INTEGUMENTARY SYSTEM
ECZEMA
• atopic dermatitis - often the first sign of an allergic predisposition in a child
• usually manifests during infancy
Asssessment:
• erythema, weeping vesicles that rupture and crusts
• severe pruritus; scratching causes thickening and darkening
• dry skin, sometimes urticaria
Intervention:
• topical steroids
• antihistamines
• coal tar preparation
• colloid baths
• diet therapy: elimination of offending food
Nursing Intervention:
• avoid heat and prevent sweating
• check materials in contact with child’s skin (sheets, lotions, soap)
• avoid frequent baths
• avoid use of soap
• provide lubricant immediately after bath
• administer topical steroids as ordered
• use cotton instead of wool
• keep child’s nails short; use elbow or glove restraints if needed
• apply wet saline or Burrow’s solution compresses
DIAPER RASH
• contact dermatitis
• plastic/rubber pants and linings of disposable diapers
exacerbate the condition by prolonging contact with
moist, warm environment
• skin further irritated by acidic urine
Assessment:
• erythema/excoriation in the perineal area
• irritability
Nursing intervention:
• keep area clean and dry; clean with mild soap and water after each stool and soon as child urinates
• take off diaper and expose area to air during the day
• client teaching:
- Proper hygiene
- Avoid use of plastic pants or disposable diapers with a plastic lining
- Avoid commercially prepared diaper wipes containing alcohols
- Avoid cornstarch; good medium for bacteria
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