Skin Conditions/Skin Care

Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Pressure ulcer risk assessment is crucial to the prevention of pressure ulcers. There are many factors which put certain patients at higher risk of developing these painful injuries that increase health care costs and lead to prolonged hospitalization, and sometimes death.

Bruce Ruben's picture

By Bruce E. Ruben MD

Part 2 in a series on infection management
For Part 1, click here

Our skin is our largest organ and performs a myriad of functions, including pain sensation, pressure sensitivity, temperature regulation and water conservation.

Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Skin tears are a common problem among the elderly due to increased skin fragility associated with aging. Due to the increasing prevalence of this problem, and the potential for poor and/or delayed wound healing in the elderly population, nurses should be aware of prevention strategies for skin tears, as well as management of skin tears once they have occurred.

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

I have been living with my daughter for almost a year and helping out at a nursing home where my granddaughter works. I don't remember having this problem last year but my skin is just on fire at times, itchy, itchy, itchy! I found a cream but ran out and couldn't remember what it was called. When I got to the pharmacy and told the lady there that I was in search of a product whose name I thought sounded like 'Narnia' she pointed me in the right direction. Then, to my surprise, she added, "but remember not to go through the wardrobe door or you might get more than you bargained for." We laughed so much I remembered I best go to the feminine hygiene section. I just wanted a slim little pad, you know for the odd cough or sneeze, but—ohhh—what a choice!

Karen Zulkowski's picture
Skin Conditions

By Karen Zulkowski DNS, RN, CWS

I previously discussed the need for a complete head-to-toe skin assessment. Certainly this can tell you whether or not the person is dehydrated, has open or discolored areas, and many other things about their overall health. Color, for example, can give you clues to additional problems such as vitamin and mineral deficiencies that can show on the skin.

Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

Looking at a person's skin from head to toe is an important nursing function. Certainly nurses document this on the patient's admission, but not so much thereafter. Often the CNA is the first person to notice a problem. Yet there may not be good communication between disciplines or training of the CNA to understand the significance of what they are observing.

Aletha Tippett MD's picture

By Aletha Tippett MD

Understanding Pathergy and Pyoderma Gangrenosum

Pathergy is an aberration of the skin’s innate reactivity from a homeostatic reactive mode closely coupled to tissue healing to an abnormal destructive/inflammatory mode. Pathergy is not well understood and the cause is unknown. It is a diagnostic criteria for Behcet's disease and there is even a Skin Pathergy Test to help with diagnosis. Pathergy has also been reported in Sweet’s syndrome and it is a hallmark of pyoderma gangrenosum.

Lindsay Andronaco's picture

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Part 2 in a series on skin failure
For Part 1, Click Here

In March of 1989 the National Pressure Ulcer Advisory Panel (NPUAP) convened, during which Karen Lou Kennedy first described the Kennedy Terminal Ulcer (KTU) phenomenon. A KTU is an unavoidable skin breakdown or skin failure that is thought to be a perfusion problem exacerbated by vascular/profusion insufficiency, organ failure, and/or the dying process. A KTU is a visible sign, an explanation, of what is transpiring within the patient.

Margaret Heale's picture

By Margaret Heale, RN, MSc, CWOCN

So after I last wrote, I was to assist with a dressing change, as the resident is more relaxed with somebody having their focus on her and not also trying to do the procedure. I have done a million or two dressings in my time but had not seen a negative pressure wound therapy (NPWT) vacuum till I started helping out at the nursing home where my granddaughter works. I came across the treatment accidentally, very accidentally.

Lindsay Andronaco's picture

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Part 1 in a series on skin failure

A few years ago, a panel of experts gathered to evaluate the nature of skin changes at life's end (SCALE) and to discuss the Kennedy Terminal Ulcer (KTU). The panel concluded that there are observable changes in the skin at the end of life and that these situations are complex. It should be noted that the skin is an organ and it can fail. The skin can also demonstrate what is happening internally, such as multisystem organ failure.