Describe the nursing assistant's responsibilities in the prevention of skin breakdown.
What will be an ideal response?
The nursing assistant should change the patient's position at least every 2 hours, and avoid friction and shearing. Turning sheets should be used for dependent patients. The head of the bed should not be elevated higher than 30 degrees for dependent patients. If patients are up in chairs, they should be taught to raise their buttocks every 10 minutes. Padding and preventive devices can be added to both the bed and the chair to relieve pressure.
It is important to encourage proper nutrition and fluid intake. If a patient is incontinent, the skin should be washed immediately, as these excretions are very irritating. The skin should be kept clean and dry at all times. The patient should be bathed daily, but hot water and friction should be avoided during bathing. It is important to keep skin folds and friction areas clean and dry. The skin surrounding red areas should be rubbed frequently. Moisturizers should be used on dry skin. Alcohol should never be used. If the skin is broken, lotion should not be applied. Friction areas may be dusted lightly with cornstarch, but this should not be allowed to accumulate. The nursing assistant should check the skin daily for signs of redness, irritation, or breakdown. Linen should be dry and free from wrinkles, crumbs, and other foreign objects.
Range-of-motion exercises should be performed at least twice daily to stimulate circulation. The nursing assistant should check for pressure from braces, prostheses, and other medical devices. Any signs of redness or skin breakdown should be reported to the nurse immediately.
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