Assignment (doc) | Nursing

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

NURSING1
Response 1:
The provided case information suggests that the patient Joyce is 77 year old and has
sustained injuries from a fall incident. The injury has resulted in tear of skin and on account
of her injury the ability to address activities of daily living has also been affected. The
evidence base suggests that the process of ageing induces significant changes within the skin
integrity. According to Blume-Peytavi et al. (2016), the process of ageing affects the
physiology of the epidermis which subsequently diminishes the ability of the dermis layer to
resist age related damage and infections. It should further be noted that research studies also
state that the dermo-epidermal junction with advancing age flattens and this results in
weakening of the skin due to the force of friction. As stated by Farage et al. (2017), the pace
of epithelisation gets delayed with advancing age and the density of the keratinocytes as well
as the langerhan cells reduces considerably. The keratinocytes and the Langerhans are
responsible for the maintenance of skin integrity among senior adults and with the poor
density of these cells, the skin becomes overtly sensitive to the process of wound healing and
infection and the recovery process gets delayed. Therefore, on account of the patient’s
advanced age, it can be said that the skin integrity is significantly impaired.

NURSING2
(Source: Bpac.org.nz 2019)

NURSING3
Research studies critically mention that there are four stages of wound healing which
comprises of the inflammatory stage, the proliferative phase and the remodelling phase
(Blume-Peytavi et al. 2016). The ageing process interferes with the cell signalling processing.
The signalling process is impacted by cytokine transduction which causes an imbalance of
the protein level for the process of healing and at the same time negatively impacts the
overall healing process (Farage et al. 2017). The process of senescence induced vascular
changes within the inflammatory steps which simultaneously impacts cell division due to
infiltration of the inflammatory macrophage (Farage et al. 2017). Also, in older adults,
remodelling of the injury takes a long time and thus it can be said that the patient would
require a lot of time for complete recovery due to impaired skin integrity.
(Source: Woulgan 2019)