Care of the Child With an

Integumentary Disorder

Nursing 346

Skin
Differences
General Care
Conditions

Bacterial
Fungal
Contact
Insect bites
Acne
Burns

Common Skin Disorders

Dermatitis is a common concern.
Dermatitis results in an inflammatory response.
Wide variation
Generally will resolve without complications
Management will vary depending on cause.
Topical management

Dermatitis
Contact

Inflammatory response of the skin

Due to exposure to chemical substance
Pruritic
Can be primary or sensitizing

Diaper dermatitis
Nursing care is aimed at
Prevent further exposure
May need topical or oral corticosteroid
Symptomatic relief

ATOPIC DERMATITIS
AD has an association with allergy with an
inherited tendency (atopy)
Diagnosis is made by history and findings
Management
Hydration
Relieve itching
Prevent infection

Nursing focus
assessment
Education
Bathing, clothing, environment, laundry

Support

ACNE

Poison Ivy, oak or sumac

Oil from the plant that affects dermal layer.
Immune response leads to blisters about 2 days
after contact.
Very itchy
Management is clean skin before urushiol attaches
Lesions are treated with topical solutions and
lotions
Nursing
Use cold water to neutralize the oil
Prevent scratching
PREVENTION BY EDUCATION

INFECTIONS
Bacterial
Impetigo

Viral
Warts

Dermatophytoses
Tinea

IMPETIEGO
Staphylococcus typical cause.
Begins as a macule to vesicle. Ruptures leaving a
moist erosion.
Exudates dries and forms the characteristic
honey colored crusts. Pruritic.
Treated with local antibiotic and softening of
crusts with a Burrows solution removal prior to
application of antibiotic
Oral antibiotics if larger spread
Nursing major focus is prevent spread of
infection, teach family to administer medications

Warts
Verruca usually caused by Human papilomavirus
Grey or brown circumscribed papules. Rough
surface
Can be difficult to treat. Local destructive therapy
Can disappear on own
Can inoculate self. Avoid scratching and picking.
Can increase in size.

Dermatophytoses

Tinea (AKA ringworm) name will

depend on area found.
Spreads from person to person or by
animal to person
Treatment will depend on location
For scalp use of 1% selenium sulfide
shampoo three times a week.
If oral griseofulvin is ordered,
administer with high fat foods to
increase absorption. Will need
monitoring of liver and renal function
as well as WBC.
Want to encourage no sharing

Burns
Pathophysiology
Therapeutic management
Nursing

Assessment
Exam
Diagnostics
Management
Dependent on extent
Stabilization is key

Classification of burns
Superficial: involve only epidermal injury; heal without
scarring in 4 to 5 days
Partial thickness: involve epidermis and portions of
dermis; heal with minimal scarring in about 2 weeks
Deep partial thickness: take longer to heal; may scar;
result in changes in nail, hair, and sebaceous gland
function
Full thickness: result in significant tissue damage and
extend through epidermis, dermis, and hypodermis;
extensive scarring results; significant time to heal needed

Burns

Nursing interventions for extensive

burns
Promoting oxygenation and ventilation
Restoring and maintaining fluid volume
Preventing hypothermia
Cleansing the burn
Preventing infection
Managing pain with a-traumatic care
Treating infected burns
Providing burn rehabilitation