ABSTRACT
Children with a petechial rash commonly present to emergency departments. The rash can be associated with serious illnesses, such as invasive meningococcal disease (IMD), but is usually associated with less severe conditions. This article discusses the common and important causes of petechial rash, including IMD, viral illnesses, trauma, Henoch-Schönlein purpura and idiopathic thrombocytopenic purpura. It also analyses the National Institute for Health and Care Excellence (NICE) ( 2014 ) pathway for management of petechial rash in children and examines treatment of the various causes. The article includes two relevant case studies and discusses the role of emergency nurses.
Subject(s)
Emergency Nursing/standards , Exanthema/diagnosis , Exanthema/nursing , Nurse's Role , Practice Guidelines as Topic , Adolescent , Child , Child, Preschool , Female , Humans , IgA Vasculitis/diagnosis , IgA Vasculitis/nursing , Infant , Infant, Newborn , Male , Meningococcal Infections/diagnosis , Meningococcal Infections/nursing , Purpura/diagnosis , Purpura/nursing , Purpura, Thrombocytopenic, Idiopathic/diagnosis , Purpura, Thrombocytopenic, Idiopathic/nursingABSTRACT
Patients with bariatric needs are likely to experience skin problems because maintaining skin hygiene, particularly between skin folds, can be a challenge. This article is a summary of a literature review that explored the evidence on skin hygiene for people with bariatric needs. The findings reveal a gap in the evidence base and the authors make several recommendations for further research.
Subject(s)
Bariatrics/nursing , Exanthema/etiology , Exanthema/nursing , Hygiene , Obesity/complications , Sweat Gland Diseases/etiology , Sweat Gland Diseases/nursing , Evidence-Based Nursing , HumansABSTRACT
This article discusses the incidence, epidemiology, clinical presentation, diagnosis, and treatment of herpes zoster, complications such as postherpetic neuralgia, and prevention through vaccination. Information on vaccine cost and insurance coverage is provided as well as two case studies illustrating various clinical presentations.
Subject(s)
Exanthema/nursing , Herpes Zoster/nursing , Nurse Practitioners , Aged , Exanthema/virology , Female , Herpes Zoster/complications , Herpes Zoster/epidemiology , Herpes Zoster Vaccine/administration & dosage , Herpes Zoster Vaccine/economics , Humans , Insurance Coverage , Insurance, Health , Male , Patient Education as Topic , Risk Assessment , United States/epidemiologySubject(s)
Exanthema/nursing , Scarlet Fever/nursing , Anti-Bacterial Agents/therapeutic use , Bacterial Proteins , Child , Diagnosis, Differential , Exanthema/diagnosis , Exotoxins , Female , Humans , Male , Nursing Diagnosis , Prognosis , Randomized Controlled Trials as Topic , Scarlet Fever/complications , Scarlet Fever/diagnosis , Scarlet Fever/drug therapySubject(s)
Child of Impaired Parents , Enterobacteriaceae Infections/psychology , Exanthema/psychology , Mental Competency , Mothers/psychology , Munchausen Syndrome by Proxy , Adult , Anti-Bacterial Agents/therapeutic use , Bacteremia/diagnosis , Bacteremia/drug therapy , Bacteremia/psychology , Catheter-Related Infections/drug therapy , Catheter-Related Infections/microbiology , Catheter-Related Infections/psychology , Catheterization/adverse effects , Enterobacter/isolation & purification , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/drug therapy , Exanthema/nursing , Exanthema/therapy , Fatal Outcome , Female , Humans , Mother-Child Relations , Postural Orthostatic Tachycardia Syndrome/therapy , Sepsis/psychology , Sick Role , Syringes , Young AdultABSTRACT
BACKGROUND: Skin breakdown increases the cost of care, may lead to increased morbidity, and has negative psychosocial implications because of secondary scarring or alopecia. The scope of this problem has not been widely studied in critically ill and injured children. OBJECTIVES: To determine the incidence of skin breakdown in critically ill and injured children and to compare the characteristics of patients who experience skin breakdown with those of patients who do not. METHODS: Admission and follow-up data for a 15-week period were collected retrospectively on children admitted to a large pediatric intensive care unit. The incidence of skin breakdown was calculated. The risk for skin breakdown associated with potential risk factors (relative risk) and 95% confidence intervals were determined. RESULTS: The sample consisted of 401 distinct stays in the intensive care unit for 373 patients. During the 401 stays, skin breakdown occurred in 34 (8.5%), redness in 25 (6.2%), and breakdown and redness in 13 (3.2%); the overall incidence was 18%. Patients who had skin breakdown or redness were younger, had longer stays, and were more likely to have respiratory illnesses and require mechanical ventilatory support than those who did not. Patients who had skin breakdown or redness had a higher risk of mortality than those who did not. CONCLUSIONS: Risk factors for skin breakdown were similar to those previously reported. Compared with children of other ages, children 2 years or younger are at higher risk for skin breakdown.
Subject(s)
Intensive Care Units, Pediatric/statistics & numerical data , Nursing Audit , Pediatric Nursing/standards , Skin Care/standards , Adolescent , Age Factors , Child , Child, Preschool , Exanthema/nursing , Exanthema/prevention & control , Humans , Iatrogenic Disease , Infant , Intensive Care Units, Pediatric/standards , Pressure Ulcer/nursing , Pressure Ulcer/prevention & control , Prospective Studies , Risk Assessment , Risk Factors , Skin Care/nursing , Skin Ulcer/nursing , Skin Ulcer/prevention & control , WisconsinABSTRACT
Epidermal growth factor receptors (EGFRs) play an important role in the development of the skin and up-regulation of these receptors is associated with many cancer-related processes, such as inhibition of apoptosis and uncontrolled cell proliferation. Accordingly, treatment of metastatic colorectal cancer with EGFR inhibitors may lead to adverse cutaneous effects that can decrease the patient's quality of life and could possibly lead to reduced, interrupted, or discontinued therapy. Effective management of these adverse effects may lessen the chance of suboptimal therapy and requires an understanding of the underlying pathophysiology, as well as knowledge of useful strategies for alleviating these effects.
