is the most effec ve way to manage pain in children?
u lizing preven on + quick ac on
What aspects of care should parents and families be involved in pain management?
pain educa on, assessment, & management
TRUE OR FALSE: Children with chronic pain always appear to be in pain.
False
Chronic pain is rarely associated with SNS arousal, which ini ates symptoms
Why must culture/beliefs/and learning pa4erns be considered in pediatric pain?
Influence how children experience, express, and cope with pain, necessita ng their
considera on for effec ve pediatric pain management.
Congenital Melanocy c Nevi (CMN)
anomaly in embryogenesis with malforma on increased risk for melanoma
How does congenital melanocy c nevi present?
,colors range from brown to black
arise from disrupted migra on of melanocyte precursors in the neural crest
mainly FLAT, but raised may occur
congenital melanocy c nevi is difficult to treat because of poten al for
malignancy
Any changes in nevus prompts?
(color, shape, thickness) warrants further evalua on
dermal melanosis AKA
Mongolian spots
Dermal Melanosis presents as
flat, bush-gray, or brown lesions that arise when melanocytes are trapped deep in the skin
Where is dermal melanosis typically found?
back or bu4ocks
**easily mistaken for bruises**
What treatment is required for dermal melanosis?
NONE, typically fade by 2 years of age
Dermal melanosis are common in which ethnic groups?
Blacks, Na ve Americans, Asians, and Hispanic popula ons
Treatment for congenital melanocy c nevi?
Prophylac c removal
**does not grantee protec on from melanoma**
REMEMBER, for congenital melanocy c nevi
reoccurrence is possible and may arise in different sites from the original nevus
Hemangiomas AKA
Strawberry mark/hemangiomas
When can hemangiomas develop?
,within the first few months of life
Treatment for hemangiomas
resolve with 5 years; over pulsed dye laser may hasten clearance by school age
Hemangionomas that compress the eye, airway, or vital organs require
IMMEDIATE referral in the neonatal period
*treat w/ prednisone 3mg/kg for 6-12 weeks*
sacral hemangiomas may be associated w/
high-output HF
Nevus flammeus AKA
port wine stain
Nevis flammeus
unilateral port-wine stain, malforma on of dermal blood vessels
lesions dark red to purple
**DO NOT FADE**
Treatment for Nevis flammeus/simplex
DO NOT require treatment, a lower pulsed dye laser may be u lized if preferred, treatment is
given before one year of age
Nevis flammeus can lead to
Ipsilateral glaucoma if the trigeminal nerve is associated
or Sturge-webster syndrome-seizures + glaucoma
Nevus simplex AKA
Stork bite, angel kiss, macular stain, salmon patch
Nevus Simplex
bilateral flat salmon-colored lesions caused by telangiectasias
occur over the eyes, scalp, neck, and blanch when compressed
supernumerary nipples (polythelia)
one or more extra nipples located along embryonic mammary ridge (the "milk line")
, spinal dysraphism
a group of neural tube defects that describe some manifesta on of incomplete fusion of the
midline elements of the spine
The strongest predicator for spinal dysraphism are
presence of two or more congenital midline skin lesions
cu s marmorata (mo4ling)
**NORMAL**
transient mo4ling on trunk and extremi es
physiologic response of uneven blood flow
common in cold infants; when warmed resolves itself
premature infants are more common
no treatment
Harlequin color change
**NORMAL**
Occurs when the baby is in a side-lying posi on.
The lower half of the body turns red and the upper half blanches with a dis nct demarca on
line down the midline.
no treatment
Erythema toxic neonatorum (ETN)
erythematous lesions, 2-3-mm macules, and papules that evoke pustules
"flea-bi4en appearance"
occur on the face, trunk, and extremi es
**Palms and soles not involved**
no treatment
Infants who appear sick w/ erythema toxic may have been exposed to
herpes simplex
candida
info/ar$cles
What is the fi h vital sign?
pain
What is the standards of care goal regarding pain?
elimina on of pain and reduc on of unpreventable pain
Inadequate pain control can lead to
a decrease effec veness of analgesia later
Unrelieved pain, even in early infancy, may have what types of effects?
