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Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
Chapter 29
The Child with a Skin Condition
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 2
Skin Development and Function
 M...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 3
Skin Disorders and Variations
 S...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 4
Skin Disorders and Variations
(Co...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 5
Skin Disorders and Variations
(Co...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
.
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 7
Stye
 A stye, or hordeolum, is a...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 8
Congenital Lesions
 Strawberry n...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
Skin Nevi
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 10
Port Wine Nevus
 Present at bir...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 11
Skin Manifestations of Illness
...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 12
Skin Manifestations of Illness
(...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 13
Skin Manifestations of Illness
(...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 14
Infections
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 16
Miliaria
 “Prickly heat” or a r...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 18
Intertrigo
 “Chafing”
 Dermati...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 20
Seborrheic Dermatitis
 “Cradle ...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 21
Diaper Dermatitis
 Skin becomes...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 22
Acne Vulgaris
 Inflammation of ...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 23
Acne Vulgaris (Continued)
 Rout...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 25
Herpes Simplex Type I
 Known as...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 27
Infantile Eczema
 Atopic dermat...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 28
Infantile Eczema (Continued)
 L...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 29
Infantile Eczema (Continued)
 T...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 30
Parent Teaching About Medication...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 31
Nursing Tip
 Parents should be ...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 32
Staphylococcal Infection
 Prima...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 33
Scalded Skin Syndrome
 Caused b...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 34
Impetigo
 Can be caused by stap...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 35
Fungal Infections
 Invade strat...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 36
Pediculosis
 Three types
 Pedi...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 38
Scabies
 Parasitic
 Caused by ...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 39
Injuries
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 41
Burns
 Leading cause of acciden...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 42
Burns (Continued)
 Types of bur...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 43
Burns (Continued)
 Can involve ...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 44
Children’s Response to Burns
 S...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 45
Children’s Response to Burns
(Co...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 46
Children’s Response to Burns
(Co...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 47
Children’s Response to Burns
(Co...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 48
Burns (Continued)
 Moderate
 P...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 49
Electrical Burn
 Child should b...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 50
Emergency Care of Burns
 Stop t...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 51
Emergency Care
 Establish an ai...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 52
Wound Care
 Can be painful; pai...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 53
Nursing Care
 Protective isolat...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 54
Nursing Care (Continued)
 Immed...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
What is it?
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 56
Frostbite
 Results from freezin...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 57
Question for Review
 What is th...
Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 58
Review
 Objectives
 Key Terms
...
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  • Review table 29-1, page 683 on the types of topical medications
  • Review table 29-3, page 688 response to burn injury in children
  • Transcript of "Ppt chapter 29 skin dz peds"

    1. 1. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Chapter 29 The Child with a Skin Condition
    2. 2. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 2 Skin Development and Function  Main function is protection  Acts as body’s first line of defense against disease  Prevents passage of harmful physical and chemical agents  Prevents loss of water and electrolytes  Can regenerate and repair itself  Along with the central nervous system, there are four basic skin sensations  Pain  Temperature  Touch  Pressure  Secretes sebum  Surface of skin is acidic  Protects from pathological microorganisms
    3. 3. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 3 Skin Disorders and Variations  Skin condition may be a manifestation of a systemic disease or may be congenital  Skin color is an important diagnostic criterion in certain diseases  Skin tests can be used to diagnose allergies  Hair is inspected for color, texture, quality, distribution, and elasticity  Condition of hair can change based on nutrition or disease status  Hair can change due to medications or medical treatments
    4. 4. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 4 Skin Disorders and Variations (Continued)  The nurse should describe the lesions with regard to:  Size  Color  Configuration  Presence of pain or itching  Distribution  Generalized or localized
    5. 5. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 5 Skin Disorders and Variations (Continued)  Managing itching is a key component in preventing secondary infection from scratching  Applying skin creams and ointments as prescribed is important, not only in the treatment of skin conditions, but also in the prevention of infections
    6. 6. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it? .
