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Monday 29 August 2011

INTEGUMENTARY SYSTEM PEDIATRICS


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:
  1. Proper hygiene
  2. Avoid use of plastic pants or disposable diapers with a plastic lining
  3. Avoid commercially prepared diaper wipes containing alcohols
  4. Avoid cornstarch; good medium for bacteria

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