Chapter 31- Care of Child with a Physical
Disorder
Jessica Gonzales RN, MSN
Cardiovascular assessment
Monitor apical and peripheral
Pulses for rate, rhythm, and quality
Auscultate for extra heart sounds
Assess height
And weight,
Growth failure
Can occur with
Sever cardiac
disease
Periorbital edema
Engorged
Neck veins
Monitor
respirations
for
rate and
effort
Ausculate
for
adventitious
sounds
Abdominal
distension
Palpate for
Hepatomegaly
And
splenogmegaly
Monitor BP for
hypo or
hypertension
cyanosis
clubbing
Peripheral edema
•Palpate
•inspect
Congenital Heart Disease
Etiology and pathophysiology:
♥ Family history of CHD
♥ Mom comes in contact with certain substances during first
few weeks of pregnancy
♥ Mom with seizure disorder and on meds
♥ Depression and lithium
♥ Uncontrolled diabetes or lupus
♥ Rubella
♥ Chromosomal abnormalities (downs syndrome, turners)
♥ infection
Left atrium
Superior vena cava
Right
atrium
mitral
aortic
pulmonic
tricuspid
Right
ventricle
Inferior vena cava
Left ventricle
1. Inferior and superior vena cava from
body into right atrium
2. Right atrium to right ventricle via
tricuspid valve
3. Through pulmonary valve to
pulmonary artery
4. Pulmonary artery to lungs
5. To pulmonary veins from lungs
6.Pulmonary veins to left atrium
7.Through mitral valve into left ventricle
8.Through aortic valve to aorta
9. To body
Tissue Paper My Assests
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Types of defects:
♥
Pulmonary Blood flow
♥
Pulmonary Blood Flow
♥ Obstruction to systemic blood flow
♥ Mixed blood flow
♥ Cyanotic
♥ Acyonotic
Cyanotic
Pulmonary Blood flow
♥TGA
Pulmonary Blood flow
♥TOF
Acyanotic
Pulmonary Blood
flow
♥VSD
♥PDA
♥ASD
Normal Blood Flow
♥COA
Cyanotic
•PDA
•ASD
•VSD
R
L
R
L
Acyanotic
4 T’s
•Tetralogy of fallot
•Truncus Ateriosus
•Transportation of
the great vessels
•Tricuspid Atresia
Clinical manifestations
•
•
•
•
•
•
•
•
•
Cyanosis
pallor
Cardiomegaly,
additional heart sounds (pericardial rubs, murmurs,)
Discrepancies between apical and radial pulses
Tachypnea
Dyspnea, grunting, crackles, and wheezes
Digital clubbing
Hepatomegaly, splenomegaly
Acyanotic
Increased
Pulmonary Blood flow
Patent ductus arteriosus (PDA) is a condition in which a blood vessel called
the ductus arteriosus fails to close normally in an infant soon after birth.
(The word "patent" means open.)
https://health.google.com/health/ref/Pate
nt+ductus+arteriosus
Acyanotic
Increased pulmonary
blood flow
Atrial septal defect (ASD) is a congenital heart defect in which the wall that
separates the upper heart chambers (atria) does not close completely.
Congenital means the defect is present at birth.
acyanotic
Increased
pulmonary blood flow
Ventricular septal defect (VSD)describes one or more holes in the wall that separates
the right and left ventricles of the heart.
Ventricular septal defect is one of the most common congenital (present from birth)
heart defects. It may occur by itself or with other congenital diseases.
A large ventricular septal defect (VSD): a hole in the part of the septum that separates
the ventricles, the lower chambers of the heart.
The hole allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood
from the right ventricle.
An overriding aorta: the aorta is between the left and right ventricles,
directly over the VSD. As a result, oxygen-poor blood
from the right ventricle flows directly
cyanotic
Decreased
Overriding aorta
Pulmonary stenosis
Pulmonary
Blood flow
Right ventricular hypertrophy
Opening
between
ventricles
Pulmonary stenosis : This defect is a narrowing of
the pulmonary valve and the passage through which
blood flows from the right ventricle to the pulmonary
artery. In pulmonary stenosis, the heart has to work
harder than normal to pump blood, and not
enough blood reaches the lungs.
Right ventricular hypertrophy : This defect occurs
if the right ventricle thickens because the heart has to
pump harder than it should to move blood
through the narrowed pulmonary valve.
