skin care for infants

skin care for infants The nurse is caring for a 2-month-old infant. The parent states the family is going on vacation next month and they are concerned about sunburn. The parent asks if it is okay to use a sunscreen lotion made for children on the infant. What is the correct nursing response? "It is okay to use a children's sunscreen as long as you avoid the face." "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every 3 to 4 hours." "You should not take your infant to a sunny location." "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the infant when in the sun." - "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the infant when in the sun." It is not recommended to use sunscreen on infants younger than 6 months of age. Instead, parents should use hats, bonnets, and light-colored clothes to shield the infant's skin, and keep the infant away from direct exposure to the sun. Telling the parent not to take the infant to a sunny location is inappropriate. The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to: miliaria rubra (heat rash). impetigo. seborrheic dermatitis. candidiasis. - impetigo. Impetigo is a superficial bacterial skin infection. Impetigo in the newborn is usually bullous (blister-like, fluid filled); in the older child, the lesions are nonbullous and have a honey-colored, crusted appearance. The nurse is examining a child for indications of frostbite and notes blistering with erythema and edema. The nurse notes which degree of frostbite? second-degree frostbite fourth-degree frostbite first-degree frostbite third-degree frostbite - second-degree frostbite Second-degree frostbite demonstrates blistering with erythema and edema. First-degree frostbite results in superficial white plaques with surrounding erythema. In third-degree frostbite, the nurse would note hemorrhagic blisters that would progress to tissue necrosis and sloughing when the fourth degree is reached. A nurse completes an assessment on an 8-month-old infant seen in the pediatrician's office for a well-child visit. The nurse notes that the infant's buttocks, perineum and inner thighs are covered in a thick coating of white ointment. When questioned, the parent says the infant has a diaper rash and the ointment is to protect the infant's skin. What is the best action for the nurse to take? Tell the parent that he or she has used too much ointment. Provide instruction on how to care for a diaper rash. Explain that frequent diaper changes will prevent diaper rash. Commend the parent on addressing the infant's diaper rash. - Provide instruction on how to care for a diaper rash. The best action for the nurse to take is to provide instruction on how to care for a diaper rash. This would include changing diapers frequently to prevent a rash, how to apply rash ointment, and how using too much ointment can cause the infant's skin to absorb the ointment. It is important to praise parents on taking good care of their child, but the best action is to provide instruction on the correct way to do so. Which intervention is the most beneficial for a burn client undergoing a skin graft? Provide pain medication on a PRN schedule as soon as pain is reported. Provide diversional activities for the client. Provide an egg-crate mattress or gel mattress for the client to lie upon. Provide around-the-clock pain medication as soon as pain is reported. - Provide around-the-clock pain medication as soon as pain is reported. When the child undergoes a procedure, such as skin grafting, that is known to produce prolonged pain, administer pain medication on a scheduled basis, rather than as needed once pain is reported. Around-the-clock pain medication will serve to diminish peaks and valleys in pain relief. Diversional activities and an egg-crate mattress are not effective treatments for severe pain. A teen has experienced a minor burn from a hair styling appliance. What interventions will be of benefit? Select all that apply. Apply a thin layer of butter on the burned area. Rinse the burned area in cool water. Apply ice intermittently. Cover with a clean nonadhesive bandage. Use aspirin for pain. - Rinse the burned area in cool water. Cover with a clean nonadhesive bandage. When caring for a minor burn at home the area may be rinsed with cool water. Ice should not be applied. Covering the burn with a clean nonadhesive bandage is recommended. Butter, creams and ointments should be avoided. Aspirin is not recommended. Acetaminophen or ibuprofen is recommended. A 3-year-old child is admitted after being severely burned. The nurse collects the following data. What finding would be most important for the nurse to report immediately? The child's respiratory rate is 42 breaths/min. The child's temperature is 101.2°F (38.4°C). The child's hourly urinary output is 150 ml. The child's pain level is a 7 on a 10-point pain scale. - The child's respiratory rate is 42 breaths/min. An increase in the respiratory rate after a severe burn may be an indication of possible serious respiratory complications and should be reported immediately in case an endotracheal tube needs to be inserted. A temperature of 101.2°F (38.4°C) would be expected with a burn. A child who has just been severely burned would be expected to have a lower urine output not higher. An hourly urine output of 150 ml exceeds the