    7. 7. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 7 Stye  A stye, or hordeolum, is an inflammation of the sebaceous gland of the eyelid commonly seen in infants and children
    8. 8. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 8 Congenital Lesions  Strawberry nevus is a common hemangioma  Consists of dilated capillaries in the dermal space  Usually disappears without treatment  May not be apparent until a few weeks after birth  Begins flat, but becomes raised, bright red, elevated, and sharply demarcated
    9. 9. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Skin Nevi
    10. 10. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 10 Port Wine Nevus  Present at birth  Caused by dilated dermal capillaries  Lesions are flat, sharply demarcated, and purple to pink  Different from strawberry nevus in that the lesion darkens as child gets older, it does not disappear
    11. 11. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 11 Skin Manifestations of Illness  Café au lait macules  Light brown, oval patches  Multiple macules are associated with neurofibromatosis (a chromosomal abnormality) and tuberous sclerosis  Hypopigmented macules  Whitish oval- or leaf- shaped  Multiple macules associated with tuberous sclerosis
    12. 12. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 12 Skin Manifestations of Illness (Continued)  Butterfly rash  Over nose and cheeks  Associated with photosensitivity  May be associated with systemic lupus erythematous (SLE)  Scaling skin eruption  Around mouth in a horseshoe-shaped distribution  Also seen on chin, cheeks, or as a perianal rash  Has papules and scales  Associated with zinc deficiency in infants, as well as diarrhea and failure to thrive
    13. 13. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 13 Skin Manifestations of Illness (Continued)  Vascular birth marks  Resemble a bruise that changes in appearance over the years  Hemangiomas around the chin may be associated with airway problems  Those appearing around the lumbar region may be associated with spinal problems
    14. 14. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 14 Infections
    15. 15. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    16. 16. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 16 Miliaria  “Prickly heat” or a rash caused by excess body heat and moisture  Sweat is retained in the sweat glands • Become blocked or inflamed • Rupture or leakage causes the skin to appear inflamed  Appears suddenly as tiny, pinhead-sized, reddened papules • May be itchy • Often appears in diaper area or skin folds  Remove extra clothing, bathing, skin care, frequent diaper changes
    17. 17. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    18. 18. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 18 Intertrigo  “Chafing”  Dermatitis in skin folds  Patches are red and moist  Aggravated by urine, feces, heat, and moisture  Prevention consists of keeping affected area clean and dry
    19. 19. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    20. 20. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 20 Seborrheic Dermatitis  “Cradle cap”  Inflammation of the skin that involves the sebaceous glands  Characterized by thick, yellow, oily, adherent, crustlike scales on the scalp and forehead  Resembles eczema, but does not itch  Seen in newborns, infants, and at puberty  Treatment is shampooing hair on consistent basis
    21. 21. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 21 Diaper Dermatitis  Skin becomes irritated by prolonged contact with urine, feces, retained laundry soaps, and friction  May be seen in response to addition of solid foods, feeding, chemicals, contact with household substances  Beefy red rash may be indicative of a Candida infection  Prevented by frequent diaper changes with meticulous skin care
    22. 22. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 22 Acne Vulgaris  Inflammation of the sebaceous glands and hair follicles  Sebaceous follicles enlarge at puberty  Secrete increased amounts of sebum (a fatty substance)  Comedo is a plug of keratin, sebum, or bacteria  Open—blackhead  Closed—whitehead, responsible for the inflammatory process of acne
    23. 23. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 23 Acne Vulgaris (Continued)  Routine skin cleansing  Greasy hair and cosmetic preparations should be avoided  Excessive cleansing can irritate skin  Multiple topical and oral treatments available  Important to stress to adolescent to follow medication treatments as prescribed
    24. 24. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    25. 25. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 25 Herpes Simplex Type I  Known as a cold sore or fever blister  May feel a tingling, itching, or burning on the lip  Vesicles and crusts form, takes up to 10 days to heal  Most communicable in the early phase of the outbreak  Recurrence is common because virus lays dormant until activated by stress, sun, menstruation, fever, or other causes  Treatment is with antiviral medications, both oral and topical