Children with TOF may develop "tet
spells“ (acute hypoxia)
• The precise mechanism of these
episodes is in doubt
• presumably results from a
transient
In resistance to
blood flow to the lungs with
flow of desaturated blood to the
body
• characterized by a sudden,
marked, increase in cyanosis
followed by syncope, and may
result in hypoxic brain injury and
death, prolonged crying,
irritability
treatment:
• Calm infant- hold over shoulder
or in knee chest position or have
child squat (increases pressure on the left side
of the heart, decreaseing the R to L shunt thus
decreasing the amount of deoxygenated blood
entering systemic circulation)
• Morphine (to decrease spasm and supress resp
center)
• Oxygen (it is a potent pulmonary vasodilator and
systemic vasoconstrictor. This allows more blood flow
to the lungs)
• Consider sedation and parlaysis
with intubation if these measures
fail
cyanotic
Increased
Pulmonary blood flow
Transposition of the great vessels is a congenital heart defect in which the two
major vessels that carry blood away from the heart -- the aorta and the pulmonary artery
-- are switched (transposed).
Acyanotic
Normal pulmonary
blood flow
Aortic coarctation is a narrowing of part of the aorta (the major artery leading
out of the heart). It is a type of birth defect. Coarctation means narrowing
Hematological assessment
Gingival pallor or bleeding
Jaundice, sclera,
retinal hemorrhage
Impaired thought
Process or lethargy
Tachycardia
Auscultate for murmurs
Tachypnea,
orthopnea,
dyspnea
Lymphadenopathy
or tenderness
Abdominal tenderness,
Hepatomegaly,
splenomegaly
Joint swelling,
Bone and joint
tenderness
Blood in urine
and abnormal
Mentsraul
bleeding
Pallor,flushing
Jaundice,
Purpura,
Petichiae,
Scratch marks
cyanosis
Decreased
muscle mass
Palpate decreased cap
fill time
Disorders of Hematological Function
•
Anemia: The condition of having less than the normal number of red blood
cells or less than the normal quantity of hemoglobin in the blood. The oxygencarrying capacity of the blood is, therefore, decreased
Failure to produce
(hem)oglobin due to
lack of iron
In anemia selective
vasoconstriction of
blood vessels
allows nonvital
areas to be
bypassed to allow
more blood to flow
into critical areas.
The skin is one of
the areas to be
considered
“nonvital” and the
result is pallor.
Iron
needed
to bind
O2
Tissue hypoxia=
↑cardiac input=
↓PVR & ↓blood
viscosity (thinner
blood) = tachycardia
and heart murmur
Iron containing O2
transport protein
that carries O2
from the lungs to
the body
Reduces O2
carrying
capacity of
the blood
O2 state to the tissues:
dyspnea on exertion, fatique,
fainting, lightheadedness, tinnitus,
headache
A genetic disorder characterized by an
abnormal form of hemoglobin within the
erythrocyte
Damaged sickle
RBC’s clump
together and stick to
the walls of blood
vessels, blocking
blood flow causing
sever pain and
permanent damage
to brain, heart,
lungs, kidneys, liver,
bones, and spleen
Ischemia in the
small blood
vessels and
infarction in
the small
bones
↓ O2 = sickle
shaped red blood
cells break apart
not acting
effectively
↑Risk of infection due to
damaged spleen from sickled
cells getting trapped
Ischemia in the
small blood vessels
and infarction in
the small bones
Aplastic Anemia is a rare but potentially life threatening
syndrome of bone marrow failure characterized by pancytopenia
↓RBC’s fatigue due to ↓O2
infections
Bruising and bleeding
Failure to produce
hemoglobin due to
lack of iron
•Iron replacement therapy
•Nutritional or dietary
counseling
•Treatment of underlying
cause
broad spectrum
antibiotics
•Infection
•Pain
•Fatigue
•Shortness if
breath
•Transfusions as needed
•Isolation precautions per
institute (reverse isolation)
•Pallor
•Dyspnea
•Petechiae
•bleeding
•Fever
•Infection
Pain medications,
local heat application
** hydration to prevent
sickling
Administer O2, semifowlers postion
Good oral hygiene, patient
safety
Prophylactic antibiotics
platelets
bleeding
•Prevent bruising
•Control bleeding
•Counsel family to not use salicylate drugs
•Transfusion of RBC’s
•IV gamma globulin and anti-D antibody therapy
•splenectomy
Idiopathic
thrombocytopenic
purpura (bleeding
in the tissue)
A bleeding
disorder in
which the
immune system
destroys
platelets, which
are necessary
for normal
blood clotting.
