This document discusses skin aging and wound care. It describes normal skin changes with aging like decreased thickness and moisture that impact wound healing. Risk factors for skin damage are reviewed like immobility and moisture. A wound staging system from I-IV is presented. The 7 principles of wound care are identified like keeping wounds clean and moist. Different wound care products are described like dressings, creams, and support surfaces. A case study is presented on a patient with diabetic foot ulcers and sacral wound, and their treatment plan is outlined.
Wound care presented by abdulsalam mohammed nursing officer, reconstructive ...Abdulsalam Mohammed Daaru
Anatomy of the skin
wound healing
Wound care as a concept
Wound Dressing vs. Wound care
Nursing management
Treatments of wounds
Challenges and recommendation
conclusion
Wound care presented by abdulsalam mohammed nursing officer, reconstructive ...Abdulsalam Mohammed Daaru
Anatomy of the skin
wound healing
Wound care as a concept
Wound Dressing vs. Wound care
Nursing management
Treatments of wounds
Challenges and recommendation
conclusion
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ
Burns management presentation by 2nd yr MSC nursing studentSigymol John
this ppt deals with the management part of burns, mainly divided as pre-hospital care, emergent phase,acute phase and rehabilitation phase along with nursing management,nursing diagnosis and interventions.
Burn depths
Superficial epidermal (1st degree)
Commonly due to sunburn.
Red, painful, peels.
Heals in days and leaves no scar.
Dermal (2nd degree)
Defining feature: blistering.
Superficial dermal (aka partial thickness):
Pink below blister, blanches on pressure, painful.
Heals in 2–3 weeks and leaves no scar.
Deep dermal (aka full thickness):
Deep red below blister from vasodilation, or red dots (vessels) on white background. No or slow blanching.
May be sensory changes.
>3 weeks to heal, and leaves scar.
Subdermal (3rd degree)
Damage extends into subcutaneous tissue.
White (or charred), painless (insensate), leathery skin.
Heals slowly by contraction.
This topic is oriented mainly on the Bailey & Love - 26th edition.
This will be of immense help for the MBBS - Students for the Theory as well as Clinical application.
Pressure sores are localized areas of tissue breakdown in skin and/or underlying tissues that develop when persistent pressure between a bony site and underlying surface obstructs healthy capillary flow.
Constant external pressure over 70 mm Hg for 2 hours produces irreversible ischemic changes.
Synonyms : Pressure ulcer, Decubitus ulcer,
Bed sore.
Micro teaching on Bed Sore / Pressure ulcer / Decubitus ulcers . The lesson plan covers the topics :
Define Pressure Ulcer
Sites of Pressure Ulcer.
Causes and predisposing factors of Pressure Ulcer
Braiden scale of Pressure Ulcer
Stages of bed sores
Preventive Measures
Management
Complications
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ
Burns management presentation by 2nd yr MSC nursing studentSigymol John
this ppt deals with the management part of burns, mainly divided as pre-hospital care, emergent phase,acute phase and rehabilitation phase along with nursing management,nursing diagnosis and interventions.
Burn depths
Superficial epidermal (1st degree)
Commonly due to sunburn.
Red, painful, peels.
Heals in days and leaves no scar.
Dermal (2nd degree)
Defining feature: blistering.
Superficial dermal (aka partial thickness):
Pink below blister, blanches on pressure, painful.
Heals in 2–3 weeks and leaves no scar.
Deep dermal (aka full thickness):
Deep red below blister from vasodilation, or red dots (vessels) on white background. No or slow blanching.
May be sensory changes.
>3 weeks to heal, and leaves scar.
Subdermal (3rd degree)
Damage extends into subcutaneous tissue.
White (or charred), painless (insensate), leathery skin.
Heals slowly by contraction.
This topic is oriented mainly on the Bailey & Love - 26th edition.
This will be of immense help for the MBBS - Students for the Theory as well as Clinical application.
Pressure sores are localized areas of tissue breakdown in skin and/or underlying tissues that develop when persistent pressure between a bony site and underlying surface obstructs healthy capillary flow.
Constant external pressure over 70 mm Hg for 2 hours produces irreversible ischemic changes.
Synonyms : Pressure ulcer, Decubitus ulcer,
Bed sore.
