A practical nurse is changing a wound dressing for an older adult client who has age-related thinning of the epidermis and decreased skin elasticity. Arrange the following actions in the correct chronological sequence to safely complete the dressing change and prevent skin tears.
- 1Don clean gloves and apply an adhesive remover or normal saline to the edges of the old tape.
- 2Gently pull the old tape parallel to the skin surface while supporting the adjacent skin.
- 3Assess the exposed periwound skin for any signs of redness or epidermal stripping.
- 4Apply a liquid skin barrier wipe to the intact periwound tissue and allow it to dry.
- 5Secure the new wound dressing in place using a gentle, silicone-based medical tape.
Answer
The correct sequence is to first moisten the old tape, gently remove it parallel to the skin, assess the exposed skin, apply a liquid skin barrier, and finally secure the new dressing with silicone tape.
The correct sequence prioritizes minimizing mechanical trauma to the aging client's fragile epidermis. Moistening the adhesive and pulling parallel to the skin prevents epidermal stripping. Assessing the skin ensures integrity before applying a skin barrier, which protects the tissue from the new, gentle silicone tape.
Step-by-Step Solution
Key Concept
Protecting fragile, aging skin from mechanical trauma and skin tears during dressing changes.