Persons with the
disease have too
few platelets in
the blood
*antiplatelet
antibody in the
spleen
Hemophillia
•
Hereditary (x-linked recessive transmitted by females found predominately in
males) bleeding disorder characterized by deficincy in a blood clotting factor
(*factor VIII{A} or IX {B})
Prednisone: decreases
antiplatelet antibodies
platelets
Bleeding
into the
tissue
Bruising
and
petichiae
Minimize
bleeding
IVIG
Anti D antibody
Disorders of Hematological Function
Leukemia -ALL (acute lymphoblastic leukemia) uncontrolled
proliferation of blast cells,which accumulate in the
marrow causing crowding and depression
of other cells
• Hodgkins diseaseThis is a malignant lymphoma
distinguished by painless,
progressive enlargement of
lymphoid tissue.
Assessment of the Immune System
Conjunctival redness
Temperature for hyperthermia
Palpate for
adenopathy
Auscultate for
abnormal
Breath
sounds
Inspect skin for
hives, edema,
lesions
Auscultate for tachycardia
Palpate for
spleneomegaly
Assess the joints for
Swelling, redness,
Tenderness, decreased
mobility
Disorders of the Immune System
Infection with HIV produces
Lymphopenia resulting in
immunosupression and AIDS
Symptoms
may not
Appear for
1 to 2 yrs
•Nonspecific
clinical manifestations
•Prevent opportunistic infections
•Administer prophylactic therapy
for P. carnii (co-trimoxazole) beginning
at 6 mos of age
•Immunizations
•Pulmonary hygiene
•Promote adequate nutrition
•Foster healthy growth and development
Disorders of the Immune System
Clinical manifestations:
•Daily afternoon
temperature spikes
•macular rash on
trunk and
extremities
•joint involvementswelling, pain,
redness
Medical management
•Nonsteroidal antiinflammatory drugs
•antirheumatic
drugs
•cytotoxic drugs
•corticosteroids
Assessment of the Respiratory System
Observe for
Alertness, change
In mental status
Temperature for hyperthermia
Auscultate for
abnormal
Breath
sounds
Monitor
respirations
for rate,
depth, and
quality,
Note any
dyspnea, use
of accessory
muscles
Percuss for
dullness
which
indicates fluid
Inspect skin color
changes, especially
cyanosis
Intercostsal,
suprasternal,
Sternal and substernal
retractions
Chest diameter
Disorders of the respiratory system
Bronchopulmonary Dysplasia
Premature lungs
needing mechanical ventilation
(high 02 and PIP) can injure the aveolar
Saccules and lead to fibrosis of these
structures
•Long term O2 therapy
•Cyanosis when breathing RA
•Manifestations of right sided failure
•Administer medications: bronchodilators, diuretic
•Planned rest periods to decrease respiratory effort and
conserve energy
•Small frequent meals to prevent over distension of stomach
•Counsel parents in ways to prevent respiratory infection
•Teach parents CPR
Disorders of the respiratory system
• pneumonia
Acute inflammation of the lung
parenchyma (bronchioles,
alveolar ducts, and sacs, and alveoli)
Impairs gas exchange
•Antibiotics if bacterial
•Assess for respiratory distress
•Provide family teaching
Respiratory
Distress
•Wheezing, crackles
•Use of accessory
•muscles
Disorders of Respiratory FunctionBronchitis/Bronchiolitis
•Wheezing
•Crackles
•Tachypnea
•Retractions
Viral infection of the lower respiratory
tract characterized by inflammation of the
Bronchioles and production of mucous
(usually caused by RSV)
•Assess for
respiratory
Distress
•Contact isolation
•Prescribed
Medications (RT)
•O2 if needed
•Fluids
Asthma is a chronic, reversible, obstructive
airway disease, triggered by various stimuli
Inflammation and
edema of muscle (spasms) •Wheezing
•Use of accessory
muscles
Production of thick mucosa resulting in
increased airway resistance, premature closure
Of airways, hyperinflation, increased work of
breathing, impaired gas exchange
•Assess respiratory status
•Administer prescribed meds
•Promote adequate O2
•Fowler’s position
•Increased RR
•Cough
•Fatigue
•Anxiety
•dyspnea
Disorders of the respiratory system
• Respiratory distress syndrome- mainly caused by a lack of a slippery,
protective substance called surfactant, which helps the lungs inflate with
air and keeps the air sacs from collapsing. Common in premature babies
whose lungs are not fully developed.
