Abstract
Prevention of pressure injury may beneficial because it helps in reducing treatment costs. A treatment plan can be effective in addressing the risk of old people from acquiring pressure injuries. Professional collaboration is recommended because the efforts of nurses, nutritionists, and physicians play a critical role in prevention. The patient needs may be fulfilled if the environment and the care providers are collaborative. Therefore, a collaborative approach can be effective in achieving positive patient outcomes. This may help in reducing health costs incurred during admission or treatment of injuries. However, knowledge and skills are critical for patients who are at risk of pressure injuries. The health professionals must formulate a care plan that will help in reducing the risk factors of pressure injuries. Innovative measures may be incorporated for effective results. This paper discusses an interdisciplinary care plan of James, who is at risk of pressure injury.
Background Information
Patient Name: James
Age: 65
Sex: Male
Demographics:
Condition: risk for pressure injury
Situation: The patient is weak and eats a poor diet
Medical History
James was diagnosed with obesity five years ago, but he returns to the hospital with mild reddening of the skin. The medical history shows that she was tested for diabetes, and the results returned to be negative. In 2015, he had been battling obesity, leading to the recommendation of good diet and physical exercises. He reported that prior to the diagnosis, he was eating a lot of junk foods with minimal exercises. His wife indicated that James has abnormal heartbeats, sweating a lot, open wounds on the skin, and mild red skin. The diagnosis shows that the patient has a pulse of 112 beats per minute and blood pressure of119/79mmg. The patient has to be on self-medication, where he used paracetamol to relieve the pain.
The patient's physical examination shows a BMI of 29.0 Kg/M2, glucose levels of 100mg, blood pressure 119/78, a pulse of 73 per minute, and 20 respiration per minute. James reports he sneezes and coughs in dusty environments or when there are pollen grains. He has lung crackles, and the legs are not swollen. The skin has some rashes where he complains of pain upon palpation. The lab results presented in the clinic show that the patient has a cholesterol cholesterol-to-HDL ratio of 5, HDL cholesterol of 40 mg/dl, triglycerides of 154 mg/dl, AIC of 6 %, sodium of 138 mg/dl, potassium of 4.1 mg/dl, blood urea nitrogen 29 mg/dl and Urine microalbumin of 41mg.
Medical Assessment
Medical history, physical examination, and lab tests of James show that the patient is at risk of pressure injury. James has a BMI of 29.0 Kg/M2, but he has really improved because he was obese based on medical history. Therefore, the BMI has really improved from the last examination because of the treatment he has been undergoing. The patient is at risk of pressure injury because of the sores on the skin and the skin's reddening. Therefore, any injuries to her skin may lead to injuries on the skin. The skin sensation indicates that the patient can have injuries on the skin if pressure is applied. Hommel and Santy-Tomlinson (2018) suggested that aging skin and multiple comorbidities are risk factors associated with skin injury. In the case of James, he is an older adult; thus, putting him under high risk of pressure injury.
Care Plan
James is at risk of skin for pressure injury, which will require holistic treatment from all the healthcare professionals, including nurses and nutritionists. The first step will involve treating the painful parts and enhancing the preventive mechanism to avoid skin injury. Therefore, an effective treatment plan will be effective for positive results. The care team will have to follow the care plan to prevent the development of pressure injuries.
