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Skin Tears: Care and Management of the Older Adult at Home

doi: 10.1097/NHH.0b013e318285c7d0
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Skin Tears: Care and Management of the Older Adult at Home


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GENERAL PURPOSE: To present comprehensive information about risk assessment, skin tear classification, best-practice prevention, and treatment guidelines to help home healthcare clinicians manage skin tears and identify patients at risk for these wounds.

LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:

  1. Outline the incidence, risk factors, and classification of skin tears among older adults.
  2. Plan the appropriate interventions for preventing and treating skin tears in older adults.
  1. Of the following, which area of aging skin is most prone to skin tears?
    1. Hands
    2. Legs
    3. Scalp
    4. Buttocks
  2. It is estimated that skin tears affect how many older adult patients in hospitals and long-term care facilities?
    1. 1 million
    2. 1.5 million
    3. 2 million
    4. 2.5 million
  3. About what percentage of older adults residing in residential community settings have skin tears?
    1. 2%
    2. 5%
    3. 8%
    4. 11%
  4. With a skin tear that is a partial-thickness wound, the
    1. stratum corneum is separated from the epidermis.
    2. dermis is separated from the underlying tissue.
    3. epidermis is separated from the dermis.
    4. epidermis and dermis are penetrated but not separated.
  5. Age-related atrophy or thinning of the dermis and epidermis results in
    1. enlarged structures between skin layers.
    2. a coarse, mottled surface.
    3. overgrowth of the subcutaneous fatty layer.
    4. a paper-thin appearance.
  6. Effects of aging on the skin include
    1. decreased nerve endings.
    2. increased vascular supply.
    3. decreased thickness of elastin fibers.
    4. increased production of sebum.
  7. About 40% of skin tears in aging skin are associated with
    1. nevi.
    2. rashes.
    3. senile purpura.
    4. seborrheic keratoses.
  8. According to the Payne–Martin Classification System, a Category III skin tear takes an average of how many days to heal?
    1. 10 days
    2. 14 days
    3. 18 days
    4. 21 days
  9. According to the Payne–Martin Classification System, a Category II skin tear has which of the following features?
    1. Partial-thickness skin loss
    2. A tear but with no skin loss
    3. Complete skin loss
    4. Extensive purpura near the tear
  10. Use of which of the following products puts aging skin at particular risk for skin tears?
    1. Nonalkaline soaps
    2. Antibacterial skin cleansers
    3. Glycerin-based washes
    4. Hypoallergenic moisturizers
  11. When assessing a patient's home environment for routine household items that cause accidental skin tears, which of the following items should the clinician remove from the environment?
    1. Throw rugs
    2. Bureaus
    3. Grab bars
    4. Lamps
  12. When assessing the home environment of a patient who uses a walker, which of the following should the clinician do to prevent skin tears?
    1. Discourage the use of the walker
    2. Replace the walker with a quad cane
    3. Ask the family to help the patient walk
    4. Apply padding to the walker
  13. To promote wound healing, clinicians should make sure patients who have skin tears consume an adequate amount of
    1. carbohydrates.
    2. protein.
    3. fat.
    4. calcium.
  14. Unless patients require fluid restriction, how much fluid should clinicians recommend they drink each day?
    1. At least 1 quart
    2. 1 to 2 quarts
    3. 2 to 3 quarts
    4. More than 3 quarts
  15. Which of the following is the recommended practice for bathing aging skin?
    1. taking a tub bath every day
    2. having a shower with warm water as needed
    3. using ample soap to clean arms and legs
    4. apply moisturizer after thoroughly drying bathed skin
  16. When cleansing a skin tear before applying a dressing, it is appropriate to
    1. irrigate the tear with normal saline solution.
    2. use a 22-gauge angiocatheter to irrigate the tear.
    3. apply an irrigation pressure of 15 to 18 psi.
    4. gently wipe any debris from the tear.
  17. Which of the following is an appropriate type of dressing for a skin tear with a moderate-to-large amount of exudate?
    1. Transparent film
    2. Acrylic
    3. Hydrogel
    4. Hydrofiber
  18. Which of the following is an appropriate type of dressing for a skin tear with a minimal amount of exudate?
    1. Petroleum gauze
    2. Alginate
    3. Hydrogel
    4. Dry gauze


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