•
•
•
•
•
•
Sudden infant death syndrome
Acute pharyngitis (sore throat)-inflammation of the pharynx
Tonsillitis
Croup – inflamation of the larynx (voice box)**
Acute epiglotitis –bacterial infection of t he epiglottis
Pulmonary tuberculosis-chronic bacterial infection caused by bacillius
mycobacterium tuberculosis
• Cystic fibrosis- an inherited disorder of the exocrine glands characterized by
excessive thick mucous that obstructs the lungs and GI tract
Measure height
And weight for growth
failure
Assessment of the GI System
Temperature for hyperthermia
Inspect abdomen
for distention,
depression,
umbilical
herniation
Auscultate to
assess bowel
sounds (do first)
Palpate for
tenderness,
rigidity, masses
and
organomegaly
Inspect skin for
pallor, jaundice,
carotenimia
Inspect mouth
For caries,
periodontal
Disease, lesions,
And clefts
Palpate hard and soft
palates for defects
Inspect the anus for
rectal bleeding and
nonpatency
Disorders of Gastrointestinal Function
Cleft lip and cleft palate are birth
defects that affect the upper lip and
roof of the mouth. They happen
when the tissue that forms the roof
of the mouth and upper lip don't
join before birth. The problem can
range from a small notch in the lip
to a groove that runs into the roof
of the mouth and nose. This can
affect the way the child's face
looks. It can also lead to problems
with eating, talking and ear
infections.
•Ensure adequate
intake of food and
fluids without
aspiration.
•Special feeding
devices may be
used.
•Frequent burping
is necessary.
•Assist parents in
dealing with the
diagnosis
Treatment usually is surgery to close
the lip and palate. Doctors often do this
surgery in several stages. Usually the
first surgery is during the baby's first
year. With treatment, most children with
cleft lip or palate do well.
Disorders of Gastrointestinal Functionconstipation/dehydration
The passage of hardened stools; may be associated with failure of
complete evacuation of the colon with
defecation
•Add fluid or
carbohydrate to the
formula, add foods
with bulk, and
increase fluid intake.
•Manually dilate the
sphincter; administer
mild
laxatives/enemas.
•Obtain history of
bowel patterns
educate on
dietary changes
and normal stool
patterns.
Disorders of Gastrointestinal
Function- diarrhea/gastroenteritis
• May be a result of a
number of disease
processes that cause
abnormal losses through
the skin, respiratory, renal,
and GI systems –
vomiting/diarrhea
• Diarrhea- A disturbance in
intestinal motility
characterized by an
increase in frequency, fluid
content, and volume of
stools
•Assess for clinical
manifestations of
dehydration.
•Observations should
include I&O; vital signs;
body weight; skin color,
temperature, and turgor;
capillary refill; presence or
absence of the sensation of
thirst; and in infants,
assessment of the
fontanels.
•I&O, promotion of
rehydration, correction of
electrolyte imbalances,
provision of age-appropriate
nutrition, prevention of the
spread of the diarrhea,
prevention of complications,
support of the child and
family
Disorders of Gastrointestinal
Function• Gastroesophageal reflux
The backflow of gastric contents into the esophagus
resulting from relaxation or incompetence of the
lower esophageal sphincter
• Hypertrophic pyloric stenosis
Pyloromytomy:
Relieves
obstruction
Narrowing of pyloric sphincter at the outlet of the stomach
• Intusseception
Telescoping of one portion of the
Intestine into an adjacent portion
Causing an obstruction
• Hirschprungs disease Congenital anomaly characterized by absence of nerves to
a section of the intestine causing inadequate mobility
Which leads to the absence of propulsive movements,
causing accumulation of intestinal contents and distention
of bowel
Disorders of Gastrointestinal
Function-hernias
•
•
•
•
•
Umbilical
Femoral
Inguinal
Hiatal
Diaphragmatic
A protrusion of the bowel through an
abnormal opening
in the abdominal wall
Most
common in
children
Surgical repair
Usually
closes by
the time
the child
is 3 years
old
Measure height
And weight for growth
failure
Assessment of the GU System
Uremic encephalopathyLethargy, poor
concentration, confusion
Temperature for hyperthermia
Ear abnormalities
Monitor RR for
abnormal rate
and depth of
respiration
Monitor blood
Pressure for hypo
Or hypertension
Abdominal
distension Bladder
For
distension
Palpate kidneys for
Tenderness, and
enlargemnt
Hypospadias,
epispadias
Inspect skin for
peripheral
cyanosis, slow cap
refill time, pallor,
peripheral edema
Inspect the anus for
rectal bleeding and
nonpatency
Disorders of Genitourinary Function•
•
UTI- characterized by inflammation, usually of bacterial origin, of the urethra, bladder,
ureters, or kidneys
Nephrotic syndrome- characterized by proteinuria, hypoalbuminemia, hyperlipidemia,
altered immunity and edema. Increased permeability to protein, protien leaks through the
glomerular membrane resulting in albumin in the urine. Once albumin is lost colloidal
osmatic pressure decreases permiting fluid to escape from the intravascular spaces to the
intirstial spaces. The volume decrease stimulates antidiuertic hormone to reabsorb water =
edema.
