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Skin
 

Skin

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    Skin Skin Presentation Transcript

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