What is the skin mucous membrane

Mucous membranes exist in various parts of the human body, such as in the mouth, uterus, intestines, and even human skin. People may not know much about skin mucous membranes and do not know what skin mucous membranes are. In order to make people understand clearly, let us introduce to people what skin mucous membranes are.

The skin and mucous membranes protect the human body, forming a closed system to the outside world. When harmful substances are about to invade the human body, the skin and mucous membranes are the first to block the external pathogenic factors outside the body.

The skin and mucous membranes are the body's first line of defense against infection.

Skin Introduction

Skin mucosa generally refers to the location of the cavity opening, such as oral mucosa, eyelid mucosa, nasal mucosa, urethral mucosa, etc.

Lymph node syndrome

Symptom description

Mucocutaneous lymphnode syndrome, also known as Kawasaki disease, is a connective tissue disease with allergic systemic small blood vessels as the main pathological changes. The main manifestations are acute fever, skin and mucous membrane lesions and lymphadenopathy. It is more common in infants and young children.

Causes

The cause of the disease is unclear, but it may be related to infection, immune response, environmental pollution, drugs, chemicals, etc. The lesions can affect arteries, veins and capillaries, and can invade multiple systems throughout the body, resulting in a variety of clinical manifestations. The most serious is coronary artery disease, which is often the main cause of death.

The course of the disease is usually 6 to 8 weeks, and if there are cardiovascular symptoms, it may last for months to years.

Main manifestations

① Fever, which may be prolonged or remittent, lasting for 1 to 2 weeks.

② Skin and mucous membrane manifestations: polymorphic urticaria, erythema or scarlet fever-like rash on the trunk, without blisters or induration. The disease initially presents as solid swelling at the extremities and membranous peeling of the fingertips during the recovery phase, which is the characteristic of this disease. The conjunctivae of both eyes are congested without purulent secretions or tearing; the lips are dry, flushed, chapped, and have a bayberry tongue; the oral and pharyngeal mucosa are diffusely red without ulcers or pseudomembrane formation.

③Non-suppurative enlargement of cervical lymph nodes.

Cardiovascular symptoms and signs are uncommon but important. Symptoms include heart murmurs, arrhythmias, cardiomegaly, and heart failure.

Nursing of infantile mucocutaneous lymphadenopathy syndrome

1. Observation and care of fever: The body temperature varies according to the early or late stage of the disease. The fever is higher in the early stage of the disease and lower in the late stage. There is no obvious relationship with age. High body temperature can cause certain damage to the body, so it is very important to measure temperature regularly and observe closely. Measure the temperature every 4 hours. To ensure accuracy, measure the temperature of the baby rectally. If the body temperature exceeds 38.5℃, physical cooling should be carried out, such as applying cold compress to the head, wiping the body with warm water for those who sweat a lot, changing underwear, and keeping the skin dry to avoid cold. At the same time, children are encouraged to drink more water. If they do not drink enough water, they should report to the doctor and receive timely intravenous replenishment. The amount of fluid replacement is generally calculated at 80 to 100 ml/kg body weight and dripped evenly to maintain water and electrolyte balance.

2. Observation and care of oral mucosa: All children have congestion of oral and pharyngeal mucosa, chapped lips, accompanied by erosion of oral mucosa and small ulcers on the tongue. Use 3% boric acid solution to gently wash the mouth twice a day. Be careful not to cause bleeding and pain during the operation to prevent the child from being frightened and refusing care. At the same time, observe the oral mucosa for erosion, ulcers and their evolution. In addition, help the child drink a small amount of warm water before and after eating to keep the mouth clean and promote wound healing. Apply sterilized paraffin oil to chapped lips to prevent bleeding and pain caused by chapped lips. We do not advocate the use of gentian violet or tin powder for application. These pigmented drugs adhere to the wound surface, which will affect the correct observation of the ulcer surface, and have a peculiar smell, which is often rejected by children and may even reduce their appetite. The children's oral mucosal erosions healed within a week after treatment. A few children had chapped lips and bleeding that did not heal for 10 to 20 days. All children used various antibiotics, and no fungal infection occurred.

