Reference no: EM133918903
SCENARIO
Ms. Margaret Cartwrightis a 76-year old female who has been admitted to the GeriatricEvaluation and Management (GEM) ward for the treatment of her stage III pressure injury on sacrum along with the assessmentand planning with her healthand social conditions. Her pressure injury appears as in the image 1 below. Some of the assessment outcomesinclude: Size, 10cm x 8cm; Exudate, large amount and serous and there is no undermining/tunnel. Dressing is changed and the wound is assessed every morning at 10am.
Dressing product currently used is a lightly absorbentproduct and tapes and always saturated with exudate at 10am.
Exudate is mostly absorbed by the incontinence pad.
Margaret generally lives alone. Her daughter lives 40 mins away from her house. According to her daughter's description, her ability to perform ADL declined drastically for the past month and has become almost immobile for the last 2 weeks and spenta lot of time in bed sittingup whenever she visited Margaret.
Her daughter is concerned about Margaret's psychological status as Margaret used to like seeing her friend for a morning tea but she has not done that for a few weeks by saying "I don't want to be smelly or in pain while seeing my friends".
Due to her frail state, she has been ambulatingwith 4 wheely frames. She has become incontinent of urine due to the mobilityissue. She wears an incontinence pad. Margaret refusescare and states,
"I don't even have energy to eat food. I am not that hungry. My bottom is sore, and I don't want to move either".
Past Medical History
Congestive cardiac failure, Hyperlipidaemia, COPD, T2DM, Anaemia of chronic disease, Malnutrition, OP, anxiety, MDD
Medication
Atorvastatin 40mg 1800, Gliclazide 40mg Daily, Metoprolol 50mg Daily, Sertraline100mg Daily Diclofenac 75mg TDS, Diazepam2.5mg TDS, Seretide MDI 250/25 1 inh Daily, Arginine120ml BD Zinc and castor oil top TDS, Calcium 1 tab Daily, Vitamin D 1 cap Daily, Ferro-tab 67.5mg Daily.
ANSWER QUESTIONS ON THE BASIS OF SCENARIO
1. An EN needs to participate with the interdisciplinary health care team in making a wound assessment and evaluation, contributing to an individual wound management plan for the person, documenting and communicating progress of wound healing and wound care strategy outcomes to the appropriate members.
Considering this statement:
Describe briefly how you, as an EN, would update and modify the wound care plan based on the assessment of Ms. Cartwright's current wound condition.
Include in your answer:
where the changesof the plan should be documented and;
who should be consulted about changing the plan.
2. Using holistic assessment approaches, identify four (4) actual and two (2) potential problemsaffecting Ms. Cartwright's timeframes of wound healingand her comfortable levels.
3. In accordancewith wound management strategies, create an individualized wound management plan to address Ms. Cartwright's actual problems that you identified in Question 2 above and meet her comfort needs such as pain relief. Provide the evaluation processes for each intervention.
4. Identify five (5) things you will educate Ms. Cartwright and her daughter about managingthe current wound condition and preventing from developing a pressure injury in the future.
5. Provide two (2) examples of how a healthcare organisation can meet criteria to achieve the Preventing and Managing PressureInjuries Standard in NSQHS Standards.