Transcript Musculoskeletal and Skin Conditions

Musculoskeletal and
Skin Conditions
RN Certificate in Palliative Care
Pathological Fractures
• Osteoporosis
• Metastatic bone disease
• Nonsurgical treatment
(bisphosphonates, radiation therapy)
• Surgical Treatment
• Bracing
• Vertebroplasty/Kyphoplasty
• Opioids and NSAIDS
• Nerve blocks
Skin and Mucous Membranes
(Xerostoma)
Pharmacolgocial
Assessment and
History
Nonpharmacological
Xerostoma
Skin and Mucous Membranes: Pruritis
Causes:
Treatment:
Generalized Skin
Problems
Medications
Organ Failure
Endocrine/Metabolic
Connective Tissue
Disorders
Tumors
Hematologic Disorders
Neuropathic/Neurogenic
• Pharmacological
based on etiology
(scabicides, SSRIs,
Cholestyramine,
Antihistamines ?,
topical agents)
• Nonpharmacologi
cal: emollients,
UV light,skin care,
cool baths,
oatmeal, stent for
biliary
obstruction. Labs.
Wounds
• Overview palliative wound care
• Assessment (Braden Scale)
• Malignant wounds:
– Hemorrhage
– Odor
– Pain
– Exudate
– Infection
• Patient/family assessment
Pressure Ulcer Assessment/
Wound Characteristics
• Edges/margins
• Undermining/tunneling
• Necrotic tissue
• Exudate
• Surrounding tissue conditions
• Induration
• Edema
• Granulation tissue and epithelialization
Pressure Ulcers
Stage 1
Stage 2
Stage 3
Stage 4
Unstageable
• Intact skin with
non-blanchable
redness
• Partial thickness
loss of dermis
• Fulll thickness
loss of dermis
• Full-tissue loss
with exposed
bone, tendon, or
muscle
• Full thickness
tissue loss in
which the base
of the ulcer is
covered by
slough
Kennedy Pressure Ulcer
Treatment and Care of
Pressure Ulcers
• Nutritional support
• Management of tissue load
• Debridement (Sharp, Mechanical, Hydrotherapy,
Enzymatic, Autolytic)
• Cleansing
• Dressings
• Infection
References
All references for symptom management are listed in classroom
WWW.CSUPALLIATIVECARE.ORG