Although the majority of older patients exhibit typical features of various infections, they may frequently exhibit altered clinical features. A change in body temperature may be as important as the absolute temperature in the elderly. Change in mental status is a common presenting clinical finding in elderly with infections. The resident should be familiar with the different stages, preventative measures and treatments for pressure ulcers. The duration and amount of pressure are the determining factors in ulcer formation.
Ulcers can develop in as little as two hours.
Since the normal intracapillary pressure ranges from 12-32 mmHg, any pressure above this can produce local ischemia. There are many different dressings to treat pressure ulcers that differ in their permeability, absorptive capabilities, and frequency of changing. Stage 3 ulcers may need debridement prior to dressing applications. Hydrocolloid dressings, which are impermeable to gas and moisture but have greater absorptive capabilities are better for stage 3 ulcers, particularly if the produce exudate. Stage 4 ulcers require surgical consultation and usually need to be packed.