Geriatric evaluation and management

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Reference no: EM133912137

SCENARIO

Ms. Margaret Cartwrightis a 76-year old female who has been admitted to the Geriatric Evaluation and Management (GEM) ward for the treatment of her stage III pressure injury on sacrum along with the assessment and planning with her health and social conditions. Her pressure injury appears as in the image 1 below. Some of the assessment outcomes include: 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 absorbent product and tapes and always saturated with exudate at 10am.

Exudate is mostly absorbed by the in continence 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, Diazepam 2.5mg TDS, Seretide MDI 250/25 1 inh Daily, Arginine 120ml BD Zinc and castor oil top TDS, Calcium 1 tab Daily, Vitamin D 1 cap Daily, Ferro-tab 67.5mg Daily.

Questiona 

1. Describe the stages of normal wound healing processes that should be expected with Ms. Cartwright.

2. List two (2) factors related to Ms. Cartwright that could impacton her normal wound healing process and brieflyexplain how they affect the process.

3. Describe the characteristics of the stage III pressure injury that are apparent in Ms. Cartwright's wound appearance in the image (1).

4. Describe the tissue types and characteristics of each that are present in Ms. Cartwright's wound bed.

5. State the common complications or abnormalities of wounds that you should be aware of when assessing Ms. Cartwright's wound.

6. Discuss the effectiveness of the current dressing productused for Ms. Cartwright's wound care based on the appearance of the wound in the image (I).

7. State what type of primary dressing product should be chosen to manage Ms. Cartwright's wound and provide rationale for the selection.                                                                                                                                                                                                                                                                                                                                                                                                                    

Reference no: EM133912137

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