You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

Choice A: Protect the skin from trauma. This is a correct answer. Purpura is the discoloration of the skin or mucous membranes due to hemorrhage from small blood vessels¹. It can be caused by various factors, such as blood clotting disorders, medications, infections, or weak blood vessels². Older adults are more prone to develop purpura because their skin becomes thinner and more fragile with age³. Therefore, protecting the skin from trauma, such as knocking against hard surfaces, can help prevent or reduce purpura.

Choice B: Remind the health care personnel to be gentle when handling this client’s skin. This is also a correct answer. Health care personnel should be aware of the risk of purpura in older adults and handle their skin with care. They should avoid applying excessive pressure, friction, or shear forces to the skin, as these can cause damage to the blood vessels and result in purpura. They should also use soft and smooth materials, such as cotton or silk, when dressing or cleaning the skin.

Choice C: Wear a long-sleeved shirt. This is not a correct answer. Wearing a long-sleeved shirt may provide some protection to the skin, but it is not enough to prevent purpura. Moreover, wearing tight or rough clothing can actually worsen the condition by causing irritation or injury to the skin. Therefore, this is not a good advice for the client.

Choice D: Tape a nonadherent dressing over the site of a skin tear. This is another correct answer. A skin tear is a type of wound that occurs when the skin is separated from the underlying tissue, usually due to trauma. Skin tears are common in older adults and can lead to purpura if the blood vessels are damaged. Taping a nonadherent dressing over the site of a skin tear can help protect the wound from infection, promote healing, and prevent further bleeding.