1. CNA 2 OSBN Curriculum http://www.medcomrn.com/de v/flash/flvplayer/movie.php?m ovie=http://ss1.medcomrn.co m/flv/78724r_sec01_300k.flv& title=&detectflash=false&detect flash=false

2.  Consists of ◦ Skin ◦ Hair ◦ Nails ◦ Glands  Group of Tissues  Largest Organ

3.  Epidermis ◦ Outer Layer  Dermis ◦ Inner Layer ◦ Connective Tissue ◦ Oil Glands ◦ Sweat Glands  Help Regulate Body Temp ◦ Blood Vessels/Nerves

4.  Protection  Excretion  Temp. Regulation  Sensory Sensation/Perception  Takes Vit. D

5.  Reveals General Body Health  Fever = Hot, Dry, Skin  Strenuous Activity = Red/Flushed  Pallor  Oxygen Content in the /Blood

6.  Excessive Pressure on Tissue  Decreased Blood Circulation  Damage to Skin and Underlying Structures

7.  Regular Skin Inspection  Frequent Turning of Immobile Pt.s  Protection to Bony Parts  Pressure Reducing Mattress  Lifting Devices  Reduction of ◦ Moisture ◦ Soiling  Frequent Skin Care

8.  Check Skin ◦ Bathing/Dressing/Transferring /Etc ◦ Applying TEDs/SCDs ◦ Where:  Boney Prominences  What to Look For ◦ Changes in  Color/Temp/Rashes  Odor/Sores/Pain

9.  Report Abnormals to Nurse  Keep Skin ◦ Clean and Dry ◦ Barrier Cream  Frequently Turn/Re-Position  Daily Skin Inspections

10.  Inflammatory Rash  Itchy & Red  Venous Stasis Dermatitis  Treatment ◦ Avoid Irritant ◦ Keep Clean  DO NOT Apply Prescription ◦ Lotions ◦ Ointments ◦ Creams

11.  Worsening of Dermatitis ◦ Severe Itching ◦ Pain  Infection ◦ Warmth ◦ Redness ◦ Swelling  Elevated Temp

12.  Report Abnormals to Nurse  Remove Irritating Agent as Directed

13.  Common: Redness/Irritation  Scales  Hereditary  Exacerbations and Remissions  Trigger Attack ◦ Stress ◦ Injury ◦ Medications  Goal of Treatment ◦ Control Sx’s ◦ Prevent Infections  Medical Emergency ◦ Covering Much of Body

14.  Pinkish Red Patches of Skin  Dry Patches w/Silvery Flaky Skin  Thick Patches of Skin  Pain  Severe Itching  Joint Pain/Aching  Nail Changes ◦ Thickening ◦ Yellow-Brown Spots ◦ Dents ◦ Separation from the base

15.  Report Abnormals to Nurse  Assist w/Bathing Daily ◦ Do NOT Scrub  Observe for Spreading Scales  Emotional Support

16. Shingles  Varicella Virus Elderly  Stressed  Immune Compromised  10 Days-2 Weeks  Painful Blisters Along Nerve Tracks  Neuralgia Long After Outbreak Cleared

17.  Flu-Like Sx’s ◦ Fever ◦ Headache ◦ Fatigue  Rash: ◦ Red/Sensitive/Sore Skin  Pain ◦ Buring/Throbbing/Ithcing/Tingling  Light Sensitivity  Swollen/Dry Eyes  Blurred Vision  Diplopia

18.  Report Abnormals to Nurse  Follow Contact Precautions

19.  Purpura ◦ Purplish, Hemorrhagic Spots ◦ Near the Surface of the Skin  Small = Petechiae  Large = Ecchymosis  Appears in Very Sick Patients

20.  Report to Nurse Stat

21.  Lice/Parasites  Infest ◦ Scalp ◦ Pubic Hair ◦ Full Body  Eggs Attach to ◦ Hair Shafts ◦ Clothing ◦ Furniture  Spread ◦ Clothing ◦ Furniture ◦ Bed Linen ◦ Shared Hats ◦ Hairbrushes  Treated w/Shampoos & Creams

22.  Itching of Scalp  Nits Attached to Hair  Lice Observed  Outbreak

23.  Report Abnormals to Nurse  Contact Precautions ◦ Use Gloves  Isolation ◦ Until 24 hrs. after Tx. Began  Treatment ◦ Apply Lotion to Dry Hair & Saturate ◦ Set 10 min ◦ Rinse ◦ Repeat in 1 Week

24.  Itch Mite Burrows Under the Skin  Highly Itchy Rash w/Tracks  Same Household  Physical Contact  Shared ◦ Clothing/Towels/Bedding  Treat Immediately

25.  Intense Itching  Skin Irritations ◦ Hives/Insect Bites/Blister ◦ Btwn: Finger/Armpits/Creases  Fever/Red Streaks/Pain/Swelling  Sores ◦ Get Worse ◦ Do Not Heal

26.  Report Abnormals to Nurse  USE GLOVES  Contact Precautions  Skin-Skin Transmission  Isolation 24 Hrs after Tx