•
Acute glomerulonephritis- antibodies interact with antigens that remain in the glomeruli,
leading to immune complex formation and tissue injury, filtration decreases and excretion of
less Na and H2O. High Blood pressure, edema, and heart failure may result.
•
Wilm’s tumor-
•
Structural defects of gu tract
Assessment of the EndocrineSystem
Measure height
And weight for growth
Failure, plot size of head
Assess vision
Monitor pulse
Increase= hyperthyroid
Decrease=hypothyroid
Auscultate to note for murmurs
Palpate hair
& nails
Lethargy, poor
concentration, confusion,
irritability
Facial abnormalities, mouth for abnormal odors and
Dental delay’s
Monitor blood
Pressure for hypo
Or hypertension
Assess for sexual development
Assess muscle
Strength and tone
Inspect skin for
color changes,
hirsutism, easy
bruising
Palpate to note
dryness, coldness,
changes in texture
Disorders of Endocrine Function
• Hypothyroidism
• Hyperthyroidism
A chronic condition
Characterized by
inadequate amount of
thyroid hormone to meet
metabolic needs.
Congenital- T4 is not
produced which is essential
for growth and development
especially brian
development, left untreated
= MR.
Acquired- inadequate
amount of T4
• Diabetes mellitus
3 p’s
•Polydipsia
•Polyuria
•Polyphagia
A chronic metabolic disorder that results from
either a partial or complete deficiency in insulin.
Type 1- characterized by beta cell destruction,
leading to absolute insulin deficiency.
Type II- insulin resistance, progressive deterioration of
Insulin secretion
Assessment of the Musculoskeletal System
Measure height
And weight for growth
Inspect posture
and gait
Palpate spine to
assess curvature
Palpate boney
Structures for tenderness,
Masses, lesions
Assess, muscle mass, tone
Observe for
structural abnormalities
Asymmetrical limbs
Disorders of Musculoskeletal Function
Scoliosis
Legg-Calvé-Perthes Disease
•Developmental Dysplasia of the Hip
Surgery to
correct
A spinal deformity that usually
Involves lateral curvature of the
Spine, spinal rotation, and thoracic
Kyphosis (hunch back)
A disorder caused
by decreased
blood supply to the
femoral head;
results in
epiphyseal
necrosis and
degeneration
A developmental
abnormality
of the femoral head, the
acetabulum,
or both; subluxation of
the hip
Disorders of Musculoskeletal
Function
Osteomyelitis
Talipes (Clubfoot)
•Infection within the bone
•In children, the metaphysis of the femur,
the tibia, and the humerus are the areas
most affected.
•It can occur at any age; the peak incidence
in children is between ages 3 and 15 years,
and boys are affected twice as often as girls.
•Congenital deformity of the foot and ankle
•Varies in severity; may involve one
foot or both feet
•Manipulation and application of a
series of short leg casts; changed
weekly to allow for further
manipulation
Disorders of Musculoskeletal Function
Septic Arthritis
•Duchenne’s Muscular Dystrophy
A sex-linked inherited
disorder characterized by
gradually progressive
skeletal
muscle wasting and
weakness
Joint aspiration and
surgical irrigation
Broad-spectrum
IV antibiotics
Fractures
An infection of a joint,
which can occur from
bacteria in the blood or
as a direct extension of
an existing infection
Most common sites
in children are
long bones,
clavicles, wrists,
fingers,
and skull.
No effective treatment
Assessment of the Neurological System
Measure head size,
Palpate fontanels
Tachycardia
Increased ICP
Assess LOC,
Cerebullar status- gait
Balance and coordination
Cranial nerve function
Esp pupillary response,
Taste, olfaction, and
tactile sense
Hypertension
Increased ICP
Assess reflexes
Assess muscle tone
and strength
Disorders of Neurological Function
Meningitis
An infection of the meninges
that is usually caused by
bacterial invasion and less
Common by viruses. The bacteria
Enter the meniges through the
blood stream and spread through
the csf.
