الأربعاء، 29 أغسطس 2018

297-Pressure Ulcer

About
Superficial to deep tissue ischemia resulting from prolonged pressure on boney prominences and or skin surfaces. Staging can be from stage I ( superficial, non-blanchable erythema) to stage IV ( Deep tissue necrosis extending down to the muscle fascia and underlying bone.
Assess
Braden or Norton scale to determine risk; size ( length, width, depth); color ( red- well granulated; black- necrotic); drainage, sloughing, superficial or deep, blanching, redness, edema, tunneling, maceration, location, sensation
Complications
Infection; sepsis; tissue necrosis; gangrene
Diagnosis
  • Acute pain related to tissue damage
  • Impaired skin integrity related to physical immobility
  • Risk for infection related to physical immobility
Goals
  • The client will regain integrity of skin surface.
  • The client will be free from infection.
  • The client will identify strategies to decrease risks of pressure ulcer formation.
Interventions
  • Identify clients at increased risks for pressure ulcers and initiate preventative measures immediately.
  • Monitor pressure ulcer, documenting LxWxD, characteristics, color, odor, etc.
  • Apply pressure reducing surfaces on mattress.
  • Turn bed-bound client at least every two hours, maintaining a turning schedule.
  • Maintain clean, dry skin.
  • Avoid massaging bony prominences.
  • Prevent friction and shear when lifting client in bed.
  • Encourage high protein meals to aid in wound healing.
  • Administer topical dressings as ordered.
  • Teach client and family how to decrease risk of skin breakdown.
  • Encourage active participation in ADL's as much as the client is able to tolerate.
  • Consult with OT/ PT for strengthening exercises, ambulation techniques.
  • Monitor for signs/ symptoms of complications.

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