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It is worth noting that the skin of senior patients has physiological features that are associated with age-related changes in the body. Moreover, frail senior adults may experience various skin wounds or dermatological diseases that are not observed in young clients (Resnick, 2016). To prevent pathology and serious diseases, proper hygienic care and regular monitoring of the patient’s condition are necessary. The purpose of this paper is to discuss the topic of skin wounds in frail elders including such aspects as diagnosis and treatment.
Various causes may lead to skin wounds including external and internal factors. External causes are the traumatic effects of the environment, and internal triggers are related to problems in the immune and endocrine systems, the gastrointestinal tract, and so on (Burr, 2012). Importantly, any type of skin wound is prone to infection, which may result in severe conditions. To diagnose a wound in a frail patient, the nurse needs to assess the staging and physiology of the injury. In addition, it is essential to examine the surrounding skin and mucous membrane. This will allow drawing a conclusion about whether the wound could have been contaminated from the environment.
In order to distinguish between colonization and infection, it is necessary to understand that colonization implies the presence of bacteria on the body or inside the patient’s body, but it does not cause disease. In its turn, infection means that the bacterium triggers a disorder in the client (Pedersen, 2018). To differentiate between the two conditions, the nurse needs to rely on their clinical observation. Infection is present not only on the surface of the injury but also deeper, which means that it impedes the healing process. Meanwhile, if the healing is not impeded, then the specialist may assume the presence of colonization.
A bruise is localized bleeding in the soft tissues, which occurs due to the violation of the integrity of the vessels. As a rule, the occurrence of bruises is associated with injuries; however, subarachnoid hematoma may be caused by non-traumatic damage to the integrity of the walls of the intact vessel. Diagnosis is carried out on the basis of the collected history and clinical symptoms of the disease (Burrell, Howard, & Murphy, 2016). If the bruise is localized on the head, the specialist may recommend radiography or magnetic resonance therapy. With extensive hemorrhages, hematoma dissection is indicated to heal the resorption and prevent the development of complications. When a bruise is surgically removed, the specialist dissects the hematoma, after which they remove blood clots and cleanse the formed cavity. For pain relief, non-steroidal anti-inflammatory drugs may be prescribed to the frail patient.
Strategies for Prevention and Improvement of Wound
Overall, the main factor that contributes to the development of such a skin wound is trauma. Therefore, prevention of bruise occurrence is based on injury aversion. However, vascular fragility, changes in the permeability of the vascular walls, and a decrease in blood clotting may also cause hematoma occurrence (Lichtman et al., 2017). Large bruises can emerge in people who are prescribed anticoagulants. In these cases, patients need to consult their doctor to determine the further course of action. For small and medium-sized bruises, for the first three days after the injury, the patient should be recommended to apply a cold compress to the damaged area (Lichtman et al., 2017). In addition, the injured limb should be kept upright to reduce swelling.
Thus, it can be concluded that bruises may occur as a result of trauma or due to non-traumatic damage to the integrity of the walls of the intact vessel. The course of treatment is determined based on the nature of the wound. To avert the emergence of bruises, the patient should be instructed on injury prevention. If necessary, the client may be referred to other specialists to eliminate the possibility that bruises are the result of pathology.
Burr, S. (2012). Identifying common lesions and rashes in the elderly. Nursing and Residential Care, 14(5), 239-242.
Burrell, C. J., Howard, C. R., & Murphy, F. A. (2016). Fenner and White’s medical virology (5th ed.). Cambridge, MA: Academic Press.
Lichtman, M. A., Kaushansky, K., Prchal, J. T., Levi, M. M., Burns, L. J., & Armitage, J. (2017). Williams manual of hematology (9th ed.). New York, NY: McGraw Hill Professional.
Pedersen, D. D. (2018). Psych notes: Clinical pocket guide (5th ed.). Philadelphia, PA: F.A. Davis.
Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.