Children under 2- poor feeding, irritability
And lethargy, high pitched cry, bulging
Fontanel, fever, resistance to being held,
Opisthotonos (hyperextension of the
Neck)
•Check for neurolical signs
and monitor LOC
•Administer prescribed meds
(antibiotic, steroid for cerebral
Edema, anticonvulsant)
•Keep room quite and decrease
Environmental stimuli
Older children- respiratory or GI problems,
nuchal rigidity (stiff neck), HA, kernigs sign,
bruzinski sign, petichial rash
Disorders of Neurological Function
Occurs with
a number
of anomalies
A condition caused by an imbalance
in the production and absorption of CSF
In the ventricular system. When
production exceeds absorption, CSF
Accumulates, usually under pressure and
Produces a dilation of the ventricles.
Communicating hydrocephalus- an impaired
Absorption of CSF in the arachnoid space
Noncommunicationg hydrocephalus- obstruction
to the flow of CSF through the ventricular system
Increased ICP- HA, emesis, irritability,
Lethargy, apathy, and confusion
Disorders of Neurological Function
Surgical treatment- removal of obstruction and insertion of shunts
to provide primary drainage of the CSF to an extracranial
compartment, usually the peritoneum (ventriculperitonel shunt or VP
shunt)
Disorders of Neurological Function
Spina Bifida
Defective closure of the vertebral
Column that may occur anywhere
But usually occurs in the lumbosacral
area.
•Occulta- does not affect spinal cord
May be dimpling of the skin, nevi,
hair tuft
•Meningocele- sac consisting of
meninges and CSF protruding
outside the vertebrae. The spinal
cord is not involved
Myelomeningocele (most common)Similar to meningocele but spinal
Cord and nerve roots are involved
Resulting in sensorimotor deficits,
Urinary and bowel problems
No cure. Surgery to minimize infection.
Preoperatively- apply a sterile dressing
To the lesion and constantly moisten it
With saline. Use protective devices
And handle infant with care.
Disorders of Neurological Function
• Encephalitis- An inflammation of the CNS, mainly the brain and spinal cord
• Cerebral palsy- group of disabilities caused by injury
or insult to the brain either before or during birth
• Seizure disorders- disturbances in normal brain function that result in
abnormal electrical discharges in the brain, which can cause LOC,
uncontrolled body movements, changes in behaviors and sensation, and
changes in the autonomic system.
Many underlying causes:
•Prenatal or perinatal hypoxia
•Infection
•Congenital malformaiton
•Metobolic disturbances
•Lead poisoning
•Head injury
•Tumor
•Medication
•Toxin exposure
•Administer prescribed meds
•Prevent injury
•Document all seizure activity
Disorders of Integumentary
Function
Antihistamines
Clip fingernails
• Contact – inflammation of the skin
resulting from contact with environmental antigens
• Diaper- form of contact dermatitis, exposure
to feces and urine
Keep the diaper area clean and dry;
change diapers as soon as possible;
cleanse area with mild soap
and water, pat dry.
• Atopic (eczema)- a pruritic response
Hydration of the skin;
control pruritus;
decrease inflammation;
and prevent secondary infections.
• Seborrheic – cradle cap
Crusts should be soaked with warm water and
compresses until loosened; shampoo and rinse.
Disorders of Integumentary Function
• Acne Vulgaris – inflammatory process
of the skin commonly seem in adolescents
meticulous skin care
is emphasized
• Psoriasis- a chronic proliferative skin disorder
characterized by thick, scaly patches and inflammation
• Herpes Simplex – a common infection, transmitted
by direct contact of infected body fliuds with nonintact
skin or mucous membranes
• Candidiasis (thrush)-white patches of candida
Nystatin suspension;
frequently found on moist tissues, tongue,
administer after
buccal cavity, vagina
feedings.
Inform parents that the
full 7-day
course of nystatin is to
be completed.
Teach parents to sterilize
bottles, nipples,
pacifiers, and teethers
Disorders of Integumentary Function
•
Parasitic infections –scabies, head lice
•
Bacterial Infections- impetigo, folliculitis, and cellulitis
The assessment
of systemic
signs and symptoms,
areas involved,
and appearance
of lesions are
helpful in establishing
the type of infection.