Skin

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Skin

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

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