expected output of a 3-year-old child. That child should be producing 1 to 2 ml/kg/hr. A normal 3-year-old child would weigh approximately 30 lb (13.6 kg), which means the output should be around 27 ml/hr. Fluid replacement for the burned child aims to have a urine output of 1 to 2ml/kg/hr. The pain rating of 7 would be expected in severe burns. The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child? Splint the leg. Briskly scrub the site. Administer pain medication. Apply ice to the affected area. - Apply ice to the affected area. Spider bites can cause serious illness if untreated. Bites of black widow spiders, brown recluse spiders, and scorpions demand medical attention. Applying ice to the affected area until medical care is obtained can slow absorption of the poison. A child has been diagnosed with atopic dermatitis. The nurse is teaching the parents about measures to control this condition. What does the nurse teach the parents? Select all that apply. "Do not use hot water to cleanse the skin." "Use prescribed steroidal lotions every day." "Keep your child's nails trimmed short." "Pat dry the skin after a bath. Do not rub." "Apply prescribed moisturizer several times per day." - "Do not use hot water to cleanse the skin." "Keep your child's nails trimmed short." "Pat dry the skin after a bath. Do not rub." "Apply prescribed moisturizer several times per day." Atopic dermatitis is a chronic disorder with a relapsing and remitting nature. The skin reaction occurs in response to specific allergens, usually foods or environmental triggers. When a trigger occurs, antigen-presenting cells stimulate interleukins to begin the inflammatory process. The skin begins to feel pruritic and then the child starts to scratch. Itchiness occurs first and then the rash appears. The nurse should teach the parents three main topics about care. The first is that the skin needs to stay hydrated. This includes not bathing in hot water, not using products with perfumes or dyes, the use of mild cleansing agents, and to pat dry, do not rub. The skin should remain moist after a bath and moisturizer should be applied to the moist skin. The second is to maintain skin integrity. This includes keeping the nails trimmed short, avoiding tight clothing, avoiding heat, and using 100% cotton clothing. The third is to prevent infection. This includes ways to decrease the scratching. Prescribed antihistamines may be given at bedtime to reduce nighttime scratching and the use of behavioral modification techniques is recommended. Steroidal lotions or ointments can help reduce inflammation, but they would only be needed during a flare-up. STEROID CREAMS ONLY DURING FLARE UP, NOT EVERY DAY The school nurse has completed an educational program on first aid practices in the home. Which statement about burn care by a participant would indicate a need for further education? "If my child has a superficial burn, I will run cool water over it." "For a superficial burn, I can cover it with a clean nonadherent dressing." "I guess my mom was right; she always put ice on our burns when we were kids." "Mild soap can be used to clean a superficial burn." - "I guess my mom was right; she always put ice on our burns when we were kids." A parent expresses a concern about white scales that have begun to flake off the 1-week-old infant's scalp. The parent asks, "What can I do to prevent this?" Which response by the nurse would be most appropriate? "How often do you bathe your infant? The infant should have a thorough shampooing every day to prevent things like this." "Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes." "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo, like Head and Shoulders." "Your child most likely has infantile seborrheic dermatitis, or cradle cap. There is no intervention needed and it should resolve in 1 week." - "Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes." Infantile seborrheic dermatitis usually responds well to cleansing the scalp with a mild shampoo. The thick, scaling lesions on the child's scalp can be treated by applying baby oil, salicylic acid in mineral oil, or a corticosteroid gel on the scalp for 10 to 15 minutes. The area is gently massaged with a soft toothbrush; then the scales can be rinsed away. A fine-toothed comb helps rid the hair of scale debris. Antiseborrheic shampoo is not recommended for infants. Accusing a parent of poor hygiene is inappropriate. Infantile seborrheic dermatitis is not a result of poor hygiene. The client is scheduled to have potassium hydroxide testing performed. What will be needed to complete this test? a blood specimen a urine specimen skin scrapings a strand of hair with the root attached - skin scrapings Potassium hydroxide (KOH) testing is done to assess for the presence of a fungal infection. Skin scrapings are placed on a microscope slide and a drop of KOH 20% drop is added. An adolescent experiencing contact dermatitis reports experiencing pruritis. What intervention will the nurse recommend to relieve the itching? Keep the area covered with clothing. Bathe with a product that is oatmeal-based. Use a fragrance-free moisturizer. Apply calamine lotion if the lesion is weeping. - Bathe with a product that is oatmeal-based. Pruritis is a common problem associated with contact dermatitis. By healing the lesions, the itching will