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N104 > Late adult III > Flashcards

Late adult III Flashcards

1
Q

What are the three layers of the skin and their function?

A

EPIDERMIS: keeps moisture in, microorganisms out

DERMIS: str and protection

SUBCUTATNEOUS: structural support and E storage

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2
Q

What are the age related changes to the skin?

A

colour/pigmentation

texture (skin tags)

vascularity and lesions
ex. senile pupura, cherry angioma, seborrheic keratosis

dec turgor

reduced thickness, inc wrinkles, sags, and dec subcutaneous fat

dec moisture and perspiration

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3
Q

What are factors affecting structure and function of skin?

A

mental status

general health

moisture

mobility and activity

nutrition

circulation

sensory perception

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4
Q

What is pressure ulcer?

A

an impairment of the skin as a result of prolonged ischemia (dec blood supply) in tissues

resulting from pressure

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5
Q

What are the 5 forces that contribute to destruction of skin?

A

mechanical

immunological

bacterial

chemical

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6
Q

What are the 4 stages in development of a pressure ulcer?

A

pressure

tissue compression

vascular obstruction

interference with cell metabolism

pressure x time = ischemia = cell death -> pressure sore

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7
Q

what is the mathematical formula for pressure?

A

pressure = force/area

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8
Q

What is erythema?

A

reddened skin, localized vasodilation

normal reaction to hyperemia (compensatory response to lack of blood flow in underlying tissue

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9
Q

What is abnormal reactive hyperemia?

A

when redness remains long after pressure is removed

> 1 hr

precursor for pressure ulcer

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10
Q

What are the 4 stages in pressure ulcer formation?

A

1) epidermis and dermis are damaged, but not destroyed
2) epidermis and dermis are destroyed, dmg reaches subcutaneous layer
3) subcutaneous layers destroyed, decaying cells produce cavity
4) muscle and bone tissue damage occurs

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11
Q

What is the most common assessment tool for the development of pressure ulcers?

A

the Braden scale

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12
Q

What does the Braden scale assess?

A

1) sensory perception
2) moisture
3) activity
4) mobility
5) nutrition
6) friction and sheer

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13
Q

If you get a high score on the Braden skill, what risk level are you?

A

high risk

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14
Q

Explain the difference between friction and shear

A

FRICTION: force occurs in a direction opposite of movement. Rubbing of surfaces

SHEAR: bones and soft tissues above them move in opposite directions (occurs when sliding pt in bed with raised head)

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15
Q

What are 8 interventions that can prevent pressure ulcers?

A

1) risk assessment (braden scale)
2) identify high risk areas
3) maintain mobility and activity
4) massage and exercise
5) pressure relieving devices
6) REPOSITIONING
7) adequate nutrition and fluids

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16
Q

What are the strategies for management of pressure ulcers?

A
  • team approach
  • reduce pressure
  • manage friction and shear
  • protect bony prominences
  • avoid unnecessary pads, sheets, clothing
  • dec moisture
17
Q

What is the ideal position for HOB to reduce pressure ulcer risk?

A

30-45 degrees not 90

18
Q

What are the three factors influencing aging?

A

family hx

environment

lifestyle

19
Q

What are some indications of underlying health problems in the aging adult?

A
  • change in mental status
  • falls
  • dehydration
  • dec appetite
  • pain
  • loss of functional ability
  • dizziness
  • incontinence
  • infection
  • alterations in gastrointestinal status
  • cardiac disease
20
Q

How does infection present in aging adults?

A

factors influencing:

decreased immune system,
higher risk for infection,
response is slower and less effective

doesn’t present the same way (ex delirium)

21
Q

What is the alteration in GI?

A

decreased peristalsis

22
Q

How does cardiac disease present in the aging adult?

A

less crushing pain, more of an aching pain

congestive heart failure is harder to notice b/c it simply causes fatigue in older adults

23
Q

How does type 2 diabetes present in the older adult?

A

more gradual onset

dehydration, confusion, weight loss are more prevalent

24
Q

How does thyroid disease present in the older adult?

A

harder to detect

fatigue, tremors

25
Q

How does depression present in the aging adult?

A

may be more difficult to notice b/c of dec activities in older adults

fatigue, dec activity

26
Q

What are the 4 roles of the nurse in caring for aging adults?

A
  • focus on care not cure
  • focus on multiple systems (ex. chronic care)
  • holistic care
  • maintenance of functional abilities and motivation

N104 (10 decks)

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