Skin Coloration
Loss of color; arterial insufficiency, decreased blood supply, anemia
What is pallor?
Obscured full-thickness skin and tissue loss.
What is an unstageable pressure injury?
Elevated blood sugars cause damage to vessels and nerves over time; typically in feet
What are diabetic ulcers?
ABCDE stands for...
What Is Assessment, border, color, diameter, evolution?
Braden Scale is out of...
What is 24?
Central vs. Peripheral; cause by hypoxia; blue tint of skin
What is cyanosis
Full-thickness skin loss and fat may be visible.
Blanchable erythema or broken skin in perineal area caused by urine and stool incontinence
What is Incontinence Associated Dermatitis?
Most serious form of skin cancer; existing mole that bleeds, itches, or changes shape/color; large brownies patch or smaller spot with black, red, or white speckles.
What is malignant melanoma?
A patient is considered at risk for skin integrity with a Braden scale less than...
What is 18
Yellowing of skin, oral mucosa, sclera, palms, and soles; Caused by liver dysfunction
What is jaundice?
Partial thickness skin loss with exposed dermis.
What is a Stage 2 pressure injury?
Skin damage from moisture but not caused by incontinence; find in skin fold: under breast, between glutes; may cause fungal infection that will lead to itching
What is Intertriginous Dermatitis?
Most common in caucasians; pearly/waxy bump or flat brown lesion
What is basal cell carcinoma?
there are ... categories in a Braden scale.
What is 6?
Velvety darkening of skin in body folds and creases; especially neck, groin, and axilla
What is acanthosis nigricans?
Non-blanchable erythema of intact skin.
What is a Stage 1 pressure injury?
Most common where adhesives are used, usually the extremities; infants and elderly are most susceptible
What are skin tears?
Firm and pimple/nodule or scaly patch; most common skin cancer in darker skin.
What is squamous cell carcinoma?
The categories of a Braden scale include...
What is sensory perception, moisture, activity, mobility, nutrition, friction and shear?
Reddening of the skin.
What is erythema?
Full-thickness skin and tissue lost; bone, muscle or tendon may be visible.
What is a Stage 4 pressure injury?
What are abrasions?
Risk factors include...
What is sun, tanning beds, moles, and ionizing radiation?
What is 2 hours?