    26. 26. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    27. 27. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 27 Infantile Eczema  Atopic dermatitis is an inflammation of genetically hypersensitive skin  Local vasodilation in affected areas  Spongiosis or breakdown of dermal cells and formation of intradermal vesicles  Rarely seen in breastfed infants until they begin to eat additional food  It is a symptom rather than a disorder  Infant is oversensitive to certain substances  Worse in winter
    28. 28. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 28 Infantile Eczema (Continued)  Lesions easily infected by bacterial or viral agents  Infants/children with eczema should not be exposed to adults with cold sores because they may develop a systemic reaction with high fever and multiple vesicles on the eczematous skin  May flare up after immunizations  Laboratory studies show increased IgE and eosinophil levels
    29. 29. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 29 Infantile Eczema (Continued)  Treatment  Aimed at relieving pruritus, hydrating the skin, relieving inflammation, and preventing infection  Emollient bath is sometimes ordered, such as a mixture of cornstarch and baking soda or oatmeal  Bath oil such as Alpha Keri helps keep skin moist  Oil should be added to bath after the child has soaked for a while and skin is hydrated; the oil will help hold the moisture in the skin  Medications  Corticosteroids  Antibiotics  Anti-itching medications
    30. 30. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 30 Parent Teaching About Medications and Therapies for Eczema  Ointments should be completely washed off between applications  Cortisone creams should be avoided because they may temporarily clear the rash but they do not resolve the underlying cause  How to apply topical medications  Absorption is best when an ointment is applied after a warm bath  Medication should be applied by stroking in the direction of hair growth (circular motions can irritate hair follicles)  Teach how much ointment to apply  The use of elbow restraints can prevent an infant from scratching while allowing freedom of movement  Do not use topical steroids when a viral infection is present
    31. 31. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 31 Nursing Tip  Parents should be taught that “kissing a wound to make it better” can introduce organisms that can cause infection
    32. 32. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 32 Staphylococcal Infection  Primary infection may develop in the newborn in the umbilicus or circumcision wound  May occur while in hospital or after discharge  Infection spreads readily from one infant to another  Small pustules on the newborn must be reported immediately  Antibiotic ointments are used in some situations, whereas in others intravenous antibiotics are required  If an infant has MRSA, the child is placed in contact isolation if hospitalized
    33. 33. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 33 Scalded Skin Syndrome  Caused by Staphylococcus aureus  Lesions begin with a mild erythema with a sandpaper texture  Vesicles appear and rupture and peeling occurs, exposing a bright red surface  Skin appears scalded, and child abuse is often suspected
    34. 34. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 34 Impetigo  Can be caused by staphylococci or group A beta- hemolytic streptococci  Bullous form seen in infants usually staphylococcal; nonbullous form is seen in children and young adults  Newborns susceptible because resistance to skin bacteria is low  Very contagious  Treatment is either oral or parenteral antibiotics
    35. 35. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 35 Fungal Infections  Invade stratum corneum, hair, and nails  Fungi are larger than bacteria  Tinea capitis—alopecia  Tinea corporis—oval scaly inflamed ring with clear center  Tinea pedis—lesions are between toes, on instep and soles; pruritic  Tinea cruris—“jock itch”
    36. 36. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 36 Pediculosis  Three types  Pediculosis capitis • Head lice  Pediculosis corporis • Body lice  Pediculosis pubis • Pubic lice, also known as “crabs”  Survival depends on blood extracted from infected person
    37. 37. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    38. 38. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 38 Scabies  Parasitic  Caused by female mite  Burrows under skin and lays eggs, especially between fingers  Burrows contain eggs and feces  Itching is intense, especially at night  Thrives in moist body folds  Spread by close personal contact  Treatment is the application of permethrin  All family members, as well as the home and car, require treatment
    39. 39. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 39 Injuries
    40. 40. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
    41. 41. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 41 Burns  Leading cause of accidental death between 1 and 4 years of age  Sometimes result of child abuse or neglect  Most likely to occur in early morning house before parents awaken and after school
