老年人皮肤问题的评估与处理.pptVIP

* * * The first stage of the NPUAP staging system is nonblanchable erythema of intact skin: the heralding lesion of skin ulceration. The NPUAP made revisions in this definition in 1995, 2007 and 2009 to reflect new research and consensus. * * [Text on slide.] * * [Text on slide.] * * [Text on slide.] Text on slide * * [Text on slide.] * * [Text on slide.] * * [Text on slide.] Over the past several years as the NPUAP has been working on refining the definition and description for DTI.36 The CMS has also interpreted DTI as subtle signs “. . . (such as a purple or very dark area that is surrounded by profound redness, edema, or induration) suggesting that deep tissue damage has already occurred and additional deep tissue loss may occur. This deep tissue damage could lead to the appearance of an unavoidable Stage III or IV pressure ulcer or progression of a Stage I pressure ulcer to an ulcer with eschar or exudate within days after admission.”8 Bony prominences, such as the knees, should not touch each other. Pillows can often be used to keep bony prominences apart. Reddened skin areas should not be massaged and donut-type devices should not be used in chairs or wheelchairs. Both of these actions may cause further skin damage. This slide shows the 30 degree lateral lying position with the use of pillows and wedges to maintain good alignment and to prevent bony prominences from touching. Optional Activity: Demonstration (allow 3 minutes) Materials: Pillows; Wedges; Three volunteers Have a participant lay down and have two other participants position pillows and wedges appropriately so that the participant is laying in the 30 degree lateral lying position. Certain activities, such as tube feeding, require elevating the head of the bed. When not contraindicated, the head of the bed should be kept low (under 30 degrees) to help prevent skin damage that may occur when a resident slides down in bed. When a resident is repositioned on a side, the resident should l