resources Integumentary by alicejenny

VIEWS: 4 PAGES: 12

									                                                                     5/30/05 draft


        Aging & the
      Integumentary
          System
Content for this module provided by
The John A. Hartford Foundation, Institute for
Geriatric Nursing, Online Gerontological
Nursing Certification Review Course
http://www.nyu.edu/education/nursing/hartford.institute/course/




Support for this project provided to School of Nursing, University of
Washington by the John A. Hartford Foundation, Geriatric Nursing
Education Grant and Nursing School Geriatric Investment Program Grant.
                                                  5/30/05 draft

          Aging & Integumentary
                Changes
Skin
•  epidermal & dermal thickening &
  contact area
• Flattening of epidermal/dermal junction
•  subcutaneous fat
•  connective tissue
•  elasticity (thinning, loose skin, wrinkles)
•  # of melanocytes
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        Aging & Integumentary
              Changes
Skin
•  hair follicle density
•  sebaceous & sweat gland activity
•  melanin
•  immune cells
•  vascularity,  nerve endings
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         Aging & Integumentary
               Changes
Nails

• Alternating hyperplasia (nail
  thickening) and hypoplasia

•  growth rate
• Longitudinal ridges
• Thinner, more brittle
                                  Dermatology Image Atlas
                                  http://dermis.multimedica.de/doia
                                       5/30/05 draft


       Aging & Integumentary
             Changes
Physiological changes
  • Loss of body hair
  • Loss of skin pigment ( melanin)
  •  sweating
  • Dry skin
  • Puritis of skin (itching)
  • Graying & thinning hair
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Aging & Integumentary Changes
Functional implications
•  susceptibility to:    • Slower healing
   • skin tears           •  barrier protection
   • bruising
   • shearing             • Delayed absorption
   • pressure damage        of medications
   • blunt trauma
                          •  UV protection
•  risk of heat stroke
  & hypothermia           •  vulnerability of
                            pressure points
                                                                                                                                              5/30/05 draft


       Aging & Integumentary
Dermis       Changes
• Paler skin color, uneven pigmentation
    • age spots (‘liver spots’)
• Skin tags, xerosis ( moisture),
  actinic & seborrheic keratosis
•  wrinkling
•  loose/slack skin, due
  to loss of connective tissue
• Fragile skin that looks ‘paper-thin’
  Photo provided by the Administration on Aging at http://www.aoa.gov/press/multimed/photos/2002/01_Jan/images_aging/photo_images_aging.asp
          Aging & Integumentary                                        5/30/05 draft



                Changes
Nursing assessment
•   Medical & surgical hx

•   Co-morbid illness/intrinsic factors
    (i.e. anemia, hypoxia, peripheral vascular disease, low albumin)

•   Risk assessment – Braden scale

•   Nutritional status – Nutrition scale

•   Hydration status

•   Functional status – Katz scale

•   Environment
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       Aging & Integumentary
             Changes
Nursing considerations
• Potential for altered topical medication
  absorption
• Prevention: 1st-line strategy for pressure
  ulcer care
•  incidence of benign & malignant growths
• Hydration, moisturizing, sun protection
• Keep dressing tape to a minimum
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