What should CNAs observe and report about a resident’s skin?

• A. Changes in hair color or texture.
• B. Any redness, warmth, swelling, or new breaks in the skin, or signs of irritation or pressure ulcers, especially over bony areas.
• C. Nail growth rate.
• D. Time of last meal before care.

Answer: (B)

Observing skin integrity and early signs of damage is essential. CNAs should look for redness, warmth, swelling, or new breaks in the skin, and any signs of irritation or pressure ulcers, especially over bony areas where pressure is greatest. Redness can indicate inflammation or the very start of skin breakdown; warmth may suggest inflammation or infection; swelling can reflect edema; new breaks in the skin are actual damage that needs assessment. Signs of irritation or suspected ulcers require timely reporting so the nurse can intervene—repositioning, skin barrier care, moisture control, or treatment as needed—to prevent progression.

These signs over areas like heels, sacrum, elbows, hips, and ankles are particularly important because pressure from lying or sitting can reduce blood flow and injure tissue there. By routinely observing and reporting these changes, you help protect the resident’s skin and prevent complications. The other options—changes in hair color or texture, nail growth rate, or the time of the last meal—don’t reflect skin integrity or risk for pressure injuries and aren’t part of standard skin observation.