Question

1. Write your paper accordingly:

• Introduction (introduce your topic and article)
• Nursing care plan
• Summary of the chosen article, attach the article to your assignment.
• Conclusion (the main points of your paper)
• Reference list using APA style.

Scenario 2

Skin Integrity and Wound Care (C/S 29-30)

A 68-year-old woman admitted in the female surgical unit, is found to have a Stage II pressure ulcer located on her right buttock near the trochanter area. The patient sustained a fractured right femur and weighs 60 pounds over her ideal body weight. The patient also is incontinent and wears a diaper.

Please help me with this writing, and I want it on a Word file for easy portability

Answer 1

Pressure ulcers are localized areas of tissue necrosis that typically develop when soft tissue is compressed between a bony prominence and an external surface for a long period of time. Stage 2 pressure ulcers are characterized by partial-thickness skin loss into but no deeper than the dermis

The most common sites for pressure ulcers to occur are over a bony prominence, such as the buttock (sacrum/ischium), heels, hips (trochanter), elbows, ankles (lateral and medial malleolus), back, shoulders, back of the head (occipit) and ears.

The stage 2 Pressure ulcer can result as Partial thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled or sero-sanginous filled blister.

Pressure ulcers on the sacral area of patients who are incontinent are at higher risk for infection and further skin breakdown. To prevent contamination and protect the wound from urine and/or stool it is important to keep the wound and periwound area clean and use a protective semi-occlusive foam (Biatain®) or hydrocolloid (Comfeel®) dressing. A hydrophilic wound dressing (Triad™) is another alternative for this difficult-to-dress area. The zinc oxide-based paste adheres to moist areas and absorbs moderate amounts of exudate.

Excellent skin care is an attribute of quality nursing care. The prevalence of skin breakdown and pressure injuries (PI’s) has become a standard by which hospitals are evaluated and assessed, with the development of PI’s recognised as a patient safety problem as they can increase morbidity and mortality. Most PI’s are preventable if appropriate measures are implemented..

Skin Care

• Keep the skin clean and dry
• Investigate and manage incontinence (Consider alternatives if incontinence is excessive for age)
• Do not vigorously rub or massage the patients’ skin
• Use a pH appropriate skin cleanser and dry thoroughly to protect the skin from excess moisture
• Use water based skin emollients to maintain skin hydration where possible
• Apply barrier cream

1. RCH Nappy goo for prophylactic nappy care to healthy skin
2. Sudocream for healthy skin/nappy rash
3. Calmoseptine Ointment for broken down skin in nappy region
4. Orabase Protective Paste for broken down skin in nappy region

• Use chlorhexidine wipes daily ONLY around CVC sites and open wounds/open sternotomies

For patients with a stage 2 or greater pressure injury or those with a Glamorgan risk score of ten or greater a Pressure Injury Prevention Plan should be commenced on EMR. The wound should be clinically assessed for the most appropriate dressing. Consult the Stomal Therapy Nurse Consultant for clinical guidance on appropriate assessment and management of the wound if clinically indicated.