    42. 42. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 42 Burns (Continued)  Types of burns include  Thermal—due to fire or scalding vapor or liquid  Chemical—due to corrosive powder or liquid  Electrical—due to electrical current passing through the body  Radiation—due to x-rays or radioactive substances
    43. 43. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 43 Burns (Continued)  Can involve skin or mucous membranes  If burned near face, flames may have been inhaled  Assessing for patent airway is a priority
    44. 44. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 44 Children’s Response to Burns  Skin is thinner, leads to more serious depth of burn with lower temperatures and shorter exposures  Large body surface area of child results in greater fluid, electrolyte, and heat loss
    45. 45. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 45 Children’s Response to Burns (Continued)  Immature response systems in young children can cause shock and heart failure  Increased BMR results in increased protein and calorie needs
    46. 46. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 46 Children’s Response to Burns (Continued)  Smaller muscle and fat content in the body results in protein and caloric deficiencies when oral intake is limited  Skin more elastic, causing pulling on the scarring areas and resulting in formation of a larger scar
    47. 47. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 47 Children’s Response to Burns (Continued)  Immature immune system predisposes child to developing infections that complicate burn treatment  Prolonged immobilization and treatment required for burns adversely affects growth and development
    48. 48. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 48 Burns (Continued)  Moderate  Partial-thickness burns involving 15% to 30% of body surface  Full-thickness burns involving less than 10% of body surface  Major burns  Partial-thickness involving 30% or more of body surface  Full-thickness burns involving 10% or more of body surface  Both types are considered open wounds that have the added danger of infection
    49. 49. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 49 Electrical Burn  Child should be assessed for entry and exit lesions  Indicates path of electricity through the body  Muscle damage can occur
    50. 50. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 50 Emergency Care of Burns  Stop the burning process  Evaluate the injury  Cover the burn  Transport to hospital
    51. 51. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 51 Emergency Care  Establish an airway  Cyanosis, singed nasal hair, charred lips, and stridor are indications that flames may have been inhaled  An endotracheal tube may be inserted to protect the airway  Establish an intravenous line  Obtain blood and other body fluids for laboratory testing  A nasogastric tube may be inserted to empty stomach and prevent complications
    52. 52. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 52 Wound Care  Can be painful; pain medications should be given in advance of the treatments to ensure adequate pain control is achieved  Cleansing and debridement  Loss of skin increases threat of infection, and fluid loss caused by evaporation can be significant
    53. 53. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 53 Nursing Care  Protective isolation is instituted  All instruments are sterile  Ointments are applied with a sterile gloved hand or sterile tongue depressor  Care must be taken to avoid injury to granulating tissue
    54. 54. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 54 Nursing Care (Continued)  Immediately report signs of infection  Observe for fluid overload  Burn victims have an increased demand on metabolism and require high-protein diet; additional vitamins and minerals may also be required  Prevention of contractures is important  Providing emotional support to the child and family is essential
    55. 55. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. What is it?
    56. 56. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 56 Frostbite  Results from freezing of a body part  Chilblain is a cold injury with erythema and the formation of vesicles and ulcerative lesions that occur as a result of vasoconstriction  In exposure to extreme cold, warmth is lost in the periphery of the body before the core temperature drops  In extreme cases, the head and torso should be warmed before the extremities to ensure survival  A deep purple flush appears with the return of sensation, which is accompanied by extreme pain  Can results in necrosis and may require amputation of the affected extremity
    57. 57. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 57 Question for Review  What is the difference between an accidental scald burn and an intentional scald burn?
    58. 58. Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc. Slide 58 Review  Objectives  Key Terms  Key Points  Online Resources  Review Questions
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