NSG125: Care of Clients with Problems in Oxygenation, Fluid & Electrolytes, Infection, Inflammatory & Immunologic Response, Cellular

Aberration (Acute & Chronic)

CONTACT DERMATITIS
1st SEMESTER | S.Y. 2022-2023 TRANSCRIBED BY: BAHI-AN, CALI, CAMID
INSTRUCTOR: PROF. ABOLBASHAR MANGONTAWAR DATE TRANSCRIBED:

CONTACT DERMATITIS MEDICAL MANAGEMENT

- a type IV delayed hypersensitivity reaction, is an acute or - Avoiding the irritant
chronic skin inflammation that results from direct skin - Phototherapy
contact with chemicals or allergens. - Medicated baths
- There are four basic types:
o Allergic PHARMACOLOGIC INTERVENTIONS
o Irritant - Hydrocortisone
o Phototoxic - Antihistamines
o Photoallergic - Barrier cream
- 80% of cases are caused by excessive exposure to or - Antibiotics
additive effects of irritants (eg, soaps, detergents, organic
solvents). NURSING MANAGEMENT
- Skin sensitivity may develop after brief or prolonged periods - Find out the cause of the problem.
of exposure, and the clinical picture may appear hours or - Avoid contact with the irritants, or wash skin thoroughly
weeks after the sensitized skin has been exposed. immediately after exposure to the irritants.
- Avoid heat, soap, and rubbing the skin.
CLINICAL MANIFESTATIONS - Choose bath soaps, detergents, and cosmetics that do not
- itching contain fragrance; avoid using a fabric softener dryer sheet.
- burning - Avoid topical medications, lotions, or ointments, except
- erythema when prescribed.
- skin lesions (vesicles) - Make sure gloves are cotton-lined; do not wear for more than
- edema 15 to 20 minutes at a time.
- weeping, crusting, and finally drying and peeling of the skin
(followed by first onset of symptoms) NURSING DIAGNOSIS
- hemorrhagic bullae (severe responses) - Impaired Skin Integrity
- thickening of the skin and pigmentary changes (repeated - Disturbed Body Image
reactions) - Risk for Infection
- abrasion due to rubbing or scratching (secondary invasion - Risk for Impaired Skin Integrity
by bacteria)

DIAGNOSTIC EVALUATIONS
- Thin Layer Rapid Use Epicutaneous (TRUE) Test
o a type of patch tests on the skin with suspected
offending agents to clarify the diagnosis
o commonly used for diagnostic evaluation of the
patient with allergic disorders

PATHOPHYSIOLOGY