Answer about Healthcare 2022

Running head: HEALTHCARE
HEALTHCARE
Name of the Student
Name of the University
Author Note

HEALTHCARE
Answer 1 (i)
According to Bonifant and Holloway (2019), the structural integrity of the skin is
hampered with the process of healing. This is because, there occurs age-related change in the
epidermis and dermis of the skin. This change, decrease the ability of the skin to resist the
damage and injury. With age, the dermoepidermal junction of the skin becomes flattened.
This flattened structure predisposed the skin tissue to get exposed to shear and frictional
forces leading to skin injury. With the dermis of the skin, there also occurs alteration in the
amount of collagen deposition and structure of collagen. Hamper in the collagen deposition
decreases the tenderness of the skin making it more rigid and vulnerable to injury under
frictional forces (Bonifant & Holloway 2019). Joyce is 77-year old and thus it is evident that
structural integrity of the skin is poor.
Figure: Difference between structural integrity of young skin and ageing skin
(Source: Bonifant & Holloway 2019)
Answer 1 (ii)
The ageing of the skin is associated with increase in the susceptibility towards a
diverse range of age-related condition like pressure ulcers and chronic wound. Due to hamper

HEALTHCARE
in the overall integrity of the skin as a result of ageing, there occurs delay on the overall
process of wound healing (Bonifant & Holloway 2019). Farage et al. (2013) stated that
Langerhans cell (LC) are antigen-presenting cells located with the epidermis of the skin and
plays an important role in acute wound healing. The number of LCs is greatly reduced among
the older adults leading to delay in the process of wound healing. The decrease in the LC also
makes the surface of the skin susceptible of skin infection and thus making the skin of the
older adults vulnerable to wound formation. According to Farage et al. (2013), the dermal
layer of the older adults have fewer number of fibroblasts, macrophages, fibroblasts along
with the decrease integrity of the extra-cellular matrix like collagen. Fibroblasts are
responsible for the formation of collagen in the skin. Hamper in the integrity in the fibroblast
leads to further decrease in the collagen formation. Lack of collagen hamper the granulation
of the tissue and thus delaying the process of wound healing. Joyce is suffer from delay in the
process of wound healing as her son reported that she has previously suffered from falls and
fractures and her recovery takes time.
Answer 2 (i)
The common medication in case of Joyce will be non-steroidal anti-inflammatory
drugs (NSAIDs) for pain management and anticholinergic drugs that are used for the
treatment of neurological complications like Parkinsons’ and dementia. The increased
tendency of accidental fall in Joyce might be a clinical manifestation of neurodegenerative
disease common at this age. Accidental fall is further associated with and hence the use of
pain killers.
Fragakis et al. (2018) stated that constipation is the common side-effect of
anticholinergic drugs anticolinergic drugs mainly blocks the action of the neurotransmitter
acetyl-choline at the neuronal synapses and peripheral nerves and thus inhibiting the
parasympathetic impulses. Parasympathetic impulses play an important role in the regulating
the peristalsis movement of the stomach. The role of the stomach apart from digestion with
the help of bile juice is to ensure passage of the food from stomach to small intestine by
peristalsis movement. This is followed by the passage of undigested food from small intestine
to the large intestine for excretion. Hamper in the blockage in the parasympathetic impulses
create a barrier for normal peristalsis movement. In the absence of peristalsis movement, the
passage of undigested food from large intestine to the rectum gets hampered leading to
constipation (Fragakis et al. 2018).