Pediatric - Integumentary Disorders - Nursing Study Notes

ATLAND Nursing
Pediatric Integumentary Disorders

Nursing Study Notes

1. Atopic dermatitis (eczema)
Overview
Atopic dermatitis or eczema is a non-contagious inflammatory skin disorder characterized by
superficial inflammation of the epidermis.


Infantile Childhood




Childhood eczema; ischemic,
Infantile sarcoma: typical facial
pruritic plaque on the neck.
oozing plaques.


Fig. 1: Forms of eczema

Causes
 Allergies.
 Family history of eczema.
 Dry skin.
 Stress.




ATLAND Nursing 1 Pediatric Nursing Study Notes

,Assessment
 Skin lesions that progress to weeping, oozing, crusting distributed on the cheeks, and
extensor surface of infants




Fig. 2: Eczema vesicles.
 Minute circumscribed papules measuring 1cm in diameter which are elevated and firm
 Fluid-filled vesicles.
 Itching with sweating
 Erythema that may be faint or intense
 Scaling

N/B. The commonly affected areas in adolescents and early adult forms are popliteal and
antecubital.

Diagnostic tests
 Based on clinical findings in the assessment
 Laboratory tests
 Skin prick tests to determine allergies.
 Blood tests include;
 Complete blood count demonstrates an increased number of eosinophils;
serum IgE may be slightly elevated;
 Radioallergosorbent test to determine some allergies.

Interventions
a) Nursing Interventions
 Administer topical corticosteroids as prescribed three minutes after bathing to reduce
swelling and itching.
 Administer antihistamines as prescribed to control itching.


ATLAND Nursing 2 Pediatric Nursing Study Notes

,  Administer antibiotics as prescribed in case of secondary infections
 Apply cool wet compresses to alleviate itching and soothe the skin.
 Keep the nails short and clean to prevent and reduce scratching.
 Administer immunomodulators (calcineurin inhibitors) as prescribed to control allergic
immune response.
 Eliminate trigger foods for suspected or known allergies
 Limit bathing time within five to ten minutes with tepid water, avoid bubble baths, rinse
well and pat the skin dry with a towel to prevent drying of the skin
 Apply moisturizers over corticosteroids within 3 minutes after taking the bath.
 Avoid exposure of the skin to irritants for example diaper wipes and fabrics.
 Eliminate conditions that exacerbate itching for example use of wet diapers.
b) Client Education
 Advice the parents to monitor signs of secondary infection which include honey-colored
crusts surrounding the erythema and seek immediate medical interventions.
 Advice the parents to use mild detergents when cleaning clothing and thoroughly rinsing
to prevent detergent allergies.

2. Impetigo
Overview
Impetigo is a highly contagious bacterial skin infection characterized by the formation of
vesicles, honey-colored crusts, or bullae. Infection sites of the skin include the face and mouth,
neck, hands, and extremities.

Causes
 Streptococci pyogenes.
 Staphylococci aureus.

Risk factors
 Age; is more common in children between the age of 2 years to 6 years as they tend to
be more active and play close.
 Close contact or crowding; crowding conditions for example those in daycare and
schools increase the chances of spreading impetigo.
 Climate; More common in hot, humid months.
 Personal hygiene; Poor personal hygiene also increases the risk for infection.



ATLAND Nursing 3 Pediatric Nursing Study Notes