Age related skin changes
What is seborrheic keratosis?
benign, waxy, pigmented, sharply circumscribed lesion with a classic "stuck on" appearance on the trunk/face. Has zero malignant transformation potential.
Stage 1 nursing management
Intact skin with localized area of non-blanchable erythema (no purple/maroon tones).
Skin remains intact. Barrier creams, turn schedule q2h, silicone foam dressings. Do not rub
Normal age related sleep shifts
Marked reduction in deep slow-wave sleep (stage 3 and stage 4 NREM) and REM sleep
Chronic. systemic autoimmune inflammatory disease targeting synovial membranes
RA
How does acute angle-closure glaucoma manifest?
sudden, excruciating ocular pain, frontal headache, colored halos around lights, nausea/vomiting, cloudy/steamy cornea, and a fixed, mid-dilated pupil
What is herpes zoster?
Painful, burning clustered vesicles distributed strictly along a unilateral dermatome that never crosses the midline
Stage 2 nursing management
Partial-thickness loss of skin with exposed viable pink/red moist dermis. Intact or ruptured serum blister
No slough, eschar, or granulation. Hydrocolloid or occlusive transparent dressing to keep moist
What is OSA?
Repetitive upper airway collapse causing apneas > 10 seconds
Asymmetrical, affects large weight bearing joints (hips, knees, lumbar spine, DIP/PIP)
OA
What is age related macular degeneration and how to monitor?
Degeneration of macula lutea causing progressive loss of central vision (central scotoma) while peripheral vision remains intact
Monitoring: instruct client to test vision weekly using an Amsler grid
Actinic keratosis is a precursor to what?
squamous cell carcinoma
Stage 3 nursing management
Full-thickness skin loss; subcutaneous adipose tissue visible. Epibole (rolled edges) & slough may be present.
Bone, tendon, and muscle are NOT exposed. Debridement if slough is present, packing if undermined
Diagnostic screen for RLS (restless legs)
Serum ferritin and iron panel
Pain worsens with joint activity/weight bearing, relieved by rest
OA
Patient teaching for post cataract surgery
No heavy lifting >10 lbs, no bending at the waist (stooping), no coughing, no vomiting, and no straining with stool
Nursing Priority for xerosis
Bathe with tepid water (never hot), use mild super fatted cleansing agents, pat dry gently, apply petroleum based emollient lotions within 3 minutes of bathing with the state corneum is hydrated
Stage 4 nursing management
Full-thickness tissue loss with directly palpable or visible bone, tendon, ligament, or muscle.
High risk for osteomyelitis. Surgical consult, specialized wound packing, pressure redistribution
Low grade fever, malaise, anorexia, severe fatigue, anemia, nodules
RA
What is prebycusis and what are the nursing priorities?
Progressive, bilateral, sensorineural loss of high frequency sounds and consonants (s, sh, f, ph)
Priorities: Face client directly at eye level in good lighting, turn off background nose, speak clearly and in a lower pitched tone. DO NOT SHOUT
How long does pruritus typically persist for in a scabies infestation?
2-4 weeks after successful permethrin eradication
Unstageable nursing management
Full-thickness tissue loss where actual base depth is completely obscured by slough or eschar.
Stable, dry, intact, adherent eschar on ischemic heels must NOT be softened or debrided.
What is the pharmacological protocol for OA and RA?
OA: Acetaminophen first line (limits 2-3 g/24h), topical NSAIDS (Voltaren), oral NSAIDs cautious
RA: DMARDs (methotrexate, biologics) early, systemic corticosteroids, NSAID adjunctive