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Pressure ulcer quizlet
Case studies of pressure ulcers
Quality improvement nursing articles on pressure ulcers
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Hello Professor Chapman, and class.
1. How do pressure ulcers form? What are the main risk factors that lead to developing decubitus ulcers (pressure ulcers or bed sores)?
Answer: "Pressure ulcers, formerly called bedsores or decubitus ulcers, develop from continuous pressure that impedes capillary blood flow to skin and underlying tissue. Several factors contribute to the formation of pressure ulcers, but impaired mobility and urinary incontinence are key" (Mahan, L., Escott-Stump, S., Raymond, J., & Krause, M.,2012). In addition, "paralysis, incontinence, sensory losses, and rigidity can all contribute to the problem. Notably malnutrition (inadequate protein) and undernutrition (inadequate energy intake) set the stage for its development and can delay wound healing. The escalating chronic nature of pressure ulcers in bed-ridden or sedentary elderly requires vigilant attention to nutrition" (Mahan, L.,
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Some nursing care protocols I have witnessed, while working in the ER are nurses using pillows to prop their patient to a upright position, while elevating the feet with a hospital wedge in between bony prone areas of the body. In addition, I have witnessed nurses manage the moisture build up on their patients body, due to perspiration and clean all soiled areas of the body immediately. It states, in our course textbook that , "nutrition recommendations for the treatment of pressure ulcers are as follows (Doley, 2010; Thomas, 2009): •Optimize protein intake with a goal of 1.25 to 2 g/kg/day. •Meet calorie requirements at 30-40 kcal/kg/day. •Assess the effect of medications on wound healing and supplement if indicated. •Replace micronutrients if depleted—routine supplementation is not warranted" (Mahan, L., Escott-Stump, S., Raymond, J., & Krause,
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
...ssure ulcers can be preventable if there is a systemic and multi-professional approach to their prevention and continuing assessment of skin integrity. Mary was determined and worked well with the physiotherapist; she was up and on her feet within a week of returning. Staff had to prompt her to move around the ward, which at times was hard for her due to her anxiety. Mary was deemed high risk for falls, so was put on a prevention of falls chart in conjunction with the pressure area chart and repositioning chart.
Ranked third by U.S. News and World Report on the list of “Best Health Care Jobs of 2017”, the Physician Assistant career has a 96 percent job-satisfaction rate, and represents one of the fastest growing jobs in the nation. Created as a position to relieve the job shortage of primary care physicians, Physician Assistants first came to be in the mid-1960s. Since then, the number of PAs in practice has just about doubled with every decade helping to improve health care not just nationally, but on a global level as well. Physician Assistants are licensed to practice medicine, prescribe medication, treat chronic illnesses, and assist in surgery in all 50 states under supervision of a physician. Although some medical practitioners perceive the role
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
The Braden Scale is a clinically valued tool that is used to predict pressure ulcers. The scale is broken down into six sub-scales; these subscales determine the risk factors associated with skin break down. Multiple aspects of a patients condition are examined, (sensory perception, moisture, activity, mobility, nutrition, friction and shear), to limit the patients susceptibility for skin break down. Since pressure ulcers are a financial burden and a cause for patient discomfort and possible infection, predicting and assessing risk has enormous benefit and significance.
In very severe cases, the subcutaneous fat and skin become weak and break down creating venous stasis ulcerations that may. Blisters may form and a clear fluid may leak from the ulcers. The people who are the most at risk of developing venous stasis are people 50 years and older and people with heart disease, are obese and sit for long periods of time every day. It is also more common in women than in men. Other causes are:
which is commonly diagnosed by prolonged pressure to the skin. A decubitus ulcer forms when constant pressure is put on skin and can damage the underlying tissue (Mayo Clinic, 2014). For example, persistent sitting in a wheelchair. It is an injury to the skin that is usually over a bony prominence like the sacrum (Kirman, C. et al. 2014). The National pressure ulcer advisory panel (NPUAP) explains that these sores result in ischemia, cell death, and tissue necrosis to the skin. The categories include four stages and two which are deep tissue injuries (NPUAP). Patients that use a wheelchair and have other disabilities have a higher chance developing pressure sores which limits their opportunity to position themselves (Mayo Clinic, 2014).
Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
This phase generates the necessary actions that are vital in preparing the wound for healing. The body is attempting to remove the triggering stimulus (if present), limit the tissue damage, and set the stage for repair and regeneration of the wound (Rowan et al., 2015). If natural biological healing does not progress satisfactorily, it can lead to a chronic wound with chronic inflammation, though this is most often associated with other disease conditions or a compromised immune system. On a larger scale, this is a significant, world-wide issue of concern for present and future research, because these types of non-healing or persistent wounds impact on the quality of life for an estimated 40 million people worldwide and are costly in many ways (Zhao, Liang, Clarke, Jackson, & Xue,
The aim of the Healthcare Quality Strategy (HQS) is to deliver excellent healthcare to the citizens of Scotland and brand NHS Scotland as a world leading care provider (Scottish Government, 2010). An improvement intervention examined in the HQS is the prevention of pressure ulcers (PUs). Using the Gibbs (1988) framework, this essay will demonstrate how I was involved in this intervention by applying my skills of compassion, person-centred care and teamwork. I have chosen PU prevention as the subject for this reflection; since, the majority of PUs are preventable (Watret and Middler, 2012) and the cost of treating them ranges from £1,214 to £14,108 (Dealey, Posnett and Walker, 2012). Supporting the Nursing and Midwifery Council (NMC) (2011) confidentiality guidelines, the pseudonym “Ruby” has been used.
Based on current evidence based practice and nursing standards, the patient who has increased risk for pressure ulcer formation should be turned at the minimum of one time in a given two hour period. This will dramatically decrease the possibility of skin breakdown that could become a pressure ulcer by quite a bit. Some ideas that have come up recently include trying to find special mattresses that help shi...
In patients with diabetic foot ulcers, how does the use of negative pressure wound therapy compared to moist wound therapy influence wound healing in a shorter period of
Gastric ulcers are open sores that develop inside the lining of the stomach. It occurs when the protective lining in the stomach stop working and breaks down. Most ulcers occur within the first layer of the stomach lining, when the ulcer goes all the way through the stomach it is called perforation and it is a medical emergency. The most common cause of gastric ulcer is an infection caused by bacteria called Helicobacter pylori (nlm.nih.gov/medlineplus) and people that are infected with H. Pylori have a 30% increase of getting stomach cancer. Drinking copious amount of alcohol, regular intake of NSAIDs, smoking and chewing tobacco, and radiation treatments can raise the risk of developing gastric ulcer (nlm.nih.gov/medlineplus/). Different symptoms may occur such as abdominal pain, feeling of fullness, mild nausea, bloody or dark tarry stools, chest pain, fatigue, weight loss, and possibly bloody vomit. People that have liver disease, COPD, kidney failure, and family history increase the risk of developing gastric ulcer (healthcommunities.com).
Infection with bacterium is considered to be the cause of recurrent attacks of hyperacidity and ulcers. Above all, modern rat-race is blamed for the increasing incidence of ulcer. Stress and anxiety are linked to increased acid secretion and result is ulcer.
“Peptic ulcers are open sores that develop in the lining of the stomach, esophagus, and small intestine as a result of an imbalance of hydrochloric acid and pepsin. These acidic digestive juices are secreted by the cells of the stomach. Named for where they are found, “peptic ulcers are a very common and often reoccurring health problem, and it is estimated that more than 20 million Americans will experience a peptic ulcer in their lifetime” (Cleveland).