Micro teaching on Bed Sore / Pressure ulcer / Decubitus ulcers . The lesson plan covers the topics :
Define Pressure Ulcer
Sites of Pressure Ulcer.
Causes and predisposing factors of Pressure Ulcer
Braiden scale of Pressure Ulcer
Stages of bed sores
Preventive Measures
Management
Complications
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
1. Alice Pomidor, MD, MPH
Department of Geriatrics
Florida State University College of Medicine
Copyright 2010, Florida State University College of Medicine. This work was supported by a
grant from the Donald W. Reynolds Foundation. All rights reserved.
Pressure Ulcers, Skin
and Wound Care
2. Objectives
Identify normal changes in aging skin and their
clinical impact
Recognize risk factors for skin damage and
pressure ulcers
Use the staging system for wounds
Choose pressure relief devices and strategies
Apply the 7 basic principles of wound care
Recognize different wound care products and
their appropriate applications
3. Case: Mrs. G
78 year old female type II diabetic
hypertensive with hyperlipidemia, probable
peripheral vascular disease
Meds: felodipine, lisinopril, glyburide, aspirin
Spot on foot, another on sacrum, recent
purulent drainage from foot
Lived alone b/f hospitalized for hip Fx,
smokes ½ ppd x 40 years, was indep ADLs
Pulses present 2+ carotids and radials, 2+
femorals, trace popliteals, DP & PT not
palpable bilaterally
5. Increasing Age
Dermis:
Less blood supply
Less elastin, collagen
20% less thickness
10 – 20% fewer
melanocytes/decade
Clinical Effects:
Delayed wound healing
High prevalence of xerosis
Skin tears and blisters easily
Prone to sun damage, malignancy
Epidermis:
Less moisture
50% slower turnover
Flattened dermal-
epidermal junction
Skin Changes with
Aging
6. Risk Factors
Decreased mobility
Poor nutrition/hydration
Vascular compromise
Sensory impairment
Multiple medical comorbidities
Pressure: unrelieved on any firm surface
Moisture: incontinence, in skin folds
Friction: dragging across sheets, agitation
Shear: sliding down in bed. pushing up w/heels
7. Describe & measure
accurately
Look!
Must see base of wound
The presence of necrotic material
means the wound cannot be staged: “at
least” a stage III
Record all 3 dimensions of length, width
and depth
8. Stage I: Erythema not resolved w/in 30 min pressure relief.
Epidermis remains intact. Reversible with intervention.
Stage II: Abrasion, blister, or shallow crater w/ partial-
thickness skin loss of epidermis and/or dermis. No
subcutaneous necrosis.
Stage III: Crater unless covered by eschar. Full-thickness
skin loss through the dermis into subcutaneous tissue.
Stage IV: Deep crater, tissue destruction extending to
fascia, possibly including muscles, tendons, joint capsule,
and/or bone.
Wound Staging
9. Describe/measure wound accurately
Put the patient in the right place at the right time
Achieve a clean, uninfected wound
Provide a moist environment suitable for healing
Minimize disruption of wound surface
Prevent damage to viable tissue: SALINE!
Feed, water, oxygenate the patient to
compensate for fluid and calorie loss
Wound Care Principles
10. Put the patient in the right
place at the right time
Choose appropriate support surfaces
Change positions q2h when supine &
q1h when up
Reevaluate the wound q1-2 weeks
14. Describe/measure wound accurately
Put the patient in the right place at the right time
Achieve a clean, uninfected wound
Provide a moist environment suitable for healing
Minimize disruption of wound surface
Prevent damage to viable tissue: SALINE!
Feed, water, oxygenate the patient to
compensate for fluid and calorie loss
Wound Care Principles
17. All wounds are colonized
No surface cultures; deep cultures OK
Anaerobic organisms plus skin flora
Cellulitis—reactive vs. infective
hyperemia
Consider osteomyelitis if less than 1 cm
from a bony surface and/or no healing
in 3 months
Local agents only reduce overgrowth
(silver, metronidazole, mesalt)
Uninfected Wound
18. Describe/measure wound accurately
Put the patient in the right place at the right time
Achieve a clean, uninfected wound
Provide a moist environment suitable for healing
Minimize disruption of wound surface
Prevent damage to viable tissue: SALINE!
