Transcript No Slide Title - University of Washington School of Nursing

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.
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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Nails
Aging & Integumentary
Changes
• Alternating hyperplasia (nail
thickening) and hypoplasia
•  growth rate
• Longitudinal ridges
• Thinner, more brittle
Dermatology Image Atlas
http://dermis.multimedica.de/doia
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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:
• skin tears
• bruising
• shearing
• pressure damage
• blunt trauma
•  risk of heat stroke
& hypothermia
• Slower healing
•  barrier protection
• Delayed absorption
of medications
•  UV protection
•  vulnerability of
pressure points
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Aging & Integumentary
Changes
Dermis
• 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
Changes
Nursing assessment
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•
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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