Minor Skin Irritations Chapter 25 pg.

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Pruritus Urticaria
“Itching” “Hives”

 Patho  Patho
o Physical or Chemical agents activate nerve o Hives caused by allergens
fibers directly or stimulate the release of  Assessment
histamine, which then act on itch receptors. o rash of white or red edematous papules or
 Assessment plaques
o Localized or generalized occur with or o lesions or wheals
without rash  Causes
o Itching Severity varies among patients o Drugs, temperature extremes, foods, infection,
o Itching worsens at night disease, cancer, insect bites
o Worsens with, skin dryness, inc. temperature,  Interventions
perspiration, emotional stress o Focus on removal of the trigger and relief of
o Xerosis (dry skin): discomfort in the absence symptoms
of skin lesions (50% of elderly PT) o Antihistamines: Diphenhydramine
o PT relieves itching by scratching or rubbing  Education
skin, further stimulating itch receptors o Avoid overexertion, alcohol (fall risk), warm
causing “itch-scratch-itch” cycle. environment
 Risks /Causes
o Comorbid medical conditions like diabetes
o Liver disease: increase buildup of bilirubin
stimulates itch receptors
o Too little or too much blood flow to the area
 Interventions
o Focus on increasing patient comfort and
preventing skin injury with loss of tissue
integrity.
o Treat underling skin disorder with topical or
systemic drugs
o Antihistamines: monitor response for does
adjustments
o Topical Steroids: apply to slightly damp skin
o Occlusive dressings: increase the dose of the
medication, avoid unless prescribed
 Education
o Chart 25-6 “Prevention of Dry Skin”
o Keep fingernails trimmed and short
o Wear mittens or splints at night
o Don’t break the skin
o Diabetics do not dig into nail corners when
trimming
 Elderly
o Common pruritic conditions: scabies and
bullous pemphigoid