3. Observation and care of skin and lymph nodes: Some children had red maculopapular rashes all over their body, which were non-itchy and did not form blisters or scabs. These rashes disappeared on their own within a week. No drug rash was observed after the use of antibiotics and aspirin. Some children have redness and swelling on the tips of their fingers or toes. When the redness and swelling subside, flaky, membranous desquamation begins to appear. When desquamation occurs, the children and their families are repeatedly warned not to tear or pull the skin artificially, which will damage the integrity of the skin. The damaged skin should be allowed to fall off on its own. And tell the family members that hair loss may occur within 1 to 3 months of the illness, and after discharge from the hospital, pay attention to head cleanliness and wash your hair regularly to prevent scalp damage.

4. Observation and care of other organ damage: According to literature reports, about 30% of children with this disease may have heart damage, such as myocarditis, pericarditis, myocardial infarction and aneurysm. We closely monitor heart rate and rhythm, measuring heart rate once every 4 hours. If you find dull heart sounds, systolic murmurs, or an increased heart rate, you should suspect heart damage and have a color ultrasound examination to clarify the condition.

5. Observation and care during drug treatment: Children with this disease have increased platelet count, hypercoagulable blood, increased synthesis of thromboxane A2, and platelets are prone to aggregation and formation of thrombus. Aspirin has nonspecific anti-inflammatory effects and can inhibit the synthesis of thromboxane A2 and prostacyclin, thus preventing platelet aggregation and thrombosis. In order to prevent Kawasaki disease from complicating myocardial infarction, different doses of aspirin and dipyridamole are used clinically for 2 to 6 months to prolong the prothrombin time and prevent hypercoagulation of the blood to form thrombi. The acute symptoms disappear and the platelet count returns to normal, which lasts for about 1 to 2 months. For patients with coronary artery dilatation, the aspirin medication period should be appropriately extended. The general recovery time for coronary artery disease is 2 to 5 months. Vitamin E can improve the stability of capillary endothelial cells, protoplasm, mitochondria, endoplasmic reticulum and lysosomes, improve the permeability and resistance of blood vessel walls, and play a certain therapeutic role in coronary artery aneurysms. Therefore, vitamin E can also be added at 20-30 mg/kg body weight per day until the inner diameter of the coronary aneurysm is <3 mm. In addition to its anticoagulant effect, aspirin can cause side effects when taken in large quantities or for a long time, which should be taken seriously. In order to reduce the irritation of the drug to the gastric mucosa and the formation of drug-induced ulcers, take the medicine after meals. Dissolve aspirin in a small amount of warm water and drink it.

6. Diet care: Fever, congestion and erosion of the oral mucosa affect the appetite of children, and they may even refuse to eat. To ensure the needs of the body, it is necessary to understand the children's usual eating habits and favorite foods, and cook them into delicious, protein-rich, nutritious, and easily digestible low-salt liquid or semi-liquid foods. The food should be warm and cool, and children who cannot eat by themselves should be fed patiently. For children who have not yet been weaned, their mothers are required to eat more nutritious foods, especially increase the amount of liquid they drink every day (broth, chicken soup, fish soup, etc.) in order to increase the amount and quality of milk. After the child's body temperature returns to normal, his appetite generally improves. In this case, he can be given a three-high diet, which is conducive to the body's rapid recovery.

7. General nursing: When a child is admitted to the hospital, the hospital patiently and in detail introduces the relevant ward system and environment to the child's family to eliminate their sense of unfamiliarity. At the same time, the hospital asks the family about the child's living habits, personality, temperament, hobbies, etc. at home. The hospital actively approaches the child with a caring gaze, gentle tone, and considerate care to gain the dependence of the child and his family. The hospital also explains the characteristics, course, treatment and prognosis of the disease to the family, so that the family can cooperate closely with the medical staff. In order to timely discover and understand changes in the child's condition, we strengthen patrols, regular observations, and use various opportunities to contact the child to carefully observe the child's mental state, vital signs, diet, urination, etc. When abnormalities such as cough, runny nose, nausea and vomiting, abdominal pain and diarrhea, frequent urination and urgency occur, report to the doctor, find out the cause, and take measures. Children with this disease are prone to heart damage and must lie down and rest, especially those who have already suffered heart damage. To this end, we should create a good ward order, keep the environment quiet and clean, and provide dedicated care, which will play a certain positive role in the recovery of the children.

complication

Other accompanying symptoms may include diarrhea, vomiting, and abdominal pain. Or pyuria, hematuria, etc. Laboratory examinations showed increased white blood cell count, increased neutrophil count, increased erythrocyte sedimentation rate, increased C-reactive protein, increased immunoglobulin, and increased transaminase in some cases. Electrocardiogram and echocardiogram changes may be seen in those with heart damage.