Summary NUR 2214 Nursing Care of the Older Adult.

NUR 2214 Nursing Care of the Older Adult. Ch. 17: Integumentary Function Age-related changes in skin structure and function: ● L oss of thickness, elasticity, vascularity, and strength that may delay the healing process and increase the risk of skin tears and bruising ● I ncreased lentigines (brown-pigmented spots, or age spots) ● L oss of subcutaneous tissue causing wrinkling and sagging of the skin, which may affect self-esteem, temperature control, and drug efficacy ● L oss of hair follicles along with thinning and graying ● I ncreased hair density in the nose and the ears, particularly in men, which may clog external ear canals and impair hearing ● T hicker nails with longitudinal lines ● D ecreased sebaceous and sweat gland activity, which affects thermoregulation and decreases sweating ● Higher incidence of benign and malignant skin growths The primary function of the skin is to serve as a barrier against harmful bacteria and other threatening agents, which makes the skin the f irst line of defense for the immune system. Other major functions of the integumentary system include (1) preventing fluid loss or dehydration, (2) protecting the body from u ltraviolet (UV) rays and other external environmental hazards, and (3) protecting underlying organs f rom injury. In addition, the skin provides thermal regulation of body temperature. Radiation, conduction, convection, and evaporation are facilitated by sensory perceptions that occur in the skin’s nerve endings. The skin also assists in the regulation of blood pressure through “local regulation of cutaneous blood flow and salt and water metabolism” (Johnson, Titze, & Weller, 2016, p. 1). The integumentary system reveals emotions such as anger, fear, or embarrassment through vasodilatation, which reddens the skin tissue. In the presence of the sun’s UV rays, the skin synthesizes vitamin D, which is then used by other parts of the body. Subcutaneous fat, the deepest layer of the integumentary system, provides insulation and acts as a caloric reservoir. The epidermis is the outermost layer of the skin. The replacement rate of the stratum corneum, the first layer of epidermis, declines by 50% as a person ages. This decline results in slower healing, reduced b arrier protection, and delayed absorption of medications and chemicals placed on the skin. The area of contact between the epidermis and dermis decreases with age, which results in easy separation of these layers. Therefore skin tears occur from harmless activities such as removing a bandage or pulling an older patient up in the bed. The dermis d ecreases in thickness by approximately 20% with aging. It consists of strong connective tissue that contains the sweat glands, blood vessels, and nerve endings. These changes lead to d iminished thermoregulatory function and inflammatory responses, decreased tactile sensation, reduced p ain perception, and development of wrinkles and sagging skin because of loss of underlying tissue. C ollagen, a fibrous protein that provides tensile strength within the dermis, stiffens and becomes less s oluble.