Which nursing intervention can help a client maintain healthy skin?
A. Keep the client well hydrated.
B. Avoid bathing the client with mild soap.
C. Remove adhesive tape quickly from the skin.
D. Recommend wearing tight-fitting clothes in hot weather.
Correct Answer: A. Keep the client well hydrated.
Keeping the client well hydrated helps prevent skin cracking and infection because intact healthy skin is the body’s first line of defense. The role of water within the stratum corneum is pivotal to the maintenance of normal skin integrity and turnover. Water allows for the increased flexibility of the tissues and is a crucial component of the enzymatic reactions responsible for cleavage of the corneodesmosome connections between corneocytes during the desquamation process.
Option B: To help a client maintain healthy skin, the nurse should avoid strong or harsh detergents and should use mild soap. Dry skin has many causes including frequent hand washing, exposure to harsh chemicals, low ambient humidity, as well as medical conditions like atopic dermatitis, ichthyosis, and psoriasis.
Option C: The nurse shouldn’t remove the adhesive tape quickly because this action can strip or scrape the skin. Conversely, when the water content is too low, hydrolytic enzymes needed for this reaction are unable to function. The water content of the stratum corneum ranges from 10% to 30% in healthy skin, as compared to 75% to 85% water content of stratum basale. This gradient is a key feature in its function as a barrier.
Option D: The nurse should recommend wearing loose-fitting — not tight-fitting — clothes in hot weather to promote heat loss by evaporation. Below a critical water concentration, the corneodesmosome connections remain intact, which results in a build-up of corneocytes and the appearance of dry, flaky skin.
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