unit 229 undertake agreed pressure care

Topics: Bedsore, Gangrene, Skin Pages: 6 (1384 words) Published: March 23, 2014
Unit 229

Undertake agreed pressure area care

Describe the anatomy and physiology of the skin

Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over a bony area such as a heel which may have been in contact with a bed or a splint over an extended period of time. The surface of the skin can ulcerate which may become infected – eventually subcutaneous and deeper tissues are damaged besides the heel, other areas commonly involved are the skin over the buttocks, sacrum, ankles, hips and other bony sites of the body.

Describe the four stages of a pressure sore

A grade one –pressure ulcer is the most superficial type of ulcer. The affected area of skin appears discoloured and is red in a Caucasian person, and purple or blue in people with a darker complexion. Grade one pressure ulcers do not turn white when pressure is placed on them. The skin remains intact but it may hurt or itch, it may also feel either warm and spongy, or hard.

In grade two-pressure ulcers some of the outer surface of the skin (the epidermis) or the deeper layer of skin (the dermis) is damaged, leading to skin loss. The ulcer looks like an open wound or a blister.

In grade three-pressure ulcers, skin loss occurs throughout the entire thickness of the skin. The underlying tissue is also damaged. However, the underlying muscle and bone are not damaged. The ulcer appears as a deep cavity like wound.

A grade four-pressure ulcer is the most severe type of pressure ulcer. The skin is severely damaged and the surrounding tissue begins to die (tissue necrosis). The underlying muscles or bone may also be damaged. People with grade four pressure ulcers have a high risk of developing a life-threatening infection.

Unit 229

Identify pressure sites of the body

For those individuals that are bed bound they are more likely to suffer with pressure ulcers on their:

Shoulders and shoulder blades
Elbows
Back of the head
Rims of the ears
Knees, ankles, heels or toes
Spine
Tailbone (coccyx’s)

For those individuals that use wheelchairs maybe more prone to pressure ulcers on their:

Buttocks
Back of arms, legs
The back of the hip bones

Identify factors which might put an individual at risk of skin breakdown and pressure sores

Mobility problems
Poor nutrition
Aged (over 70 )
Incontinence (urinary or/and bowl )
Serious mental health conditions
Underlying health condition ( that disrupts blood supply and makes skin more fragile)

Unit 229

Describe how incorrect handling and moving techniques can damage the skin

Poor positioning can lead to the individual slipping/sliding on the bed this action can cause friction and shearing of the skin, this can also happen by not using the correct techniques or equipment for instance by using a sliding sheet and placing the individuals feet being flat on the bed can help with correct positioning and reducing the risk of friction or shearing.

Identify a range of interventions that can reduce the risk of skin breakdown and pressure sores

Relieving pressure
Promoting circulation (maintaining activity)
Allowing air to reach the skin
Reducing temperature and humidity and humidity
Avoiding incontinence
Allowing skin to being inspected
Good personal hygiene
Nutrition
Quit smoking

Describe changes to an individual’s skin condition that should be reported

You should report any new sore/ulcers or red areas to nurses or managers, or any changes to existing pressure sores should also be reported to nurses/doctors. Once the sore as progressed to a grade two this should then be more thoroughly investigated by outside sources, (social workers, and health boards). It is important to do regular inspections of the individual’s skin and more frequently if sores are present.

Unit 229

Understand good practice in relation to own role when...
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