Assessment 1- Practical Integumentary

Student Name Sunil Bhattarai CIT Number 281659

Competency Title, Code

and Banner Code HLTAAP003 CONFIRM PHYSICAL HEALTH
CRN

Assessment Type ✘ Written Case Study Project Assignment ✘ Other

Assessment Name Practical assessment Integumentary System

Assessment Date 23/02/2023

Student Statement: This assessment is my own work. Any ideas and comments made by other people have been
acknowledged. I understand that by emailing or submitting this assessment electronically, I agree to this statement.

Student Signature Sunil Bhattarai Date 23/02/2023

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Assessment instructions:
To complete part one of the integumentary system assessment, students will work in groups
to perform a skin assessment on the manikin in the Simulated Learning Environment (SLE).
There are skin alterations present on the manikins. The students are required to undress
the manikin and assess the skin integrity top to bottom on both front and back and identify
the alteration on the sheet below, including where on the body the alteration is present. All
alterantion are required to be identified in order to get a satisfactory grade on part 1 of the
assessment.
If the group of students are uncertain of what an alteration may represent, they are allowed
to ask the RN present (teacher), as they would do in a clinical setting.
After completion of the skin assessment the student are required to complete the
worksheet individually and include referencing.

The completed skin assessment and worksheet are to be uploaded in the drop box on
eLearn by the due date.

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Integumentary system worksheet

Read about the skin by accessing the article on the following link:
https://medlineplus.gov/ency/article/004014.htm

1. Discuss four (4) changes that occur in the layers of the skin as ageing occurs. Your discussion must include changes in
the epidermis, in connective tissue, subcutaneous fat and sweat glands.

The four changes that occour in the layers of the skin as ageing occours are given below:

Changes in the epidermis: The epidermis thins as ageing occurs, leading to a decrease in the production of keratinocytes,
which are the cells that make up the majority of the epidermis. This can result in skin becoming thinner and more fragile,
leading to an increased risk of skin damage and injury.

Changes in connective tissue: As we age, the production of collagen and elastin in the skin decreases, which leads to a loss
of elasticity and firmness. This results in wrinkles and sagging skin. Fibroblasts, the cells responsible for producing collagen
and elastin, also decrease in number, which further contributes to skin ageing.

Changes in subcutaneous fat: Subcutaneous fat decreases with ageing, particularly in the face, hands, and feet. This loss of
fat can cause the skin to look less plump and youthful, leading to a more aged appearance.

Changes in sweat glands: The number of sweat glands in the skin decreases with ageing, and the remaining sweat glands
become less active. This can result in the skin feeling drier and more prone to irritation and infection.

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 2. Explain the effects these changes may have on the skin of older clients.

As explained above, older people will be more susceptible to skin problems The effects of aging on the skin can result in a
decreased ability to protect the body from external stressors, leading to increased susceptibility to injury, infections, and
other skin-related conditions like dryness of skin, fragility and thinness, skin irritation and so on. It is important for older
clients to take extra care of their skin, such as using moisturizers, avoiding prolonged sun exposure, and seeking medical
attention for any skin changes or issues.

3. List and describe 1 potential complication related with skin integrity that may be caused by using incorrect manual
handling techniques when repositioning an immobile patient. Reduce Skin Tears-Patient Manual Handling Techniques | KMO
Health
and use your nursing textbook to answer this question.

Using incorrect manual handling techniques when repositioning an immobile patient can lead to several potential
complications related to skin integrity such as :
 Pressure ulcers or bedsores
 Skin tears or abrasions
 Shearing or friction injuries
 Hematomas or bruises
 Edema or swelling
 Reduced circulation and tissue perfusion
 Increased risk of infection

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One such complication is pressure injuries or pressure ulcers, also known as bedsores.
When a patient is repositioned, pressure is exerted on certain areas of the body where the skin is in contact with the bed or
other surfaces. If this pressure is not distributed evenly or if it is too intense, it can cause damage to the skin and underlying
tissues. In the case of immobile patients, who are unable to change positions themselves, the risk of pressure injuries is
especially high.

4. what are the consequences of lack of proper pressure area care in immobile patient? What are the preventative
measures to prevent this from happening?
Clinical Guidelines (Nursing) : Pressure injury prevention and management (rch.org.au)

Unequal distribution of pressure, poor blood flow, friction, shear, and tissue ischemia can all contribute to the develop of a
Pressure injury. The deep fascia, subcutaneous fat, skin, bone, and muscle can all be damaged by unrelieved pressure in
immobile patients.

Preventative measures to prevent pressure injuries include:

Regular repositioning of the patient to relieve pressure on bony prominences

 Using pressure-relieving devices such as special mattresses, cushions or pads
 Ensuring the patient's skin is clean and dry
 Monitoring the patient's skin for any signs of redness or damage
 Providing good nutrition and hydration to promote skin health
 Ensuring the patient is mobilized as much as possible, within their abilities and limitations, to prevent prolonged pressure
on any one area of the body.

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5. The development of skin cancers represents a variation from normal of the integumentary system. Access the following
link to read about melanoma.
http://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer/melanoma.html

i) List four (4) possible causes of melanoma

Four possible causes of melanoma are:
 Exposure to UV radiation: Overexposure to sunlight or artificial UV radiation sources, such as tanning beds, is a significant
risk factor for melanoma.
 Genetics: A family history of melanoma or inherited gene mutations, such as those in the CDKN2A or CDK4 genes, can
increase the risk of developing melanoma.
 Age: Melanoma can occur at any age, but the risk increases with age.
 Weakened immune system: People with weakened immune systems, such as those with HIV/AIDS or who have undergone
organ transplants, have an increased risk of developing melanoma.

ii) List six (6) symptoms which may indicate a change from normal.
The six (6) symptoms which may indicate a change from normal are:
 A mole or pigmented spot on the skin that changes in size, shape or color.
 A new mole or spot on the skin that appears suddenly or begins to grow rapidly.
 Irregularly shaped moles or spots with uneven borders or multiple colors.
 Moles or spots that are larger than 6mm in diameter.
 Itchy, painful or bleeding moles or spots.
 A dark streak or line underneath a nail that extends from the nail bed to the tip of the nail.

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References

Cancer Council Australia Melanoma Guidelines Working Party, Clinical practice guidelines for the diagnosis and management of melanoma, Cancer
Council Australia, Sydney, viewed 22 July 2020, available from wiki.cancer.org.au/australia/Guidelines:Melanoma.

RCH. (n.d.). The Royal Children's hospital melbourne. The Royal Children's Hospital Melbourne. Retrieved February 28, 2023, from
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Pressure_Injury_Prevention_and_Management/

Wounds International. (2018, April 24). The prevention and management of skin tears in aged skin. THE PREVENTION AND MANAGEMENT OF
SKIN TEARS IN AGED SKIN. Retrieved February 28, 2023, from
https://www.woundsinternational.com/uploads/resources/57c1a5cc8a4771a696b4c17b9e2ae6f1.pdf

U.S. National Library of Medicine. (n.d.). Aging changes in Skin: Medlineplus medical encyclopedia. MedlinePlus. Retrieved February 28, 2023, from
https://medlineplus.gov/ency/article/004014.htm

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