Wounds of the Skin Essay Paper

Posted: November 8th, 2022

Wounds of the Skin Essay Paper

Reflect on geriatric patients from your practicum site. Consider frail elder patients that you have assessed for skin wounds such as bumps, bruises, shingles, herpes, bullous pemphigoid, Stevens-Johnson syndrome, etc. Explain the consequences of these types of wounds for frail elders. Then, describe a patient case including the care plan for assessment, diagnoses, treatment, management, and patient education. Explain whether the patient’s care plan was effective. Include how you might proceed differently in the future. If you did not have an opportunity to evaluate a patient with this background during the last 8 weeks, you can select a related case study or reflect on previous clinical experiences.Wounds of the Skin Essay Paper

Wounds of the Skin

Elderly patients are at a higher risk for skin injuries and wounds because of the decreasedregulation of epithelial tissue. The skin becomes fragile and less in turgor, this leads to more frequent tears. Skin changes caused due to ageing can lead to increased risk for skin damage (Da Rosa Silva,2017). Skin wounds can be a bigger problem for the elderly individual because the healing process is prolonged because of the decreased blood flow as they age. Skin and the integumentary system need to be closely monitored because it can lead to severe injuries, infection and even sepsis if not taken care of in time. If patient is needed to be aggressively treated in the hospital, it can lead to muscle wasting and decrease in mobility, and would require physical therapy which can lead to additional health expenses.

Case Study

70-year-old female came into the office with a laceration on the right leg, when asked what happened she said” hit it in the backyard on the fence”. Past medical history included Type 2 diabetes, high cholesterol, and high blood pressure. Initial treatment included clearing it out with normal saline, and antibiotic ointment was applied. Antibiotic was also given to be taken at home. Patient was also given a booster tetanus shot because it was caused in the backyard and the fence was metal. Patient wound was dressed, and told to follow up in two weeks to check the progression of the healing. On Follow up, the wound was healing and it did not show any signs of worsening infection like redness or drainage. Patient’s vital signs including temperature was normal. Patient was instructed to continue the antibiotic ointment, and patient was given education on the risks of diabetes mellites and delayed wound healing. Patient was given education on injury prevention.Wounds of the Skin Essay Paper

In future consultations for similar presenting patients, the assessment and treatment plan will be similar. This patient skin injury was improving and healing well.

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References

Da Rosa Silva, C. F., Santana, R. F., de Oliveira, B. G. R. B., & do Carmo, T. G. (2017). High prevalence of skin and wound care of hospitalized elderly in Brazil: a prospective observational study. BMC Research Notes, 10, 81. http://doi.org/10.1186/s13104-017-2410-6

Skin Bruises

The rate of wound healing in elderly patients is slower in comparison to young adults. This may be as a result of a delayed inflammatory response where failure of expansion on of blood vessels prevents the reach of nutrients and white blood cells to an infected wound (Rayner et al., 2018).  As a result, either delayed/poor wound healing occurs. Most elderly people are often weak, frail or have comorbid conditions which increase their risk to experience falls. Therefore, they can easily fall or bump over a hard surface which leads to bruises.Wounds of the Skin Essay Paper

Bruises are common injuries of the skin which lead to skin discoloration. Blood from below the skin tends to collect around a skin surface leading to either a blue or black mark. In elderly individuals, bruises are common since their skin is often thin due to the normal aging process (Rayner et al., 2018). Besides, the bloods vessels that are supported by the various tissues tend to increase in terms of fragility with time.

Case Study

            A 72-year-old White American female presented in the outpatient clinic with bruising over her left upper arm and the left chest wall.  She reported that the bruising were as a result of abrasion over a wall. She had a well-known history of congestive heart failure and hypertension. The initial treatment involved pressing over the affected region with an ice pack for up to 3o minutes to reduce swelling and speed up the healing process. Acetaminophen was thereafter administered as a painkiller. It was necessary to avoid either ibuprofen or aspirin which could likely slow down the process of blood clotting. Within 48 hours, a warm washcloth was applied to the bruises for close to 10 minutes. The client was advised of repeating this process twice on a daily basis. This washcloth had warmth and heat that increased blood flow to the skin for faster healing. The patient was educated on the need to wear appropriate footwear to prevent fall risks and to undergo frequent monitoring and medication adjustment for the same purpose. In future, patient who present the same way will be managed in a similar manner.Wounds of the Skin Essay Paper

Reference

Rayner, R., Carville, K., Leslie, G., & Dhaliwal, S. S. (2018). Skin tear risks associated with aged care residents: a cross-sectional study. Wound Practice & Research: Journal of the Australian Wound Management Association, 26(3), 127.