Integumentary System Issues for Older Adults Flashcards
Exam 4 (Final)
Introduction
What is skin the most visible indicator for?
Skin is the most visible indicator of biologic aging, lifestyle, and environment
Introduction
Processes skin affects include:
Thermoregulation
Excretion of metabolic wastes
Protection of underlying structures
Synthesis of vitamin D
Maintains fluid and electrolyte balance
Sensation of pain, touch, pressure, vibration, and temperature
Age-Related Changes That Affect the Integumentary System
include what layers?
Epidermis:
Dermis:
Subcutaneous tissue and cutaneous nerves:
Nails:
Hair
Age-Related Changes That Affect the Integumentary System
Epidermis: What does it serve as? What happens with age?
serves as a barrier –with age there is flattening of the dermal-epidermal junction
Age-Related Changes That Affect the Integumentary System
Dermis: What is the function of this layer?
Dermis: functions—temperature regulation, sensory perception, and nourishment for all skin layers
Age-Related Changes That Affect the Integumentary System
Dermis: What happens with age?
Dermal thickness diminishes (skin becomes thinner/transparent)
Atrophy of the hair bulbs, sweat and sebaceous glands
Age-Related Changes That Affect the Integumentary System
Subcutaneous tissue and cutaneous nerves: functions include:
Subcutaneous tissue and cutaneous nerves: functions—
storage of calories,
insulation for body,
and regulation of heat loss
Age-Related Changes That Affect the Integumentary System
Nails: What happens with age?
become thinner, fragile, brittle, and prone to splitting thickened
Age-Related Changes That Affect the Integumentary System
Hair: What happens with age?
loss of body hair (trunk, axillae, pubic), graying, and balding
Which is a normal age-related change in the integument?
A. Dermal thickness diminishes
B. Subcutaneous tissue expands
C. Secretion of sebum increases
D. Rate of nail growth intensifies
Dermal thickness diminishes
Beginning in early adulthood, dermal thickness gradually diminishes. With increased age, some areas of subcutaneous tissue experience atrophy. Secretion of sebum begins to diminish in the third decade. The rate of nail growth also begins to slow in early adulthood
Risk Factors That Affect Skin Wellness include:
Genetic influences
Health behaviors and environmental influences
Sociocultural influences
Medication effects
Risk Factors That Affect Skin Wellness include:
Genetic influences: What?
Heredity: development of skin and hair changes
Risk Factors That Affect Skin Wellness include:
Health behaviors and environmental influences: Such as?
Smoking, sun exposure, emotional stress, substance or alcohol abuse
Risk Factors That Affect Skin Wellness include:
Sociocultural influences: Such as?
Cultural factors, societal attitudes, advertising influences hygiene and skin care
Risk Factors That Affect Skin Wellness include:
Medication effects: Such as?
Photosensitivity (intensified response to ultraviolet radiation) *Thiazides, phenothiazines, tetracyclines, amiodarone, and sulfonamides are the medications most often associated with photosensitivity reactions.
Risk Factors That Affect Skin Wellness include:
Medication effects: What kind of meds cause photosensitivity?
*Thiazides,
phenothiazines,
tetracyclines,
amiodarone,
and sulfonamides are the medications most often associated with photosensitivity reactions.
Functional Consequences Affecting Skin Wellness
What happens to wound healing with age?
Delayed wound healing and increased susceptibility to skin problems
Functional Consequences Affecting Skin Wellness
Delayed wound healing and increased susceptibility to skin problems. What is there an increased risk for?
Increased risk for postoperative wound disruption, decreased tensile strength of healing, and increased risk of secondary infections
Functional Consequences Affecting Skin Wellness
Photoaging:
premature aging
Functional Consequences Affecting Skin Wellness
Comfort and sensation: What happens with age?
