Skin
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  • 1. Integumentary SystemMed Surg CertificationAmy Dunbar RN, MSN, CWOCN 6-2-05
  • 2. ObjectivesIdentify the functions of the skinIdentify the nursing assessment of theskinIdentify common pathophysiologicevents associated with skinDetermine ostomy care
  • 3. Layers of SkinEpidermisDermis
  • 4. AppendagesHairSebaceous glandsExocrine GlandsAprocrine GlandsNails
  • 5. Changes with AgingEpidermal turnover increasesSkin is drierDecreased skin elasticityChanges in thermoregulationDecreased melanocytes
  • 6. Skin AssessmentItchingPainRashDry, rough, scalyBlistersHot/cold spots
  • 7. ObjectivesInspection Palpation *color *turgor *hair *moisture *lesions *temperature
  • 8. PsoriasisNo cureTreated withtopical steroidsand phototherapy
  • 9. SclerodermaUsually treatedwith steroidsand cholinergics
  • 10. ShinglesContagiouswhen exudatefrom blisters ispresentMay benefitfrom antiviral
  • 11. Skin CancerMalignantmelanoma canmetastasizePrevention
  • 12. Rule of 9’s -Head = 9 -Each arm = 9 -Front of trunk = 18 -Back of trunk = 18 -Each leg = 18
  • 13. Concernsimpaired gas exchangefluid replacement
  • 14. InterventionsSkin Grafts-may be autologous-additional wound will be presentFasciotomy-relieves pressure when edema is extreme
  • 15. Stage I Pressure Ulcer
  • 16. Stage II Pressure Ulcer
  • 17. Stage III Pressure Ulcer
  • 18. Stage IV Pressure Ulcer
  • 19. Unstageable Pressure Ulcer
  • 20. Post Operative considerations Stoma appearance Pouch maintenance Releasing gas Pouch emptying
  • 21. Stoma Appearance
  • 22. Pouch Maintenance
  • 23. Releasing Gas
  • 24. Pouch Emptying
  • 25. SummarySkin/Wound is complexNursing assessment and interventioncrucialOstomy care is daily