Assignment NR 602 Common Neonatal Conditions
Assignment: NR 602 Common Neonatal Conditions
Common Neonatal Conditions
Skin Conditions
Table 39-3 lists newborn skin disorders.
TABLE 39-3
Comparison of Newborn Skin Disorders
| Rash | Significant Maternal or Infant History | Rash Description | Diagnostics | Management/Treatment |
| Milia | None | Firm, pearly, white papules over cheeks, nose, and forehead | None | Superficial inclusion cysts will spontaneously resolve |
| Sebaceous hyperplasia | None | Prominent, yellow-white papules over cheeks, nose, and forehead | None | Overgrowth of sebaceous glands will spontaneously resolve in first few weeks |
| Erythema toxicum | None
Presents at 24 to 48 hours |
Yellow-white papules with an erythematous base over cheeks, nose, and forehead | Wright stain demonstrates large number of eosinophils
Cultures are sterile |
Clears within 2 weeks, completely gone in 4 months |
| Transient neonatal pustular melanosis | None
More common in darker skinned persons |
Vesicopustules that rupture easily and leave a halo of white scales around a central macule of hyperpigmentation on trunk, limbs, palms, and soles | None | Spontaneous resolution in 2 to 3 days although hyperpigmentation can persist for up to 3 months |
| Sucking blisters | Results from vigorous sucking in utero on the affected part | Scattered superficial bullae on the upper arms and lips of infants at birth | None | Will resolve without additional intervention |
| Cutis marmorata | Accentuated physiologic response to cold | Lacy, reticulated, red or blue vascular pattern | None | Transient and will resolve with warming |
| Harlequin color change | None | Half of the baby’s coloring is red and the other pale | None | Transient and will resolve |
| Nevus sebaceous | None | Yellow, hairless smooth plaque on head or neck | None | Total excision prior to adolescence; refer to dermatologist |
| Herpes simplex virus (HSV) | Mother may have active lesions or a history of disease | Grouped vesicles on erythematous base | DFA or ELISA detection of HSV antigens | Acyclovir |
DFA, Direct fluorescent antibody; ELISA, enzyme-linked immunosorbent assay.
Milia
Milia are multiple, firm, pearly, opalescent white …
Sebaceous Hyperplasia
Sebaceous hyperplasia is characterized by prominent yellow-white papules …
NR 602 Common Neonatal Conditions
Impetigo
Impetigo is a common contagious bacterial infection of the superficial layers of the skin. It has two forms: …
FIGURE 37-4 A, Nonbullous impetigo. B, Bullous impetigo. (From Bologia J, Schaffer JV, Duncan KO, et al: Dermatology essentials, Philadelphia, 2014, Saunders/Elsevier.)
Assignment NR 602 Common Neonatal Conditions
Clinical Findings
History
- Pruritus, spread of the lesion to surrounding skin, and earlier skin disruption at the site
- Weakness, fever, and diarrhea may accompany bullous impetigo
NR 602 Common Neonatal Conditions
Physical Examination
The following can be found:
- Nonbullous, classic, or common impetigo—begins as 1- to 2-mm erythematous papules or pustules that progress to vesicles or bullae, which rupture, leaving moist, honey-colored, crusty lesions on mildly erythematous, eroded skin; less than 2 cm in size; little pain but rapid spread
- Bullous impetigo—large, flaccid, thin-wall, superficial, annular, or oval pustular blisters or bullae that rupture, leaving thin varnish-like coating or scale
- Lesions are most common on face, hands, neck, extremities, or perineum; satellite lesions may be found near the primary site, although they can be anywhere on the body
- Regional lymphadenopathy …
NR 602 Common Neonatal Conditions
Diagnostic Studies
Gram stain and …
Differential Diagnosis
Herpes simplex, …
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Management
Management involves the following:
- Topical antibiotics may be used if the impetigo is superficial, …
- Cephalexin: …
- Amoxicillin/clavulanate: …
- Dicloxacillin: …
- Cloxacillin: …
- Clindamycin: …
- For widespread infection with constitutional symptoms and deeper skin involvement, use an oral antibiotic active against beta-lactamase–producing strains of S. aureus, such as …
- If an infant has bullous impetigo, use …
- If there is no response in 7 days, swab beneath the crust, and do Gram stain, culture, and sensitivities. Community-acquired MRSA should be considered. This organism is more susceptible to clindamycin and trimethoprim-sulfamethoxazole (TMP-SMX) (see Chapter 24 for treatment of MRSA).
- Educate regarding cleanliness, hand washing, and spread of disease.
- Exclude from day care or school until treated for 24 hours.
- Schedule a follow-up appointment in 48 to 72 hours if not improved.
Complications
- Cellulitis may occur with nonbullous impetigo and …
- Lymphangitis, suppurative lymphadenitis, guttate psoriasis, …
- Staphylococcal scalded skin syndrome (SSSS) is a blistering disease that …
Patient and Family Education
- Thorough cleansing of any breaks in the skin helps prevent impetigo.
- Postinflammatory pigment changes can last weeks to months.
- The patient should not return to school or day care until 24 hours of antibiotic treatment is completed.
- Important information for writing discussion questions and participationHi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource
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