Components of the Patient's Skin

Components of the patient's skin will first include the collection of data. Normal skin characteristics include being intact without abrasions, warm and moist, localized changes in texture across the surface, skin color variations from body part to body part and good turgor, generally smooth and soft. As a nurse any differences or variations from the normal must be reported and documented.

When a patient's physical condition changes it is often related to skin changes or alterations. The color may change, and hydration, turgor, texture, thickness or temperature may change. When the skin remains healthy and intact its physiological function remains optimal.

What is impaired skin integrity? Impaired skin integrity is a risk that is higher in patients who stay in one position for a period of time without relief to the area of pressure, in which a pressure sore can then develop. The patients who are especially at risk are the debilitated, older, chronically ill, incontinent, disabled, or the patient with a spinal cord injury. Not to mention patients who have limited mobility or overall poor nutritional intake are at risk for impaired skin integrity.

Pressure ulcers occur when there is significant pressure on the skin to cause the blood vessels to collapse. When this takes place the blood and fluid to the cells is impaired and results in ischemia to the cells. When the external pressure against the skin is greater than the pressure in the capillary bed, blood flow is then decreased to the nearby tissue. If this pressure continues on for a period of longer than 2 hours cell necrosis may then start to occur.

Shearing force is when the layers of tissue slide into one another, resulting in a "kinking" or stretching of the subcutaneous blood vessels, when this happens a interruption of blood flow to the skin. Friction is the rubbing of the skin over any surface which produces friction; this may include removal of layers of tissue.

When a patient is unable to properly take care of their needs including taking care of skin hygiene it is the nurses job to make sure their patients are not laying in a position for long and should preposition their patients every 1 to 2 hours. If your patient is at risk for shearing force or friction proper medical devices should be in place to help prevent skin integrity from happening to the patient. These medical devices are often ordered for the patients by the physicians based on the nurse's comments to the doctor.