Nursing Care Plan for Impetigo

Pathophysiology

Impetigo is the most common bacterial skin infection in children. Impetigo is highly contagious and normally appears around the nose, mouth and extremities. It is characterized by blisters with yellow fluid that rupture and leave a honey-colored crust. Impetigo is spread through direct contact with sores and scratching may cause the lesions to spread.  The normal course of infection typically lasts 2-3 weeks without treatment. Systemic complications, including rheumatic fever and glomerulonephritis are rare, but can occur.

Etiology

Impetigo is caused by common bacteria, usually Group A beta-hemolytic streptococcus or Staphylococcus aureus that enters through breaks in the skin.  It often accompanies poor hygiene and is more prevalent in warm temperatures. The condition is considered contagious as long as lesions are present.

Desired Outome

Patient will be free from infection and exhibit an absence of skin lesions; patient will not have systemic complications

Impetigo Nursing Care Plan

Subjective Data:

  • Generalized weakness
  • Malaise
  • Itching

Objective Data:

  • Multiple lesions or bullae around the mouth and nose or extremities
  • Honey-colored crust around lesions
  • Fever
  • Diarrhea

Nursing Interventions and Rationales:

  1. Assess skin for lesions; note color and presence of crusting
    • Open sores or blisters may form around mouth and nose, but may also be located on trunk and extremities. Ruptured blisters and sores may have yellow crusting on or around the lesions.
  2. Assess vitals; note fever
    • Monitor for signs of systemic infection or complication
  3. Maintain contact precautions
    • Disease is spread through direct contact with lesions. Use PPE and sanitize equipment or tools (or use disposable equipment if available)
  4. Apply topical antibiotics with sterile, individual applicators
    • Topical antibiotics may be appropriate when a small area is affected. A 7 day course is generally required.

      Make sure to avoid contamination of container and other areas when applying topical treatments.
  5. Administer oral antibiotics
    • Oral antibiotics may provide better treatment of infection than topical treatments alone. There should be signs of improvement after 2-3 days of treatment.
  6. Make sure patient’s fingernails are trimmed and clean; use mittens or socks on the hands of infants as appropriate
    • Itching is a common symptom. Scratching lesions will cause the disease to spread to other parts of the body, or other people.
  7. Educate patient and caregivers about how to prevent the spread of disease to others
    • Infected child should use their own towels and linens which should be washed alone.

      Ensure good hand washing habits;
      Avoid contact with others who may have depressed immune system.

      Avoid outside play, high temperatures that will make the sores worse.

References

Date Published - Nov 15, 2018
Date Modified - Nov 15, 2018