Feed, water, oxygenate the patient to
compensate for fluid and calorie loss
Wound Care Principles
19. Moist environment
If it’s wet, dry it (alginate, hydrofiber,
foam)—excess drainage apparent
If it’s dry, wet it (hydrogel)—secondary
film of dried material will become visible
If it’s just right, keep it that way
(hydrocolloid or hydrogel)
20. Minimize disruption
Dressing changes traumatize the healing
wound surface
Goal: once per day
Better: even less often!
Also more cost effective when accounting
for nursing time
31. Describe/measure wound accurately
Put the patient in the right place at the right time
Achieve a clean, uninfected wound
Provide a moist environment suitable for healing
Minimize disruption of wound surface
Prevent damage to viable tissue: SALINE!
Feed, water, oxygenate the patient to
compensate for fluid and calorie loss
Wound Care Principles
32. Preserve viable tissue
Everything except saline is cytotoxic in
wet-to-dry dressings
Always use saline for cleansing
Beware of commercial cleansers or
antibiotic topicals
Protect the surrounding skin (tape
anchors, petroleum)
Shield wound/skin from incontinence
33. Feed, water and
oxygenate
Stress-level protein/calorie replacement
– 1.5 gm/kg/d of protein
– 30 kcal/kg/d
Minimum 125% daily fluid requirements
for insensible loss & drainage
Consider transfusion for Hgb <9.0
Keep blood sugars below 200
Assess nutrition by Hgb & prealbumin
q2 wks
34. Compression: Ted hose, Jobst stockings, etc.
Support surfaces: Foam, gel, air and fluid-filled, etc.
Negative pressure therapy: lg, high-exudate wounds
Hydrotherapy: whirlpool debridement
Hyperbaric oxygen: anaerobic, radiation, salvage sites
Electrotherapy: low-intensity DC, AC. Limited data and
reimbursement
Ultrasound: results equivocal at best
Supplements: pentoxifylline, zinc, vit. C, oxandrolone
Adjuvant Therapies
35.
36. Mrs. G’s studies
Labs:
– Glucose 200-280’s
– Basic metabolic panel otherwise normal
– Hgb/Hct 10/ 30
– WBC 14.9, no shift
– Albumin 3.0
X-ray: Negative for osteomyelitis
Dopplers: Significantly impaired arterial blood flow,
right greater than left
Arteriogram: Significant disease of the trifurcation,
reconstituted below with collaterals
37. Mrs. G’s treatment
plan
Use silver alginate/hydrofiber daily to the foot to
keep it moist
Debride sacral wound until the base can be seen;
consider enzyme to assist break up of slough
Refer to vascular surgeon for evaluation of possible
femoropopliteal bypass later
If bone visible on sacrum, IV antibiotics for possible
osteomyelitis followed by oral therapy for total 8
week course
Start protein supplement and check prealbumin,
Hgb 2 weeks later
Reduce blood sugars by increase in oral therapy
and use of sliding scale insulin to target range
150’s
38. Mrs. G’s treatment
plan
Use extremity padding of some type; order mattress
overlay
Consider physiatry consult for weight-bearing
reduction orthotic for right foot as well as usual hip
rehab therapy
Encourage to walk to increase blood flow
Check fasting lipid profile
Reduce blood pressure with ACE inhibitor
Encourage to stop smoking
Consider subacute/nursing home placement for wound
care and physical therapy
39. Objectives
Identify normal changes in aging skin and their
clinical impact
Recognize risk factors for skin damage and
pressure ulcers
Use the staging system for wounds
Choose pressure relief devices and strategies
Apply the 7 basic principles of wound care
Recognize different wound care products and
their appropriate applications
Editor's Notes
What are the normal changes of aging skin which put her at risk?
What are her other risk factors?
What stage do you think these two wounds are at?
What kind of pressure relief would you use for Mrs. G?
What condition is Mrs. G’s wound in? Does she need any type of debridement?
What type of dressing do you want to put on Mrs. G’s foot?
What type of dressing do you want to put on Mrs. G’s sacrum?
How often do you have to/want to change it?
What still needs to be done for Mrs. G? When do you want to see her again?
Are there any of these which you think would be appropriate for Mrs. G?