The patient is a 34-year old female with PMHx obesity, obstructive sleep apnea (OSA), Hypothyroidism, s/p R Thyroidectomy for large goiter and Grave’s disease, HTN, PSHx of
R Thyroidectomy (5/2007) and C-section of infra-umbilical longitudinal. She presented to the clinic with imaging demonstrating a large soft tissue mass arising from left iliopsoas muscle with some vessel involvement. She has 2 – 3 year history of increasing LLE edema > RLE, increasing LLQ discomfort.
After the patient’s admission on 09/14/2016, she underwent multiple procedures, e.g., RIJ central line placement, L retroperitoneal exploration, radical resection of L retroperitoneal mass, L iliac lymphadenectomy, placement of clips for tumor localization, repair of L
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However, the blister was not noted on the first wound care assessment that was done on 09/30/2016 “Patient evaluated for pressure related injury, No evidence of pressure related skin damage at present. On the center of back, skin fold, and left buttock, 1 cm, re-epithealizied, pink tissue was noted”. The patient’s initial Braden score was 9 that indicated the patient’s high risk for pressure-related skin damage. On the following skin evaluation sessions by wound care, Stage II pressure ulcers were assessed on the right buttock, induration of the left upper leg, dark discoloration from mid inner thigh to the medial aspect. Intertriginous Dermatitis (ITD) was noted in right inguinal area and had purulent drainage present. Also, several small areas of partial thickness skin loss were assessed due to moisture, pressure and sheer. Nevertheless, it was documented that overall skin wounds were resolving. On the other hand, two Stage IV pressure ulcers sites were documented on 11/11/2016: (1) left ankle distal area that was open, red, bleeding, and raw, and the medial area of the ankle that had black scab; and (2) posterior head (occiput) had a large, formerly fluid-filled blister that split open. There was purulent drainage, tunneling, and circumferential undermining that …show more content…
Pressure ulcer prevention strategies, e.g., turning and repositioning protocols were also
A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two
Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian Journal Of Plastic Surgery, 45(2), 244-254.
This is a 58-year-old male Caucasian returning to the clinic for hyperlipidemia, BPH, reflex sympathetic dystrophy of the right lower extremity.
Abdominal Ultrasound: She doesn’t have masses, fluid collections, and infection. Also, she doesn’t have pancreatitis and gallbladder disease.
A pressure ulcer is a localized injury to the skin usually over bony prominence, as a result of pressure, or pressure in combination with shear. It is estimated that 5 to 10 percent of patient admitted to the hospital acquire a pressure ulcer and it result in increased suffering, morbidity and mortality. The policy titled Pressure Ulcer Prevention and Managing Skin integrity provides direction for the nurses to prevent the development of pressure ulcer. It
She weighs 159 pounds, oxygen saturation is 97% in room air. Patient is sitting comfortably in no apparent distress. Eyes: Pupils are equal, regular, reacting to light with intact extraocular movements. Oropharynx is normal. Ears: Normal, external auditory canal, and tympanic membrane. Neck: Supple. Chest: Clear to auscultation. Left thumb mild tenderness. Good range of motion.
Pressure ulcers additionally called bedsores or pressure sores, are wounds to skin and fundamental tissue coming about because of delayed weight on the skin. A pressure ulcer is confined damage to the skin or basic tissue more often than not over a hard unmistakable quality, as a consequence of weight, or weight in blend with shear and contact. Since muscle and subcutaneous tissue are more defenseless to weight incited harm than skin, bedsores are regularly more awful than their introductory appearance. Pressure ulcers are then organized to direct clinical depiction of the profundity of detectable tissue demolition. It is assessed that these ulcers commonness in intense consideration is 15%, while frequency in intense consideration is 7%. It is evaluated that 2.5 million patients are treated for bedsores in US wellbeing acute care facilities every year. Pressure ulcers cause significant damage to patients, obstructing useful recuperation, often bringing on torment and the improvement of genuine diseases. They have additionally been connected with a broadened length of stay, sepsis, and mortality. Truth be told, about 60,000 US facility patients are assessed to pass away every year from complexities because of these ulcers. The evaluated expense of dealing with a solitary full thickness ulcer is as high as $70, 000, and the aggregate expense for treatment of pressure ulcers in the US is assessed at $11 billion every year.
She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et
Pressure ulcers refer to damage that occurs to the skin of a patient. Pressure, shear and friction are among the known causes (Shahin, Dassen & Halfens, 2009). Pressure ulcers mostly affect the lower part of the body, the elderly and patients with spinal injuries (Shahin et al, 2009). They are expensive to treat, require long periods of time and numerous treatments to heal. As a
One of the greatest indicators for the quality of care is health care facilities is the amount of pressure ulcers acquired in patients. Approximately 1 million people develop hospital-acquired pressure ulcers each year affecting hospitalized patients in both acute and long term care settings. The incidence of pressure ulcers ranges from 0.4%-12% in acute care settings, along with the prevalence range from 12%-18%. Pressure ulcers cause increase pain, suffering, and decreased quality of life along with extended hospital stay. According to the national pressure ulcer advisory panel a pressure ulcer is defined as “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination
A pressure ulcer is an area of skin with unrelieved pressure resulting in ischemia, cell death, and necrotic tissue. The constant external pressure or rubbing that exceeds the arterial capillary pressure (32 mm Hg) and impairs local normal blood flow to tissue for an extended period, results in pressure ulcer (Brunner and Smeltzer, 2013). According to National Pressure Ulcer Advisory Panel, 2014, pressure ulcers are a major burden to the society, as it approaches $11 billion annually, with a cost range from $500 to $70,000 per person pressure ulcer. It is a significant healthcare problem despite much investment in education, training, and prevention equipment. This paper includes two different studies to link cause-effect and prevention of pressure ulcers.
Pressure ulcers are defined by the National Pressure Ulcer Advisory Panel (NPUAP) as a site of “injury to the skin and/or underlying tissue usually over a boney prominence, as a result of pressure, or pressure in combination with shear and/or Friction” (NPUAP, 2017). A Hospital Acquired Pressure Ulcer (HAPU) is a pressure ulcer that was obtained while at the hospital. These can change the patients plan of care and can lead to pain, loss of function, extended hospital stays and increased cost. HAPU is considered a medical error so there for Medicare is no longer reimbursed for stage II to IV HAPU unless they were determined to have been present at admission or within 2 days after admission (Kandilov, Coomer, &
The purpose of this paper is to discuss pressure ulcers (PUs) and their prevention. The National Pressure Ulcer Advisory Panel (NPUAP), European Pressure Ulcer Advisory Panel (EPUAP), and Pan Pacific Pressure Injury Alliance (PPPIA) define pressure ulcers as a ‘localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear’ (Brown, 2016, p. S6). Pressure ulcers are a healthcare problem that can have detrimental effects on patients’ quality of life and can be regarded as an indicator of poor nursing practice. Hospital-acquired pressure ulcers (HAPUs) result in costly settlements
Patient History: my patient is a 79 y/o female. She weighs 71.7 kg and is 165.1 cm tall. She has a history of colon carcinoma and hypertension. She has had a previous cholecystectomy, appendectomy, and removal of a uterine polyp. She has no history of bleeding disorders. She was a smoker, but quit 30 years ago. She smoked a half pack per day for 10 years; rare alcohol use. She is status post right-hemicolectomy. She is allergic to penicillin.