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Nursing Intervention |
Rationale |
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Avoid taking axillary temperature |
James is elderly, and the axillary temperature is not recommended because the results may not be accurate. |
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Assess and record skin turgor |
The skin is usually prone to skin dehydration if the patient consumes less water. |
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Monitor fluid intake |
The patient is required to take at least 2 liters daily to hydrate the body. This will help in addressing other complications associated with skin injuries. However, patients with renal disorders may be exempted from the consumption of water |
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Observe skin areas that are red or changes in the skin texture and breakages. |
Redness or breaks of the skin requires proper management to avoid further complication that may be caused by infection. |
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Assess the pattern of physical exercises
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Patients or caregivers are advised to conduct pressure-relieving movements for patients who are at high risk. The movements are beneficial to the elderly because they help in avoiding pressure injuries. Forward bending, lifting up a chair, and side bending may help in moving the body muscles, which may reduce the pressure concentration (Bhattacharya & Mishra, 2015). These exercises can be done by the elderly because they are easy and can be done while they are at home. Pillows, cushions, and pads may be used during the exercises do reduce external pressures. This will be effective because the |
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Monitor the diet of the patient |
The patient should eat a healthy diet for positive patient results. Protein-energy malnutrition may increase the risk of pressure ulcers for older or diabetic patients (Bhattacharya & Mishra, 2015). Therefore, the patient must consume a healthy diet that consists of protein, vitamins, and carbohydrates. A balanced diet will be fit to keep patients healthy and avoid pressure injuries. Nutritional assessments, such as weight loss, fluid assessment, and progressions, are necessary (Bhattacharya & Mishra, 2015). They may help in addressing the nutritive content of the patient |
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Assess skin hygiene |
Adhering to proper skin hygiene may help in promoting healing of the sores. Bhattacharya and Mishra (2015) suggested that patients at risk of developing skin ulcers should keep their skin dry and clean skin. Protective devices may be incorporated to relieve external pressures. The cushions should be free from infections that may cause more sores on the skin. The patient may be required to maintain proper hygienic measures for positive results |
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Assess the glucose levels |
Glucose levels are critical in understanding if the patient could be suffering from other conditions such as diabetes. The glucose levels should be between 140mmHg-180mmHg. If the patient is beyond the limit, proper treatment will be recommended. |
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Encourage minimal movements |
This may help in reducing skin contact that would cause skin injuries. The pressure may come from the unnecessary movements that may have an impact on the skin. Therefore, the patient should move only when necessary. Strenuous work that exact pressure on the skin should be avoided. |
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Monitor the environment of the patient. |
The skin should be free from continuous contact that could cause sores. Pneumatic ripple beds may be used to prevent pressure ulcers for patients who are at high risk (Bhattacharya & Mishra, 2015). The beds may be used for immobile patients because they help reduce direct contact with the skin. The rooms should also be well-ventilated where air can flow in and out. This may help in preventing pressure injuries for patients who are at high risk. Water filled tied surgical hand gloves may help in relieving pressures in hospitals setups (Bhattacharya & Mishra, 2015). In the home environment, the patient may be forced to use low-cost-pressure-relieving devices. |
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Evaluate patient's understanding of the medical conditions and treatment plan |
The patient's understanding is critical in ensuring that the patient will follow the treatment plan. Medical errors may lead to the development of pressure injuries, especially for older patients. Therefore, the patient should understand the different ways of avoiding |
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Encourage regular hospital visits |
Patients at risk of developing pressure injuries are recommended to visit the hospital regularly. Systematic skin inspection once a week may help in the prevention of pressure ulcers (Ebi et al., 2019). Healthcare professionals may assess the condition and check if the risks are reducing. This can be effective because it can help in encouraging the follow-up of patients. The hospital visits may help in understanding if the patient is following the treatment protocol. In the long run, the risk of pressure injuries may be reduced drastically. |
Treatment Goal
At the end of treatment, James should be at a low risk of developing pressure injuries. The skin should always be dry and clean, thus overcoming the external pressures. The patient should also have a BMI of 25 within the recovery period. These results will be indicators of a successful treatment plan.
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References
Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: current understanding and newer modalities of treatment. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India, 48(1), 4.
Ebi, W. E., Hirko, G. F., &Mijena, D. A. (2019). Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC nursing, 18(1), 20.
Hommel, A., & Santy-Tomlinson, J. (2018). Pressure Injury Prevention and Wound Management. In Fragility Fracture Nursing (pp. 85-94). Springer, Cham.