subside. Bathing with oatmeal-based products will accomplish this healing. If the area is too involved, then products like a topical corticosteroid can be used. Calamine lotion is a product that can help with itching, but it is primarily used to dry out weeping lesions. Moisturizers can be applied to the irritated skin, but they must be free of fragrances and dyes. The area should not be covered but allowed to be exposed to air to aid in healing. An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? Select all that apply. photosensitivity headache dryness burning flu-like symptoms - photosensitivity dryness burning Adverse effects associated with topical retinoid therapy include burning, dryness, and photosensitivity. Flu-like symptoms and headache are associated with topical immune modulators. The nurse is caring for a 15-year-old adolescent client with psoriasis. In addition to the plaques, what would the nurse expect to note? hyperpigmentation fissures and scaling on palms and soles fever and malaise lichenification - fissures and scaling on palms and soles Fissures and scaling on the palms and soles are common findings with psoriasis. Fever and malaise, lichenification, and hyperpigmentation are noted with other integumentary disorders but are not typical physical findings with psoriasis. The nurse is working with the caregiver of a neonate. The caregiver states, "My first baby had a disorder they called seborrheic dermatitis; what can I do to prevent this baby from having that?" Which response is the most appropriate? "You should wash your neonate's hair every day to help prevent this disorder." "Be careful to not get any lotion or oil on the neonate's head, and that will help prevent the disorder." "There is nothing you can do to prevent this disorder; it will go away by the time your neonate is a toddler." "If you will keep hats and bonnets off your neonate's head, you will not have to worry about the neonate getting the disorder." - "You should wash your neonate's hair every day to help prevent this disorder." Seborrheic dermatitis is commonly known as cradle cap. Daily washing of the neonate's hair and scalp can help prevent it. When teaching a group of caregivers of infants, the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash. "The formula she drinks sometimes causes her to have a diaper rash." "They told me to use baby powder every time I change her so she won't get diaper rash." "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash." "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." - "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." Infants may have a sensitivity to some soaps or disposable diaper perfumes, and the use of strong laundry detergents without thorough rinsing can cause diaper rash. Diarrheal stools, prolonged exposure to wet or soiled diapers, use of plastic or rubber pants, infrequently changed disposable diapers, inadequate cleansing of the diaper area (especially after bowel movements), and yeast infections are also causative factors. Exposing the diaper area to the air helps clear up the dermatitis. The use of baby powder when diapering is discouraged because caked powder helps create an environment in which organisms thrive. The nurse is evaluating the parents' understanding of atopic dermatitis. Which statement shows their understanding? "Flare-ups of lesions are not uncommon following therapy." "Atopic dermatitis turns to asthma later in life." "Atopic dermatitis follows a streptococcal infection." "Hydrocortisone cream may lead to kidney disease." - "Flare-ups of lesions are not uncommon following therapy." Atopic dermatitis is relapsing and remitting. It may recur when the child is re-exposed to the substance to which he or she is allergic, even following treatment. Approximately 30% of children with atopic dermatitis develop allergic rhinitis and asthma. It does not occur as a result of a strep infection. It is caused by an inflammatory process. The use of periodic hydrocortisone cream will not lead to kidney disease. ... - Signs and symptoms of impetigo include erythema, regional lymphedema, and small vesicles that develop into plaques with a honey-crusted appearance usually found around the nose and mouth.Cellulitis is an infection of the skin. Signs and symptoms include erythema, pain, swelling, regional lymphedema, and fever.Folliculitis is an infection of a hair follicle. Signs and symptoms include erythema around the follicle. The nurse is caring for a 1-year-old in a pediatric clinic. The child was brought to the clinic with symptoms of dry, itchy red patches of skin on the arms and legs. A diagnosis of atopic dermatitis (eczema) is made. What is a key element in the treatment regimen for this diagnosis? teaching the child not to scratch the "itchy" skin frequently rehydrating the skin applying topical antibiotics routinely daily oral cortisone - frequently rehydrating the skin Frequently rehydrating the skin is a key element of the treatment regimen. To maintain healthy skin in the child with AD, hydration practices should be implemented to replace moisture in the stratum corneum and prevent transdermal water losses. Scratching the itchy skin is a reflex that is very difficult to stop; preventing the itch is more effective. Topical antibiotics and oral cortisone are not treatments for atopic dermatitis.