Week 3 Skin Integrity Flashcards
What are some of the factors that affect skin integrity, specifically diminished sensation?
Why is it so important to pay attention to
- peripheral vascular disease
- spinal cord injury
- diabetes, stroke
- trauma or fractures
These make them vulnerable
What are some of the factors that can impair cognition and ultimately affect skin integrity
- Alzheimer’s disease
- dementia
- altered level of consciousness
What is maceration
wrinkly toes and fingers after being in water too long
What does denuded mean
skin breakdown (diaper rash on babies)
What are some lifestyle habits that can affect skin integrity
- cigarette smoking
- tanning salons
- piercings and tattoos
What are the two types of wounds?
Give examples of each
Open wound: lacerations, abrasions (breakdown in tissues)
Closed wounds; contusions, bruises (no breakdown in tissues)
What is an example of excoriation
scratching at chicken pox which pops the vesicle
What are the characteristics of an arterial ulcer
- appears punched out
- pale wound base
- shiny, thin, and dry surrounding tissue
- very painful
Is an arterial ulcer considered acute or chronic
chronic
Where are arterial ulcers commonly found
ankles, toes, side of foot
Where are venous stasis ulcers commonly found
inner ankle, lower part of calf
What are the characteristics of a venous stasis ulcer
- shallow with irregular wound margins
- ruddy or beefy red wound base
- red/brown and edematous surrounding tissue
- moderate to heavy drainage
- painful when dependent or with dressing change
Where do diabetic foot ulcers typically occur
plantar surfaces (ball of foot, heel, toes)
What are the characteristics of a diabetic foot ulcer
- drainage, swelling, redness
- painless
- highly susceptible to infection
What are the 4 wound tissue types
Explain the characteristics of each
- epithelization - pink and dry
- granulation - red and moist (good thing)
- slough - yellow
- eschar - black