Dry skin is the most universal complaint,
decline in tactile sensitivity,
effect of thermoregulation
Functional Consequences Affecting Skin Wellness
Cosmetic effects include:
Cosmetic effects:
paler,
thinner,
more translucent,
irregular pigmentation
Pathologic Conditions Affecting Skin: Skin Cancer
include:
Skin tears:
Skin cancer:
Pathologic Conditions Affecting Skin: Skin Cancer
Skin tears: What are they? What is used to classify them?
traumatic wounds involving dermis and/or epidermis caused by friction, rubbing, shearing force
Skin tear classification system
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer: What is it?
abnormal growth of skin cells
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer: How does it occur?
Age-related changes and long-term sun exposure
Basal cell carcinoma
Squamous cell carcinoma
Melanoma
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer:
Nursing prevention of skin cancer:
Nursing prevention of skin cancer:
*wear a hat while participating in outdoor activities
*Liberally apply sunscreen to all exposed parts of the body 30 minutes before outdoor activity
*Re-apply sunscreen every 2 hours while doing outdoor activities
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer:
Basal Cell Carcinoma: How does it appear? How common is it?
This cancer typically appears as a white waxy lump or a brown scaly patch on sun-exposed areas, such as the face and neck.
Very common, more than 3 million cases annually.
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer:
Squamous Cell Carcinoma: Who is it?
Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface.
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer:
Squamous Cell Carcinoma: How do they grow?
Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface.
They tend to grow slowly and usually occur on sun-exposed areas of the body, such as the face, ears, neck, lips, and backs of the hands.
Pathologic Conditions Affecting Skin: Skin Cancer
Skin cancer:
What is the most serious type of skin cancer?
Malignant Melanoma
Most serious type of skin cancer
Pressure Injury Ulcers
Pressure ulcers: What are they?
Pressure ulcers: localized injury to skin over bony prominence due to pressure or with shearing
Pressure Injury Ulcers
Pressure ulcers: What is associated with increased risk? What are examples?
Various medical devices associated with increased risk for developing pressure ulcers
Masks, orthotics, tubing, immobilizers, stockings, boots, nasogastric tubes, cervical collars or braces, tracheostomy tubes, and ties
Pressure Injury Ulcers
Pressure ulcers: What is there a mandate to do?
Mandate to document the presence of any skin breakdown on admission and during hospitalization
Pressure Injury Ulcers
Pressure ulcers: How are they classified?
Staging classifications for pressure ulcers: anatomic depth of soft-tissue damage
Pressure Injury Ulcers
Pressure ulcers: What are the stages?
Stage 0: normal skin
Stage I: nonblanchable erythema
Stage II: partial thickness
Stage III: full-thickness skin loss
Stage IV: full-thickness tissue loss
Unstageable: full-thickness skin or tissue loss—depth unknown
Pressure Injury Ulcers
Pressure ulcers: Stage 0
Stage 0: normal skin
Pressure Injury Ulcers
Pressure ulcers: Stage 1
Stage I: nonblanchable erythema
Pressure Injury Ulcers
Pressure ulcers: Stage 2
Stage II: partial thickness
Pressure Injury Ulcers
Pressure ulcers: Stage 3
Stage III: full-thickness skin loss
Pressure Injury Ulcers
Pressure ulcers: Stage 4
Stage IV: full-thickness tissue loss
Pressure Injury Ulcers
Pressure ulcers: Unstageable
Unstageable: full-thickness skin or tissue loss—depth unknown
Pressure Injury Ulcers
reactive hyperemia: What occurs in this?
reactive hyperemia: area has remained red for two hours and does not blanch when tested
Pressure Injury Ulcers
Evidence-based tools for identification and risk? What is the scale?
Braden scale: best practice <9 very high risk for pressure ulcers
Pressure Injury Ulcers
Nursing interventions:
Nursing: frequent repositioning of immobilized clients
Which nursing intervention acts to promote good skin circulation and prevents pressure ulcers?
A. Application of moisturizing agents at frequent intervals
B. Massage over bony prominences
C. Promotion of shearing forces
D. Utilization of incontinence pads
Application of moisturizing agents at frequent intervals
In addition to preventing persistent pressure on the skin, it is important to avoid any friction or shearing forces and to ensure that the skin is free of excess moisture.
The nurse should also promote good skin circulation by applying moisturizing agents at frequent intervals, avoiding massage over bony prominences
