Pediatric Integumentary & Musculoskeletal Nursing – Review

Thirty Q&A-style flashcards covering key pediatric integumentary, infection, burn, dermatologic, and musculoskeletal concepts from the lecture.

Q1: What are the three main layers of the skin from outermost to deepest?

Epidermis (outer), Dermis (middle), Hypodermis/Subcutaneous layer (deepest).

Q2: Why is intact skin critical for infection prevention?

It acts as a physical barrier; punctures or wounds create entry points for pathogens that can lead to systemic infection and sepsis.

Q3: What organism causes oral thrush in infants, and which medication is commonly prescribed?

Candida albicans; treated with the antifungal nystatin (swabbed or placed in the cheek).

Q4: Name two key measures to prevent reinfection of thrush during feeding.

1) Boil or sterilize nipples/bottles for at least 3 minutes; 2) Practice meticulous hand and breast hygiene if breastfeeding.

Q5: What does Candida diaper dermatitis look like and which barrier agents help protect the skin?

Bright red, possibly blistered rash in the diaper area; zinc-oxide or petroleum-based ointments create a moisture barrier.

Q6: List three common triggers that can exacerbate atopic dermatitis (eczema).

Dry winter air, allergens (food, dust, pollen, wool, soaps), and emotional stress/over-heating.

Q7: How often should topical corticosteroids generally be applied for atopic dermatitis according to recent guidance?

Once daily (rather than twice) until the skin feels smooth, then taper.

Q8: Which two bacteria most commonly cause impetigo and what classic appearance does it form?

Staphylococcus aureus and Group-A β-hemolytic Streptococcus; lesions form a honey-colored crust after rupturing.

Q9: How does bullous impetigo differ from non-bullous impetigo?

Bullous (common in infants) begins as large fluid-filled blisters that collapse; non-bullous starts as papules → pustules with honey crust and affects all ages.

Q10: What infection-control teaching is essential for families managing a child with impetigo?

Frequent handwashing, use of gloves for ointment application, cleaning lesions 3-4×/day, and keeping the child’s linens, towels, and bed separate.

Q11: Why should MRSA boils or blisters never be intentionally “popped”?

Bursting spreads the infection to surrounding skin and bloodstream, increasing risk of severe illness.

Q12: Define cellulitis and state the usual treatment route.

A deep bacterial infection of dermis/subcutaneous tissue causing red, painful, edematous skin; usually requires systemic (oral or IV) antibiotics, not topical alone.

Q13: Which products are first-line for treating head lice in children, and which older product is no longer recommended?

Permethrin (Nix) or pyrethrin shampoo (RID) are first-line; Lindane (Kwell) is avoided due to neuro-toxic side effects.

Q14: Describe two environmental steps to eradicate pediculosis.

1) Wash clothes/bedding in hot water & dry on high heat; 2) Seal unwashable items in a plastic bag for 2 weeks or spray mattress with disinfectant.

Q15: How does pediatric burn surface-area estimation differ from adults?

Uses age-adjusted charts (pediatric % charts) rather than the adult “Rule of Nines,” because infants’ heads and trunks represent larger percentages.

Q16: Which burn depth is usually painless in the center and why?

Full-thickness (third-degree) burns destroy nerve endings, leaving the center insensitive, though surrounding partial-thickness areas remain painful.

Q17: What are the first three priorities in emergency management of major burns?

Maintain airway, support breathing, establish circulation (ABC) before wound care.

Q18: Which topical agent is commonly applied to partial-thickness burns and what allergy must be checked first?

Silver sulfadiazine (Silvadene); verify the patient is not allergic to sulfa drugs.

Q19: What is the analgesic of choice for severe pediatric burn pain and how is it usually given?

Morphine sulfate administered IV, with close respiratory monitoring.

Q20: Why must adolescents on isotretinoin (Accutane) use reliable contraception?

Isotretinoin is highly teratogenic and can cause severe fetal malformations; pregnancy prevention is mandatory.

Q21: Name two daily skin-care practices that help reduce acne outbreaks.

Gentle twice-daily cleansing with non-comedogenic wash/scrub and avoiding heavy, oily cosmetics.

Q22: What is ossification and what is the significance of the epiphyseal plate?

Ossification is hardening of bone from cartilaginous tissue; the epiphyseal (growth) plate is where longitudinal bone growth occurs and must remain intact.

Q23: List the “Five P’s” assessed for neurovascular status in a limb cast.

Pain, Pallor, Pulse, Paresthesia, Paralysis.

Q24: Compare drying characteristics of plaster vs. synthetic (fiberglass) casts.

Plaster: 24–72 h to fully dry, cool to touch; Synthetic: dries in <30 min but produces more heat while curing.

Q25: What conservative method is most often used to correct idiopathic clubfoot in infants?

The Ponseti serial casting technique, gradually repositioning the foot; severe cases may require surgical tendon release.

Q26: What are two classic physical signs of developmental dysplasia of the hip (DDH) in infants?

Asymmetric gluteal/thigh skin folds and shortening or lower height of the affected knee during flexion (positive Galeazzi sign).

Q27: State one critical rule for parents using a Pavlik harness for DDH.

Never adjust the straps themselves; only trained providers should alter strap length to keep hips flexed and abducted safely.

Q28: How is cerebral palsy (CP) classified in terms of progression, and why is early therapy important?

CP is non-progressive (does not worsen structurally), but early physical/occupational/speech therapy maximizes developmental potential and function.

Q29: Describe two hallmark features of spastic cerebral palsy.

Hypertonic, jerky movements with muscle stiffness and possible scissoring of the legs due to adductor spasm.

Q30: List two perinatal risk factors associated with development of cerebral palsy.

Apgar score <5 at 5 minutes or neonatal seizures within 48 h of birth; additional factors include maternal infections or birth hypoxia.