Question

CASE

Mrs. Smith, 73 years old, was brought to the emergency room due to the in-car traffic accident. As a result of physical examination and diagnostic tests, permanent paralysis (hemiplegia) was determined on the left side and she was admitted to the neurology clinic. Mrs. Smith, who has been inactive for a long time, complains of constipation, urinary incontinence, insufficient sleep and is fed with a nasogastric tube due to difficulty swallowing.

QESTIONS

1. What are the risk factors for the bedsores? Which of these risk factors are available to Mrs. Smith? Please write nursing interventions to prevent bed sores in Mrs. Smith

Answer 1

Question 1

What is bedsores ?

Bedsores are ulcer that happen on areas of the skin at lying in bed.

Risk factors of bedsores?

It is ulcer that happen on areas of the skin that area under pressure from lying in bed, sitting in a wheelchair for prolonged time.

Bedsores can happen when a person is bedridden or otherwise immobile, unconscious or unable to sense pain.

When a person lying in bed during prolonged time , it lead to cutoff the blood supply to where the pressure is excerted during lying in bed.

Stage 1 = pain in that area with reddish colour.

Stage 2 = it turn purple or bluish colour.

Stage 3 = it turn dark brown or black colour.

Then it become ulcer , that happen in that area of the skin.

Question 2

According into our patient mrs smith

she already 73 year old . Bedsores is very complicated in our patient . Because , blood supply is slightly low in muscle and joint areas. so its very easily lead to ulcer.

Already she has hemiplegia on the left so, she can't move or turn easily . She have lots of problems : -

1. Constipation - its lead to continue abdominal pain.

2. Insufficient sleep :- its lead to illnesses and tiredness or lead to bad health conditions.

3. Use nasogastric tube :- thats lead to insufficient amount of vitamins ,minerals, nutrition in body .

Question 3

Bedsores prevented by :-

1. Turning and repositioning every 2 hr

2. Sitting wheelchair and straight in wheelchair, changing position every 15 mints

3. Clean the skin and dry.

4. Provide good nutrition.

According into our patient turning or repositioning is not easy, because she has hemiplegia on the leftside.

But , she can lying on hemiplegia side or unaffected side.

Hemiplegia side is supported by pillow during sleeping, sitting in bed or wheelchair.