Ulcerated hemangioma

[aeris99]

I had an interesting case recently that has me searching for information.

A 5 month old was admitted with an ulcerated hemangioma located on the trunk. The ulceration was perhaps the size of a quarter while the hemangioma was quite large and deep. Treatment included topical analgesics, Telfa dressing,and PO propranolol.

While on the floor I searched within the hospitals online references to find out why propranolol was being used. It is not an approved use but the hospital reference stated that it can slow or stop the growth of the hemangioma.

I'm having trouble thinking through why this would be the case? I know that it is a non-selective beta-blocker. A side effect is vascular insufficiency. Would this cause a decrease in blood flow to the growth?

I'm also a bit stumped as to what potential nursing dx would be appropriate. I'm looking at the impaired skin integrity, impaired comfort, risk for infection and risk for bleeding. I had looked at impaired nutrition: less than body requirements because the infant is so uncomfortable being held that it is interrupting her feedings. However "risk for impaired nutrition: less than body requirements" is not a NANDA dx. This kiddo is otherwise in good health.

When doing an infant care plan is it appropriate to consider the parents as well, for instance impaired family process?

I am going to use acute pain as my actual dx so my NIC/NOC will focus on that.

[Jacob080110]

Propranolol for infantile hemangioma. DermNet NZ This website explains why propranolol is used and how it works, it is very interesting and it may be helpful.

[aeris99]

Propranolol for infantile hemangioma. DermNet NZ This website explains why propranolol is used and how it works, it is very interesting and it may be helpful.

That was a good read. Thank you for pointing me to it.