Impetigo NCLEX Review

This NCLEX review will discuss impetigo.

As a nursing student, you must be familiar with impetigo and how it affects the pediatric population. In addition to the signs and symptoms, nursing interventions, and treatment for this condition.

Don’t forget to take the free impetigo quiz after reviewing this material.

Impetigo Lecture

Impetigo NCLEX Review

What is impetigo? It is a skin infection that is highly CONTAGIOUS!!!

Quick Facts about Impetigo for Nurses:

• It affects children ages 2-6 but can affect adults.
• Infections are most common during the summer months.
  • WHY? Children are more active than adults in that they are running around bumping and scraping their skin, which decreases its integrity and allows for bacteria to enter the skin. In addition, children play in close proximity with each other and this leads to the spread of the infection.
• Impetigo tends to be found most commonly on the FACE (mouth or nasal area). It can also be found on hands, arms, and the legs.
• It is VERY contagious and can be spread easily. As the nurse it is important to educate the child’s parent about using separate linens, towels, toys etc.
• What bacteria are the most common causes of impetigo?
  • Staphylococcus aureus
  • Streptococcus pyogenes

How does impetigo happen? Example: A child experiences a slight trauma to an area on the skin. It may be a simple cut, crack, scratch, or an allergic reaction on the skin from contact dermatitis. This allows for one of the bacteria above to enter the skin and cause an infection.

Signs and Symptoms of Impetigo

Sequence of how it presents:

• It will start out as an itchy, painful red blister or bump….the area doesn’t seem to heal but spreads.
• If it’s a blister it can rupture….if not a blister it just spreads.
• Then the lesion will start to leak fluid that is honey-colored (strep)….clear or pus (staph).
• In addition to this it will leave behind red patches that crust over with yellowish brown crust….a painful swollen lymph node may present near the site because the immune systems recognition of the bacteria in the body.

Hallmark: Yellowish Brown Crust!

Nursing Interventions for Impetigo

Prevention of spreading to other areas of the patient’s body (**Touching the site can spread it to another site on the body), others, and yourself!

• Meticulous hand hygiene along with placing the patient in contact precautions, if hospitalized.
• Keep the child from scratching or touching sites on the body and keep the nails short along with performing regular hand hygiene with antibacterial soap (important for parents and other children in the home to follow as well).

Treatment: topical or oral (severe cases) antibiotics

• Remove the crust prior to applying antibiotic ointment with warm water and antibacterial soap. WHY? This is where the bacteria live and the ointment needs to come into contact with the skin to kill the bacteria.
• It’s contagious until the site is completely healed (it can be weeks) if NOT on treatment
  • If receiving treatment:
    • NOT contagious after 48 hours with TOPICAL ointment and 24 hours for ORAL antibiotics.
  • Educate about completing full regime of treatment, especially if the patient has strep impetigo: can develop glomerulonephritis

Home education: separate linens, clothes, towels, toys etc. hand hygiene among family members, and child.

References: