Exam 17: Care of Aging Skin and Mucous Membranes

The admitting nurse gives the new long-term care facility resident a score of 20 on both the Norton Risk Assessment Scale and the Braden Scale for Predicting Pressure Sore Risk. These scores indicate that the resident has

What factors make the older adult more susceptible to pressure injuries? (Select all that apply.)

When performing a skin assessment for pressure injuries on an older man who is immobile and prefers to lie on his right side, the nurse will pay special attention to the __________. (Select all that apply.)

What preventative action can be taken to prevent skin trauma from shearing force?

What interventions by the nurse will aid in maintaining skin integrity in the long-term care facility residents? (Select all that apply.)

What is the cause of progressively graying hair?

When the patient complains of dry mouth, what should the nurse assess for?

What position would be most appropriate to reduce pressure injuries in an immobile patient?

The nurse assesses an area of skin on the patient's upper thigh that is different in appearance than the surrounding skin. What documentation would be the most informative?

A patient's toenails are brittle and thick. What other assessment should the nurse be sure to include?

The long-term care facility nurse requests a dental consult to treat gingivitis in a resident. If left untreated, what can gingivitis ultimately cause?

What is the purpose of the hydrocolloid dressing applied to a clean stage 2 pressure injury? (Select all that apply.)

On the admission assessment of a resident to a long-term care facility, the nurse notes a painless area on the patient' s coccyx that has partial skin loss. The nurse would record this as a stage _____ pressure injury.

Which long-term care residents would benefit from a referral to a podiatrist? (Select all that apply.)

The nurse instructs a group of older adults on how to maintain intact skin. What would be included in the teaching plan? (Select all that apply.)

A dark-complexioned African American has a suspected skin breakdown over the trochanter. What would be appropriate measures for the nurse to implement during the assessment? (Select all that apply.)

The patient who has been on long-term antibiotic therapy inquires what may have caused thrush. What is the most informative response of the nurse?

What would be the most effective intervention to prevent pressure ulcers in the bedridden patient?

The older man complains of a hard white patch that has developed on the side of his tongue. What would be the most appropriate action of the nurse?

What are causes of xerostomia in the older adult? (Select all that apply.)