Professional Documents
Culture Documents
Chronic Illness
Chronic Illness
Dehydration
Physiological Changes with Aging
- Tenting of skin is normal with aging. Hand not a reliable indicator of dehydration
Dermatologic - Use abdomen/forehead
Structural changes Clinical implication
- Delirium is frequently caused by dehydration and may accompany UTI.
Thinning of epidermis - Increased wrinkling
- Dry appearance Pressure Ulcers
- Uneven pigmentation
- Susceptible to infection when break - Localized ulcerations of the skin or deeper structures
occurs - Areas susceptible
Thinning of dermis: decreased vascularity - Decreased elasticity
- Pressure of 70 mmHg applied for longer than 2 hours can produce tissue
- Increased wrinkling
- Vulnerable to trauma destruction
- Decreased body templ regulation
Stages of Pressure Ulcers
Decrease in amount of subcutaneous fat - Sagging of skin
- Decreased fat pads on soles of feet, I- Nonblanching macule that may appear red or violet
which may impair ambulation;
II- Skin breakdown as far as the dermis
increase chance for pressure ulcers
Changes in adnexal structures: sebaceous - Decreased sweating III- Skin breakdown into the subcutaneous tissue
and sweat glands - Decreased growth of hair IV- Penetrates bone, muscle, or joint
- Decreased nail growth
- Thinning and graying of hair Nursing Interventions:
susceptibility to infection
1. Prevent pressure ulcers development (meticulous skin care and positioning)
Changes in neurosensory function - Potential for injury
2. Avoid elevation of head of bed greater than 30 degrees
3. Reposition every 2 hours
Nursing Implications: 4. Use an alternating-pressure mattress or air-fluidized bed
5. Use normal saline for cleaning and disinfecting wounds
1. Skin care: gently stimulate non-reddened intact skin sits with massage
6. Apply well-to-dry dressings as directed; or assist with surgical debridement
a. Avoiding the use of hot water and limit the use of soap
7. Cover the wound with a protective dressing (i.e. hydrogel dressings)
2. For immobile patients, consistent repositioning is essential (q 30)
8. Obtain wound cultures and apply topical antibiotics.
3. Keeping bed linens clean, dry, and wrinkle free.