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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

Assignment NR 602 Common Neonatal Conditions

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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

    Welcome to class

    Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to.

    I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

    Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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    Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

    Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

    I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

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