A gerontologic nurse is teaching a group of nursing students about integumentary changes that occur in older adults, such as thinning skin. How should these students best integrate these changes into care planning?

By avoiding the use of ice packs to treat muscle pain

By protecting older adults against excessive sweat accumulation

By protecting older adults against shearing injuries

By avoiding the use of lotion on older adults' skin

Answer and Explanation

The Correct Answer is C

A. Avoiding the use of ice packs to treat muscle pain - While ice packs can cause skin damage in older adults with thinning skin, it is not the most appropriate response to the question. Protecting against shearing injuries is a more direct and specific concern related to thinning skin.

B. Protecting older adults against excessive sweat accumulation - Excessive sweat accumulation can lead to skin irritation, but this option does not directly address the issue of thinning skin as the primary concern in the question.

C. By protecting older adults against shearing injuries
Thinning skin in older adults makes them more vulnerable to skin injuries, especially shearing injuries. Shearing occurs when the skin is pulled in one direction while the underlying bone and tissues are pulled in the opposite direction. This can lead to skin tears and other wounds, which can be painful and slow to heal in older adults. Nurses should take special precautions to prevent shearing injuries, such as using lift sheets or sliding devices when moving patients, and ensuring that patients are repositioned frequently to reduce friction and shearing forces.

D. Avoiding the use of lotion on older adults' skin - Proper moisturization of the skin is important, especially in older adults, to prevent dryness and skin breakdown. Avoiding lotion is not a recommended practice; instead, choosing appropriate, non-irritating lotions can help maintain skin integrity.

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Correct Answer is D

Explanation

A. Chronic pain - Chronic pain is a concern for the client, but addressing the underlying issue of ineffective tissue perfusion will help alleviate pain by promoting healing and reducing tissue damage.

B. Impaired skin integrity - Impaired skin integrity is a result of ineffective tissue perfusion. By addressing perfusion issues, skin integrity can be improved as tissues receive adequate oxygen and nutrients for healing.

C. Risk for injury - While clients with arterial insufficiency ulcers are at risk for injury, the immediate concern is addressing the ineffective tissue perfusion to prevent complications related to poor circulation, such as tissue necrosis and infection.

D. Ineffective tissue perfusion- Arterial insufficiency ulcers are caused by inadequate blood flow to the tissues. The priority issue for a client with an arterial insufficiency ulcer is ineffective tissue perfusion. Due to decreased blood flow, tissues do not receive enough oxygen and nutrients, leading to delayed wound healing, tissue damage, and potential complications. Interventions should focus on improving circulation, promoting vasodilation, and enhancing perfusion to facilitate wound healing and prevent further tissue damage.

A. Venous thromboembolism (VTE) B. Cellulitis C. Arterial insufficiency D. Thrombocytopenia

Correct Answer is B

Explanation

A. Venous thromboembolism (VTE) - While VTE can cause leg pain and swelling, the presence of fever, chills, and localized trauma history in this scenario points more toward cellulitis.

B. Cellulitis
The client's symptoms, including pain, swelling, fever, chills, and sweating, are indicative of cellulitis, which is a bacterial skin infection. The history of trauma to the leg (hitting the leg on the car door) could have introduced bacteria into the skin, leading to the infection. The client's diabetes mellitus type 2 also increases the risk of developing skin infections due to impaired immune function and circulation. Cellulitis often presents with localized pain, swelling, warmth, redness, and systemic symptoms like fever and chills. Immediate medical evaluation and appropriate antibiotic treatment are necessary for cellulitis.

C. Arterial insufficiency - Arterial insufficiency typically presents with symptoms like intermittent claudication, rest pain, and non-healing wounds due to poor circulation. The symptoms described in the scenario are more consistent with an acute infection (cellulitis) rather than chronic arterial insufficiency.

D. Thrombocytopenia - Thrombocytopenia is a condition characterized by low platelet count and does not directly cause localized pain, swelling, and redness in the leg as described in the scenario.

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A gerontologic nurse is teaching a group of nursing students about integumentary changes that occur in older adults, such as thinning skin. How should these students best integrate these changes into care planning?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is diagnosed with an arterial insufficiency ulcer. The nurse should plan interventions to address which priority issue?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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A gerontologic nurse is teaching a group of nursing students about integumentary changes that occur in older adults, such as thinning skin. How should these students best integrate these changes into care planning?

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