Nega ve physiological/ psychological effects
(e.g Stress response behavior
& Increased pain sensi vity)
What is the most effec ve way to manage pain in children?
u lizing preven on + quick ac on
What aspects of care should parents and families be involved in pain management?
pain educa on, assessment, & management
TRUE OR FALSE: Children with chronic pain always appear to be in pain.
False
Chronic pain is rarely associated with SNS arousal, which ini ates symptoms
Why must culture/beliefs/and learning pa4erns be considered in pediatric pain?
Influence how children experience, express, and cope with pain, necessita ng their
considera on for effec ve pediatric pain management.
Congenital Melanocy c Nevi (CMN)
anomaly in embryogenesis with malforma on increased risk for melanoma
How does congenital melanocy c nevi present?
,colors range from brown to black
arise from disrupted migra on of melanocyte precursors in the neural crest
mainly FLAT, but raised may occur
congenital melanocy c nevi is difficult to treat because of poten al for
malignancy
Any changes in nevus prompts?
(color, shape, thickness) warrants further evalua on
dermal melanosis AKA
Mongolian spots
Dermal Melanosis presents as
flat, bush-gray, or brown lesions that arise when melanocytes are trapped deep in the skin
Where is dermal melanosis typically found?
back or bu4ocks
**easily mistaken for bruises**
What treatment is required for dermal melanosis?
NONE, typically fade by 2 years of age
Dermal melanosis are common in which ethnic groups?
Blacks, Na ve Americans, Asians, and Hispanic popula ons
Treatment for congenital melanocy c nevi?
Prophylac c removal
**does not grantee protec on from melanoma**
REMEMBER, for congenital melanocy c nevi
reoccurrence is possible and may arise in different sites from the original nevus
Hemangiomas AKA
Strawberry mark/hemangiomas
When can hemangiomas develop?
,within the first few months of life
Treatment for hemangiomas
resolve with 5 years; over pulsed dye laser may hasten clearance by school age
Hemangionomas that compress the eye, airway, or vital organs require
IMMEDIATE referral in the neonatal period
*treat w/ prednisone 3mg/kg for 6-12 weeks*
sacral hemangiomas may be associated w/
high-output HF
Nevus flammeus AKA
port wine stain
Nevis flammeus
unilateral port-wine stain, malforma on of dermal blood vessels
lesions dark red to purple
**DO NOT FADE**
Treatment for Nevis flammeus/simplex
DO NOT require treatment, a lower pulsed dye laser may be u lized if preferred, treatment is
given before one year of age
Nevis flammeus can lead to
Ipsilateral glaucoma if the trigeminal nerve is associated
or Sturge-webster syndrome-seizures + glaucoma
Nevus simplex AKA
Stork bite, angel kiss, macular stain, salmon patch
Nevus Simplex
bilateral flat salmon-colored lesions caused by telangiectasias
occur over the eyes, scalp, neck, and blanch when compressed
supernumerary nipples (polythelia)
one or more extra nipples located along embryonic mammary ridge (the "milk line")
, spinal dysraphism
a group of neural tube defects that describe some manifesta on of incomplete fusion of the
midline elements of the spine
The strongest predicator for spinal dysraphism are
presence of two or more congenital midline skin lesions
cu s marmorata (mo4ling)
**NORMAL**
transient mo4ling on trunk and extremi es
physiologic response of uneven blood flow
common in cold infants; when warmed resolves itself
premature infants are more common
no treatment
Harlequin color change
**NORMAL**
Occurs when the baby is in a side-lying posi on.
The lower half of the body turns red and the upper half blanches with a dis nct demarca on
line down the midline.
no treatment
Erythema toxic neonatorum (ETN)
erythematous lesions, 2-3-mm macules, and papules that evoke pustules
"flea-bi4en appearance"
occur on the face, trunk, and extremi es
**Palms and soles not involved**
no treatment
Infants who appear sick w/ erythema toxic may have been exposed to
herpes simplex
candida
