Nursing Care of the Patient with Complex Sensory/Perceptual

Alterations and Disorders of the Integumentary System

Objectives:
By the end of Lesson Plan 12, the learner will be able to:
1.
2.
3.
4.
5.
6.
7.
8.

Discuss the normal anatomy, physiology, and functions of the skin.

Identify the variations in skin assessment findings for the older adult.
Identify primary and secondary skin lesions with their pattern and distribution.
Explain the etiology, clinical manifestations, and collaborative care of patients with
benign and malignant dermatological disorders.
Discuss nursing interventions and rationale for the nursing diagnoses of Impaired
Tissue Integrity.
Discuss the skin tests and procedures used in diagnosing skin and related disorders.
Plan health teaching for discharge planning and home maintenance for the patients
who have benign or malignant skin disorders.
Summarize the psychologic and physiologic effects of chronic dermatologic
conditions.

Read This:
Lewis: Chapter 23 (review); Chapter 24 (p. 427-435 & 440-448)
Lilly: Chapter 56 (901-915) ***different than in syllabus*** (dermatologic drug chapter)
Lutz: Chapter 7 & 8 (review)
Castillo: p. 179-180
Habel, M. & Tatliff, C. (2015). Providing relief for patients with malignant wounds.
Retrieved online nurse.com/ceu/south. PDF available here:
Listen to This:
Lesson Plan 12 Voice Over PPT:
Do This:
In preparation for next terms management course, this Lesson Plan has afforded you
an opportunity to begin practicing your skills with graded Discussion Boards. You have

been placed into groups for this discussion board and given topics. Please note your
group number and topic as designated in Canvas. The grading rubric and due dates for
this discussion are listed below.
Once you locate your group and topic, conduct an internet or library search for a
scholarly, peer reviewed article no more than 5 years old that supports the information
provided. You should support your initial posting with at least one scholarly article and
respond to two initial postings of peers with references, for a total posting count of three
for this assignment. Responses should be more than Good Job! or I agree.
Posting early to the discussion board is encouraged as this will allow for maximum
interaction between peers. Duplicate article submissions by peers on initial postings will
result in a loss of points, so early posting is also encouraged. More posting and
discussion is encouraged beyond the minimum three required.

Integumentary System Discussion Board Grading Rubric

Criteria
Initial posting
provides
thorough
assessment
of topic and
is on time.

Points
Meets all
expectations

Only minor
omissions

Multiple
omissions

Needs significant
improvement

Not done

50 pts

40 pts

30 pts

20 pts

0 pts

Meets all
expectations

Only minor
omissions

Multiple
omissions

Needs significant
improvement

Not done

25 pts

20 pts

15 pts

10 pts

0 pts

/50

Instructor
comment
Use of
literature and
evidence in
initial posting
and
responses.
Instructor
comment

/25

Integumentary System Discussion Board Grading Rubric

Responses
include
analysis and
critique of at
least 2 other
initial
postings.

Meets all
expectations

Only minor
omissions

Multiple
omissions

Needs significant
improvement

Not done

20 pts

15 pts

10 pts

5 pts

0 pts

APA style as
possible in
Canvas.

Meets all
expectations

Only minor
omissions

Multiple
omissions

Needs significant
improvement

Not done

Instructor
comment

5 pts

/20

Instructor
comment

/5
4 pts

Total Points

3 pts

2 pts

0 pts
/100

Initial Post Due to Discussion Board no later than Monday, 4/13/15, @ 2330. This is
post #1 of 3 for the week. Remember early posting is encouraged for scholarly
discussion to occur.
Response Posts to 2 group members initial postings are due by Monday, 4/20/15 @
2330. These are posts #2 & #3 for the week. More posting is encouraged, but not
required. Also, if someone posts to you, you should respond. This is like a discussion
in class as if you were carrying a conversation back and forth on a nursing topic.
The instructors realize that Canvas sometimes has formatting issues with APA style, but
please note this has been taken into consideration within the grading rubric. Please no
attachments, cut and paste your work into the discussion board, providing a reliable link
or searchable reference for your article. Reformat as necessary.
Discussion Board Topics By Group:

Group 1 (Mrs. Licalzi):

Your 38 year old female patient who earns her living as a professional surfer is
preparing for discharge after removal of basal cell carcinoma of her right ear. 1/3 of her
ear is now missing and she appears to be profoundly depressed. Address any
discharge teaching needs.
Group 2 (Ms. Thomas):
You are a nursing student about to present a pamphlet at a local health fair that will
provide melanoma skin safety tips for all ages. Being a diligent student you do your
research for modifiable and unmodifiable risk factors to include in your pamphlet for
pediatric through gerontologic age groups. Address teaching needs by age group.
Group 3 (Mrs. Simpson):
As a home health nurse, you travel to the home of your 78 year old male diabetic patient
for his weekly wound care and note that he has lichenification and areas of excoriation
to his left shin. Provide what this is, how it may have occurred, what may relieve the
issue and any patient education that is pertinent.
Group 4 (Ms. Waite):
You are caring for a 45 year old Caucasian female patient with a rapidly changing black
mole on her left leg. It used to be a flat, brown mole that she had for years. The
patients reports that the lesion has become slightly raised with irregular borders over a
period of 4 weeks. Upon history evaluation, the patient also states that she has used a
tanning bed about 20 times a year for about 5 years and does not use sunscreen while
working outside or at the beach. There were no family history events of malignant
melanomas. Skin examination reveals an 8 mm x 10 mm irregularly shaped two-toned
brown papule with ill-defined light-brown to pink medial and lower borders, and a darkbrown central area. It resides on the calf of the left leg. There is no lymphadenopathy.
The rest of her exam is normal. Provide a suspected medical diagnosis for her, the tool
used for exam and diagnosis, potential diagnostic and therapeutic treatments in the
upcoming plan of care with the role of nurse in each, and any education provided to the
patient.

Group 5 (Ms. Thompson):

You are caring for a 57 year old male patient with chronic stable plaque psoriasis of his
right knee, elbow, and calf. Anticipate necessary pharmacologic orders for this patient
and any associated teaching involved with them. Also provide non-pharmacologic
interventions that may provide relief from the plaque. Include any other teaching points
as relevant to this patients plan of care.
Group 6 (Ms. Francis):
Youve spent a lot of time educating patients on sun safety. Now you are reading in the
journals about a therapy called phototherapy/photodynamic therapy that uses UV light
for certain conditions. Which conditions of the integumentary system is it used for?
How is it safe without causing further skin cancer? Does it use other medicines with it?
What kind of patient education is involved?