Running Head: EVALUATION OF DERMATOLOGICAL DISORDER 1
EVALUATION OF DERMATOLOGICAL DISORDER 3
WK 5 Journal Entry
Assessment and Management of Paediatric Dermatologic disorder
Gloria Okoye
Walden University
NURS - 6541N – 1
Prof. Nogueira
Dermatology disorders are an infection and abnormal appearance of the skin. Mostly repented by skin lesions, the skin disorder serves as an indicator of an underlying internal disease for examples internal cancer, GI disorders or endocrinopathies. Dermatological disorders are best examined before treatment or diagnosis but the most suitable is clinical acumen and appropriate laboratory tests. Origin of dermatological disorders are of different types including; bacterial infections, hereditary conditions, vascular lesions, tumors, and growths.
Examination of a Paediatric Dermatological Disorder
Early on Monday morning, a mid-age African American mother walks into the clinic carrying a 10 old month infant. The parent complains of the Childs' difussed pruritic rash , and relapsing skin dryness, inflammation and erythema for the last 2 week. Mother states that infant has been current with immnuization . Mother denies any fever, diarrhea, or decreased appetite , no exposure to a new medication or change of detergent at the onset of the rash. The only medical history is chronic dry skin and urticaria that has been wel controlled. Other than occasional itching, otherwise, well developed , well nourished infant. From examining the infant, it was evident that the child’s skin was affected by lesions that occur as a result of irritation and scratch marks. The disorder seems to have affected the face and flexural parts of the body mostly. Upon abrasion the affected parts the child tends to remain calm, indicating that the affected parts are sensitive to touch.
Upon further examination, the skin is dry and staph aureus. Other symptoms are papules and vesicles, erythema, skin infections and secondary erosions and lichenification (Stevens & Godstein, 2014).
Diagnosis
From the symptoms and medical examination,
V/S was within normal range , then it was concluded that the patient as suffering from Eczema and contact dermatitis (atopic and discoid) that is most common among infants that are in their early childhood especially for one year. It is associated with the immune response of the infant and if the condition is not contained it results in secondary bacterial infections especially around the flexural joints. It serves as a barrier of the epidermal barrier function (Burns, 2013).
Management of Dermatological Disorder
The eczema disorder is managed through manipulation of the environment such as education on the removal of prickles. Adequate skin care includes consistent application of emollients for clear skin (Dermnet.com, 2011).
Medications Provided:
Clindamycin 600mg po q8 hrs for 7 days
Atarax 10mg every 6 hrs at night for itching
Zyrtec 5mg po once a dat duing the day for itching /allergy
Mometasone ointment 0.1% topical BID
Apply Vasaline externally 4 times a day to all the skin
Bland skin care and Bleach bath was discussed with infant mother, Booklet on children’s allergy and skin problems was given to the monthe. If not responding to emollients, mother will call the clinic . The skin infections should be treated adequately through bathing with bleach and oral antibiotics (Dermnet, 2014). Mother was also refered to dermatology for further allergy testing and treatment and then f/u.
My “aha” moment was when I examined the patient and observed the skin symptoms and the allergic reactions. This was a connection to the classroom studies that linked the symptoms to desk studies and clinical experiments to the daily nursing experiences.
Conclusion
Dermatological disorders among infants is a critical case and should be contained and treated as soon as possible before it becomes critical or life threatening. Parental and medical care is therefore of significance in this case.
References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
Dermnet.com. (2011). Dermnet Skin Disease Atlas. Retrieved from http://www.dermnet.com/
DermNet New Zealand Trust. (2014) DermNet NZ. Retrieved from http://www.dermnetnz.org/
Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America by Stevens, D.L., Bisno, A.L., Chambers, H.F., Dellinger, E.P., Goldstein, E.J.C., Gorbach, S.L., Hirschmann, J.V., Kaplan, S.L., Montoya, J.G., & Wade, J.C. in Clinical Infectious Diseases , 59(2), 10-52.