1SA1a. One of the inmates had a wound on the medial side of his left shin. He had been refusing the nurses to let them change the dressing all morning, but one of the nursing aids bartered a fluffier pillow in exchange for allowance for cares, which included a dressing change. He agreed. Upon unwrapping his bandages, it was apparent that the patient had re-wrapped the baggage wrap himself, at some point throughout the night. The problem was, it was rewrapped too tight. His leg was swollen around the bandage wrap. We loosened the bandage wrap, cleaned, and redressed the wound. The swollen leg indicated that he was already experiencing poor lymph exchange and poor blood circulation. further complications from these could have resulted in blood …show more content…
My patient was a young man in his mid twenties. He had no hearing, speaking, or visual barriers, and he was ready and willing to learn as evidenced by him stating “I want to go home, how can I do that?” He displayed a knowledge deficit related to wound care as evidenced by him stating that he’d never done this before. Our expected out come was to teach him 4 ways he can help keep his wound and dressing clean. After the provider ordered discharge instructions, we provided his teaching in written format as well as verbal instruction. Before this teaching, I collaborated with my nurse about the important topics we should cover in the instruction. We agreed on the following instructions, which were written down in an easy to read format and presented to the patient. Instructions were as follows: Continue to take medications as prescribed, especially the antibiotic, until completed. The dressing on his left forearm will be changed everyday by a nurse that will come by his unit. Please, notify a nurse if the dressing becomes soiled, wet, starts leaking, or comes off. We asked him to repeat instances when he would notify a nurse to change his dressings; he was able to repeat all 4 circumstances when he would need a nurse to change his dressing. He also stated he had no
The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.
Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.
Outline and discuss a clinical audit that you have undertook into one aspect of care delivery and reflect upon the experience using Driscoll’s model of structured reflection. Word Count (2197)
A meaningful event from my clinical experience was during week six when one of my colleague and I along with the RN performed a wound care procedure on one of my client who had pressure ulcers on her coccyx area and wound on the right foot. It was my first time doing wound care on a client who has severe wound type. Client is a 90 years old female who has been admitted to the unit for Osteomyelitis, it is an infection of the bone, caused by bacteria breaking into the body’s tissues and entering the bloodstream through an open wound (LeMone, p.1382). The client said a dog bit her foot at a park few years ago and that’s how she got the wound. Client has a wound care dressing order that needs to be changed daily with Betadine soaked gauze for all areas,
The following assignment will take the form of a case study. The subject is a 79-year-old sikh gentleman, who will be known as patient X. Patient X only speaks English as his second language. Patient X has developed a wound on his right hip after being admitted a few days previously, after suffering from a stroke. Patient X has a history of a mild stroke and has slow mobility and uses the aid of a frame to mobilise. Patient X is obese, a heavy smoker and now
I get to see various types of wound, from pressure ulcer of different stages, unbelievable edemas, arterial and venous ulcers, diabetic ulcers, and many other wounds of uncertain causes. I have never expected to see those kinds of wounds. I have seen different drainage amount, color, and odor, various shapes and location of the wounds, and amputated edematous legs. I have learned also the different types of dressings and antibacterial ointments used. I had given the chance to observe a client on their high-tech hyperbaric oxygen therapy which makes the wound healing even faster. The most important lesson I have learned from the team members was, “DO NOT GET
Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him.
I observed the documentation process from week -2 in my clinical setting and through reading the related documents I gained theoretical knowledge of documentation . I week -4 I did the the return demonstration of documentation with my instructor successfully and started the documentation process in clinical and developed my communication skill . I think my learning plan helped me to achieve this goal . When I started this semester I wanted to learn about the wound care . To achieve this goal I observed the techniques of wound care in week -10 demonstrated by my instructor and reviewed the related resources of wound care . In week -11 I was successful in return demonstration of wound care and evaluated by my instructor . The plan I made
On assessment, the wound was slightly exudates, odour, sloughs and dry skin patches on the surroundings. Sprakes (2010) state that, holistic assessment of patient and the wound are essential in order to facilitate the wound healing process. Ousey and McIntosh (2010) points out that, chronic wounds are exacerbated by a sequence of misdiagnosis, neglect, incompetence or inappropriate treatment strategies. I observed that, M’s wound was with exudates and sloughs; this
Tammy, I would agree there is a major difference between knowing how to perform a specific skill and knowing how to perform that skill effectively. I think it is great that you offer new nurses to your department an extensive orientation and training. Wound vac care can be tedious, depending on the wound, requiring much training and then follow-up training to ensure it is being performed correctly. The surrounding skin appearance of a wound bed is a good indicator of correct wound vac application. Your expertise in wound care with precise skin barrier methods prevented further complications with this already painful wound. When patients get, frustrated or are having a lot of pain related to a treatment or procedure, many times they will refuse
Mr. J.’s daughter noticed a red mark on her father who then reported this to the nursing assistant and her concerns were immediately dismissed. If the nursing assistant was properly trained in the use of restraints and had knowledge of patient outcomes, this patient would not have developed a pressure ulcer. The nursing assistant should have immediately informed the nurse and measurements should have been taken to prevent further breakdown of the patient’s skin which was not done. It is evident in reading this case that Mr. J developed a Stage I pressure ulcer from being retrained in one position with no assessment or release for an undetermined amount of time.
This paper is written from the perspective of a nurse-manager for a hospital floor and focuses on a proposed change to that floor: the addition of a certified wound care nurse. It begins by describing the benefits of a specialized wound care nurse, the existing conditions on the hospital floor, and how each of the stakeholders would be impacted by such a change. It utilizes Lippitt's phases of change theory to describe how those changes would be implemented on the floor, outlining each of the phases in implementing such a change.
During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to
A critical literature review exploring the effectiveness of using skin staples as opposed to sutures or skin adhesive as closing materials after orthopaedic surgery.
According to Walker and Avant (1995), concept analysis allows nursing to examine the attributes or