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Course: Pediatric Nursing

Topic: Nursing care of child with Integumentary System Part I

The Nurses International Community

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Module Goals

Learners will be able to:

Identify common integumentary disorders in children including signs and symptoms.
Describe common diagnostic procedures for integumentary disorders and nursing implications.
Explain common medical treatments for children with integumentary disorders and nursing implications.
Discuss the nursing management of a child with an integumentary disorder.

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Skin Infection

Skin is the largest organ of the body

First line of defense against infection

Skin infections are caused by a wide variety of germs

Bacteria
Virus
Fungi
Parasites

Symptoms can vary from mild to serious

Piatro, 2022

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Types of Skin Rashes

Conditions that cause skin rashes:

Dermatitis
Viral infections
Bacterial infections
Fungal infections

Cleveland Clinic, 2022

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Dermatitis

An umbrella term for any condition that causes skin inflammation
May cause rashes, itchiness and dry skin
Occurs at any age
Types:

Diaper rash
Cradle cap
Eczema and
Contact dermatitis

Cleveland Clinic, 2022

Contact info: info@nursesinternational.org

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Dermatitis: Diaper Rash (Diaper Dermatitis)

Common in infants
Occurs when moisture in diaper area causes irritation, growth of fungi or bacteria
Prevention:

Keep diaper area clean and dry
Change diapers frequently
When changing diaper, leave it off for a short while before dipering again
Apply ointment or cream that contains zinc oxide or petroleum

Cleveland Clinic, 2022

Contact info: info@nursesinternational.org

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Case Study

A mother whose 8 months old is being treated for severe diaper rash ask how the rashes could be prevented in future?

What would a nurse suggest to the mother about the prevention of diaper rash?

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Dermatitis: Cradle Cap (Seborrheic Dermatitis)

Yellow scaly patches often surrounded by a red rash on baby’s scalp
Overproduction of the oil-producing sebaceous glands
Treat at home with mild baby shampoo
May lightly rub the scale off if tolerated well by infant

Cleveland Clinic, 2022

Contact info: info@nursesinternational.org

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Dermatitis: Eczema (Atopic Dermatitis)

Symptoms:

Itchy, red, irritated and dry skin

May be caused by seasonal or allergic triggers
Treatment :

Good skin care
Bathing in mildly warm water
Moisturize regularly, especially immediately after baths or water exposure

Cleveland Clinic, 2022

Contact info: info@nursesinternational.org

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Dermatitis: Contact Dermatitis

A reaction to an allergen or an irritant

Allergens may include:

Poison ivy or medications

Irritants may include:

Perfumes, soaps, cleaners and paints

Itchy skin rash that may be painful
Treatment:

Moisturizers
Anti-’itch’ creams
Topical or oral steroids

Cleveland Clinic, 2022

Contact info: info@nursesinternational.org

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Critical Thinking Question

A baby has developed ‘cradle cap’, what kind of treatment would parents expect from a care providers?

Antibiotics
Moisturizers
Antihelminthic
Anti-’itch’ creams
Topical or oral steroids

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Viral Infection

These infections cause skin rashes

Measles/ Rubeola
Rubella
Varicella/Chickenpox)
Fifth disease
Note: Please see these disorders in Communicable disorders (I) slide deck: https://docs.google.com/presentation/d/1D8m4O7adsEcB8yu3Jt75YwZxy9lTb3Db/edit#slide=id.g1305a874c9f_0_18

Children’s National, n.d

Contact info: info@nursesinternational.org

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Nurses Role

History taking
Physical examination
Ease symptoms:

Encourage drinking fluids
Give Acetaminophen or ibuprofen for fever/ discomfort

Health Education:

Immunization for prevention of disease
Transmission of diseases
Preventive measures for transmission

Emotional support

Contact info: info@nursesinternational.org

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Case Study/ Critical Thinking Question/ What Would the Nurse Do?

Identify some viruses that are responsible for the skin diseases and rashes.

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Cultural Considerations

Religion, culture, beliefs, and ethnic customs can influence how families understand and use health concepts:

Health beliefs: In some cultures talking about a possible poor health outcome will cause that outcome to occur.
Health customs: In some cultures family members play a large role in health care decision-making.
Ethnic customs: Differing gender roles may determine who makes decisions about accepting & following treatment recommendations.

AHRQ, 2020

Contact info: info@nursesinternational.org

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Cultural Considerations (Continued)

Religion, culture, beliefs, and ethnic customs can influence how families understand and use health concepts:

Religious beliefs: Faith and spiritual beliefs may affect health seeking behavior and willingness to accept treatment.
Dietary customs: Dietary advice may be difficult to follow if it does not fit the foods or cooking methods of the family.
Interpersonal customs: Eye contact or physical touch may be ok in some cultures but inappropriate or offensive in others.

AHRQ, 2020

Contact info: info@nursesinternational.org

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References:

CDC. (2021 April 28). Chickenpox (Varicella). https://www.cdc.gov/chickenpox/about/index.html

Cleveland Clinic. (2022). Skin Conditions in Children. https://my.clevelandclinic.org/health/diseases/6951-skin-conditions-in-children

Children’s National. (n.d). Pediatric Common Skin Disorders. https://childrensnational.org/visit/conditions-and-treatments/skin-disorders/common-skin-disorders

Contact info: info@nursesinternational.org

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References:

Government of Canada. (2012). Pediatric and Adolescent Care - Chapter 18 - Communicable Diseases. Clinical Practice Guidelines for Nurses in Primary Care - Pediatric and Adolescent Care. https://www.canada.ca/en/indigenous-services-canada/services/first-nations-inuit-health/health-care-services/nursing/clinical-practice-guidelines-nurses-primary-care/pediatric-adolescent-care/chapter-18-communicable-diseases.html

Piatro, M. A. D. (2022 February 3). Skin Infection: Types, Causes, and Treatment. [Review of article ‘Skin Infection: Types, Causes, and Treatment’ by, T. Sarah). https://www.healthline.com/health/skin-infection

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